Hockessin, DE mom Karen James takes new senator Laura Sturgeon on an impactful pediatric home visit

Karen and Natalie have become strong home care advocates, and recently visited the state house to make their voices heard

BAYADA DPN client 8-year-old Natalie and her mother Karen recently hosted newly elected state Senator Laura Sturgeon (D-Hockessin) in their home. After hearing that Senator Sturgeon was a school teacher with 23 years of experience whose campaign trail promises included advocating for children, Karen knew that a home visit would be an ideal opportunity to educate the new senator on home care and how it enables so many Delaware children to grow up safely at home.

The visited started with a tour of Natalie’s bedroom, where Karen explained each piece of specialty equipment to the senator—from the hospital bed Natalie sleeps in, to her feeding pump, pulse/ox machine, oxygen tank and suction machine, as well as Natalie’s medications and their monthly stock of supplies. Senator Sturgeon was taken aback—she didn’t realize how much a family had to learn when caring for a medically-fragile child.

Afterwards, Natalie, Karen, and the senator then gathered at the kitchen table to discuss what legislative supports families like theirs need to be able to stay together at home. Karen was ready with the answers: Support higher reimbursement rates for in-home skilled nursing services and direct support professionals. She told Senator Sturgeon how happy they are with the care they have—a RN accompanies Natalie to school and to summer camp—but was honest about the number of nurses who are leaving home care to work for higher wages in hospitals. Natalie’s nurses have quite literally saved her life and Karen knows the nurses she trusts with Natalie’s care may have to do so again in the future. Children like Natalie thrive better in a stable environment with reliable, consistent nurses—and a situation where there is a revolving door of nurses can put her in a dangerous situation.

“Natalie can’t attend school if she doesn’t have a nurse with her. School nurses are busy already with managing students with asthma, diabetes, or severe food allergies, and ensuring Natalie’s medication schedule is met every day would be too much without the support of a stable and dedicated RN,” said Karen.

Senator Sturgeon became one of the best Champions for Home Care in the legislature this year. Having no personal or previous experience with medically-fragile children, the time she spent with Natalie’s family made a huge impression on her. Through the last weeks of session, she was one of the most vocal proponents of increasing skilled nursing rates to ensure that we can continue to recruit and retain the highest quality nurses to take care of people like Natalie.

“I know how incredibly time-consuming and overwhelming it can be to raise a medically-complex child. I feel that it’s our duty as parents to get involved in advocacy on behalf of our own children, and on behalf of the many others that don’t have a voice,” said Karen. “I am deeply touched that the hour Senator Sturgeon spent at our house made such an impression on her. I hope that parents across the country get involved in advocacy. It’s critical that we unify our voices in support of the care that helps keep children like Natalie thriving at home.”

In talking about this experience, Karen recommends that other families:

  • Talk with their elected officials calmly and respectfully.
  • Present the facts, staying on message but being honest about how much you do for your child. 
  • Be sure to remind your senator or representative that your child represents the state’s most vulnerable population.
  • Remember that party status shouldn’t matter because elected officials are public servants. Even if you disagree with them on some things, they’re open to learning more about medically-fragile children, so thank them for that and for their help. 
  • Be direct and tell them which bills you want them to support or oppose.
  • Always thank them for their service to your state. 

BAYADA is encouraging more employees to involve clients and families in advocacy this summer by coordinating home visits and inviting local legislators to clients’ homes.  We’ve seen time and again how these visits, usually no more than an hour in length, have changed legislators into advocates and advocates into Champions for Home Care. As we continue to press for higher reimbursement rates, we need more of our legislators to understand these issues personally and to get to know their constituents who rely on BAYADA’s care to live safely at home.

If you want more information on how to host a home visit, contact Mike at  msokoloski@bayada.com or reach out to your GAO Director.

Ambassador Spotlight: GA Ambassador of the Year Doug McNew (NAP)

“Be creative, flexible, and determined—get the job done for our clients.” – The BAYADA Way 

GA Ambassador of the Year Doug McNew hosted Rep. Terry England on a home visit with client Laney and her mom Erin. Here Laney is pictured with her nurse, Katie.

