Whether you are a professional or family caregiver, home care recipient, or otherwise, you know why home care is safer, more patient-preferred, and less costly than institutional care. Home care provides vulnerable seniors and adults with disabilities with one-on-one care that enables them to stay safe and independent in their own communities. While its benefits—and the inherent drawbacks of institutional care—are evident to us, home care is still not widely recognized as a long-term solution. This is because nursing home care is still often seen as the “default” option for those that need consistent care, particularly under Medicaid.
But tables are beginning to turn: As the COVID-19 pandemic has shed light on the dangers of nursing home care. With recent reports citing that a staggering 40% of COVID-related deaths have occurred in nursing homes, people are more widely recognizing home care as the long-term care setting of the future.
Home care saves state Medicaid programs money and helps vulnerable Americans stay out of costlier and more infectious settings like hospitals and rehab facilities. It enables more than 8.3 million Americans to remain healthy at home, thanks to the 3.2 million compassionate and dedicated frontline direct care workers, including home health aides and personal care assistants, that keep these at-risk populations safe, independent, and out of riskier institutional settings.
In a post-COVID world, home will become recognized much more widely as the care setting of the future. With the US’s aging population growing quickly, and with families’ recently-discovered reservations about placing their loved ones in a long-term care facility, it is important that governments across the country take steps to make sure that the home care industry grows proportionately along with the demand for it. This includes: Increasing state and federal Medicaid rates for home care services so that providers can raise wages and allow more caregivers to be recruited to the home care workforce; Rethinking outdated laws and regulations that allow vulnerable populations to more readily access nursing home care; and instituting built-in protections for Medicaid-based agencies, such as relief funding for extraneous costs that occur during an emergency like COVID-19.
A “Home First” mentality would allow for individuals to stay safe at home and away from group settings that encourage virus spread. Now more than ever, the potential dangers of institutional care are becoming a frightening reality and we as a nation need to consider the future of healthcare as our population continues to age, and as more medically-fragile and disabled individuals are able to live independently. By updating laws to prioritize home care, we have the opportunity to create a meaningful, cost-effective and common-sense change to healthcare for the post-COVID future.
By: Dave Totaro, Chairman of the Partnership for Medicaid Home-based Care
Below, please find an opinion piece authored by Dave Totaro—Chairman of the Partnership for Medicaid Home-based Care (PMHC) and BAYADA Home Health Care’s Chief Government Affairs Officer. This was originally published in the Scranton Times-Tribune on May 10, 2020.
Our nation’s frontline healthcare workers have been recognized during the COVID-19 pandemic, arguably more than ever before—and rightfully so. These essential workers put their health and safety on the line in order to make sure that the most vulnerable populations are taken care of. But these workers—particularly the caregivers that keep these individuals at home and out of riskier settings like nursing homes—deserve more than cheers, front lawn signs, and complimentary cups of coffee. It is time that our federal and state governments fairly compensate these brave and compassionate workers for the sacrifices that they are making during this critical time through Hazard Pay—that is, temporary increases in hourly wages for workers who are risking the most yet earning the least.
Congress has passed three stimulus bills so far, and have done so quickly and commendably with an eye toward helping the economy and the unemployed. But these packages have not yet focused on compensation for those who are working—the essential employees that risk their safety to care for the many that can’t help themselves. And while many healthcare professionals within hospitals and institutions have been impacted, the federal government has not yet prioritized the caregivers that keep people healthy at home.
Congress is currently working on the fourth (and likely final) stimulus bill. This presents a vital opportunity to increase Hazard Pay for healthcare workers who put their safety on the line every day. While the first three stimulus packages have increased emergency funding for states, only a handful of states have used those funds to increase pay for frontline healthcare workers. Currently, there are three potential proposals that would serve to increase pay for these workers across the US—either of which would reward home care workers and incentivize many to begin or continue their career in a field that is much-needed during this time.
Home care workers—particularly home health aides—are largely females of color who are making slightly above minimum wage. Yet they are some of the most essential workers—caring for those who are unable to care for themselves. And not only is their job physically and emotionally tolling, but the prioritization of hospital care has made it increasingly harder for home care agencies to access personal protective equipment, such as masks, gloves, hand sanitizer, and gowns, for these workers. And, to top it all off, we are regarding them as heroes without considering fair compensation for their commitment and sacrifice.
