On March 28, our annual North Carolina Hearts for Home Care Ambassador Symposium took place, where we provided tools and resources to our volunteer Ambassadors. The training focused on a variety of topics, including leading a legislative meeting and building relationships with lawmakers.
addition to special guests former Representative Bill Brawley, Senior Healthcare Campaign Director of MomsRising Felicia Burnett, Association for Home
& Hospice Care’s VP of Government Affairs Tracy Colvard, and Staff Attorney with Charlotte Center for Legal Advocacy
Louise Pocock, the shining star of the Symposium was client Dimpal, who inspired
all of our Ambassadors with her story of her journey into advocacy.
Beyond detailing the specific challenges she and her family face as a result of low state Medicaid reimbursement rates, Dimpal also described the ways in which home care and her nurses have changed her life and granted her independence:
“Without my nurses, I wouldn’t have been able to go to college and to live a full life. Without them, I’d likely be stuck in a hospital or a nursing home,” said Dimpal.
It was this gratitude for her nurses that propelled Dimpal to share her story and to advocate for others who rely on the state’s Private Duty Nursing (PDN) program to survive.
To hear more about Dimpal and the importance of advocacy, you can watch her full speech here. You can also read about her nursing care in the Gaston Gazette after a reporter came to her house to learn more about how her nurses impact her everyday life.
Special thanks to our Hearts for Home Care Ambassadors
for volunteering their time and talents advocating for our staff and clients!
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.
year was Rhode Island’s first year with a full-time Government Affairs Office
(GAO) program—And what a year it was. Together with our Rhode Island office
staff, field staff, clients, and families, we were able to band our voices
together in advocacy to achieve monumental increases on behalf of our staff and
result of our efforts, the State increased Medicaid rates for certified nursing
assitants (CNAs), and to the State’s private duty nursing (PDN) program. These
increases allow BAYADA to raise field workers’ wages and better compete for a
larger segment of the workforce. As a result, BAYADA is in a better position to
recruit and retain the staff necessary to keep up with demand, and Rhode
Islanders are poised to see increased access to reliable, consistent care.
work is far from done. BAYADA’s GAO, along with the continued advocacy of so
many of you, is focusing on four key issues at this time:
Priority #1: Continued COLa Adjustments
2018 increases also included a first-in-the-nation Cost of Living adjustment
(COLa), which will provide additional increases to Medicaid rates
every year based on the Bureau of Labor Statistics’ Cost of Medical Services
annual adjustment. Our first majority priority
for 2019 is to ensure that the state keeps its commitment to COLa and
includes it in the state budget each year. If passed, this year’s COLa will add
an additional 1.9% to current rates to ensure they remain consistent with
actual, determined cost of living increases. In March, GAO director Ashley Sadlier testified in support of this
important adjustment in front of the House and Senate Finance Committees alongside
other supporters. At this time, we see no opposition and continue to monitor COLa
through the state’s budget process.
Priority #2: High Acuity
Skilled Nursing Rate Modifier
issue that Rhode Island’s skilled nursing offices often face is recruiting the
specialty-trained nurses necessary for more complex, high acuity clients. Luckily,
home care supporters in the House agree. Recently, representatives Patricia Serpa and Mia Ackerman introduced House Bill
5621, which calls for a 10% increase to Medicaid reimbursement rates for nursing
services provided to clients with tracheostomies and/or ventilators. The bill
has taken the next step in the legislative process by being referred to the
House Finance Committee. Currently, GAO is awaiting a date for the bill to be heard.
If you, a loved one, or your staff or clients would benefit from such a bill,
please reach out to firstname.lastname@example.org!
We hope to have a strong showing of support at the state house when the bill
moves forward and we would love your help.
Priority #3: Helping Pediatric Clients
Transition to Adult Clients
BAYADA has collaborated
with the Rhode Island Partnership for Home Care (RIPHC) to advocate for
additional resources for pediatric clients currently receiving home nursing
services who are transitioning to adult services. Currently, clients that are transitioning face many challenges
navigating the system, especially when determining what programs and
services they are eligible for. BAYADA and the Partnership have met with the
Executive Office of Health and Human Services (EOHHS), the Department of
Behavioral Healthcare, and Developmental Disabilities and Hospitals (BHDDH) and
Managed Medicaid, to create plans on how
to streamline the process for this population and expand eligibility options
for families. To date, several BAYADA clients have transitioned to a more
appropriate program for the level of care that they require. GAO looks forward
to continuing to help our partners at the State to develop plans to ensure
parents, caregivers, caseworkers, schools, and agencies are equipped with the
resources necessary to assist families in navigating the challenges of
transitioning from pediatric to adult home care services.
