2019: The Year of the Ambassador!

GAO continues to grow and strengthen our Ambassador program. Symposiums and other engagement activities are currently underway–don’t miss your chance to get involved!

US Senator Debbie Stabenow (D-MI) poses with Chief Government Affairs Officer Dave Totaro (center) and our Ambassadors of the Year at the 2018 Ambassador Awards trip in Washington, DC

When the Government Affairs Office (GAO) launched the Hearts for Home Care Ambassador program nearly ten years ago, we envisioned that each service office would have a designee who would essentially act as the GAO liaison for that office. How much we’ve grown! Today, our Ambassadors go above and beyond to be the voice for our staff and clients, and they truly exemplify the leadership and excellence qualities that have grown to be associated with the Ambassador program.

In 2018, GAO committed to a more robust and centralized grassroots program, including a stronger dedication to the Ambassador program. In 2019, under Grassroots Advocacy Manager Mike Sokoloski’s leadership, the program is set to have its strongest year yet. This year we will be sharing a new “Ambassador Dashboard” that will help our advocates stay engaged and track their progress, create more 30-minute advocacy Zoom trainings, and bring our top-performing advocates on an exclusive Ambassador Awards trip to Washington, DC in May!

Additionally, one of the most exciting changes we have underway is our newly-revamped state-by-state Ambassador Symposiums. Our Ambassador Symposiums are newly designed and structured to train rookie Ambassadors while simultaneously energizing more seasoned advocates. This year we are partnering with outside organizations and bringing in more legislative and client guest speakers to truly show attendees the impact that strong advocacy has in making meaningful changes for our staff and clients.

DE Senate Majority Leader Nicole Poore joined a recent Ambassador Symposium and shared her thoughts on the importance of advocacy with attendees

So far in 2019, we have held our first Ambassador Symposium in Newark, DE for both our Maryland and Delaware Ambassadors. Here, DE Senator and Majority Leader Nicole Poore came to share her passionate story about how she initially became involved in advocacy for her child, and how she now sees her role as being an advocate for all her constituents. Throughout the spring, we will continue to host Ambassador Symposiums in New Jersey, North Carolina, South Carolina, Georgia, New York and Rhode Island. Whether or not you’ve attended in the past, be sure to check out what being an Ambassador is all about during our upcoming symposiums!

As our Ambassador program continues to grow, we are seeking new Ambassadors from all service and support offices, and are seeking greater involvement from field staff, clients, and other organizations. It is vital that we join together as Hearts for Home Care to strengthen our collective voices in support of home care. Our Ambassadors serve as the forefront of our advocacy program, and truly make the difference in educating local legislators about home care and its impact on clients and communities.

For more information about the Ambassador program, upcoming Symposiums, or home care advocacy in general, contact me today!

2019 Ambassador Symposium Schedule*

SC – 2/20 at the state capitol in Columbia

GA – 2/21 at the state capitol in Atlanta

PA – 2/28  at the Hilton Garden Inn in Harrisburg

NJ – 3/13 at the New Jersey Learning Center in Pennsauken

NC – 3/28 at the North Carolina Learning Center in Charlotte

NY – TBD

RI – 4/9 at the Capitol in Providence (morning of Advocacy Day)

*Please note that the DE/MD Symposium has already occurred, but it’s not too late to become an Ambassador if you are interested! Contact Mike Sokoloski for information.

Angela Ortiz: A BAYADA Home Health Care Parent’s Journey into Advocacy

Home care advocate Angela Ortiz delivers the keynote address at a legislative reception held in the Massachusetts State House.

Angela Ortiz is a fierce advocate for her medically complex daughter, Ayla, and for other medically complex children and adults across Massachusetts.

Earlier this month, Angela delivered her keynote address at the 40th Annual Legislative Reception held by the Massachusetts Developmental Disabilities Council and The Arc of Massachusetts.

Angela’s inspiring speech, delivered in front of over 200 people, including several state legislators and Massachusetts Governor Charlie Baker, was met with uproarious applause and overwhelmingly positive feedback.

