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!

Increasing Maryland’s LPN Rate

This session, our major legislative goal in Maryland is to increase the Medicaid LPN rate across all programs and client groups from $34.16 to $42.81. It is an ambitious goal—initial budget estimates place the cost to the state at $26 million per year. With neighboring states reimbursing LPN care at $45, $46.14 and $50 per hour, it is easy to see why there is such a problem of access to care across Maryland. The low reimbursement simply does not support a sufficient wage to be able to consistently recruit and retain the skilled nurses that we need to be able to commit to serving a larger number of clients.

Problems within the Maryland Department of Health and a general lack of transparency have hindered this effort in past months. There have been a few targeted data points essential to such a large budget ask that BAYADA and Maryland-National Capital Homecare Association (MNCHA) through our best efforts, have been unable to obtain.

We started this session asking key legislative champions to help us get this information, using their political pressure to get information from the Department of Health or to introduce legislation that would establish an oversight working group to investigate the issue. Several legislators have been deeply troubled by the idea of children and adults with disabilities being unable to access the skilled nursing care they need to remain at home safely and have stepped up to help. This information, and the support we are gaining from those in key positions to move this effort through to becoming law, is a key step in increasing this LPN rate.

Thank you to Ambassadors Dan Guidebeck, Nikita Mutter, and Matt Paske for joining in legislative meetings and sharing the stories of how this issue impacts our clients and employees. Your commitment to advocacy reminds me of why we do what we do every day.

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!

It’s In DE Governor John Carney’s Hands

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

The rate floor bill we’ve worked so hard on, now sits on Governor John Carney’s desk.  Many bills passed in the last days of session, at the end of June, each requiring his consideration before he signs them into law or vetoes them.  HB200, which sets a “rate floor” or minimum reimbursement rate for Registered Nurse (RN) and Licensed Practical Nurse (LPN) level nursing care equal to the Delaware Health and Social Services (DHSS) fee for service rates, would help ensure home health care clients across the state have access to care.  We have sent him information about why this bill is so important to our clients and employees and we await his decision.  The bill becomes law and is effective upon his signature.

 

Delaware Rate Floor Bill Passes

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

The General Assembly, in the wee hours of the morning on the last day of session, passed the rate floor bill! This measure will ensure that Managed Care Organizations (MCOs) hourly home health care rates for registered nursing (RN) and licensed practical nursing (LPN) care will never fall below Delaware Health and Social Services (DHSS) hourly rates. This will help to ensure access to home health care for Delawareans with disabilities, and giving providers the ability to make informed business decisions. Dedicated effort by our BAYADA team of clients and employees, in partnership with the Delaware Association for Home and Community-Based Care and other home health care providers, made this possible. Thank you for your emails, phone calls, and attendance at Advocacy Day in Dover. This bill will go into effect when Governor John Carney signs it.

PA Office of Long-Term Living Announces Temporary Rate Floors

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

Last week, during the Pennsylvania Homecare Association Annual Conference, Deputy Secretary for the Office of Long-Term Living (OLTL) Jen Burnett announced Managed Care Organizations (MCOs) will be required to reimburse providers at least the state posted fee-for-service reimbursement rate for personal assistant services. This “rate floor” will be in effect for the first 36 months post transition of each region. After the announcement, I had the opportunity to speak with Deputy Secretary Burnett, and she stated the reason OLTL made that decision was to provide stability for providers. During our conversation, I asked that her office consider extending the temporary rate floor to registered nurse (RN) and licensed practical nurse (LPN) services as well for the same reason. She invited us to meet with her formally to discuss. BAYADA’s Government Affairs Office (GAO) will work to set up a meeting with OLTL to lobby for the inclusion of RN and LPN services in the 36-month rate floor.