At BAYADA, one of the most impactful way we can educate legislators on the importance of home care is through home visits. A home visit occurs when an office employee brings a legislature into a client’s home to show them first-hand the level of care that goes into keeping a vulnerable individual safe and healthy at home. In the past quarter, North Atlantic Pediatrics (NAP) director and 2018 Georgia Ambassador of the Year Doug McNew hosted two impactful home visits—one that even led to increased hours to pediatric client Laney!

In May, Doug, nurse Katie, and Laney’s family hosted Appropriations Committee Chairman representative Terry England (R – District 116) in Laney’s home. This home visit was an incredible opportunity to show Chariman England how much care goes into keeping Laney home. After a recent hospitalization, Laney’s mom reached out to GAO Director Melissa Allman to ask for Chairman England’s support to help during this time. Without hesitation, Chairman England reached out to his contacts at the Department of Community Health to voice his support for increased hours for Laney. And it worked: the Department approved the request! Kudos to Doug and the entire NAP team for going above and beyond to support Laney during this time! 

Doug recently hosted his second home visit with Speaker Pro Temp Jan Jones (R – District 47) and Representative Chuck Martin (R – District 49) with NAP client Matthew and his father, Rick, to discuss their current challenges with the current GAPP program and resources available for Matthew.  During the home visit, both Rep. Jones and Rep. Martin showed great interest, asked questions, and requested to continue our brainstorming efforts to ensure our families are receiving the care they need in their homes. 

In addition to home visits, Doug continues to move forward with meetings and recommendations to the Department of Community Health. In May, Doug and GAO met with the director of DCH and submitted recommendations to the current pediatric personal care programs.  The director was very open, and willing to discuss the changes with her medical directors.  Establishing these changes will allow the office to provide additional care to their pediatric nursing clients. This would reduce the two supervisory monthly visits per employee down to one monthly visit, and be a cost savings to the office. 

Thank you, Doug, for your continued commitment to advocacy on behalf of our clients through home visits! GAO needs your help showing how home care impacts so many individuals across Georgia and beyond. If you have a similar story, or family who would be willing to host a home visit, please contact Melissa Allman, and she will assist you in coordinating. These are great opportunities to not only to educate our lawmakers on how important home care is to Laney and others like her, but to also support our clients and families during a time in need.    

A Win for South Carolina’s Older Pediatric Population – TRAC Program Approved!

GAO Director Melissa Allman, Senior Transitional Care Manager Tonya Watts, and WOW Regional Director Ali Genthner recently met with DHHS and Medicaid and received approval for BAYADA’s TRAC program!

At the end of June, GAO Director Melissa Allman, Regional Director Ali Genthner, and Senior Transition Care Manager, Tonya Watts met with South Carolina’s Department of Health and Human Services Pediatric Program Coordinator and Medical Directors to discuss BAYADA’s Transition Readiness Assessment and Collaboration (TRAC) Program. BAYADA’s TRAC program was approved! This will allow our Skilled Nursing offices to be staff and recruit more adult nurses without the required one year of hands-on clinical pediatric experience. The offices will also be able to fill more open hours and care for more adolescent age clients utilizing the TRAC program. 

Tonya Watts, Senior Transitional Manager shared, “Due to the ability to use the TRAC program, the Rock Hill, SC Skilled Nursing Office (ROC) will be transitioning their first client home at the end of this month utilizing the TRAC program.”

Ali Genthner, Willow (WOW) Regional Director shared, “We were very excited about the opportunity to meet with the DHHS and their medical directors, and grateful GAO was able to arrange the meeting.  We had a big win with removing a nursing requirement which will assist us with recruiting more nurses and helping more clients.”

Please stay tuned as we continue to continue meeting with DHHS leadership, and working to modernizing South Carolina’s current Medicaid waiver programs and increasing the reimbursement rates for private duty nursing. 

NJ Legislative Update: Private Duty Nursing (PDN) and Personal Assistance Services (PCA) Rate Increase Efforts

Private Duty Nursing (PDN) Update

Dana Insley, mom of Pediatrics client Abi, testifies at a bill hearing

The Private Duty Nursing (PDN) Bill was introduced in early February and passed the Senate Health Committee unanimously (9-0) on June 3, 2019. The bill, which proposes to increase the PDN reimbursement rate by $10 to $60 for RNs and $48 for LPNs while setting a rate floor such that managed care entities can reimburse no less than the state fee-for-service, has been double-referenced to the Senate Budget and Appropriations Committee. The PDN bill will likely be heard in committee during the fall.