Priority #4: Continued
2018 brought success to Rhode Island’s home care front, GAO continues to build
relationships to ensure that legislators and regulators understand the
importance of home care to so many of Rhode Island’s families, and support
policies that ensure its accesibility. Recently, alongside the Partnership, GAO
director Ashley Sadlier met with Rep. Joseph McNamara, the Chairman of the
Rhode Island House of Representatives Committee on Health, Education and
Welfare. Rep. McNamara is in a key role to influence legislation, and BAYADA looks
forward to continuing to be a valuable partner to Chairman McNamara—and many
other key legislators and regulators—on issues such as employee training and
supervision, access to care, and challenges that providers, employees, and
families see within the home care industry.
Delaware Ambassadors and employees have set participation records
at two key annual advocacy events this year—The Delaware Association for Home and Community Care (DAHCC) Legislative Day
and our annual testimony in front of Delaware’s Joint Finance Committee (JFC).
The first, the Delaware Association for Home and Community Care
(DAHCC) Legislative Day on March 13, had a
record attendance of more than 50 attendees! 41 registered for the event,
which would have been a record itself, but the larger-than-expected turnout was
an impressive surprise. Seven providers,
including BAYADA, were represented, and the crowd included six families advocating for themselves
and their nurses. Everyone wore their own company’s branded gear but united
behind Hearts for Home Care buttons that proclaimed, “Home Health Care Matters to Me.”
Legislators heard our message was heard loud and clear.
In another first for Delaware, two legislators spoke in support
of a large rate increase for Delaware’s home care RNs and LPNs at the DAHCC Day Press Conference. To make it
even better, the two were none other than the Senate Majority Leader, Senator Nicole Poore, and the House
Majority Leader, Representative Valerie
Longhurst. Both spoke passionately about the importance of home care in our
communities and the need to increase reimbursement to ensure that this vital
care is available to those who rely on it.
They were joined in speaking by the Executive Director of DAHCC, Jean Mullin, and BAYADA client Haley Shiber.
A week later, on March 20, Delaware advocates broke another
record when 15 members of our community
testified before the powerful Joint Finance Committee (JFC) in support of
increasing Medicaid home care reimbursement rates. Led by Jean Mullin, participants included Torie Carter, Jenny Scott, Mandy Brady, Judeth Smith, Ali Knott,
Danielle Myers, Shannon Gahs, Dave Totaroand representatives
from Epic/Aveanna and Maxim/Aveanna. Client Haley Shiber was unable to attend in
person but sent a powerful testimony video to the JFC members before the
hearing. The Joint Finance Committee hears budget requests from all state
agencies and testimony from the public before making an annual budget
recommendation to the full General Assembly. The General Assembly frequently
follows the majority of those recommendations. Members of the committee told
BAYADA in the days following the hearing that they had never before seen such a large contingent testifying on a single issue!
The industry-wide coalition led by BAYADA and DAHCC is pushing
the Delaware legislature for a 21%
increase in the Medicaid home care RN and LPN rates, which would impact our
Skilled Nursing practices—Pediatrics and Adult Nursing. Because of the home
care Rate Floor passed two years ago mandating that Medicaid MCOs pay no less
than Medicaid fee-for-service, these new higher rates would have to be paid not
only for “straight Medicaid” hours but also those funded by managed care in
Delaware. These two rates currently remain at their 2006 levels, harming our
ability to recruit and retain the highly-skilled RNs and LPNs that are so
important to the lives and welfare of our clients.
Thank you to our advocates
who turned out and made sure that Delaware’s decision makers know that we are
here to advocate on behalf of our staff and clients, and that home care makes a
difference in the lives of so many Delawareans!
Great things happen when we advocate together! After years of
advocacy from BAYADA, our partners, and many parents and home care employees, the
Maryland General Assembly recently passed two pieces of legislation that collectively will increase all Medicaid
home and community-based services reimbursement rates by more than 30% over
the next six years. Though initially met with opposition from Governor Larry Hogan,
the Maryland General Assembly heard our voices and overwhelmingly voted to
override his veto of one of the bills.
The first bill, the state’s annual budget, provides a rate
increase of 3% that will go into effect July 1, 2019. The second bill, also
effective July 1, 2019, contains an amendment which will increase reimbursement
rates by 4% each year between July 1, 2020 and July 1, 2025.
