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.

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.

BAYADA Meets with NJ Governor Chris Christie

Submitted by Louise Lindenmeier, Director, NJ Government Affairs (GAO)

Chief Government Affairs Officer Dave Totaro, State Assistive Care Practice Leader Eric Thul, and Director, Strategy & Value-Based Partnerships Matt Lippitt met with New Jersey Governor Chris Christie to discuss the recently signed law which sets a floor for minimum reimbursement under managed Medicaid for Personal Care Assistant Care.  Our team explained the challenges under managed Medicaid, how reimbursement is used to support personal care services, and the wage needs of the home health aides.  The meeting was very informative for both the Governor and us, and served as an excellent start towards addressing the unintended consequences of the Governor’s conditional veto.


Photo: Matt Lippitt, Eric Thul, Governor Christie and Dave Totaro

BAYADA NJ PAC Hosts a Fundraising Event for Assemblyman Troy Singleton

Submitted by Louise Lindenmeier, Government Affairs Office (GAO) NJ Director

 On Thursday, October 26, the BAYADA NJ Political Action Committee (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 the assemblyman 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 of home care, our clients, and employees for many years.  He recently sponsored legislation that will mandate the managed care companies to reimburse the Personal Care Assistant 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 their homes.

NJ Managed Medicaid Bill Receives a Conditional Veto

Submitted by Louise Lindenmeier, Director, NJ Government Affairs (GAO)

Governor Chris Christie conditionally vetoed A320/S1018, which sets a minimum managed care reimbursement rate for the Personal Care Assistant program at the state’s fee for service rate.  His veto addresses a wage pass through, budget funding for fiscal year 2019, removal of the Consumer Price Indices adjustment every 5 years and included an audit process for the increase in reimbursement.   On July 31, the bill went back to the Assembly where it received unanimous support by the legislature.  The Senate will vote on the bill when they reconvene for it to become law. The Government Affairs Office (GAO) will work with the industry on how to address the new stipulations within the bill.

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.

Personal Care Assistant Fee-for-Service Rate Increased in NJ State Budget

Submitted by Louise Lindenmeier, Director, NJ Government Affairs (GAO)

On July 3, Governor Christie signed the NJ budget which contains a budget resolution to increase the Personal Care Assistant rate under fee-for-service. I am happy to inform you the NJ PCA fee-for-service rate is now $19.00 per hour. The new rate is effective as of July 1, 2017.
This is largely due to the support of BAYADA leadership, the directors and their office staff, and our wonderful Hearts for Home Care Ambassadors who made legislative office visits, held legislative roundtables, and offered home visits advocating for our clients and families. Great advocacy efforts by all!