Angela stated, “One mother shared with me that she used to have that fight and fire within her when her daughter was younger, but that her flames had since burned out. She shared that my speech really spoke to her and reminded her of how important it is to find it again. I hope that sharing my story and my journey will inspire others to take action… No matter how slow-seeming your journey may be, it’s important we remember why we advocate: To give a voice to those without one.”

Angela is the founder of the Massachusetts Pediatric Home Nursing Care Campaign that was launched in April 2016 to address the longstanding crisis families have been in struggling to find and retain Continued Skilled Nursing to properly care for their loved ones with complex medical needs at home.

Below is the full transcript of her keynote address.


*Arc/MDDC 40th Annual Legislative Reception Keynote*
Angela Ortiz
March 7, 2018

Next month will mark two years since I entered the State House with a group of parents from the Mass Families Organizing for Change Leadership Series. I was a mother desperate to improve the quality of life for my daughter, Ayla, who was just two at the time, and very sick.

I was drowning in my own worries and fears that came with her complex medical needs, but more so in the inability to access vital home care services she was approved to receive yet didn’t come.

Imagine being thrown into the deepest of seas and when you call out for help there aren’t enough life vests to go around or enough lifeboats to bring you and your family to safety.

I felt so powerless…until…I entered this building. It’s the day I became an advocate!

I was equipped with a vision for my daughter and new tools and the confidence to be a part of some kind of change to address a burning need that affects her life and so many other medically fragile children and adults in the Commonwealth.

That day ignited a flame so deep within me…and I’ve been “FIRED UP” ever since.

I’ll never forget a moment I shared with Ayla shortly after her heart surgery. I put my index finger in the palm of her tiny hand, we locked eyes seeing past all the tubing and drains, and she wrapped her fingers around it and squeezed with such intensity. Wow! At just 3 days old…my fragile and recovering newborn showed her FIRE and fighting spirit…that energy moved me. It strengthened me. It gave me hope that things would work out and be okay.

You see, we all have it in us…this FIRE!

And today, I want to remind you of that and call attention to it in hopes that each of you will set out to find what it is that sparks or rekindles the flame within you. Because when it happens, it’s an unstoppable force, you feel you can move through anything, no hurdle is too high no matter what your life circumstances are in that moment. You find a way! It’s so deeply rooted in love, you can’t help but burst into action and be a part of something bigger than yourself and your own lived experience.

There is no greater time to awaken your inner fire and unleash that advocate in you than when your life or the life of a loved one depends on it. And that time is now! 

I’m counting on all your flames, and more importantly, the disability community is counting on them because it’s in our collective energy, strength, and spirit where I believe the resolve lies as we blaze through every obstacle that aims to unravel and weaken the civil rights of people with disabilities that so many before us have fought so long and hard for.

Yes, we face an uncertain future, but the one thing we have control over is our own certainty of being there, in some way, to do something; to take a stand; to have a voice; to be ready to take action to defend the current laws and protections in place while we also continue to advocate and lay the groundwork for new laws and protections that keep us moving forward.

Each one of you has a place and purpose on this advocacy journey! Whether you are just stepping on it for the first time or you’ve been paving the way for years, as Ayla’s favorite song demands…“This little light of mine, I’m gonna let it shine”. DO JUST THAT…let your light shine, let it shine, let it shine.

You will be a moving force…we will be a moving force… and the future will be bright.

Thank You


For information about how you can begin your journey into home care advocacy, contact advocacy@bayada.com.

Additionally, follow our Facebook and Twitter to keep up with regular updates about how you can get involved.

Client & Family Stories: Meet Tara Montague

Tara is an advocate for her family, and yours.

NJ Assemblywoman Carol Murphy with home care advocate Tara and daughter Mary, who has SMA
NJ Assemblywoman Carol Murphy (right) learned about the benefits of home care when she visited Mary and Tara at their home.

Last summer, as lawmakers in Washington, DC debated health care reform, Tara Montague had cause for concern. The proposed legislation included significant cuts to Medicaid, which for Tara and her family, could have been disastrous.

