Hearts for Home Care Kicks Off 2019 with Two Heartfelt Visits with New Jersey Clients

Last week, Hearts for Home Care members and BAYADA employees Dave Totaro, Tara Montague, and Alisa Fox traveled to northern New Jersey to meet two home care clients and their caregivers to learn more about how home care has impacted their lives and how they advocate on behalf of themselves and their loved ones.

Meeting Addy and Gloria


Photo: DOV client Addy R. and her HHA Gloria have an unbreakable bond

First, the team stopped by a BAYADA service office in Dover, NJ to meet the staff and learn about the struggles the office regularly faces in recruiting and retaining home health aides. Per staff member Helena Anton, challenges lie primarily within staunch competition in the area and finding the high-quality and compassionate caregivers that “you can tell are put on this earth to care for others,” as Helena puts it.

“Smaller home health care companies can usually pay the caregiver more in wages because we put that money into benefits, training, and supplies. But the real problem is that Medicaid reimbursement rates are so low that these caregivers—no matter what company they work for—aren’t making enough. That’s why we need to advocate to make sure the state sees how low wages are impacting so many New Jerseyans that are able to live and their communities and thrive with home care,” added Helena.

After the discussion, the Hearts for Home Care advocates met home care client Addy and her aide Gloria. The crowd was nearly brought to tears by Addy’s story regarding the challenges she has been able to overcome with her “teammate”—which is what she calls Gloria.

“I was extremely touched by Addy’s and Gloria’s relationship. Not only is it clear how much Gloria has impacted Addy’s daily life and her sense of self-worth, but the way that Gloria talks about Addy’s influence on her own life is incredible. You can tell that Gloria was truly put on this earth to be the nurturing, compassionate caregiver that she is,” said Tara Montague.

Recently, Addy and Gloria visited Senator Steve Oroho to share their story and to advocate for better state home care policies. “Helping people is important. And it’s important that those who help others get the help that they need too,” Addy told the group. Addy recommitted to continuing to advocate for herself and for others who are impacted by home health care. “I want to share my message with legislators. It’s my way of giving back,” she said.

Lili and Emma Welcome Advocacy into Their Home


Photo: Lili and her nurse Barbara share a high five

Next, Dave, Tara, and Alisa traveled to Morristown to visit home care client Liliana “Lili” and her mother Emma in their home. As a single mom, Emma relies on home nursing so that she can keep her full-time job and keep Lili at home. She told us that her service office team works hard to ensure that every one of Lili’s shifts are covered. She also shared about times when that coverage wasn’t so steady: “Our routine and our comfort level is only as good as today…When Lili’s main nurse Liz retired, we had a few months where we didn’t know what tomorrow would bring.”

Lili benefits from New Jersey’s private duty nursing (PDN) program, which allows for children and adults with skilled care needs to live at home. Without this program, it is unlikely that Lili would have been able to grow up with her mom and graduate from school as she did. The PDN program’s rates need to be raised in order to better attract more nurses to home care, as most can currently make a higher wage delivering skilled care in a hospital or nursing home. One of Hearts for Home Care’s major advocacy goals for 2019 is to educate legislators on the need for a rate increase and to secure one on behalf of all New Jersey home care clients, families, and nurses.

Like Addy, Emma is committed to ongoing advocacy to ensure that nurses see home care as an attractive employment option, so that other families can receive the home care that they need too. In recent years, Emma has hosted state elected officials in her home. “Seeing our daily routine and how important it is for Lili to have a nurse at home is the most impactful way for an assemblyman or senator to understand home care,” said Emma. “As a mother of someone who is able to stay home due to in-home nursing care, I see it as my duty to advocate…Not just for Lili, but for those in the state who are struggling to get the nursing they need.”

“It’s our clients’ and families’ voices that make the biggest impact on our state and federal elected officials’ decisions about home care. Because of advocates like Addy and Emma, legislators better understand the impact home care has on their communities,” said advocate Dave Totaro, who also serves as BAYADA’s chief government affairs officer.