Thank you to the more than ten clients and families, including Dana Insley who testified in-person, who have submitted testimony detailing the challenges and obstacles they face as a result of chronically low reimbursement. With more than a decade without an increase to the PDN program reimbursement rate, this much needed increase will ensure home health care providers can recruit enough reliable, highly skilled nurses so that our clients never have to go without the care they need.

GAO will continue to keep office staff and clients updated as the bill continues to move throughout the remainder of the year.

PCA – Minimum Wage Bill Update:

The New Jersey legislature narrowly avoided a government shutdown when Governor Murphy signed the $38.7B fiscal year 2020 budget into law on Sunday, June 30. The governor used his line-item veto power to cut nearly $50 million from the legislature’s proposed budget.

Included in this next year’s budget is an increase to the reimbursement rate for the Personal Care Assistant (PCA) program. Lawmakers have provided funds to increase the rate from $16 to $18 per hour effective July 1, 2019.

On the same day as Governor Murphy signed the budget, he also conditionally vetoed the PCA Bill, which, in addition to a rate increase, proposed a five-year rate increase structure and eliminated language which required 100% of realized increases to be passed directly to home health aides. Governor Murphy’s conditional veto eliminates the proposed rate increase structure, sets the PCA reimbursement rate at $18 (as in the budget), and retains language to eliminate the pass-through requirement.

To become law, the bill must be voted on once more by both the House and the Senate. The legislature will convene to vote in late July or early fall. We will continue to provide timely updates as we learn more about the legislature’s voting schedule.

Thank you to our many clients and Hearts for Home Care Ambassadors who went above and beyond to ensure we received this important increase. Moving forward, advocating for ongoing increases to the PCA reimbursement rate in conjunction with the rising minimum wage will be instrumental in ensuring providers can continue to provide personal care services in New Jersey and to keep vulnerable New Jerseyans where they belong – safe and at home.

If you have any questions about our PDN and PCA legislative priorities, please contact advocacy@bayada.com.

PA Approves a 2% PAS Increase! Thank You for Your Advocacy

A true team effort: The PA PAS increase happened as a result of strong advocate engagement and industry-wide advocacy from clients, families, and home care workers across the state

On June 28, Pennsylvania Governor Wolf signed the 2019-2020 budget into law. Included in the $34 billion budget was a 2% increase for Personal Assistance Services (PAS) under the Office of Long-Term Living (OLTL). This increase will go into effect January 1, 2020 and will predominantly affect our Assistive Care State Programs (ACSP) offices. This increase will result in an additional $700,000 in annualized revenue and an additional $625,000 in operating surplus.

The GAO office would like to thank our many wonderful Ambassadors and leadership that advocated for our clients, families, and staff. This increase was over five years in the making, and these advocates made home care a priority through countless meetings with legislators in their district and at the Capitol, writing op-eds for local papers, and helping to host over 20 legislators in clients’ homes. GAO would like to thank a few of our advocates who went above and beyond to ensure our legislators knew the necessity of this increase.

A Big Thank You to our BAYADA Advocates!

Chris Bender– Chris has consistently advocated our clients and families through office visits and lobby days. She hosted a PIT office legislative visit to show the village it takes to provide such complex and necessary care to our clients. Chris also worked with the public affairs branch of GAO to find clients and field staff to advocate for this rate increase as well in the media. As a result, Chris and two aides from her office were featured in a front page Pittsburgh Post-Gazette article, and CM Melissa Donatore’s op-ed was published in a later edition of the Gazette. Additionally, client Vanessa R. was featured on a WPXI broadcast piece that covered the need for higher wages for home health aides. Go Pittsburgh!

Melanie Brewer – With a background in the field of politics, Melanie advocated for our clients and staff through her current and previous relationships and connections. She quickly established herself as a trusted resource on home health care to Erie area legislators, and reinforced why home health care matters to so many.