Now more than ever, the potential dangers that go hand-in-hand with nursing home living are becoming a frightening reality and we as a nation need to consider the future of healthcare as our population continues to age. Nearly 20% of COVID-related deaths have occurred in nursing homes. Not only is in-home care the best way to ensure that the most at-risk populations—seniors and the medically fragile—stay as isolated as possible rather than be grouped in together, it also ensures that they are in the most cost-effective setting for their families and for the state and federal governments themselves.
COVID-19 has hit many Americans hard, and few are exempt from at least some negative consequences as a result. But it is clear that there are some who are risking more than others, and who are sacrificing their personal safety in order to keep others healthy and independent at home… both in times of crisis and times of normalcy. So while the recognition and support of frontline workers is certainly appreciated, it does little to truly show home care workers how valuable they are. Through the development of the fourth stimulus package, the federal government has the opportunity to meaningfully show at-home caregivers what they mean to America—both now and in the future. Home health care has been making headlines in recent media coverage.
In order to join those who are advocating for better home health care funding and policies on behalf of beneficiaries, their families, and frontline workers, contact us at email@example.com
NJ Blog Takeover: Paraplegic Keith Braswell writes about his life with a severe disability – and how working with his aide through NJ’s Personal Care Assistant (PCA) program has helped him to live life on his own terms.
My name is Keith Braswell and a car accident in 2008 forced my entire way of life to change. I was left paraplegic and since then, I have been able to remain a vital, active member of my community thanks to the help of my home health aide, Quisela. As a 46-year-old adult, it can be tough for me to rely on someone else for everything from getting out of bed, bathing, eating laundry etc., but Quisela does everything she can to make sure that I feel safe and comfortable.
While Quisela is very reliable, filling all of my state-approved 40 hours of care without a day off, her choice to stay working as a home health aide is becoming more unrealistic by the day. This is because New Jersey’s Medicaid reimbursement rates under the Personal Care Assistant (PCA) program—the one that I and thousands of others like me rely on—don’t allow for aides to make a fairwage for the compassionate work they do. For example, in Newton, aides make minimum wage to slightly above minimum wage, and can often secure jobs with less required training, stress, and physical requirements at places like Walmart, Home Depot or Dollar General—all of which are located within the municipality or along route 206. This is especially true since NJ raised minimum wage in the beginning of year, while the Medicaid reimbursement rate remained stagnant.
I am beyond appreciative of how important Quisela’s vigilant and caring work is to my life, and I frequently go out of my way to make sure she is paid as much as possible, like booking my recent surgery around her vacation time to make sure that she wouldn’t lose any hourly pay. If I were to ever lose my aide, I would likely be forced into an institution which means losing what remains of my independence along with the quality of one-on-one care that I receive at home.
I humbly ask that the state legislature consider an increase in Medicaid reimbursement rates, so that individuals like myself can continue to choose to live independently at home. Many choices were taken away from me because of my injury, and losing this choice as well would be heartbreaking for myself and for thousands like myself across the state of New Jersey.
-Keith Braswell, Newton
About the NJ Blog Takeover: For the next few weeks, Hearts for Home Care will be featuring posts authored by NJ families affected by the state’s shortage of in-home nurses and home health aides to showcase the need for increased funding for New Jersey’s Private Duty Nursing (PDN) and Personal Care Assistant (PCA) programs. For more information on how you can get involved and let your elected officials know why increased in-home nursing availability is important to you, email firstname.lastname@example.org.
NJ Blog Takeover: Michelle, who is the sister of TBI Victim Brandy Lino-Corona, writes about her sister’s life after becoming severely disabled – and how working with nurses through NJ’s Private Duty Nursing (PDN) program has helped her family define their new normal.
victims of traumatic brain injuries, access to reliable home health care can be
the deciding factor that keeps people either permanently institutionalized, or
at home with their loving families. My 17-year-old sister, Brandy, suffered a
Traumatic Brain Injury (TBI) from a severe car accident in September of 2018.
Since then, the state of New Jersey has authorized 16 hours of specialized
nursing care per day for Brandy. This care allows her to stay safe at home, and
allows my father, mother, and I to lead proactive, fulfilling lives outside the
home. However, Brandy rarely receives all of her authorized hours due to New
Jersey’s inequitable Medicaid reimbursement rates for their state-funded
Private Duty Nursing (PDN) program.