There are plenty of ways to advocate, even from home! To find out ways that you can make an impact, contact us at advocacy@bayada.com. Together, we can share our voices to make 2019 the best year for home care yet.

NC: Legislature Kicks Off 2019, Former Home Care Champion Nelson Dollar Joins Speaker’s Staff


Former Representative and home care Champion Nelson Dollar joins Speaker of the House Tim Moore’s staff as Senior Policy Advisor

Lawmakers returned to Raleigh on January 9 for the 2019-2021 long legislative session.  We expect to see some changes in committee assignments and leadership, especially in the House Appropriations for Health & Human Service (HHS), with the election defeat of Chairman Nelson Dollar.

Dollar–the former chairman of the House Appropriation Committee—has transitioned from the public sector to a senior policy advisor to the Speaker of the House Tim Moore. Dollar has been a home care champion for years and was named BAYADA’s Legislator of the Year in 2016 and 2018 for his efforts. He was instrumental in securing much needed Medicaid reimbursement rates increases for nursing and aide services. He has also been instrumental in protecting from elimination the Certificate of Need (CON) process for our Medicare offices.  His expertise and knowledge on complex issues at the statehouse will serve North Carolina well. As you may recall, Dollar lost his seat by 884 votes last November to Democrat Julie von Haefen.

While we are sad to see our former Champion lose this leadership position, there are other home care Champions that we anticipate seeing in key roles. We expect to see Representatives Donny Lambeth and Josh Dobson as co-chairs of HHS. Further, we anticipate Senators Ralph Hise and Joyce Krawiec in chair positions serving the Finance and/or Health Committees. All four legislators are well-versed in home care and the challenges our clients and staff regularly face throughout North Carolina due to our collective advocacy efforts. This puts BAYADA in a great position to move forward with our next round of asks.

Our major reimbursement priority this session is to increase the Medicaid private duty nursing (PDN) rate from $39.60 to $45.00 over the course of two years. This increase is necessary to help us recruit and retain the high quality, compassionate nurses we need to care for the many North Carolinians that need skilled care to stay at home.

Sharing your voice is key to achieving our goals: Be sure to look for opportunities to advocate as we seek to support our clients and staff. Of note, please save the date and be sure to look out for communications regarding our Legislative Day, which will be held in Raleigh on May 1.

South Carolina Representative Garry Smith Visits Local Family to Learn How Home Care Impacts his Constituents

Rep. Garry Smith (left) visits home health care client Emma (held), mom Gina (right) and their in-home BAYDA nurse Danielle (second from left).
Rep. Garry Smith (left) visits home health care client Emma (held), mom Gina (right) and their in-home BAYDA nurse Danielle (second from left).

 

South Carolina State Representative Garry Smith (R, District 27) visited a local family in his district to learn how his constituents and many South Carolinian families rely on home care to keep their loved ones together at home and out of more expensive settings. Rep. Smith is one of the many legislators that Hearts for Home Care advocates bring into home care clients’ homes to show them how federal, state, and local policies affect home care recipients and their families.

During his visit, Rep. Smith met 21-month old BAYADA Home Health Care client Emma Ferguson, Emma’s mother Gina, and Emma’s in-home BAYADA Nurse Danielle Rian. Emma was born with a Chronic Lung Disease of Prematurity, which causes Emma to experience severe breathing problems, pain, and other symptoms. At her young age, Emma has already had several surgeries and currently still requires use of a Gastrostomy-Jejunostomy (G-J) Tube to assist with her feedings and medication management throughout the day. At birth, state Medicaid authorized Emma to receive private duty nursing (PDN) services in her home so that Emma can remain safely and comfortably at home with her mother.