Donna Buhosky – Donna attended many district office visits in her area, as well as a variety of community events hosted by legislators. She became a constant advocate for Pennsylvania’s most vulnerable populations at these events, reiterating the need to increase the reimbursement rate.

Tom Johnson-Medland– Tom not only attended many legislative visits and community events but was able to secure his office’s license through his legislative contacts. He worked with two area legislators and the Department of Health to keep his office compliant. Their willingness to work with Tom is a testament to his relationship with the legislators and his reputation as a trusted provider of home care. Tom also encouraged his fellow employees to take action on the alerts sent out by GAO, resulting in 100% participation from his office employees.

Donna Pierantoni – Clinical Manager Donna Pierantoni advocated for a PAS increase by lending her name to an additional op-ed penned to the Tribune-Review.

Candice Poole – Candice attend a multitude of events in her area hosted by the local legislators to ensure they knew just how important adequately funding home health care is to their communities. Additionally, she fostered advocacy within her office and encouraged her fellow employees to get involved. She helped identify and prepare clients for our public affairs efforts, and authored an op-ed that was featured in PennLive.

These advocates demonstrated how important advocacy is to living The BAYADA Way. They demonstrated that our clients come first by working to make sure our legislators understand how important home health care is to their constituents in addition to their current positions at BAYADA. These advocates, along with many others, went above and beyond their job description to help our clients access the care they need and continue to foster the growth of BAYADA.

If you are interested in becoming an Ambassador, email Mike Sokoloski at msokoloski@bayada.com.

Three Steps Forward, One Back—NC Lawmakers make Strides Towards Helping the State’s Most Vulnerable

Earlier this month three separate pieces of legislation moved forward to support some of North Carolina’s most vulnerable citizens, and one may have put them in jeopardy.  The first three provisions, yet to be passed, are still being considered. First, lawmakers are closing the coverage gap with the design of a health care program that addresses the needs of citizens who are ineligible for Medicaid due to their income levels but who are otherwise unable to afford health insurance. HB 655 will ensure hundreds of thousands of North Carolinians have access to health care.

Second, lawmakers set aside $2.7 million for the Division on Aging to help address the 11,000 persons on waiting lists for services across the state. The most heavily funded services are in-home aide services, home delivered meals, and transportation assistance. This is a great first step to address the service gaps within our Block Grant programs and supporting individuals to stay home.

Lastly, the state added 1,000 new waiver slots for individuals living with intellectual and developmental disabilities (I/DD). These slots will help address the more than 11,000 persons on waitlists across the state. The provision also calls for a study on rates and wages of direct support personnel. GAO is encouraged with these provisions and will look for opportunities to provide input on the wage study. Our top priority is to ensure enough reimbursement and program funds to address staffing shortages resulting from low wages so BAYADA can take care of more people at home.

The “oh no” provision, if passed, that will jeopardize our Medicare offices and clients comes in the form of changes to Certificate of Need (CON) laws (HB126).  Hearts for Home Care Ambassador Neal Luther took a stand by sending a personalized message to Senate Republicans which read, “As an occupational therapist working with Medicare seniors, my priority is to ensure seniors get the care they need in the most cost-effective setting – home. HB126 causes me great concerns because it allows continuing care retirement communities (CCRC) to go around the CONs rules. As a therapy professional I follow the rules, CCRCs should be expected to follow them too.”  While it is likely that this bill will pass the Republican-led Senate, GAO will continue to garner support to solidify the House’s opposition on changes to CON laws that will help us keep Medicare seniors safe at home. 

As of publication, 66% of Medicare directors have taken action.  Thank you for being an advocate for our staff and clients. Your advocacy voice is important. 

Momentum Going Strong: RI Offices Continue with Legislative and Home Visits

Rose Jones, Director of the RI Division of Elderly Affairs (DEA), recently visited BAYADA in Rhode Island to learn about the important work we are doing to ensure “people have a safe home life, with comfort, independence and dignity.” She toured the RSP, RIS, and RSP office spaces – including our training & simulation (SIM) labs, and held a roundtable discussion where office employees and GAO reviewed:

DEA Director Rose Jones visits RI Offices and SIM labs

     ✔ How clients receive home care services from a licensed agency through DEA,

     ✔ Process of recruiting/training/retaining our workforce, including CNAs, LPNs, & RNs,

     ✔ Opportunities to ensure everyone has access to safe, affordable and quality care at home when they need it

During her visit, she said “it takes a village to provide care to Rhode Islanders needing assistance so they can remain at home”… and we couldn’t agree more!  We truly appreciate Director Jones taking the time and asking questions to dig deeper into home care, and for meeting with some of our passionate staff who truly #LoveWhatTheyDo. We look forward to connecting her with clients and field staff through a home visit in the coming months!

