Home Health Aides Deserve Better Wages! If Done Right, Mandatory Minimum Wage Increases Will Help

Home health aides provide a lifeline to millions of Americans, but low wages make it difficult to recruit and retain enough to keep up with the demand. If done thoughtfully, mandatory minimum wage increases can help support these valuable workers

It’s undisputable: Home health aides provide a lifeline to millions of Americans that need assistance living where they want to be—at home. But low wages often disincentivize home care workers from staying in the field. The problem lies in Medicaid reimbursement rates: Home health aides rely largely on state-determined Medicaid reimbursement rates for their wages, and those rates have stagnated well below the cost of living—and many states have not addressed this in years.

Luckily, many states have proposed increasing the mandatory minimum wage. And while many businesses often oppose such measures—many home care industry leaders have come out in support of it because they recognize the importance of aides in helping keep people at home and earning a fair wage for doing so. But we must ensure that minimum wage increases are done with the recognition that many home care programs rely on state funding to pay their workers. And if that funding isn’t increased in tandem with mandatory minimum wage increases, the state could unintentionally be putting vulnerable residents at risk.

Simply put, if Medicaid reimbursement rates for home care services are not increased at all, or at a rate too low to cover new minimum wage standards, then many home care providers will need to consider whether they can afford to keep their doors open. If providers do decide that they cannot remain sustainable and do decide to forgo providing Medicaid-based home care services, then the real loser is the millions of Americans that rely on that provider to live independently at home. Down the line, this could result in more people who can live at home with help from a home health aide into being forced into nursing homes.  

“People want to live at home. And it’s the most cost-effective option for states. Home health aides are the backbone of our industry and we absolutely support wage increases for our workforce, but states need to be thoughtful in their approach to protect the many seniors and individuals with disabilities that rely on home and community-based services. We are working with state legislatures to make sure that they understand the relationship between rates and wages, and the potential risk to vulnerable residents who need home care,” says BAYADA Chief Government Affairs Officer Dave Totaro.

So far this year, 18 states have started the year with higher minimum wages than the year before. If you live in a state where the minimum wage is set to increase, then you have a unique opportunity to advocate and tell your legislators about the importance of home care and of paying home health aides a living wage. Contact advocacy@bayada.com to find out ways you can play a role in ensuring that home care is accessible to the many that want to stay at home, and that home care workers continue to be attracted to a field that helps them do just that.

NJ PCA “Clean-up” Bill Awaits Health Committee Vote

NJ Senator Troy Singleton and Assembly Committee on Human Services Chairwoman Assemblywoman Joann Downey have introduced legislation S1820/A3632 to further clarify the Personal Care Assistant (PCA) increase to direct care workers.

The legislation will simplify the process for the PCA direct care worker’s rate increase and will take provider costs into account. GAO is currently meeting with members of the legislature to ask for their support for this clarification bill.

As background, New Jersey’s PCA program has had historically low reimbursement rates under the state’s fee-for-service. Over the last three years, GAO was successful in increasing the state -fee-for-service rate from $15.50 to $18.00 per hour and last year, to $19.00 per hour. Unfortunately, when the PCA program transitioned to Managed Medicaid, managed care companies did not follow the same reimbursement rates and continued to pay, in many cases, less than $15.50 per hour.

In the last legislative session, GAO was successful in passing legislation which set a reimbursement floor in managed care for PCA at $19.00 per hour. However, Governor Christie conditionally vetoed the legislation with a stipulation requiring all increases pass directly through to direct care workers.

The legislation introduced by Senator Singleton and Assemblywoman Downey will further clarify the PCA increases to account for direct and indirect provider costs. If you have any questions about this bill or any other bills in NJ, please feel free to email me at llindenmeier@bayada.com.

BAYADA NJ PAC Hosts a Fundraising Event for Assemblyman Troy Singleton

BAYADA staff and NJ Assemblyman Troy Singleton (center)

On Thursday, October 26, the BAYADA NJ PAC hosted a fundraising event in Trenton honoring 7th District Assemblyman Troy Singleton. Attendees included 7th District Assembly candidate Carol Murphy, representatives from the home care industry and other industries supportive of Assemblyman Singleton, who is currently running for the 7th District Senate seat.

Chief Government Affairs Officer David Totaro welcomed Assemblyman Singleton and thanked the many sponsors and attendees who contributed over $13,000 in support of the Assemblyman’s campaign. Assemblyman Singleton has been a supporter home care, our clients, and employees for many years. He recently sponsored legislation that will mandate managed care companies to reimburse the Personal Care Assistant (PCA) Program at no less than the state’s fee-for-service rate.

In July, Assemblyman Singleton introduced new legislation to increase the reimbursement rate under state fee-for-service for private duty nursing by $10 per hour. During the event, BAYADA recognized Assemblyman Singleton as the “Legislator of the Year” for his ongoing commitment to making home care better and stronger, as clients and families deserve the care they need in the setting they prefer: their own homes.

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.