The severity of Brandy’s injuries left her incapable of
moving, eating and even breathing on her own. Nurses that work with her need to
be up-to-date on life-saving techniques such as tracheostomy care, respiratory
treatments, suctioning, monitoring vital signs, feeding tube care and feedings
and administering meditations. Additionally, Brandy must be readjusted every
two hours in order to combat her risk of skin breakdown and bedsores. This
regularly poses as an obstacle when nurses miss their scheduled shifts as this
task requires two people due to her size.
Like so many medically-complicated residents of New
Jersey, my sister is at risk of institutionalization and/or hospitalization
without the proper nursing care she requires. With potential caregivers
persuaded by competitive wages and less physically and mentally taxing
employment, eligible patients’ access to qualified healthcare professionals
diminishes. New Jersey’s legislators need to consider the plight of their most
vulnerable constituents and make the decision to increase Medicaid
reimbursement rates. An increase in New Jersey’s Medicaid reimbursement rates
would provide a second lease on life for Brandy and those like her, as well as
instill a sense of hope for their families whose only desire is to be able to
continue to care for their loved one in their own home.
-Michelle Lino, Absecon
About the NJ Blog Takeover: For the
next few weeks, Hearts for Home Care will be featuring posts authored by NJ
families affected by the state’s shortage of in-home nurses and home health
aides to showcase the need for increased funding for New Jersey’s Private Duty
Nursing (PDN) and Personal Care Assistant (PCA) programs. For more information
on how you can get involved and let your elected officials know why increased
in-home nursing availability is important to you, email email@example.com.
Representative Zack Hawkins, an active supporter of home health care, recently visited
with a Durham family who rely on services to stay safe at home.
Hawkins visited with a constituent, Mr. Aubrey Mendenhall, an armed service Veteran with
a wonderful sense of humor. As a young US Sargent in Germany, he saw the
prettiest lady working at the base general PX store…and spent the next thirty
days asking her out. Margarete finally agreed and they’ve been together for more
than 65 years.
five years ago, Mr. Mendenhall was diagnosed with Dementia – a condition characterized by a decline in memory, language,
problem-solving and other thinking skills that affect a person’s ability to perform
everyday activities. His dementia makes it difficult for him to manage without constant
supervision and puts him at a high risk of falling. A certified nursing
assistant (CNA) comes to help him bathe, toilet, and dress. “The aide’s goal is
to help Mr. Mendenhall stay as independent as possible. Make sure he doesn’t
fall or get an infection that can put him in the hospital,” said BAYADA Home
Health Care Clinical Manager Megan Russell, RN.
Department of Veterans Affairs covers 11 hours of aide services per week. Outside
those 11 hours, Margarete is his constant companion and support. She uses the 1
½ – 2 hour breaks she receives each day to perform other necessary tasks such
as running to the grocery store, to a doctor’s appointment, or to simply have an
uninterrupted cup of tea. It is her only break from caregiving. At 90 years old,
dealing with her own health issues, and after five years of serving as Mr.
Mendenhall’s primary caregiver, Margarete finds herself exhausted!
tears in her eyes, their only daughter, Kathy, commented that she is
considering quitting her job as a nurse and move in with her parents so that
she can better manage their care. While carrying for a loved one with a chronic
illness can be profoundly meaningful, it can also be overwhelming as the physical,
emotional, financial tolls compound on the family caregivers.
“Having personally been
touched with seeing my mother and aunt provide care to my grandmother, I
understand how important it is to be able to take care of one’s family,” said
Representative Hawkins. “And as a lawmaker, we need to support seniors and
their families. To ensure they can live a full life at home. Care at home is an
important option, less expensive, and where people want to be.”
According to AARP’s online article, Caregiver Burnout, “over time, that physical and psychological wear and tear can lead to caregiver burnout – a condition of feeling exhausted, listless and unable to cope.” Russell has reached out to the VA case manager to explore respite care which would allow for the family some much needed breaks. The Mendenhalls want to stay together, however, they need some additional support to effectively care for themselves while maintaining their responsibility to their loved one.
“In-home care programs provide one-on-one care by
licensed nurses or certified nursing assistants under the care of a physician,”
said BAYADA Area Director Lee Dobson. “They
allow families to stay together and be safe at home. It really gives the state
more for less and is clearly part of the health care budget solution.”
When BAYADA Home Health Care client Jim Davies received a notice in the mail last year that his insurance would be transitioning to another agency, he tried not to panic. After all, the letter stated there would be no change, he would still receive coverage for his home health care nursing and personal care home health aide services.
