Blog Takeover: My Family Hosted a Legislative Home Visit ─ You Should Too.

My name is Lisa Letterman and my son John was in a severe car accident in 2020, which left him paralyzed from the neck down, unable to walk, talk, or breathe on his own. As he was preparing to be discharged from the hospital, I unfortunately was not aware of any other long-term care option other than a nursing facility, so I made the difficult decision to send him to a facility in Virginia. But after a short time, it was clear that John’s health and quality of life were deteriorating, so I started researching other care options until I found home care.

After a long and stressful separation, John was finally able to return home to receive in-home care under North Carolina’s Private Duty Nursing (PDN) services. Since returning home with one-on-one nursing care, his condition has improved immensely. He no longer requires a feeding tube, he is now able to talk on his own and is even slowly making progress in regaining movement. However, there is a new hurdle that we face: trying to find enough nursing coverage for John. There is a critical nursing shortage that leaves families like mine struggling to care for our loved ones on our own, putting us in a constant state of exhaustion and concern when we can’t get coverage. I knew that something must be done to fix this shortage, so I started to advocate.

Our experience with a legislative home visit:

Recently, John and I invited our North Carolina Representative, Dudley Greene into our home (virtually), to show the importance of in-home nursing services and to advocate for better access-to-care. At first, I wasn’t sure what to expect from the virtual visit, but I can tell you it was an incredible experience that I believe other home care families should consider when wanting to advocate and make a difference.

Before the visit, BAYADA client services manager, Rachel Miller, handled the logistics. Once we agreed to opening our home, she handled everything from scheduling, practicing our call, and keeping us updated. When the 30-minute meeting began, it was like Rep. Greene was sitting in our home having a conversation with us. He could see all of John’s machines, medical routine, and he listened to the challenges we face. It was clear by the look on Rep. Greene’s face that he was truly understanding our situation in a way that no letter, email, or phone call could describe. We had his undivided attention for 30 minutes and in that time, we showed him the power of home care. After the visit was over, both John and I were impressed with how easy and rewarding the process was.

Top Left to Right: BAYADA CSM, Rachel Miller; BAYADA Government Affairs Manager, Cai Yoke; BAYADA Director, Kristen Church
Bottom Left to Right: North Carolina State Rep. Dudley Greene, BAYADA client & NC resident, John Letterman during the virtual home visit.

Why I advocate:

I advocate for home care because I can’t image what it would feel like to go through what John, and others like him, have had to experience and not have anyone around to speak up on your behalf.  I have seen John in every stage of his recovery: in the hospital, nursing home and then at home. It is because of PDN that John is thriving and living the quality of life he deserves. I want other families to have access to this same high quality, in-home care, but without better state-funding, that won’t be possible.

John Letterman with BAYADA nurse.

Why YOU should participate in a home visit:

Legislators like Rep. Greene determine the budget and funding for these types of programs, so we must do our part to educate them as best we can. I believe that legislators want to make a difference in their communities and help their constituents, but most are not aware these issues even exist. The more that decision-makers understand of the benefits of in-home care, the more advocates we have supporting our cause. Whether it’s a virtual or in-person home visit, these types of interactions with legislators give them a glimpse inside our challenging environment and help them understand the importance of in-home care ─ something that an email, letter, or phone call could never convey.

Advocacy Matters!

Despite the fact that many people in government and regulatory positions agree that home health care is a cost-effective, patient-preferred solution, it continues to be prioritized below institutional care. Not investing in home care will decrease the supply of qualified workers, increase turnover, and compromise the quality of home care services. At Hearts for Home Care, we help those that care about home care by enabling YOU to get involved at the capacity in which you’re able to do so.

Email us at advocacy@bayada.com or visit our website  in order to learn more about the home care advocacy community and find opportunities to get involved.

Patient Recognition Week: Celebrating Patients Who Live Their Life to the Fullest Thanks to Home Care

For thousands of Americans across the country, home care allows them to be contributing members of society, giving them the freedom and independence to live life to the very fullest despite their diagnoses. During National Patient Recognition Week, Hearts for Home Care celebrates some of these unique and inspiring patients who are foraging their own path and letting nothing slow them down. These individuals are proof that quality, in-home care, can truly change someone’s life for the better.

La Mondre Torohn Pough

La Mondre Torohn Pough, South Carolina.