Tara and her husband, Jim, rely on home care nursing for their daughter Mary, 20, who has spinal muscular atrophy (SMA). They know that many families turn to Medicaid to cover the cost of home care and feel fortunate to have private insurance for Mary’s nurses. However, they depend on Medicaid for Mary’s prescriptions and medical equipment, which total in the thousands each month.

“Mary is on numerous medications, and her medical equipment includes a ventilator, oxygen, a wheelchair and hospital bed, feeding pump supplies, a nebulizer, pulse oximeter machine, and more,” said Tara. “Without Medicaid, I don’t know what we’d do, and that’s why I fight so hard to get Mary the benefits she needs.”

Giving families a voice

As a parent of a child with special needs, Tara can understand and empathize with our clients’ daily struggles because she lives it, every day. Last year, she joined BAYADA’s Government Affairs office as manager of client and family advocacy. Here, she continues to fight for Mary, and for every pediatric and adult client who depends on home health care to live with comfort, independence, and dignity.

“Last summer I worked with BAYADA clients who were willing to share their stories with federal legislators to help prevent the Medicaid cuts,” said Tara. “As I continue to grow in this new role, I hope to encourage more and more families to speak up, to have a voice, and to know that they can make a huge difference in the legislative process.”

Getting involved is quick and easy

Tara knows all too well that for clients and families, the biggest obstacle to getting involved is time. That’s why she encourages them to register with BAYADA’s Hearts for Home Care Advocacy Center at heartsforhomecare.com.

We are not looking for a huge time commitment, it’s whatever they feel comfortable with doing,” she said.

The mission of Hearts for Home Care is to be a voice for BAYADA employees, clients, and their families. Through education, advocacy, research, and community service, BAYADA advocates for policies that support the highest quality of home health care services. The online advocacy center keeps clients and families informed about legislative issues at the state and federal level that can impact the home health care industry, and their access to care.

Advocacy can be a simple as taking five minutes to log onto the Hearts for Home Care Advocacy Center website and sending a pre-written email to local, state, and federal legislators. If clients and families want to do more, they can share their stories on the Hearts for Home Care Advocacy Center website; attend a lobby day at their state capital, a legislative round table, or a town hall; they can visit a legislator’s office; or invite a legislator into their home to see, first hand, how home health care professionals help improve lives.

Connecting with families and sharing stories

Tara has a degree in political science and extensive experience in marketing. In her previous role as a community liaison with a BAYADA Pediatrics office in New Jersey, she educated physicians about home health care, started a parent support group, coordinated a family resource fair, and helped families navigate through insurance challenges.

In her new role she hopes to develop training materials and tools for clients and families who want to become more active in advocacy efforts. But even more, she is looking forward to getting to know clients and families from across the country, and helping to share their stories – just like Mary’s.

To learn more about Hearts for Home Care, how you can get involved with advocacy, or how you can share your story, contact Tara at tmontague@bayada.com.

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!

States Struggle to Recruit and Retain In-Home Nurses Due to Low Reimbursement Rates… But Advocacy Can Help

Home health care companies around the country struggle to recruit and retain enough qualified workers to support the growing number of children, adults and seniors that want to be cared for in their own homes. Recruitment and retention issues stem from a number of reasons, including the nationwide nursing shortage, low US unemployment rates, and inadequate Medicaid reimbursement rates that leave home care providers in a position where their wages cannot compete with those of other settings and industries.

BAYADA Home Health Care was recently featured in a Wall Street Journal article for the company’s efforts in solving for this by recruiting nurses from Puerto Rico to fill open nursing positions in Minneapolis. The island’s unemployment rate, currently at 10.8% is much higher than that of Minneapolis, which is currently listed at 2.4%.

A 2.4% unemployment rate is low even compared to the US rate, which is currently at a 17-year low of 4.1%. This low unemployment rate is compounded by the fact that in many states, Medicaid reimbursement rates are too low for home care providers to be able to recruit and retain workers, who can be paid a higher wage in other settings, like hospitals, and industries, like fast food and retail.

