|Lacy is a three-year-old diagnosed with cerebral palsy (CP) and chronic respiratory failure living with a tracheostomy and feeding tube. Lacy and her family rely on skilled nurses to provide continuous hands-on care so that she can avoid hospitalization and stay where she belongs – at home. |
“I don’t know what I’d do without my nurses,” says Lacy’s grandmother – her primary caregiver following the murder of her daughter when Lacy was in utero, “They’re my lifeline.”
Although Lacy receives services under the NC’s Private Duty Nursing (PDN) program, she doesn’t get all the coverage for which she qualifies and needs because nurses are difficult to recruit and retain. Open shifts are common in PDN due to Medicaid’s low reimbursement rate. Lacy’s grandmother had to quit her job in order to take care of her, and nursing coverage is only enough so that she can get sleep and perhaps run an errand.
Hearts for Home Care advocates are serving as a voice for home care clients like Lacy, and for family members who are impacted by the lack of nurses like her grandmother. To encourage state and federal legislators to support higher wages for in-home caregivers and increase vulnerable residents’ access to services, you can make a difference! Learn about ways you can participate in advocacy through our website, or by emailing firstname.lastname@example.org today!
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!
Submitted by Louise Lindenmeier, Director, NJ Government Affairs, (GAO)
NJ GAO held its first Advocacy Week, May 1 – 5, as Ambassadors met with 25 legislators. Throughout New Jersey, 67 office employees, two home health aides, and two clients spoke with legislators about the difficulties of attracting and retaining nurses, covering hours for private duty nursing, and the need for higher reimbursement for the Personal Care Assistant program under managed Medicaid. The aides told the legislators how much they love their work but can’t make enough to support their families. The clients spoke about how important their aides are by providing care, and, if not for the aides, they would be in long-term care.
As part of the advocacy week, office staff participated by sending out 408 emails to state legislators regarding the importance of home care. The message asked the legislators to support a reimbursement floor rate in managed Medicaid. Everyone who met with legislators expressed how much they enjoyed the experience and how good it felt to advocate for our clients and families.
Submitted by Louise Lindenmeier, Director, Government Affairs (GAO)
As we continue on our PCA journey for increased reimbursement rates, the next effort to increase the PCA reimbursement rate now sits on the governor’s desk. A320/S1018 would require the minimum reimbursement rate for PCA in managed Medicaid to be no lower than the state’s fee-for-service rate. Currently, we are asking all the PCA aides and clients to sign and send letters to the governor’s office, urging him to sign the legislation into law.
Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)
On July 10, Dave Totaro and I met with Governor Roy Cooper. We discussed state and federal issues related to health care delivery in NC. He recognized and applauded our recent federal call to action and indicated that type of outreach makes a difference. We also discussed Medicaid Reform, the LME/MCO system, CON, and Medicaid rates. It was a great conversation with a supporter of home care.
Submitted by Shannon Gahs, Associate Director, DE Government Affairs (GAO)
Following compelling testimony by clients Nancy and Christopher Lemus, Delaware Association for Home and Community-based Care (DAHCC) President Bob Bird, Delaware Pediatrics (DP) Associate Director Mandy Brady, and myself, the House Health & Human Development Committee passed a bill that would set a minimum reimbursement rate paid by Medicaid managed care organizations (MCOs) to home health care providers for skilled nursing services.
Representatives asked probing questions, sparking true debate over the measure. The vote was 10-0 with 4 additional members absent. The bill must still pass the full House, the Senate Health, Children & Social Services Committee, and the full Senate. The legislature closes on June 30. If this bill passes, MCOs would not be able to pay any less than the Department of Health and Social Services (DHSS) pays for the same care, giving DHSS the ability to ensure access to needed services.