LaMondre Torohn Pough not only lives his life in his community, independently, but is also contributing member of society. Thanks to the support of home health aides who care for him and keep him safe at home, LaMondre has become a highly successful businessman, owning his own podcast, 5P with LaMondre, and company that focuses on inspirational speaking, entrepreneurship, and consulting. If it weren’t for his in-home caregivers, LaMondre would need to be cared for in a long-term care facility instead of thriving at home.

In return, LaMondre is a passionate advocate for the healthcare heroes who care for him along with other people with disabilities. He says: “Caregivers contribute so much to the community of people with disabilities and society as a whole. Effective advocacy is essential to ensure that we create an equitable and sustainable future. We are in this together.”

John Letterman

John Letterman with his home care nurse, North Carolina.

After a severe car accident in 2020, North Carolina resident, John Letterman was left paralyzed from the neck down, unable to walk, talk, or breathe on his own. Unfortunately, as he was preparing to be discharged from the hospital, John’s family were not told they had the option of bringing John home under Private Duty Nursing (PDN) care. Knowing no other option, they placed him in a nursing facility where his health deteriorated.

After a long and stressful separation from his family, John was finally able to return home to receive PDN services in his home. Since returning home with one-on-one nursing care, his condition has improved immensely, no longer requiring a feeding tube, able to talk on his own, and slowly making progress in regaining movement. Thanks to this quality, in-home care, John recently invited Representative Greene into his home (virtually), to show the importance of the care he receives and advocate for better access to care. John said that it’s important that decision-makers understand the impact of home care, espeically if they are the ones passing the budget and determining funding. “We need more people educated about home care so they can be advocates for us too,” he said.

Erin Hamby

Erin is 20 years old and relies on highly skilled nurses to care for her complex medical needs in the comfort of her home. If it weren’t for access to home care, Erin would unfortunately be in a skilled nursing facility, separated from her family and friends and without the personalized care she receives at home. However, thanks to in-home care, she has not let her diagnosis slow her down! With the support and care from her in-home nursing team, Erin has been attending college at Caldwell Early College and most recently, she was accepted at N.C. State, which she will be attending virtually in the fall!

Erin Hamby, North Carolina.

Erin’s father says that home nursing is crucial to Erin’s quality of life: “It allows her to be home and not in a facility. Her nurses have become her friends and they are invaluable to us as a family in managing her medical needs, equipment, and prescriptions. I don’t know how we would manage without these nurses, to be perfectly honest.”

Advocacy Matters!

Despite the fact that many people in government and regulatory positions agree that home health care is a cost-effective, patient-preferred solution, it continues to be prioritized below institutional care. Not investing in home care will decrease the supply of qualified workers, increase turnover, and compromise the quality of home care services. At Hearts for Home Care, we help those that care about home care by enabling YOU to get involved at the capacity in which you’re able to do so.

Email us at advocacy@bayada.com or visit our website  in order to learn more about the home care advocacy community and find opportunities to get involved.

New Year, New Home Care Wishes for 2022

2021 has been an incredible year for home care advocates, who continued to discover that meeting with legislators and sharing their personal home care stories did not have to occur in-person only. Embracing an increasingly digital world has been an advantage to many home care clients, caregivers, and families who are home-bound or have mobility issues—or are just plain too busy to be able to travel to and from legislative meetings.

Additionally, in the second year of COVID, many state and federal decision makers started to truly understand why home care makes sense: It keeps vulnerable individuals at home and out of potentially-infectious institutions, and it saves Medicaid programs money by doing so. 2021 was filled with many legislative accomplishments in which lawmakers opted to increase funding for home care programs in light of the ever-persistent challenges home care clients and families continue to face—primarily the difficulty in accessing home care when there is still—despite increasing funding—a workforce shortage.

In-home nurses, home health aides, and other caregivers are the backbone of the home health care industry. Home care would not be possible without these compassionate heroes that help families stay together. And while 2021 was filled with accomplishments, two advocates share their New Year’s hopes and show us why we all must recommit ourselves to home health care advocacy in 2022.

Below, see what home care client Ari A. of North Carolina, and home care mom Jill P. shared with us regarding the challenges they still face, and what they hope to see in the New Year.

Ari A. – Home care client in North Carolina

Ari with nurse Katrina Clagg, LPN.

I can’t tell you how much of a God-send it was to recently learn the fantastic news. NC Governor Cooper signed a budget that raised the Medicaid reimbursement for Private Duty Nursing (PDN) by 13.6%! I know so many people, including myself, who have been struggling to get their shifts covered because of low pay. These struggles go back several years, even before the pandemic. COVID -19 just made the staffing crisis in home care more visible to the public. I’m glad it did. It meant that the NC legislature could see more clearly the dire need, and they acted. Talk about seizing the moment! For this, the NC General Assembly will forever have my gratitude. 