And it doesn’t end with a lack of workers for home care providers. This lack of caregivers can lead to an access to care issue in which individuals who can be cared for at home are left with no option but to receive care in a hospital or institution. Finding qualified caregivers is often cited as home care providers’ top challenge, and future estimates show that demand for in-home care will continue to grow due to the aging of baby boomers at alarming speeds.

What can you do to help? Share your voice. Reimbursement rate review and adjustment decisions are generally made in state capitols when legislators determine that such a need exists. This need must be communicated to legislators so that they understand the pressing nature of the issue and what could happen to the state’s Medicaid population if the issue is not addressed.

We can help you reach your legislators to let them know what increased reimbursement rates mean for you and your community. And if you would like to make an even bigger impact, consider meeting your lawmakers in-person at our Lobby Day. We take care of the scheduling and preparations- all you need to do is show up and share your voice. Upcoming Lobby Days are as follows:

Minneapolis, Minnesota: 3/6/18
Dover, Delaware: 3/14/18
Columbus, South Carolina: 4/4/18
Harrisburg, Pennsylvania: 5/22/18
Raleigh, North Carolina: 5/30/18
New Jersey: District office visits 4/20-5/4/18
Maryland: TBD

Contact Rick Hynick to find out what you can do to advocate, whether it be sharing your personal story, contacting your legislators, or participating in an upcoming state Lobby Day!

Meeting with SC State Legislators to Increase Reimbursement Rates for our Medicaid Waivers

SC Representatives Bruce Bryant and Thomas Pope discuss home care, Hearts for Home Care advocacy
SC Representatives Bruce Bryant (left) and Thomas Pope (right) met with Lee Dobson and me (center) to discuss home care

Area Director, Government Affairs, Lee Dobson and I have been making the rounds and walking the halls at the state capitol to educate key legislators about home care.

Our meetings with SC Senators Mike Gambrell and Floyd Nicholson gave us the opportunity to educate them on our challenges with staffing and reimbursement rates.  Senator Gambrell stated, “I’m familiar with home health care. My dad had services after his hospital stay, and he has been able to recover quickly because of the nurses.”  We also met with Representatives Bruce Bryant and Tommy Pope who also shared their experience of home care.

Representative Tommy Pope, Ex Officio, stated “I understand the cost savings home care can offer, and feel people want to be home.”  We had an encouraging meeting with the Assistant Director for Budget Development Senate Finance Committee, Angie Willis.  She is very interested in learning more about home care needs for South Carolinians and how the state legislature can help.

We also had a productive meeting with House Ways and Means Chairman Brian White and his Chief of Staff Beverly Smith. Chairman White has supported home care for many years and was previously instrumental in passing the enhanced rate differential for nursing. He gave us great insight on the challenges and opportunities within the political process and has helped us shape our path towards higher reimbursement rates.  We look forward to working with these and other lawmakers as we increase awareness and garner support for BAYADA’s legislative priorities.

If you’d like to find out what you can do to help advocate for higher reimbursement rates, sign up to become a Heart for Home Care!

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!

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!

Fifth Annual NJ BAYADA Champion Awards Ceremony Connects with Purpose

Dave Totaro, Champions Assemblywoman Nancy Munoz, Senator-elect Declan O’Scanlon, Lieutenant Governor-elect Sheila Oliver, and Louise Lindenmeier

In December at the BAYADA Home Health Care Champion Awards we reflected on a year of many victories and looked ahead to a new year with new challenges. Speakers, awardees and nearly 100 guests celebrated the successful increase of NJ’s fee-for-service rate for personal care assistants to $19 per hour. We also acknowledged employees’, clients’ and home care industry friends’ commitment to advocacy. These efforts led to the passage of A320/S1018, which was signed by Governor Christie earlier this year. Effective this July, A320/S1018 requires Managed Medicaid reimbursement rates for home health aide services to be at or above the state’s fee-for-service rate.

An inspirational highlight of the night, those in attendance were moved by Dana Insley’s touching speech. Dana is the mother of a young client who had a difficult start to life. Dana’s daughter was placed in foster care before being adopted by the Insley family. Dana spoke of the blessing home care has been in her family’s life and discussed the significant improvements her daughter has made with the support of her BAYADA nurses.

