Home care has a distinct place in the future of US healthcare

States are beginning to make key changes to increase families’ access to home care

The COVID-19 pandemic has increased people’s awareness of the US healthcare system’s dependence on institutional care, and the potential dangers that come with a reliance on congregate healthcare settings. Nursing homes and hospital are a necessary part of the healthcare continuum, but COVID has undoubtedly increased the public’s appetite for—and governments’ understanding of—accessible home care.

90% of America’s seniors say that they prefer to age in place…

COVID may have a long-term effect on healthcare policy, as it has shifted the spotlight to the inherent benefits of home-based care. Home care is cost-effective: It costs governments, insurance companies, and individual families less to provide care in the home than in a hospital or facility. It’s also patient preferred: 90% of America’s seniors say that they prefer to age in place, and families with medically-fragile children and adults know their loved ones do better when they are in their own home environments.

In general, across the US, funding for home care programs continues to lag behind funding for services delivered in facilities like hospitals and nursing homes.

Home care advocates—state and national home care associations, providers, home care employees, and clients & families—have been advocating for better funding and better policies for home care for years with mixed success. In general, across the US, funding for home care programs continues to lag behind funding for services delivered in facilities like hospitals and nursing homes. But in this first post-COVID budget season, advocates have seen successes!

We’ve moved the needle: Several states increased their Medicaid funding for home care programs. The New Jersey legislature increased funding for home care by $2 more per hour, and for skilled nursing home care by $10 more per hour. Additionally, Delaware increased funding for skilled in-home nursing by 15%, and Georgia, Indiana, Missouri, and Pennsylvania have increased funding for private duty nursing by 10% or more. Thank you to these states for recognizing the importance of home care.  Increased funding will help thousands of children, seniors, and adults with disabilities and medical complexities access the home care they’ve been struggling to access due to caregiver shortages that have plagued the nation.

Other states have increased funding for home care at smaller increments, including Minnesota and Vermont. While any increase is appreciated, there is still work to do in these states and many others: Increasing funding, and reviewing it regularly, is essential in ensuring that caregivers’ wages can remain competitive as costs of living continue to rise year by year. If home care funding is raised now, but then ignored for years to come, then families that need home care will be back to the same situation they were in pre-pandemic: Struggling to find the care they need to stay safe and healthy at home.

On behalf of the home care community, thank you to the many legislators and decision-makers who have supported home care this year!

Reflecting on South Carolina’s and Georgia’s First Year with a Full-Time GAO Program

By: Melissa Allman, GAO Director for South Carolina and Georgia

Thank you to the many advocates that contributed to SC and GA’s successes in 2018!

What a difference a year makes. This time last year I was just transitioning out of my role as Division Director for the Palmetto Division and into my new role directing our advocacy activities in South Carolina and Georgia. I didn’t know I was in for so much! As I reflect back on 2018, my thoughts go immediately to two things: First, the successes that we were able to generate for our staff and clients and secondly, the many BAYADA leadership, staff, and clients that shared their voices and helped us win!

South Carolina

This year not only were we able to achieve an 8.2% rate increase for all personal care Medicaid waiver services in South Carolina, but we made so much headway engaging our office staff, field staff, and clients. As one person running around in the state house, I can only do so much. It is your stories and your voices that truly have made our first full-time year in South Carolina a remarkably successful year.

Aside from our rate increase, South Carolina advocates hosted five home visits with state lawmakers, hosted two legislative roundtables, and Speaker Pro Tempore Tommy Pope attended a Hero Ceremony for his constituent—a home health aide from RHS. In addition, we attended several events to support our champions. Then-CLP Director, Haley Keisler was named South Carolina Home Care and Hospice Association’s (SCHCHA) 2018 Professional of the Year, and ROC client Mitchell H.’s mom and caregiver, Tammy Roberts, was recognized as the SCHCHA 2018 Caregiver of the Year. 

Left: SCHCHA Executive Director Tim Rogers (left) and I (right) pose with SCHCHA’s 2018 Caregiver of the Year Tammy Roberts (center) and her grandson.

Right: SCHCHA Executive Director Tim Rogers (left) and I (right) pose with SCHCHA’s 2018 Professional of the Year, former CLP director and current AVL director Haley Keisler and her family.

Additionally, we were able to engage a record 25 Hearts for Home Care ambassadors and advocates to attend Lobby Day, where we connected BAYADA staff to lawmakers to share why our families deserve to be able to stay together through home care.

A record breaking Lobby Day in Columbia

Georgia

As I reflect back on the past year, my heart is full of gratitude for all of Georgia’s leadership, Ambassadors, and advocates. Your support and advocacy made all the difference! Not only were we able to generate a rate increase for private duty nursing (PDN) services under the Georgia Pediatric Program (GAPP) waiver, but we’ve made our voices heard and our industry and company better known in the state capitol. We are truly set up for a stellar 2019!

So far in 2019 we have already began meeting with Georgia’s House and Senate leadership and the Georgia Department of Community Health (GCH). We are seeking to further increase the RN and LPN rates under the GAPP program and gain enhancements for PDN waivers for the adult population under the New Options Waiver (NOW), Comprehensive Supports Waiver (COMP) and Independent Care Waiver (ICWP) programs. We will be seeking even further involvement from our GA advocates, and I am excited to see what we can accomplish together!

Meetings are already underway for 2019: I can’t wait to see what we can accomplish together for GA!