Now that PDN can be more competitive with higher pay, hopefully nurses in other fields will see why we love home care. We love it because it is a protective shield that protects patients like me from the harm that can happen to us each and every day. Just last week my airway became totally blocked all of the sudden. Once again, one of my nurses saved my life. She acted professionally and calmly as she quickly fixed the problem. I wouldn’t have gotten such a fast response anywhere else other than one-on-one care at home. Without it, I certainly would have died. 

Home care to me also means love. I get to spend my life at home, sharing the love of my family, instead of being stuck in a medical facility, or not alive at all. It’s the best Christmas gift that keeps on giving all year round! 

So for all you working in the hospital or as a travel nurse, I have great hopes for 2022. Home care overall is fast becoming the new front line of medical care. More and more people that need complex care are coming home from the hospital and we need you! Simply put, taking care of people in their own home is the best way to advance your skills and help vital members of the community as well. Chronically ill patients like me are ready to welcome you into our homes with open arms. You will find that it is one of the greatest gifts you will receive! 

With Much Thankfulness, 

Aaron “Ari” Anderson 

Jill P. – Maryland mother of home care client Nadiya

Nadiya (front) is able to spend the holidays at home with mom Jill and her family

Nadiya shares a smile in her MD home.

Our 17 year old daughter Nadiya has life threatening seizures and multiple complex disabilities caused by a rare genic disease. She relies on night nursing to keep her safe. It is essential but for the last several weeks we have had only 2 of our 7 nights covered.

It is difficult to find capable, reliable nurses who have the skills to manage complex unpredictable seizures and assist with her activities of daily life. Because we live close to DC, many good nurses choose to work in DC where they can make more money through higher Medicaid reimbursement rates.

My child’s future health and safety as she transitions into adulthood, is reliant on home care. This is a great concern for our family. The pandemic has made this already complicated problem much worse. For 2022, I hope that more state and federal lawmakers continue to see how impactful home care is for families. I hope that more families become involved in advocacy and share their stories so that there is a groundswell for better wages and incentives for these frontline workers.

Home care nurses are an essential support that need to be valued and compensated competitively for their important work. Until that changes Nadiya’s future care is not secure. 

Jill Pelovitz

Parent, Caregiver, and Passionate Advocate

Pennsylvania Home Care Recipients Advocate for Better Access to Home Care

 Pennsylvania ranks seventh in the nation for the percent of its population that is 65 years of age or older1. As Baby Boomers continue to age and the population of older adults needing long-term care increases, the need for caregivers will continue to increase as well. Since COVID shined a light on major drawbacks of congregate living facilities like nursing homes and institutions, it is not just the elderly population that are choosing to be cared for at home. This is great news for the hundreds of thousands of individuals and families who prefer to age at home rather than in a facility. However, it also poses a major problem: there aren’t enough caregivers to take care of the current Pennsylvania population at home let alone the 29% growth that will occur by 2028, leaving a shortage of 73,000 home health aides2. This is due in large part to low state funding for Medicaid programs like Pennsylvania’s Personal Assistance Services (PAS) that cares for medically fragile individuals.

Stephen Hoppy from Luzerne County, PA with his home health aides

This is where our advocates come in. Home care recipients across the Commonwealth have banded together to help alleviate this growing caregiver shortage. Advocates like Stephen Hoppy from Luzerne County, PA are speaking out and helping raise awareness of the inadequate state funding. Stephen is approved for 20 hours per day of care from the PAS program, but since he cannot find enough caregivers to cover all those hours, he has been paying $500 per week out of his own pocket to help secure that coverage. Recently, Stephen was interviewed by FOX56 News about how the caregiver shortage has affected him.

“I am advocating because our healthcare system is compromised. There are plenty of people worse off than me that can’t get home care, which is unacceptable. These home health aides are medical professionals, and they need to be paid for their expertise and knowledge,” says Stephen.

COVID has only exacerbated this issue, with a mass exodus of health care workers no longer willing to risk their lives for a career that yields an average of only $12.40/hour. BAYADA Home Health Care has had to deny 40% of PAS cases in 2020 and 2021 because there were not enough caregivers to staff the cases. Teri Henning, the executive director of the Pennsylvania Homecare Association (PHA), says she’s hearing similar numbers from PAS providers across the board. “They simply cannot compete for the workforce,” she says. “Home health aides can earn more money doing similar work in other state home care programs, or in nursing homes, or even doing less physically- and emotionally-demanding work at Amazon, Target, or in fast food.”