However, Jim was not convinced. The 66-year-old, who
suffered a spinal cord injury as a result of a diving accident 20 years ago, is
nearly paralyzed from the neck down. He relies on his nurses for his complex
medical needs, which include wound care, range of motion exercises, mechanical
transfers to and from bed, medication administration, catheter care, and care
to prevent a serious complication called autonomic dysreflexia, which can lead
to seizures, stroke, or even death.
As a former sheriff and local fire commissioner, Jim is used
to working collaboratively with others to make things happen. That’s why he
immediately called a case manager at the insurance company, who reiterated what
was explained in the letter, his home health care coverage would not change.
to the end of the year when Jim received another letter, this time from the new
insurance company. Despite written and verbal assurance that his coverage would
not change, the new company denied his home health care services, insisting Jim
was stable enough and no longer needed nursing care.
Jim reached out to his BAYADA Mercer County Adults (MCA) office Director Meghan Hansen and Clinical Manager Sharon Wheelock who appealed the decision on his behalf, to no avail. That’s when they turned to BAYADA Government Affairs Area Director Louise Lindenmeier, who suggested Jim reach out to New Jersey Assemblyman Daniel Benson, a member of the state Health and Senior Services Committee.
home visit leads to positive change
called Assemblyman Benson’s office, I wasn’t sure what the response was going
to be, but I was pleasantly surprised,” says Jim. “The assemblyman made me feel
that as his constituent, my problem was a major concern, and he owned it.”
Benson visited Jim and his wife of 40 years Rosemary at their home to witness,
first-hand, the critical role home care nurses play in Jim’s health and
well-being. During the visit, Assemblyman Benson also learned about the
catastrophic medical consequences of stopping Jim’s nursing care and BAYADA’s
unsuccessful efforts to appeal the denial from the insurance company.
Following the visit with Jim, Assemblyman Benson jumped into action. He joined BAYADA Managed Care (MCO) Director Pamela Soni, BAYADA Area Director for Pediatrics Managed Care (MCP) Stephanie Perna, and Louise for a meeting with the NJ Department of Banking and Insurance to discuss Jim’s case. In addition, he personally contacted the insurance company to negotiate the contract, resulting in a reversal of the denial. Thanks to his efforts, the issue was resolved within two weeks.
really important to educate politicians on how insurance changes can impact
their constituents,” says Jim, who encourages others in similar situations to
reach out to legislators who may be more than willing to help. “Assemblyman
Benson should be recognized for his prompt and professional response to my
Benson considered it a privilege to play a role in helping Jim. “It was my
honor to work with Mr. Davies to ensure that he received the care he needs and
deserves,” he says. “As legislators, it is our sworn duty to represent our
constituents, and that means lending our assistance whenever possible, whether
by simply cutting through red tape or elevating a situation to a higher level
so that it is promptly addressed. I would encourage those in need to reach out
to their elected representatives to learn what they can do for them.”
Want to Help Make a Difference: Register
for Hearts for Home Care
Whether you can give a minute, an hour, or a day, there are many ways to get involved in advocacy. It can be as simple as sending a pre-written email to your local legislators, hosting a legislator in your home, or attending an event at a legislator’s office or your state capitol.To learn more, consider becoming a “Heart for Home Care” advocate. It only takes five minutes to register at heartsforhomecare.com. You’ll receive email updates about current issues and opportunities to make your voice heart.
Over the past several years, home care offices across South Carolina have struggled to stay sustainable due to low state Medicaid reimbursement rates for in-home nursing services. As more and more providers shut their doors, GAO and our advocates continued to fight towards a solution so that South Carolina’s most vulnerable residents could continue to access the skilled care they needed to stay at home.
After aggressive advocacy and a public affairs push throughout 2019, our concerted efforts are beginning to pay off! After more than a decade without a nursing increase, the state recommended a 15% increase, effective July 1, 2020. After further advocacy efforts focused on the urgent need for an immediate increase, including articles profiling affected families in the media, the SC Department of Health & Human Services (DHHS) issued the initial 5% increase be effective January 1, 2020. This 5% increase will generate nearly $230,000 in additional annual revenue.
BREAKING: DHHS is committed to including the remaining 10% to be effective July 1, 2020. If the provision is passed into law as planned, then PDN services will see a total 15% increase from 2019 levels (5% increase effective January 1, 2020, and an additional 10% targeted for July 1, 2020), resulting in nearly $690,000 in additional annual revenue.
