Delaware Hearts for Home Care Advocate Shares Heartfelt and Impactful Story with Legislators!

Recently, a Delaware pediatric licensed practical nurse (LPN), Charlene Chappell, signed up for Hearts for Home Care and wanted to get involved. And did she come out in full force!

After sharing powerful and heartfelt testimony in Dover, DE’s Legislative Hall about the impact she makes on families and the challenges low Medicaid rates bring to nurses who want to provide one-on-one care to families at home, Charlene listened to a radio show where host Joel Olsteen spoke about “an itch you just can’t scratch.”

That got Charlene thinking about more advocacy. Charlene said, “I feel that the majority of men and women that serve as elected officials have no clue what’s required of a family when they have a child that has special needs and is differently abled! They don’t understand that nurses need to be attracted to home care so that families can rely on this care to keep their medically-complex children at home.”

That inspired her to write the below story and send it to all Delaware legislators. Read Charlene’s powerful story below!

My Itch!

I have an itch! Mo matter how hard I try to let someone know, I can’t.  I’m 8 years old and I can’t tell Mommy where I itch! I can’t reach my itch! Its 2:30 in the morning and Mommy has fallen asleep in the chair next to my bed because she had to work today and then take my sister to her dance lesson. When she finally arrived home she threw some dirty laundry in the washer, and cooked dinner. After dinner she put the wash in the dryer, and then she loaded the dishwasher. She came in my room to check on me and feed me. Off she went to make sure my sister had done her homework and was in the shower. Oh no, an alarm is going off! Here comes Mommy. I wish I could tell her how much I love her for all she does and about my itch. She looks so tired. It’s almost 8:00 pm. The phone is ringing. Hurry Mommy before they hang up!

I can hear Mommy on the phone. “What! Oh no, please tell me it’s not true. I’m so tired tonight. I don’t know if I can stay up all night with him but I must. I have to make sure he’s ok on his ventilator and his medications are given at the right time, so he doesn’t have a seizure, and that the tube feeding is running properly. He has to be repositioned every two hours so his skin doesn’t break down. I have to check his diaper too. Well… thanks for the phone call.”

Oh no. Mommy just found out my favorite night nurse called out tonight, and the rest of forever. The agency is going to try and find a replacement as soon as possible, but that may take some time. Nurses aren’t as anxious to get into home health care nursing because they can make more money at a hospital. Mommy is going to miss work because she will have to stay up with me as Daddy’s gone from home with his job right now. Mommy may lose her job. I’m so sad my nurse left. She really knew me and she knew when I had an itch. She would gently scratch me all over till she found it, like Mommy does. She understands my cues and my facial expressions as I can’t talk, or walk, or move because of my illness. 

I heard Mommy talking to the lady at the agency about the nursing shortage in home health care. She told Mommy that the money provided for reimbursement by Medicaid, not Medicare, has not increased in 13 years! The last time there was an increase in Medicaid was in 2006! I wasn’t even born then! She also told Mommy that the companies are running out of their own funds to supply the raises the nurses deserve. God bless the nurses that do work in home health care, for a lesser wage then they deserve, and take care of not only me but my mommy and Daddy too. Without them my Mommy and Daddy would not get the proper rest, would have to quit work to care for me. It would not be a good thing for my family. We would all suffer. I don’t want to go anywhere but here in my room. What if we can’t find a new night nurse? Where will I go? I overheard the doctors and nurses at the hospital talking last time I was admitted for a bad seizure and they said that all children do better in the home setting for getting well once they can leave the hospital. They are less likely to get sick again from a disease they acquired while in the hospital, and all of us are more comfortable in our own bed!

I hope my story has helped you to understand why we need to increase the Medicaid budget. Not Medicare, but Medicaid. Mommy told me that some people get confused so that’s why I will say it one more time. Please increase the Medicaid funding for home health care nurses.

Thank you for reading this. Mommy thanks you as well as all the other children and their parents that require specialized home health care nursing.  And yes, Mommy found my itch!

Thank you, Charlene, for sharing your creative and passionate story with Delaware’s legislators. We must all share our voice to make an impact, and your advocacy highlights your deep commitment to your clients’ care.

Hearts for Home Care is seeking to advocate for higher reimbursement rates for skilled nursing services in Delaware so that nurses can be better attracted to home care, and so families that need this care to stay together at home can more easily and reliably access it. For information on how you can get involved, contact us today

Delaware Sets Grassroots Advocacy Records in 2019!

More than 50 home care employees, clients, and family members attended the DE Association for Home and Community Care Legislative Day!