“BAYADA Home Health Care has had to deny 40% of PAS cases in 2020 and 2021 because there were not enough caregivers to staff the cases.”

Pittsburgh resident, Maria Kolat with son Matthew

Home care advocate and mother, Maria, from Pittsburgh has also joined Hearts for Home Care’s advocacy efforts after experiencing these issues firsthand with her 22-year-old son, Matthew, who is developmentally disabled and requires non-stop supervision. Since COVID, their lives have dramatically changed—his schooling, his ability to receive psychological and medical care and—very significantly—his family’s ability to access the home health aide (HHA) care that Matthew needs and is qualified to receive. Maria and Matthew were featured on Pittsburgh’s local KDKA 2CBS station advocating on behalf of home health aides.

“Aides are leaving the caregiving field to work at big retail like Walmart and Amazon—or in fast food,” says Maria. “They can make $15 an hour or more there. When we see a revolving door of aides, Matthew can’t get the one-on-one care he needs, which puts him at risk.”

Home care advocates like Stephen and Maria give life to our advocacy efforts ─ their real-life experiences aren’t just numbers and statistics, but genuine struggles that thousands of Pennsylvanians endure every single day. They help tell the story so that legislators and influencers can fully grasp how their decisions are affecting their constituents and communities.

Home care advocates like Stephen and Maria give life to our advocacy efforts.

At the end of the day, when aides are not being drawn into working in home care, it’s Pennsylvania’s most vulnerable residents like Matthew and Stephen who suffer. PHA, home care providers, and advocates are asking the State to increase funding for the PAS program. Additional funding would put home care agencies in a better position to recruit and retain more HHAs, and thus ensure that PAS beneficiaries can continue to access the care they need to stay safe and healthy at home.

  1. https://www.leadingagepa.org/Portals/0/154869%20Long%20Term%20Care%20Statistics%20Book%20revised%20final.pdf page 14.
  2. https://mercer.healthcare-workforce.us/ +math

Advocacy Matters!

At Hearts for Home Care, we help those that care about home care by enabling you to get involved at the capacity in which you’re able to do so. Email us at advocacy@bayada.com or follow us on Facebook.com/Hearts4HomeCare in order to learn more about the home care advocacy community and find opportunities to get involved.

Home Care Has a Distinct Place in the Future of US Healthcare

States are beginning to make key changes to increase families’ access to home care

The COVID-19 pandemic has increased people’s awareness of the US healthcare system’s dependence on institutional care, and the potential dangers that come with a reliance on congregate healthcare settings. Nursing homes and hospital are a necessary part of the healthcare continuum, but COVID has undoubtedly increased the public’s appetite for—and governments’ understanding of—accessible home care.

90% of America’s seniors say that they prefer to age in place…

COVID may have a long-term effect on healthcare policy, as it has shifted the spotlight to the inherent benefits of home-based care. Home care is cost-effective: It costs governments, insurance companies, and individual families less to provide care in the home than in a hospital or facility. It’s also patient preferred: 90% of America’s seniors say that they prefer to age in place, and families with medically-fragile children and adults know their loved ones do better when they are in their own home environments.

In general, across the US, funding for home care programs continues to lag behind funding for services delivered in facilities like hospitals and nursing homes.

Home care advocates—state and national home care associations, providers, home care employees, and clients & families—have been advocating for better funding and better policies for home care for years with mixed success. In general, across the US, funding for home care programs continues to lag behind funding for services delivered in facilities like hospitals and nursing homes. But in this first post-COVID budget season, advocates have seen successes!

We’ve moved the needle: Several states increased their Medicaid funding for home care programs. The New Jersey legislature increased funding for home care by $2 more per hour, and for skilled nursing home care by $10 more per hour. Additionally, Delaware increased funding for skilled in-home nursing by 15%, and Georgia, Indiana, Missouri, and Pennsylvania have increased funding for private duty nursing by 10% or more. Thank you to these states for recognizing the importance of home care.  Increased funding will help thousands of children, seniors, and adults with disabilities and medical complexities access the home care they’ve been struggling to access due to caregiver shortages that have plagued the nation.