The evening’s honorees, Lieutenant Governor-elect Sheila Oliver, Senator-elect Declan O’Scanlon, and Assemblywoman Nancy Muñoz were visibly moved by Dana’s remarks and reiterated their support for home care during their acceptance remarks.

Also honored at the ceremony was Assemblyman Paul Moriarty, who represents New Jersey’s 4th District, which encompasses the Insley family’s home. Assemblyman Moriarty had visited the Insleys home in the past and was able to glean a full and meaningful understanding of the day-to-day life of a child receiving home care.

After a heartfelt evening that reminded everyone of our purpose and why we do what we do, Chief Government Affairs Officer David Totaro took the stage to remind all of those in attendance of the importance of advocacy and that, in addition to words, action is needed. He noted the huge impact of New Jersey advocates, who sent nearly one-quarter of all messages directed to federal legislators this summer from BAYADA’s network during the health care reform debate. Thank You for your commitment to advocacy.

Together with our Champions, we can make a meaningful difference to the lives of our clients and BAYADA caregivers. If you would like to get more involved in New Jersey’s advocacy program, sign up to become a Heart for Home Care Advocate.

NJ GAO 2017 Year in Review

As I reflect on 2017 and what we have accomplished, the first thing that comes to mind is Thank You. Thank you for your support, your engagement and your advocacy efforts — all of which made a difference in the lives of our clients, families and employees.

2017 was the “Year of Client Advocacy and Engagement.” Clients and families engaged lawmakers and the community at-large through home visits, family support group meetings, and phone calls and meetings with lawmakers in Trenton. These efforts ensured that our aides, nurses, and the importance of home care remained top of mind to New Jersey representatives and senators.

2017 was successful in many ways and set us up for even bigger wins in 2018. Below, please find a summary of 2017’s priorities and accomplishments:

• The Managed Medicaid Rate Floor bill was signed into law, effective July 1, 2018. The new law mandates a 100% pass-through of increased reimbursement to aides. In 2018 we will introduce a new bill which will be more reflective of a competitive wage environment and will mirror the original bill with no mandated pass-through.

• The Personal Care Assistant (PCA) fee-for-service rate was raised from $18.00 per hour to $19.00 per hour through a budget resolution, effective July 1, 2017.

• We successfully lobbied against Governor Christie’s intent to end the NJ/PA Reciprocity Tax agreement. This accomplishment saved our employees and BAYADA thousands of dollars in taxes.

• In July, the Private Duty Nursing (PDN) bill was introduced. This bill’s aim is to raise the PDN reimbursement rate by $10 per hour for RNs and LPNs. While the bill did not ultimately pass the state legislature in 2017, it brought awareness to the need for higher reimbursement rates within the program. We will continue to pursue this bill’s passage as a major goal for 2018.

• In conjunction with NJ’s Home Care Association, we successfully lobbied for legislation that permits physical therapy aides to practice in clients’ homes as long as the aides are supervised by a licensed physical therapist every two weeks.

• The BAYADA Champion Awards were held in December. This year we honored Lieutenant Governor-elect Sheila Oliver, Assemblywoman Nancy Munoz, Assemblyman Paul Moriarty and Senator-elect Declan O’Scanlon for their unwavering support of home care.

• BAYADA hosted a fundraiser for Senator-elect Troy Singleton, raising over $13,000 for his election fund.

• BAYADA reviewed and submitted comments to the state regarding the new 10:60 home care regulations.

Looking ahead to 2018, we will be working with Governor-elect Murphy and NJ legislators new and old to continue to advance home care and community-based services for our state’s neediest populations. GAO seeks to push for new laws to improve reimbursement rates within the PDN program, introduce legislation to provide technical changes to the current PCA managed care law, pursue minimum wage law changes, address parking challenges for our nurses and, of course, continue to advocate on behalf of our employees, clients and their families.

Cheers to an exciting year ahead! If you would like to get more involved in New Jersey’s advocacy program, sign up to become a Heart for Home Care Advocate.