It was a true honor to work along side of you all, and I’m looking forward to working with you as we continue to raise awareness for our state’s most vulnerable children and adults. Thank you to the many advocates that made 2018 a success, and that will help pave the way for more successes in South Carolina in 2019 and beyond!

Service Offices Build Momentum with Multiple Home and Office Visits!

GAO and four South Carolina service offices have been busy hosting lawmakers in home visits throughout the state. These visits show our state’s decision-makers the importance of home care, the impact it has on their constituents and all South Carolinians, and remind them to remember our stories and our clients when they vote on issues that affect the home care industry!

Upstate Pediatric Office (USP) Leads the Way for South Carolina Home Visits by Hosting Rep. Garry Smith in Pediatric Home Visit

The Upstate Pediatric Office (USP) led the way with South Carolina’s first home visit with Representative Garry Smith in Greenville. USP and Rep. Smith visited 20-month-old pediatric client Emma who had recently been discharged from her Medicaid waiver services. Luckily, after multiple hospitalizations that occurred during her discharge, she received reauthorization and was able to get her services back, which have since kept her healthy and out of the hospital. This home visit enabled Rep. Smith to see just how powerful and important these services are in keeping families together safely at home. Since his visit, South Carolina’s general assembly voted to increase the Children’s Personal Care reimbursement rate for Home Health Aide Waiver.

USP Client Services Manager Kelsey Harris, stated “It was so cool to have a legislator take time out of his schedule to see our processes in the office and how they lay the framework for the field employees and the care they provide. His investment of time in learning about our client and the difficulties the family faces is vital to the continued growth and success of homecare in South Carolina!”

To read more about Rep. Smith’s home visit, see our Hearts for Home Care blog article.

Columbia Adult Nursing Office (COA) Hosts Impactful Visit with Representative Chip Huggins

The Columbia Adult Nursing Office (COA) recently hosted South Carolina’s second home visit with Representative Chip Huggins. GAO joined COA staff and the representative in a visit to client Alexis A., a 20-year-old anoxic brain injury client, and her parents in their Chapin home.

Alexis’s mother shared with Rep. Huggins the challenges she has had with the process of getting in-home care for her daughter. She stated, “This has been the most difficult process. I get many different answers and constantly get pushed around from one person to the next. I feel it would be in the state’s best interest to streamline the process for families like ours who don’t have the time to make multiple calls a day. I take care of Alexis 90 hours a week–at times I don’t even sleep because of her skilled needs. I don’t just advocate for higher rates for Alexis, but for our nursing teams, and for parents that experience a similar situation now or in the future.”

Impacted by his visit, Rep. Huggins stated, “I will do whatever I can to assist you and Alexis. That is what I’m here for.” Since the visit GAO has set up a meeting for August 14, 2018 to discuss the opportunities to improve the state’s home care waivers.

 

Upstate Adult Nursing Office (USC) Visits Vent Waiver Client with Senator Tom Corbin

The Upstate Adult Nursing Office (USC) hosted the third legislative home visit in Spartanburg. This visit was especially unique as Senator Tom Corbin and BAYADA adult nursing client Jeffrey B. bonded over several mutual connections. Senator Corbin attends church with a family Jeffrey had previously worked with. Additionally, they both also have a love for the Clemson Tigers and enjoy stories about the history of their community. Senator Corbin spoke with Jeffrey’s wife, Vonda Kay, about her challenges receiving home care services for Jeffrey. Vonda Kay explained how she cares for her husband 129 hours a week because he receives a limited 39 hours of private duty nursing.

She also shared with Senator Corbin the difficultly of obtaining reliable care—of the list of 15 providers that Jeffrey’s case manager gave her, BAYADA was the only agency that called her back. Senator Corbin, who has a son with autism, understands the struggles our families go through due to the low reimbursement.  He stated, “Wow, when do you get rest? I understand home care is a cost savings to the state, and I’m willing to do whatever I can to support you and Jeffrey. I’m shocked at how much you have had to go through. I know we can work together to make some changes.”

GAO is planning to meet with Senator Corbin at the end of August to discuss further opportunities to assist our Vent Waiver clients.

Rock Hill Skilled Nursing Office (ROC) Host Home Visit with Representative Richard Yow

Our Rock Hill Skilled Nursing team (ROC) recently hosted Representative Richard Yow in a home visit with client Mitchell H. Mitchell is a 29-year-old who was in an automobile accident at the age of 23. At the time of the accident he had a 4- year old son. His son, Allen–now age 10–is a vibrant and active young boy who is very hands-on with his dad’s care. Having home care for Mitchell is not only important for his health, but also enables him to see his son grow up. Mitchell’s mom, who is his primary caregiver and biggest advocate, states, “Allen is Mitchell’s only motivation to keep moving forward. He wants to see his son grow, attend sports events, and just be there for him. Without Allen and being able to see him daily, he wouldn’t be with us today.”

Rep. Yow also shared stories of his own personal challenges he has with working with resources in the state. His father was in an automobile accident as well a few years ago, and the family continues to fight for his healthcare needs. Rep. Yow stated, “I know how challenging and stressful it can be. I also know I will do whatever I can to help you and Mitchell.”

Home visits like these really give elected officials a better understanding of how their decisions on key issues like Medicaid impact South Carolinians who are seeking to remain safely at home with their families. To find out ways in which you can participate in a home visit with a local legislator, or other ways you can advocate, email advocacy@bayada.com.