Other states have increased funding for home care at smaller increments, including Minnesota and Vermont. While any increase is appreciated, there is still work to do in these states and many others: Increasing funding, and reviewing it regularly, is essential in ensuring that caregivers’ wages can remain competitive as costs of living continue to rise year by year. If home care funding is raised now, but then ignored for years to come, then families that need home care will be back to the same situation they were in pre-pandemic: Struggling to find the care they need to stay safe and healthy at home.

On behalf of the home care community, thank you to the many legislators and decision-makers who have supported home care this year!

Why Home Care Matters – Meet Lacy!

Lacy and her primary caregiver–her grandmother–rely on in-home nurses to keep Lacy safe and comfortable at home
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 advocacy@bayada.com today!

GAO MD: 30% Increase to All Home- and Community-Based Services through 2025!

Client and family advocacy helped to bring MD’s dire need for a rate increase to the Baltimore Sun’s front page

Due to GAO’s advocacy efforts and that of our clients, employees, and industry partners, the Maryland legislature voted to increase Medicaid reimbursement rates for all home- and community-based services by 30% over the course of six years! In addition to traditional lobbying and grassroots advocacy efforts, the skilled nursing unit collaborated with GAO to deploy a public affairs campaign that led to home care clients’ stories being published in the Washington Post and Baltimore Sun, thus further showing legislators and the public the dire need for a Medicaid rate increase.

This monumental increase will enable BAYADA to compete for approximately 50% of the state’s LPNs, who are currently more attracted to hospitals and other settings where wages are higher. This in turn will enable BAYADA to better fulfill its vision of serving millions of people worldwide.

GAO anticipates that, as a result of this increase, the skilled nursing unit will open an office in 2020.

South Carolina Families Suffer as Reimbursement Rates Stay Stagnant for Over a Decade

Home care clients like Rashad (right) can stay at home with skilled nursing care, but a lack of state funding is making it more difficult for many South Carolinians
Home care clients like Rashad (right) can stay at home with skilled nursing care, but a lack of state funding is making it more difficult for many South Carolinians

The facts are clear: Home care is less expensive than hospital or other institutional care. Plus, it enables medically complex children and adults to remain at home amongst their loved ones. But because the State of South Carolina has not increased reimbursement rates for skilled nursing home care services since 2008, families are finding it increasingly harder to access the skilled, high quality care that they need to stay as independent as possible in their communities.

State funding for home care has not been increased in more than a decade. At the same time, hospitals and other facilities have been steadily able to increase wages. Even more so, nurses can make more in home care in surrounding states. Now, home care providers find that they can compete for less than a quarter of all the nurses available in South Carolina. When agencies face such recruitment and retention struggles, home care recipients and their families suffer.

When there are less home care nurses available, families find that they experience missed shifts, which can not only create undue stress and chaos as loved ones must miss work, lose out on sleep, and forego other necessary activities—but it also puts the client in danger. For those who need skilled nursing care, missed shifts can mean dangerous consequences, including trips to the ER and unnecessary hospitalizations.

Even more so, many major home care providers have already left South Carolina because of the low funding for home care. Stagnant rates that are more than a decade old make keeping their doors open unsustainable. As more and more agencies leave the state, the harder it is for families to access care. Simply put, if the State does not take action to increase funding for home care, South Carolina’s most medically complex and vulnerable families will have few options for care.

South Carolina’s concerned families are making their voices heard: They are reaching out to their legislators and media to share their message: Increase funding for home health care so that families can access the high quality, reliable care that they need to be where they want to be: At home.

To find out how you can get involved in advocacy, contact us at advocacy@bayada.com today.

Where Does the Money Go? NC State Budget and Bill Tracking Update

State Budget Update

North Carolina is required to balance its budget each year, and health and human services makes up 22.4% of the already tight $24 billion budget

In North Carolina and across BAYADA’s GAO states, our legislative goals tend to revolve around two main tenets: First, achieving policies that streamline processes so that service offices can operate without added burdens and so residents can readily access care, and second, to increase reimbursement rates so that we can recruit and retain the caregivers necessary and ensure that we have the supply necessary to meet the demand.  

It seems like common sense—North Carolinians want to stay in their homes, and home care services cost states less than care delivery in a different setting. So why can’t legislators simply fund home care programs at higher rates? The truth is that there are many competing interests and priorities, and limited amounts of state resources.