Further increases are needed to
ensure access to care for all vulnerable South Carolinians. These major steps
forward would not have been possible without sharing our collective voices to
showcase the importance of care in the home care and the need to regularly
maintained viable reimbursement rates.
Thank you to all of our South Carolina offices, leadership, clients, and families that shared their stories and advocated for this important increase!
For most people, turning 21 is a milestone to celebrate. But
the State of Rhode Island is putting undue pressure on medically complex Rhode
Islanders who are turning 21. For those who receive home care services under Medicaid,
such as the Katie Beckett waiver, their medical coverage changes on their 21st
birthday, which affects who pays for their services, the types of services
available to them, and their state-authorized hours and funding levels. Without
proper planning and communication,
these changes can result in uncertainly of continuity of care and access to
home care services.
For young adults like Zach, Corinna, Brandon, and their families, turning 21 has been a source of significant stress and uncertainty rather than the celebration it deserves to be. Upon “aging out” of Medicaid, they have received word from the state that their care would be changing without much warning. Parents of medically complex individuals tend to be lifelong advocates on behalf of their children, and so all three have been able to retain their services on a month-to-month basis. “This is just a band-aid that covers the issue,” says BAYADA Home Health Care’s Government Affairs Director Ashley Sadlier. “Each month, they don’t know whether that band-aid will stay on or get ripped off. Everyone deserves to stay at home if it’s their wish to do so, and it’s arbitrary that a birthday is basically a penalization in Rhode Island.”
The interesting fact is that the State has already created a policy stating that home care children and their families are to be educated on their options by the age of 17. But Rhode Island has not upheld its end of the bargain: Families find that they receive little to no communication from the State, and that when they reach out to find out their children’s care options, the State is slow to respond and typically unable to provide proactive guidance to help families navigate this change . “Modern medicine and advances in home care have allowed for many children to live past the age of 21. That should be a reason to celebrate, not a reason to cut an individual’s services off suddenly,” says Corinna’s mother Michelle. “Home care saves the state money, and it keeps families together. Why would you put a child in danger when it’s clear that home care has enabled them to live their best life?”
Families, home care providers, and and other organizations across the state are currently working with the State to identify a solution. Without home care, clients stand a greater risk of infection, hospitalization, or even a permanent move to a skilled nursing facility. Parents know that a child doesn’t stop being your child when they reach adulthood, but it’s time that Rhode Island recognize this as well.
The facts are clear: Home care is less expensive than
hospital or other institutional care. Plus, it enables medically complex
children and adults to remain at home amongst their loved ones. But because the
State of South Carolina has not increased reimbursement rates for skilled
nursing home care services since 2008, families are finding it increasingly
harder to access the skilled, high quality care that they need to stay as
independent as possible in their communities.
State funding for home care has not been increased in more
than a decade. At the same time, hospitals and other facilities have been
steadily able to increase wages. Even more so, nurses can make more in home
care in surrounding states. Now, home care providers find that they can compete
for less than a quarter of all the nurses available in South Carolina. When
agencies face such recruitment and retention struggles, home care recipients and
their families suffer.
When there are less home care nurses available, families
find that they experience missed shifts, which can not only create undue stress
and chaos as loved ones must miss work, lose out on sleep, and forego other necessary
activities—but it also puts the client in danger. For those who need skilled
nursing care, missed shifts can mean dangerous consequences, including trips to
the ER and unnecessary hospitalizations.
Even more so, many major home care providers have already
left South Carolina because of the low funding for home care. Stagnant rates
that are more than a decade old make keeping their doors open unsustainable. As
more and more agencies leave the state, the harder it is for families to access
care. Simply put, if the State does not take action to increase funding for
home care, South Carolina’s most medically complex and vulnerable families will
have few options for care.
South Carolina’s concerned families are making their voices
heard: They are reaching out to their legislators and media to share their
message: Increase funding for home health care so that families can access the
high quality, reliable care that they need to be where they want to be: At
In North Carolina and across BAYADA’s GAO states, our legislative goals tend to revolve around two main tenets: First, achieving policies that streamline processes so that service offices can operate without added burdens and so residents can readily access care, and second, to increase reimbursement rates so that we can recruit and retain the caregivers necessary and ensure that we have the supply necessary to meet the demand.
It seems like common sense—North Carolinians want to stay in their homes, and home care services cost states less than care delivery in a different setting. So why can’t legislators simply fund home care programs at higher rates? The truth is that there are many competing interests and priorities, and limited amounts of state resources.