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.

BAYADA employees made their voices heard in front of the DE Joint Finance Committee

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!

Educating Legislators Key to Success in Both States

Curt Knott, Chris Knott, Ali Knott, Kim Hill, Mandy Brady, Shannon Gahs, and Maggie Tracy met with Rep. Kevin Hensley to thank him for his support of home health care.

In both Delaware and Maryland, the legislature is keyed up to see a lot of change in both the leadership of key committees that debate our issues and the rank-and-file membership of those committees. BAYADA, together with our trade associations and other providers, has the potential to use this time of change to educate newly-elected and newly-promoted representatives about the complex and detailed issues within Medicaid reimbursement. The best way we can recruit these leaders to become Champions of Home Health Care is to show it to them in person!

What can You do?

  • Invite a legislator to your office.
    • Whether it is for a competency training, an awards ceremony, a community or recruiting event, legislators will understand our complex issues better when they are exposed to it more. Invite them for a lunchtime Town Hall meeting with your office staff, to talk about the issues that affect your work, or ask them to present your next Heroes Award!
  • Invite a legislator on a Home Visit.
    • Legislators are happy to meet the people they represent and seeing our clients is sometimes the best way to explain how important home care is to their lives.
  • Invite candidates or recently-elected legislators to sit in on training.
    • Whether nurses are gaining new skills or are brushing up on existing ones, showing legislators how much effort we put into training and ensuring the skills of our nurses goes a long way toward helping them understand that home health care encompasses a myriad of different specialties.

These interactions make a huge difference.  A legislator in Delaware, someone who has been a supporter of BAYADA for a long time, told us this year that she wants to know more about our day-to-day. She said other groups who are asking for increases in the state budget call her weekly. She and her associates want to hear about new issues, training, community events, staff meetings, awards and current events in our world.  Being up to date will help her advocate better for our clients and employees in private negotiations!

Shannon and Maggie are here to help!  If you are interested in helping to educate a legislator but need some support in planning or preparing for it, contact us.

The Power of Advocacy: Home Care Employees Share Impassioned Testimony to Advocate for Nursing Rate Increases

Home health care advocate testifies in front of Delaware Joint Finance Committee 2018
BAYADA RN Victoria Carter advocates for higher reimbursement rates by providing moving testimony in front of the Delaware Joint Finance Committee

On February 21, seven BAYADA Home Health Care employees, one of whom is a parent and caregiver of a medically complex child, testified in front of a dozen Delaware state legislators and nearly 80 community members to advocate for a Medicaid reimbursement rate increase for registered nurses (RNs) and licensed practical nurses (LPNs).

The Delaware Joint Finance Committee met to hear the Department of Health and Social Services’ (DHSS) annual budget request in what ended up being a crowded room that drew so many members of the public that overflow seating had to be provided in the cafeteria, where a live video feed of the hearing was streamed. Though a few of these advocates were initially hesitant to speak in front of legislators- let alone such a crowd- what kept them going is their commitment to advocating on behalf of home care nurses, their clients, and their clients’ loved ones.

These advocates’ testimonies detailed their personal stories of why the committee should include additional funds to DHSS’s budget to be used to increase the state’s reimbursement rates for RN and LPN care by about 25%. Delaware’s current rates have not been increased in more than ten years, and these current rates are not adequate to keep up with demand for in-home nursing care because of the pressure that low rates place on providers’ ability to recruit and retain quality nurses. With a rate increase for RN and LPN care, providers would be able to attract more nurses to deliver the in-home care that pediatric, adult, and senior home care clients need.

BAYADA registered nurse Jen Saulsbury shared a moving story about two of her pediatric clients and the impact that nursing turnover rates, which stem from Delaware’s low reimbursement rates, has on them. She shared a crayon-drawn card from one of her pediatric clients to accompany her story, which nearly brought the committee to tears.

Committee co-chair Representative Melanie George-Smith and Senator Nicole Poore vocalized their support of increased reimbursement rates for RN and LPN care. It goes to show that advocacy is a powerful force in creating the changes necessary to support home care employees, clients, and their families.

Top left to bottom right: Danielle Myers, Jennifer Scott, Alice Knott, Amanda Brady, nursing student Morgan Luther; Jennifer Saulsbury, Victoria Carter, Shannon Gahs

Advocacy is powerful. The stories that these advocates shared in front of the committee were not those of data, numbers, and dollar signs, but rather their unique, passionate perspectives of why this issue is so important that it deserves legislative attention and action.

