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 firstname.lastname@example.org.
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
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
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
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.
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.
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. 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
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.
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
✔ 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
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!”
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
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!
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.
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.
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 email@example.com.
Earlier this year, New York Governor Andrew Cuomo
announced his plan for the 2020 state budget, including a 3.6% planned budgeted increase to overall health care spending.
When proposed tax revenue estimates came in much lower than anticipated, the
administration decided to cut approximately
$550 million of this increase. But after strong advocacy effortsfrom
many health care groups across the state, the Governor and his
administration changed their position, keeping the $550 million Medicaid
increase in the budget.
BAYADA’s Government Affairs Office (GAO)
participated in several conference calls with the New York State Home Care
Association (HCA) to learn more about Medicaid spending, which accounts for 42%
of the budget, and what we and our office staff, clients, and families can do
to advocate for higher wages for home care nurses through increased
Currently, New York’s Medicaid reimbursement
rates are well-below surrounding states, so many caregivers are discouraged
from entering—or staying in—the home care industry due to abysmal wages. It
also impacts BAYADA because the rates are currently so low that we are currently not be able to provide sustainable Medicaid-based
home care in the state and pay caregivers an appropriate wage.
As part of a larger national trend, New York did
vote to increase the statewide minimum wage to $15 per hour incrementally
through 2021. New York understands that home care providers that do provide
Medicaid-based services would not be
able to comply with this minimum wage mandate and stay sustainable under
current rates. The final budget did include an additional $1.1 billion to support the cost of raising minimum wage for
health care workers. BAYADA is currently advocating
for similar increases in other GAO states that have increased the mandatory
minimum wage, but have not increased reimbursement rates in tandem. Medicaid
rates must keep pace with the rising cost of living and increased wage mandates
to ensure that providers can stay in business, and to ensure that vulnerable New
Yorkers can have access to quality home care.
Indira is at Jessie’s home every morning at 5:00 without fail. After taking on Jessie’s case and learning that she spent most of her time in bed, it became Indira’s mission to consistently challenge her to get out of bed and get active. Now, every morning before dawn, Jessie starts her morning with a smile, anxiously waiting for Indira to arrive.
While helping Jessie, who is 31 and diagnosed with cerebral palsy, with her activities of daily living, Indira also incorporates games, crafts, dancing, and singing. After a few short months with her beloved caregiver, Jessie now has a newfound confidence in her physical abilities and communication and language skills. Indira has quickly ingrained herself as part of Jessie’s family, whose loved ones call Indira “a Godsend.”
CHHA Michele has been with her client Marie since January of 2017, but you would think they have known each other forever. They share a special bond, and Marie even says that Michele is “like a daughter” to her. Marie lives alone, and if not for Michele’s visits, would be lonely and potential in danger. In addition to the personal care services that Michele provides to keep Marie safe and healthy, you see their bond shine when Michele frequently makes puzzles and quizzes to stimulate Marie’s mind—or as they like to call it, “using our noodles.”
Marie says that without Michele, she would not be fully able to take care of herself. But As soon as Marie arrives at Marie’s door, the time flies as Marie keeps her on her toes—both figuratively and literally. In addition to regularly stimulating Marie’s mind, Michele makes sure that Marie is safe and on balance as she moves around her apartment.
We need your help in supporting dedicated caregivers like Indira and Marie through advocacy. To find out ways you can get involved, email firstname.lastname@example.org today.
“Parents deserve to be parents, not skilled nurses, and more importantly, children deserve to be children—not patients.” Two moms share how PDN impacts their families’ lives
This year, our major focus in New Jersey is to fight for higher reimbursement rates for New Jersey’s Private Duty Nursing (PDN) program. One of the most impactful ways to influence legislators is to engage clients and families into advocacy through testimony, which is delivered by these clients to legislators who are in key positions to influence legislators. Below, find powerful excerpts from two moms who support a PDN increase on behalf of their children and their families.
Dana I. – Mother to
BAYADA Client, Abi
“There is truly no way to explain on how much caring for a medically
fragile child impacts a family. Every errand, every event, every move of your
day becomes centered around their care. Abi has been authorized for skilled
nursing care by our insurance company, yet she still has five or more unfilled
shifts every week.
Lapses in nursing
coverage put tremendous pressure on our entire family—we often have to miss work
and stay home to provide for her care, putting strain on the family finances. Lost
nursing hours also means the entire focus of our time becomes all about our
medically-fragile child, and the balance between the other children becomes
strained and we often miss beloved activities or events.