It is important to recognize the constraints with which lawmakers must work. Last year, Health & Human Services represented 22.4% of North Carolina’s nearly $24 billion state budget, second only to education, which represented 57.5%. Looking forward to the upcoming budget year, the state’s fiscal research arm reported that top budget pressures include: public schools, higher education, the state health plan, and Medicaid/Health Choice—meaning that there is a lot of pressure on the state’s already tight budget—and that’s not to mention the other interest groups we compete with, such as state nursing homes and other healthcare coalitions.

As GAO continues to garner legislative support for $29.5 million in state funds needed for the Medicaid rate increases we are seeking, advocacy efforts will play an important role. Please watch for ways to support our legislative ask, and please reach out to Mike Sokoloski at msokoloski@bayada.com to learn how you can get involved in advocacy on behalf of your staff and clients.

NC Bills we are following


“I’m just a bill” – Knowing the path by which a bill must travel is important as we follow various bills. 

To date, 824 bills have been filed in the North Carolina General Assembly this session. GAO continues to work through the proposed bills to evaluate their impact on home health care, home care, and hospice. Below are a few bills that are of interest:

1. H70 – Delay NC HealthConnex for Certain Providers, sponsored by Representatives Dobson, Murphy, White, and Lambeth

Home care champion Representative Josh Dobson submitted the bill that extends the deadline by which certain providers, including home care and home health care agencies, must participate in and submit data to the state’s Health Information Exchange Network, NC HealthConnex.  We commend the bill sponsors for this delay.

While participation in and submission to NC HealthConnex is important and necessary in that it grants both the state and providers electronic, timely access to demographic and clinical data, our industry and others provider sectors do not have a consistent platform or an easy way to gather and transmit the required data. Access to this data and clinical information will help the state and providers identify spending trends that will facilitate health care cost containment while also improving health care outcomes only if the data is reliable and consistently reported.

This extended deadline proposed by House Bill 70 grants us additional time to meet the reporting requirements.  We thank all the bill signatories for recognizing the administrative burden and granting additional time to meet the requirement.

The bill passed both the House floor on March 27, 2019 and is headed to the Senate.

2. H745– Medicaid Funding Request for Private Duty Nursing (PDN), sponsored by Representatives White, Lambeth, Adcock, and Cunningham

Our health care members, a home care nurse (White), a hospital administrator (Lambeth), a nurse practitioner (Adcock), and a hospice nurse (Cunningham), introduced H745 to increase the Medicaid funding for nursing under PDN from $39.60 to $45.00 by requesting $4.1M for 2019-2020 and $8.3M for 2020-2021 in recurring state funds.

As health care leaders, they recognize the importance our services play in keeping some of North Carolina’s most clinically complex citizen at home and out of more expensive settings. While the necessary funds were not allocated in the House Budget, we have an opportunity to get it into the Senate Budget and are continuing to advocate for this option.   

3. H728– Increase Innovation Waiver Slots, sponsored by Representatives Insko, Hawkins, and Lambeth

This bill appropriates 500 Innovation Waiver Slots to address the waiting lists. It would support North Carolinians living with intellectual and developmental disabilities (I/DD) and help them receive needed services within their home and community.  The bill proposes to appropriate $5.3M for 2019-2020 and $10,9M for 2020-2021 in recurring funds.

4. S361– Increase Innovation Waiver Slots, sponsored by Representatives Insko, Hawkins, and Lambeth

This proposed bill attempts to address several different health care issues in one bill. This approach makes it challenging to garner support in its entirety.  The bill includes the following provisions:

  • Elimination of Certificate of Need (CON) – Any action that erodes the established process by which a need is determined may lead to destabilizing our health care industry. The established CON process allows for any group to apply for a Special Needs Determination should they feel health care needs are not being met in their community.
  • Establishes a carve-out for PACE organization – Any action that allows a group to be exempt from following Home Care Licensure Rules puts recipients at risk as the organization would not be required to follow health and safety rules outlined state licensure.
  • Medicaid Expansion – Any opportunity for the North Carolina’s working poor to have access to health care coverage, the better. This provision includes a work requirement with exceptions for individuals attending school and or deemed disabled.
  • Addition of Innovation Waiver Slots – Any opportunity for more individuals living with intellectual and development disabilities (I/DD) to have access to needed services, the better.

The introduction of this bill is the first step in a long process. GAO will continue to monitor and support the I/DD slot provision which aligns with our access to care goals. Some of the other items are very controversial because they create a slippery slope on oversight.

To find out what you can do to encourage your legislators to support the introduction of this bill, contact Lee Dobson at ldobson@bayada.com.

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.