Advocacy doesn’t necessarily involve testifying in front of a crowded room. It can be sharing your unique story or picture with us, writing an email to a legislator, or participating in a meeting to talk about issues you face every day. A state-funded nursing rate increase cannot happen without getting other passionate individuals involved. If you would like to find out how you can to advocate for better home care laws and regulations, let’s talk about how you can get involved. Email me today!

Increasing Reimbursement Rates for RNs and LPNs in Delaware

At the end of June, 2017, through the efforts of our Ambassadors, our industry partners, our clients, and our legislative champions, the Rate Floor Bill passed the Delaware General Assembly.

This year, in the second year of Delaware’s two-year legislative session, our major legislative goal is to achieve an increase in the Medicaid fee schedule for RN and LPN hourly care. These two rates have stagnated since 2006. We are asking the legislature to update both according to the Consumer Price Index. Doing so would move LPN care from $46.14 to $56.01 and RN care from $51.50 to $62.51 per hour.

Our initial meetings with key members of the Joint Finance Committee have been very positive.  We are working with them to include increased funding for this request in this year’s budget. If successful, our MCO contracts would have to be renegotiated so that reimbursement would be equal to or greater than the new fee schedule amounts.

If you’d like to learn about how you can get more involved in our advocacy efforts, sign up to be a Heart for Home Care!

Plans for Healthcare Overhaul in Delaware

In his State of the State Address last week, Delaware Governor Carney said, “Here’s the bottom line.  We’re spending too much money on healthcare, and we’re not getting the best results.  We need to come to the table – state government and hospitals most of all – and be part of the solution… Now it’s time to make the hard decisions and change the way we deliver healthcare.”

We’ve heard Department of Health and Social Services’ (DHSS) Secretary Odom-Walker discuss similar issues over the last several months. In public hearings across the state, she has discussed health care reform in other states across the country and the need for fundamental changes to the way health care is delivered, how chronic health issues are prevented and treated and how funding can be used to encourage better coordination and more focused care to obtain good health outcomes.

Secretary Odom-Walker and Governor Carney have great faith that Delaware’s small size will enable quick transition to a new, more efficient delivery model. We are closely monitoring these developments and have reminded both the Secretary and the Governor of the importance of home health care in reducing costs and obtaining better outcomes for Delawareans.

If you have any questions about what’s going on in Delaware’s state capitol, let’s chat! Email me at sgahs@bayada.com.

Legislature is in Session!

Both Delaware and Maryland have opened their 2018 legislative sessions and our advocacy work is in full swing. Delaware’s legislature will be open until June 30 in the second year of its two-year legislative session. The Maryland General Assembly is already nearly 20% over—as of today, there are 74 days left in the 90-day session.

Both sessions have been very busy already. Delaware and Maryland Hearts for Home Care Ambassadors and I have been working hard to reach legislators to educate and inform them about what home care means to our clients and families, and about what can be done to address the issues our industry faces every day.

If you’d like to learn about what you can do to take part in our advocacy efforts, sign up to be a Heart for Home Care!

Building Relationships with Federal Legislators and Community Partners in Delaware

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

Wilmington (WIL) Director and Hearts for Home Care Ambassador Kim Roman and I joined the Alzheimer’s Association Delaware Valley Chapter for coffee with Senator Tom Carper (D-DE).  Healthcare issues, including funding for Medicare and eligibility for Medicaid, are increasingly in the federal spotlight and up for debate in Congress.  It is important to build relationships with our federal legislators and to make sure they know how important home health care is in their states!

 

Delaware Department of Health and Social Services Continues Toward Development of Total Cost of Care Model

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

Secretary Kara Odom Walker held a public hearing on how the state can focus on the Total Cost of Care this week.  Thought leaders from across the country, and representatives from states that have undertaken these sorts of efforts, already gave presentations and shared lessons.  Secretary Odom Walker is intent on building a data-driven system based on nationwide best practices.  As this effort moves forward, the Government Affairs Office (GAO) will work with our division directors and state government leaders to ensure that the value and importance of home health care in this effort is recognized.

 

New Addition to DE Managed Care Organizations and Increased Focus on Value-Based Payments

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

The Department of Health and Social Services (DHSS) announced that United Healthcare will no longer participate in the state’s managed Medicaid program and that AmeriHealth Caritas will take its place beginning January 1, 2018.  DHSS also announced a target of linking payments to quality of care rather than quantity of hours provided, a trend the Government Affairs Office (GAO) has seen in other states and programs.  GAO will partner with other BAYADA support teams to help ensure that this shift is beneficial to our clients and the work we do.