Abi is not a child that
we can just hire a babysitter for. Her high level of care and constant need for
monitoring makes it impossible to have any sense of normalcy without capable
& consistent nursing support. There are simply not enough nurses in home
care to cover all of the needs of my family and the needs of many, many others.
is not the answer. My precious daughter brings many challenges to our home, but
it would be heartbreaking to have to put her in an institution for lack of
nursing support. So here I am prayerfully putting a name and a face to those of
you who have the power to make a real difference in this area. Competitive
wages would bring stability to her home care nursing and allow our family and
families like us to stay together and thrive.” -Dana Insley, Abi’s mom
Emma K. – Mother to
BAYADA client, Lili
“While I count my
blessings that we have the right nursing team in place, I often think of the
families across the state that can’t fill their nursing shifts. It takes me
back to the last time our scheduled nurse had a family emergency and there was
no other nurse available to cover her shift. As a single mother of a
medically-complex, ambulatory child with no family in the area, you can imagine how it plays out when there isn’t a nurse available for
Lili: I have to call out of work myself and cancel any commitments I’ve made
for the day. I can’t get the groceries that I was planning to pick up or even
do a load of laundry since I can’t leave Lili alone for even a minute. And I
have to again plan to do these things during the times I’m expecting to have a
nurse to stay with Lili because I can’t get them done otherwise.
We as a society have developed a system of reliability for our communities: Teachers help children learn, police keep our streets safe, ER doctors save lives, and pharmacists fill our prescriptions. But we are failing in keeping home nursing readily available. Just as a prescription, Lili’s care is prescribed by her doctor and authorized by the state. But we cannot rely on its availability. I hope that our state decision makers prioritize home care, if solely for the fact that it keeps children like Liliana at home and keeps families together. Parents deserve to be parents, not skilled nurses, and more importantly, children deserve to be children—not patients.” -Emma K., Liliana’s mom
Dana and Emma exemplify the power of sharing your story. If you’d like to highlight the powerful story of your experience in a home care office, or the story of a client, their loved one, or a caregiver, contact email@example.com.
BAYADA’s Government Affairs Office (GAO) is proud to join with fellow advocates like you to continue to advocate for better wages for our caregivers and increased access to home health care for the tens of thousands of New Jersey residents that rely on this care to stay safe and independent at home. Thank you to our many employees, clients, and families who have advocated on behalf of yourselves, your loved ones, your staff, and your clients regarding our two major 2019 issues:
1. Personal Care Assistant (PCA) Program – Increased Reimbursements for Increased HHA Wages
GAO is working in collaboration with other providers and the New
Jersey Home Care and Hospice Association to educate our legislators on the
importance of adequate funding for the
Personal Care Assistant (PCA) program.This is especially important as the State recently mandated an increased
minimum wage. BAYADA supports a wage increase for all of our home health aides
(HHAs) for the incredible, lifechanging work they do—but additional advocacy is
necessary so state legislators understand the importance of proportional PCA
program funding so that providers like BAYADA can comply with the new mandate
and stay sustainable.
Click here to check out how HHA Indira helps her client Jessie stay at home, and about CHHA Michele’s special bond with her client Marie. We are hopeful that our advocacy efforts can lead to a fairer wage for aides like Indira and Michele, as well as better recruitment and retention rates across the ACSP practice so that all New Jersey residents who need this important service can access it. To find out how you can get involved, email firstname.lastname@example.org today.
GAO is working with the New Jersey Home Care and Hospice
Association to educate our legislators on the importance of adequate funding for the Private Duty Nursing (PDN) program.
Current PDN program funding makes it difficult for providers like BAYADA to
recruit and retain the nurses necessary to care for New Jersey’s most medically
complex and residents. This difficulty results in significant access to care
issues, as only 85% of scheduled hours are currently filled, and
vulnerable New Jersians are going without the care they need to stay safe and healthy
We are lucky to have home care supporters in the legislature who understand the struggles our caregivers and skilled nursing clients face—Recently, Bill S1733/A4575, which proposes a $10 per hour increase for RN and LPN home care services, was introduced. In addition to the increase, this bill also seeks to establish a “rate floor” so that managed Medicaid providers reimburse no less than the state fee-for-service rate for in-home skilled nursing services.
But we need your help in getting this bill to the finish line. Soon, this bill will be up for a hearing, and clients’ and employees’ testimony make the most impact in showing legislators the challenges that arise from inadequate funding and the associated access-to-care issues.
Click here to read excerpts from two clients’ testimonies regarding the importance of PDN in their lives. Powerful stories like the ones Dana and Emma share help our advocacy efforts and show legislators the impact of home care in making a real difference in vulnerable New Jersey residents’ lives. To find out how you can get involved, email email@example.com today.