Currently, Marylanders who rely on in-home nursing care have only
83% of their authorized hours filled, meaning that families struggle to fill
their medically complex loved ones’ skilled home nursing care nearly 20% of the
time! We have found that Medicaid rates have stagnated below the cost of living
and below wages seen in other settings—such as hospitals and facilities—and surrounding
states—and that families were struggling to fill these hours. We are hopeful that
these access-to-care issues will be alleviated as providers will be able to
recruit and retain nurses within the home care industry, and that more of Maryland’s
most medically complex will be able to stay safe where they want to be—in their own homes.
This was a true team effort led by BAYADA and the Maryland National-Capital Area Home Care Association (MNCHA) and including MNCHA member providers, several individual families, parent advocacy organizations and disease-specific advocacy organizations. Special thanks to JoAnn Saxby, Patrick O’Malley, Eddie Dyer, Patty Watson, and Susan Ingallswho all played important parts in making this happen and to BAYADA Delaware employees Mandy Brady, Kristyn Kelsch, and Taylor Kosinski who went above and beyond to advocate in their sister state. Mike Sokoloski, Tara Montague, and Nicole Onofrio were instrumental in supporting two Town Halls and Legislative Day, and Alisa Fox coordinated timely articles in The Baltimore Sun, The Washington Post, and on WDVM TV in Western Maryland. Maggie Tracy managed countless logistical hurdles and supported direct lobbying and grassroots efforts.
Thank you to everyone who played a role in this major achievement! Advocacy cannot succeed if only one voice is heard, and your advocacy has contributed to the well-being of so many Marylanders in need of home care.
For more information on this increase, or how you can get involved in advocacy in Maryland, please contact Shannon Gahs at email@example.com.
Assemblywoman Murphy was alerted to the issue after Hearts for Home Care manager and advocate Tara Montague told her about the issue, and how it has impacted her daughter, Mary, and many of New Jersey’s medically fragile children. Mary and Tara have utilized the fund, and have been important advocates in ensuring the fund is both adequately funded and accessible for the many New Jersey residents that need it.
Currently, families can apply to the Catastrophic Fund to purchase a modified van so that they can safely transport their medically fragile child. However, current regulations require that families pay for the van upfront and wait to be reimbursed by the Fund. This stipulation presents a sincere barrier to transportation for families that cannot afford to front tens of thousands of dollars while they wait to be reimbursed.
Mary’s Law addresses this issue by requiring the Catastrophic Fund to provide direct payments for the purchases of specialized, modified motor vehicles. In addition, this legislation will increase the annual surcharge for New Jersey employers from $1.50 to $3.00 per employee to insure the Catastrophic Fund is adequately funded to meet the its purpose and demands.
“Medically fragile children like Mary deserve to travel safely and freely. This legislation ensures that children and their families receive the help they need regardless of their financial situations. Ever since Mary was born, I’ve been a staunch advocate for her needs and for better laws and policies, but I never thought advocacy could hit so close to home–Mary and our family are ecstatic that we can bring about change for all New Jersey’s children and families that need it,” said Tara.
Thank you to Tara and Mary for continuing to be effective advocates on access to transportation. Hearts for Home Care will continue to provide updates as the legislation progresses through New Jersey committees and chambers. If you have questions about this legislation or how to get more involved in advocacy on behalf of yourself, a loved one, or your staff and clients, please contact firstname.lastname@example.org today.
BAYADA’s Government Affairs Office (GAO) offers employees
and clients many ways to get involved in advocacy through our Hearts for Home
Care program. One of the very easiest ways to get involved with advocacy right
from your cell phone or desk is by taking action on an Action Alert. Generally,
GAO will send out an action alert email to all employees, or employees in a
certain state, when a piece of legislation requires support or opposition from
our elected officials. Action alerts take
two minutes to complete and most of the work is done for you—All you need to do
is click a couple of buttons in order to send a pre-written email to your legislators
to encourage their action!
During the previous quarter, GAO sent out two federal action alerts to all BAYADA office staff. The first alert was sent on February 14 and requested that employees take action to urge their officials to support a bill to counteract certain sections of the Patient Driven Groupings Model (PDGM) that would be harmful to our Home Health staff and clients. The second alert was sent on February 27, and asked that employees urge their federal legislators to support action to revise an outdated Medicare requirement to allow non-physician practitioners (NPPs), such as nurse practitioners and physician assistants, to certify a patient’s eligibility for coverage of home health services. You can still take action on this alert here.