It is important to recognize the constraints with which lawmakers must work. Last year, Health & Human Services represented 22.4% of North Carolina’s nearly $24 billion state budget, second only to education, which represented 57.5%. Looking forward to the upcoming budget year, the state’s fiscal research arm reported that top budget pressures include: public schools, higher education, the state health plan, and Medicaid/Health Choice—meaning that there is a lot of pressure on the state’s already tight budget—and that’s not to mention the other interest groups we compete with, such as state nursing homes and other healthcare coalitions.
As GAO continues to garner legislative support for $29.5 million in state funds needed for the Medicaid rate increases we are seeking, advocacy efforts will play an important role. Please watch for ways to support our legislative ask, and please reach out to Mike Sokoloski at firstname.lastname@example.org to learn how you can get involved in advocacy on behalf of your staff and clients.
NC Bills we are following
To date, 824 bills have been filed in the North Carolina General Assembly this session. GAO continues to work through the proposed bills to evaluate their impact on home health care, home care, and hospice. Below are a few bills that are of interest:
Home care champion Representative Josh Dobson submitted the bill that extends the deadline by which certain providers, including home care and home health care agencies, must participate in and submit data to the state’s Health Information Exchange Network, NC HealthConnex. We commend the bill sponsors for this delay.
While participation in and submission to NC HealthConnex is
important and necessary in that it grants both the state and providers electronic,
timely access to demographic and clinical data, our industry and others provider
sectors do not have a consistent platform or an easy way to gather and transmit
the required data. Access to this data and clinical information will help the
state and providers identify spending trends that will facilitate health care
cost containment while also improving health care outcomes only if the data is
reliable and consistently reported.
This extended deadline proposed by House Bill 70 grants us
additional time to meet the reporting requirements. We thank all the bill signatories for
recognizing the administrative burden and granting additional time to meet the
The bill passed both the House floor on March 27, 2019 and is headed to the Senate.
2. H745– Medicaid Funding Request for Private Duty Nursing (PDN), sponsored by Representatives White, Lambeth, Adcock, and Cunningham
Our health care members, a home care nurse (White), a hospital administrator (Lambeth), a nurse practitioner (Adcock), and a hospice nurse (Cunningham), introduced H745 to increase the Medicaid funding for nursing under PDN from $39.60 to $45.00 by requesting $4.1M for 2019-2020 and $8.3M for 2020-2021 in recurring state funds.
As health care leaders, they recognize the importance our services play in keeping some of North Carolina’s most clinically complex citizen at home and out of more expensive settings. While the necessary funds were not allocated in the House Budget, we have an opportunity to get it into the Senate Budget and are continuing to advocate for this option.
3. H728– Increase Innovation Waiver Slots, sponsored by Representatives Insko, Hawkins, and Lambeth
This bill appropriates 500 Innovation Waiver Slots to address the waiting lists. It would support North Carolinians living with intellectual and developmental disabilities (I/DD) and help them receive needed services within their home and community. The bill proposes to appropriate $5.3M for 2019-2020 and $10,9M for 2020-2021 in recurring funds.
4. S361– Increase Innovation Waiver Slots, sponsored by Representatives Insko, Hawkins, and Lambeth
proposed bill attempts to address several different health care issues in one
bill. This approach makes it challenging to garner support in its entirety. The bill includes the following provisions:
Elimination of Certificate of Need (CON) – Any action that erodes the established process by which a need is determined may lead to destabilizing our health care industry. The established CON process allows for any group to apply for a Special Needs Determination should they feel health care needs are not being met in their community.
Establishes a carve-out for PACE organization – Any action that allows a group to be exempt from following Home Care Licensure Rules puts recipients at risk as the organization would not be required to follow health and safety rules outlined state licensure.
Medicaid Expansion – Any opportunity for the North Carolina’s working poor to have access to health care coverage, the better. This provision includes a work requirement with exceptions for individuals attending school and or deemed disabled.
Addition of Innovation Waiver Slots – Any opportunity for more individuals living with intellectual and development disabilities (I/DD) to have access to needed services, the better.
The introduction of this bill is the first step in a long process. GAO will continue to monitor and support the I/DD slot provision which aligns with our access to care goals. Some of the other items are very controversial because they create a slippery slope on oversight.
To find out what you can do to encourage your legislators to support the introduction of this bill, contact Lee Dobson at email@example.com.