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Home Health Aides’ Low Wages: Turning Public Awareness into Action

Home health aides keep hundreds of thousands of disabled adults and seniors at home and out of costlier settings. Low Medicaid reimbursement rates keep them from making a better wage, and it's up to state governments to address this issue.
Home health aides keep hundreds of thousands of disabled adults and seniors at home and out of costlier settings.

As home care clients, employees, caregivers, and family members, we know one thing for a fact: Home health aides do incredible, compassionate work that enable hundreds of thousands of residents across the country to stay at home and out of costlier, more infectious settings like nursing homes and hospitals. And we certainly know another fact: The work that aides do is invaluable, and it’s time that they begin to receive a fair wage for the hard work they do.

Low aide wages have recently made national headlines and the message is clear: We will need more and more home health aides as America’s population continues to age. But home health care providers are having trouble recruiting and retaining the quality, reliable workforce needed to keep up with the growing demand.

Recently, Hearts for Home Care advocate and BAYADA Home Health Care’s chief government affairs officer, Dave Totaro, submitted his opinion on the matter to STAT News, a media company focused on finding and telling compelling stories about health, medicine, and scientific discovery. He posed the question:

“To say that home health aides’ work is demanding is an understatement. They make it possible for 14 million Americans to stay in their homes and out of expensive and impersonal institutional settings like hospitals and nursing homes. Performing this necessary and in-demand work takes a physical and emotional toll, yet these individuals do it with compassion day in and day out.

So why do we treat home health aides as low-wage, low-value workers?”

The problem lies primarily in states’ low Medicaid funding for home care programs. Though states typically pay an hourly rate for providers who deliver home health aide services, these rates have largely been low for many years, or raised periodically, but at a rate too low to keep up with real costs of living and providing services. Because these rates must cover wages, training, benefits, new hire costs such as background checks and TB shots, and supplies, it is nearly impossible for home health care companies to take such a low rate and provide aides with a wage high enough to compete with industries like fast food and retail.

News coverage of the issue has been effective in bringing greater public awareness to the issue, especially as nearly all individuals will be touched by home care at least once in their lives, whether it be for themselves, a parent, friend, or other loved one. Now is the time to take awareness and turn it into action. Call your state legislator and let them know what home care means to you. Contact advocacy@bayada.com for information on what you can do to share your voice and support home health aides.

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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.

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Making The Rounds in North Carolina

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

BAYADA Chief Government Affairs Officer Dave Totaro and I met with key lawmakers this past week, seeking their support for a rate increase for aide services under three Medicaid programs – Personal Care Services, Community Alternatives Program for Disabled Adults (CAP-DA), and CAP for Children (CAP-C)- in two different settings: in-home care and adult care homes.  While the lift is heavy, $47.8 million to bring the rate from $13.88 to $17.00 over two years, our conversations were positive.  We also met with the newly appointed but not yet confirmed Secretary of Health & Human Services, Dr. Mandy Cohen.  A good round of meetings!

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Dave Totaro, Lee and Dobson Rep. Carla Cunningham, who is a nurse