In March, Emma’s PDN services were terminated when Medicaid determined that her skill level no longer qualified her to receive care in her home. From March until May, Emma attended a local day care facility for children with complex needs so that her mother could continue to work. During this time, Emma was hospitalized on several occasions and required ventilator support due to respiratory illness. In May 2018, Emma’s mother Gina reapplied for PDN services, and Emma was able to start receiving care at home again. Emma currently receives 32 hours of PDN services in her home, and since the reauthorization, she has not been readmitted to the hospital.

Emma’s mother Gina stated, “I’m grateful Rep. Smith was able to visit our home to see how Emma and other medically-complex children can grow up and thrive with in-home nursing. These kids deserve some normalcy in their lives, and I have seen first-hand how much better she does when she can be with me at home rather than in an institution. She only receives 32 hours a week, and this allows her to receive the care she needs in the best place–her home–and allows me to be able to work to support my family.”

After the home visit, Rep. Smith said, “visiting sweet Emma and her family has opened my eyes to what home care means to my constituents and to the many South Carolinians who depend on Medicaid home care to stay with their families and out of higher-cost settings. I look forward to exploring ways we can help keep families together while at the same time effectively managing the state’s budget.”

“One-on-one nursing services have allowed Emma to remain safely at home under the Medically Fragile Children’s Medicaid Nursing Waiver. This program is an alternative to nursing home placement at a lower cost to the state,” said Melissa Allman, Hearts for Home Care advocate and Director of Government Affairs for BAYADA. “In-home nursing care helps minimize deterioration and can prevent costly hospitalizations as staff can address subtle changes in the medical condition before it becomes serious. I hope that more legislators continue to learn about how cost-effective these services are to the state, and how valuable they are in keeping South Carolinian families together.”

Home visits like this one really give elected officials a better understanding of how their decisions on key issues like Medicaid impact real people who are seeking to remain safely at home with their families. To find out ways in which you can participate in a home visit with a local legislator, or other ways you can advocate, email advocacy@bayada.com.

Private Duty Nursing Bill Introduced to Raise Reimbursement under State Fee-For-Service

On July 13, Assemblyman Troy Singleton and Senate Majority Leader Loretta Weinberg introduced legislation A5089/S3400 which increases the New Jersey private duty nursing rate under State Fee-For-Service Medicaid by $10 per hour for registered nurses and licensed practical nurses. The last rate increase for private duty nursing was in 2008. BAYADA has been working with the Home Care Association and other providers discussing the need for a rate increase as it is difficult to recruit and retain nurses. BAYADA did an internal study and found of the scheduled hours, only 72% of those hours were filled, leaving clients and families without care.

When “Talking Back” Informs Future Direction in North Carolina

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

Over the last month, our BAYADA ad hock regulatory and legislative review teams, comprised technical experts from our various practices, have been busy reviewing proposed Medicaid clinical policies and a managed care model to craft recommendations.  A formal comment is BAYADA’s opportunity to provide substantive feedback to inform changes in regulatory oversight and payment reform.  Click to read BAYADA’s comments:

 

[Call out box]

Special thanks to our review BAYADA teams for sharing their insight and operational experience.

Medicaid Transformation Workgroup
  • Joe Seidel, ACSP
  • Rup Kelly, NEM
  • Nick Bellomo, HAB
  • Jessica Bogdanoff, HAB
  • Allison Swisher, Ped
  • Suzanne Cook, AN
  • Ali Genthner, AN

 

  • Shannon McCarson, ACSP
  • Kerry Meabon, ASP
  • Paul Seugling, CMO
  • Diane Turner, CMO
  • Jen Vranick
  • Kelly Lawson, ICO
  • Louise Lindenmeier, GAO-NJ
  • Lee Dobson, GAO-NC
   
Private Duty Nursing (PDN) Clinical Policy Workgroup
  • Robin McCarson, Ped
  • Allison Swisher, Ped
  • Kathryn Hawley, Ped
  • Virginia Steelman, Ped
  • Rup Kelly, NEM
  • Suzanne Cook, AN
  • Ali Genthner, AN
  • Lee Dobson, GAO