RI Home Visits with Reps. Julie Casimiro and Camille Vella-Wilkinson

Recently, Zachary, his mom, Lee Ann Quinn—a BAYADA clinical manager— and their family graciously opened their doors to Representative Julie Casimiro to educate her about high acuity home care services Zach receives. Zach’s nurse and CNA were there along with his dad, Mike, and little sister, Olivia. Mom Lee Ann said, “Thank you all for coming to meet us today. It was a true pleasure! My family and I are passionate about keeping Zach right where he is at home where he belongs and it is so important for him to be heard!”

The RI offices and GAO also took Representative Camille Vella-Wilkinson on a home visit to meet Bob, a very inspirational Vietnam Vet who appreciates his home care services. Bob was able to share his story with Rep. Vella-Wilkinson so that she better understands how CNA services keep Rhode Islanders safe at home and out of costlier nursing homes.

Shout out to our amazing BAYADA leadership and GAO Hearts for Home Care Advocacy ambassadors from RSP, RIS and RSP. Special thank you to Lee Ann Quinn (Clinical Manager), Wendy Milot (Director), Richard Boschwitz (Director), Lindsey Jamiel (Director), Cristina Viveiros Gomes (CM II), Elizabeth Schenck, (CSM) Alex Brown (RSP), and Dana Medeiros (Area Director) for helping to coordinate and host these important and impactful visits!  

RI Budget Sees First-in-the-Nation COLa for Home Care Services!

It takes a village: GAO, RI office staff, industry partners, and clients from across the state advocated for rate increases and the first-ever COLa adjustment

Rhode Island’s home care advocates scored big when they received their monumental across-the-board increases for home care services last year. That’s because, in addition to the increases, an accompanying provision called for regular yearly cost-of-living adjustments (COLa) for services provided through licensed home care agencies. This means that each year, home care rates must be adjusted to reflect real market changes. On July 5, Governor Raimondo signed the budget, which included the first-of-its-kind 1.9% COLa for CNA and nursing services!

Significantly, this 1.9% increase represents the fifth increase for home care that the state has received in the past four years. Also significant is the fact  that, while home care rates have stagnated throughout most other states in recent years, Rhode Island has found a unique way of ensuring that home care staff and clients now can rely on the COLa to ensure they are not left in the lurch each year.

Thank you to the General Assembly and Governor Riamondo for investing in home care and supporting the work we do to keep Rhode Islanders safe at home.     

NC Clients Make Their Voices Heard

To achieve our legislative priorities, we utilize a variety of tactics to ensure our legislators are educated about the obstacles our clients’ and employees’ face and the urgency of increasing funding for home care. We are grateful to our many Hearts for Home Care Ambassadors, and office employees who have participated in these important advocacy efforts; whether you’ve met with your legislator at a Legislative Day, helped organize a home visit or legislative round table, or taken the time to respond to one of our several action alerts this session, your continued advocacy is vital to achieving our goals.

Further, many of our clients have gone above and beyond in making advocacy a priority and have articulated the obstacles, challenges, and hardships they and their families must confront due to chronically low reimbursement. We have shared these powerful stories directly with legislators to educate them on the value of home care. It is important they recognized the need for adequately funding the Medicaid, including the Private Duty Nursing (PDN) and Personal Care Services (PCS) programs, and the various Community Alternative and Innovation Waivers.  Introducing lawmakers to their constituents who are most directly affected by the decisions they make is an excellent way to share their stories and make an impact.

See below to meet several of our client advocates! If you are interested in becoming more involved in advocacy, or have a client who is interested in sharing their story, please contact advocacy@bayada.com.

NC Client Spotlight: Meet five BAYADA clients that have engaged in advocacy this quarter!

North Carolina Legislative Day 2019 Photo Gallery