See the results of both action alerts below. Congratulations to the Firewheel and Flame
Lily divisions, which had the most participation in these two alerts! We
are proud of your commitment to advocacy and your dedication to speaking to our
many clients that do not have the voice to speak for themselves!
Thank you to the many employees that took action and encouraged their peers to do so as well. As you can see from the below charts, both alerts—which both impact our Home Health employees and clients the most—continue to see relatively low participation. It’s important that we share our voices wherever possible, and particularly for Action Alerts that are easy to complete. We are hoping that all BAYADA employees recommit to advocacy. During the next federal action alert we hope to see 50% or more office staff participation.
On March 6, 24 energetic BAYADA employees and one BAYADA Assistive Care State Programs (ACSP) client gathered in South Carolina’s state capitol for a day of meaningful and heartfelt advocacy. The South Carolina Home Care and Hospice Association (SCHCHA) hosted its second annual Legislative Advocacy Day, and this year, a record-breaking total of nearly 60 advocates attended!
BAYADA’s advocates joined other attendees and walked the halls with a clear message: Investing in our Nursing Medicaid Waiver programs will save the state money and keep our medically fragile children, disabled adults, and seniors home with their loved ones and out of higher cost facilities. We care about home care, and so should you!
With their passionate message in hand, advocates spoke with over 50 legislators about the importance of home care. This year we were able to speak to all key lawmakers in both the House and Senate to ensure our message was heard by as many ears–and the right ears–as possible.
“Advocacy can’t be effective with only one person working towards a goal–one voice can only go so far! That’s why I am so proud to work in South Carolina, where so many of our office employees, field employees, and clients recognize the importance of sharing their voices too. The more impassioned people we have involved, the more of a difference we can make on behalf of all South Carolinians that rely on home care,” said GAO director Melissa Allman.
BAYADA employees were excited and inspired by the impact they made that day. Thank you to the many participants for the difference you make on behalf of all South Carolinians that rely on home care to stay independent in their communities!
Affairs Office (GAO) staff members often say, “Advocacy never sleeps.” For the
GAO federal affairs team—Government Affairs Officer Dave Totaro and Senior
Associate Lindsey Wright—we can also say “Advocacy never stays put.” Over the
past quarter, GAO has traveled to Washington, D.C. several times, as well as to
Massachusetts, Florida, Indiana, Arizona, and Colorado—among other places.
Most often, GAO
travels specifically to meet with
legislators in D.C. and around the country to educate them about home care and
the benefit it has in keeping millions of America’s seniors and individuals
with disabilities independent and in their communities. Most recently, the
federal affairs team has also taken to visiting BAYADA’s Home Health service offices
to get employees involved in advocacy.
In late February,
Dave and Lindsey traveled to D.C.’s Capitol Hill to meet with 11 key
congressional members and their staff. On April 2, they traveled back to the Capitol
along with two Hearts for Home Care Ambassadors—Anthony D’Alonzo (MHH) and
David Mead (NLP)—and other GAO staff—to participate in the NationalAssociation for
Home Care and Hospice’s (NAHC) annual March on Washington. This year, marchers
were asked to educate legislators on two important bills: The Patient Driven
Groupings Model bill, which if passed will eliminate reimbursement cuts based
on behavioral assumptions, and the Home Health Improvement Planning Act, which
if passed will allow non-physician practitioners to sign off on care plans. The
visits were successful and resulted in additional cosponsors for both bills.
federal affairs team can only make so much headway alone. GAO relies on advocates like you to make sure that all
legislators hear our messages loud and clear. Dave and Lindsey have begun
traveling to Home Health service offices around the country to tell employees
what they can do to get themselves and their clients involved in advocacy, and the
importance of doing so.
“As much as I travel to spread our message to our country’s decision makers, it’s important that I also use my time to get our staff involved. Home Health employees and clients are affected by what our legislators and regulators in D.C. make decisions on every day. The more our people mobilize and advocate, the more those decision makers will see how their choices affect real people’s lives,” said Dave Totaro.
trip to four Home Health service offices across Arizona and Colorado, Dave and Lindsey
focused on Medicare policies, current bills, and how employees can get involved
to make a difference. They also listened to each office’s unique
challenges in delivering care to clients, and how policy changes could alleviate
some of those issues. Thank you to the many BAYADA service offices that
welcomed GAO with open arms and open minds, as well as to the employees who
signed up to become Ambassadors. To learn about ways you, your staff, and your
clients can advocate, contact Lindsey Wright at email@example.com. We look forward to
working with you!