NJ Home Visit Sheds Light on Need for Home Health Aides

Submitted by Tara Montague, Manager, Client and Family Advocacy, NJ (GAO)

Perth Amboy (PER) Client Service Manager Julia Nelson and I had the pleasure of meeting with PER client Joseph P. and his mother Bernadette at their home in Manasquan.  We were joined by Assemblyman Edward Thomson and Director of Constituent Services Kerry Textor.  As a client in the Personal Care Assistant (PCA) Program, Joe told the Assemblyman how much he loved his home health aide Alice.  Bernadette shared that she is an 86 year old mother caring for her 57 year old son who has multiple sclerosis.  PCA services are vital to her ability to keep Joe at home as he wishes. Unfortunately, they are not always able to get someone to cover the hours authorized due to the difficulty of recruiting aides in the Monmouth County area.  The Assemblyman, who is new to the office, offered to look into what additional services or supports they may be entitled to in order for Joe to remain with his family.

Photo (left to right): Julia Nelson, Bernadette P, Tara Montague, Joseph P, Assemblyman Thomson
Photo (left to right): Julia Nelson, Bernadette P, Tara Montague, Joseph P, Assemblyman Thomson

U.S. Senate Aging Committee Staff Spends Day with BAYADA

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

Recently, Samantha Koehler, policy aide to the U.S. Senate Special Committee on Aging for ranking member U.S. Senator Bob Casey, and Vicki Hoak, Executive Director of the Pennsylvania Homecare Association, spent the day in Philadelphia with BAYADA Home Health Care.  During her time with us, Samantha spent time learning about the inner workings of our service office and went on two home visits, one to an assistive care state programs client and another to a hospice client.

During Samantha’s visit, we discussed the most recent issues to impact home care in Pennsylvania including the institutional bias that still exists, the challenges with the recent proposal to block grant or institute per-capita caps to Medicaid, and the harmful proposed home health groupings rule.

Samantha loved getting to spend some time with Ms. Lenora E. and her aide Kimyatta J. Ms. E has been a BAYADA client for over a year and gets nine hours of care a day.  She is served by the Philadelphia Corporation of Aging (PCA) office. She also met Florence G., a 101-year-old heart patient who can remain at home with her daughter because of the care we deliver. She loves her Clinical Manager Faith Brown almost as much as she loves her children, grandchildren, great-grandchildren, and great-great grandchildren. Grace is served out of the Pennsylvania Media Hospice (PMH) office.

A big thank you to the PCA and PMH staff for hosting Samantha!

Executive Director of PHA Vicki Hoak, BAYADA Aide Kimyatta J., BAYADA Client Lenora E. and Policy Aide Samantha Koehler sit and discuss home care.

NJ Personal Care Assistant Legislation A320/S1018 Awaits Governor’s Signature

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.

North Carolina Budget Released

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

On June 19, lawmakers released a $23 billion budget for 2017-2019. Below are some of the provisions impacting us:

  • Increased Personal Care Services Rate: This provision increases the Medicaid rate for aide services under the Personal Care Services (PCS) program and the Community Alternatives Program for Children (CAP-C). The rate will increase from $13.88 to $15.50 (July 1, 2017) and $15.60 (January 1, 2018) pending approval from the Centers for Medicare & Medicaid Services (CMS). Much to our disappointment, CAP-DA was left out of the budget. A technical issue made it difficult to increase the CAP-DA rate within the established budget neutrality requirement. A rate increase would have meant fewer authorized hours for clients to stay within overall program requirements. BAYADA’s Government Affairs Office continues to work on a solution.
  • Protected the certificate of need (CON) for home health care from being eliminated.
  • Expanded Innovations Waiver slots: This provision added 400 additional Innovations Waiver slots across the state.

NJ Client Advocates for Our Aides

Submitted by Tara Montague, Manager, Client and Family Advocacy, NJ (GAO)

On May 26, as part of the Home Care Association’s Advocacy Day, our client, Victor Muniz, spoke during a press conference held by Senate Majority Leader Loretta Weinberg. Victor, who receives personal care assistance through the Jersey City (JC) office, shared the importance of home health aides in his rehabilitation and his ability to live independently. In addition, William Chambers, father to Perth Amboy (PER) client Billy Chambers, spoke about how home health aides enable him to continue to care for his son at home, but there is a strong need for increases in reimbursement rates. He stressed that aides are simply not paid enough money for what they do.

Mr. Muniz was also interviewed by a reporter from NJ Spotlight about this issue.

GAO Makes Progress on Rate Increase During Meeting with Senator Scott Wagner

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

On April 6th BAYADA Leaders, including Practice President David Baiada, Chief Government Affairs Officer Dave Totaro, Assistive Care State Programs (ACSP) Practice Leader Eric Thul, Crocus Division Director Kevin Kuzmick, PCA Director Donna Russell-Kane, and I  met with Senator and Gubernatorial Candidate Scott Wagner.  This meeting was a result of a previous meeting that Dave Totaro and I had with Senator Wagner introducing the need to increase the personal assistant services (PAS) rate under the Office of Long-Term Living (OLTL) by an average of 10%.

The meeting took place in the BAYADA PCA office. We discussed the ACSP business, its challenges and advantages, as well as the wage issues associated with the program.  Senator Wagner also heard first-hand about what it’s like to be a home health aide from PA Department of Aging’s Direct Care Worker of the Year, BAYADA aide Anne Pannone. 

The conversation was productive, and Senator Wagner understands the value of home care and the cost savings it can provide to the Commonwealth. He has agreed to help us in our legislative priority of increasing the PAS rates and would also like to spend a day in the field with Anne to see the work first-hand.

We look forward to continuing to work with Senator Wagner.