South Carolina Families Struggle Due to Lack of In-Home Nurses

William Walker is pictured with his parents Christina and Aaron. The Walkers are looking for an in-home nurse so that they can finally bring William home.

Just like many new parents across South Carolina and the US, Christina and Aaron Walker are excited to bring their newborn baby boy–William–home from the hospital. But unlike most other new parents, they can’t. That’s because William was born a little more than three months early, with medical complications.

But it’s not the complications themselves that have restricted William to the NICU–but rather, the lack of in-home nurses in the state. Baby William is medically cleared to go home, but the hospital cannot discharge him until an in-home nurse is available to care for him at the Walkers’ Bradley residence.

“The State hasn’t increased funding for the Private Duty Nursing (PDN) program in more than a decade. As a result, agencies that hire and provide in-home nurses to families like the Walkers can’t recruit and retain enough nurses to keep up with the demand,” says BAYADA Government Affairs Director for South Carolina Melissa Allman.

In the past decade, costs of living have gone up tremendously, and so home care agencies are struggling to pay nurses fair wages and stay sustainable as the funding has stagnated. PDN program funding must cover nurses’ wages–plus training, benefits, supervision, and supplies. Rates are so low, that many agencies have even left the state entirely.

Moreover, nurses are attracted to institutions and other settings–such as nursing homes, hospitals, and doctors’ offices–where they can earn more in wages. “The backwards part is that the state can save money and keep families together by keeping medically-complex residents at home and out of institutions. It’s a win-win,” says Melissa.

Christina and Aaron are celebrating every milestone that William reaches in the hospital. At five months, they are more than ready to take their baby boy home. Children deserve to grow up at home among their peers and loved ones. But if the state does not address PDN program funding in a way that ensures agencies can stay sustainable and raise nurses’ wages, then there will be more cases like William’s, where parents must continue to visit the NICU or another facility to see their son or daughter.

Read more about William’s journey here. If you know of a qualified nurse that is interested in caring for William, contact BAYADA Home Health Care at 864-448-5000. If you would like to learn about ways in which you can advocate for better nursing wages in South Carolina or elsewhere, contact Hearts for Home Care at advocacy@bayada.com

Public Affairs: BAYADA’s First Full Year of Full Time Public Affairs Efforts Secures Media Attention and Contributes to Legislative Wins!

BAYADA’s public affairs program has generated public and legislative awareness about home care, its importance in communities across the country, and the issues clients and families face accessing care due to low state reimbursement rates.

BAYADA has used public affairs efforts throughout the past several years. That is—in states where GAO and state leadership knew that increased public awareness and engagement would reinforce a strong lobbying message, GAO deployed these efforts, which resulted in increased legislative & regulatory pressure on BAYADA’s key issues. This was particularly true where BAYADA, home care recipients, and the industry needed rate increases to stay sustainable and to be able to recruit and retain enough caregivers to meet clients’ demand.

2019 was the first year that BAYADA invested in a full-time public affairs program. Here, public affairs staff executed several state-specific campaigns to further BAYADA’s legislative agenda, as well as an “umbrella” campaign to highlight the challenges seen regularly on the national home care and home health care front.

GAO enlisted public affairs firm Regan Communications Group (RCG) full-time to put clients’ and caregivers’ stories in the spotlight. No easy task, especially as media and newsworthy issues tend to change minute-by-minute, RCG regularly delivers by getting GAO’s legislative message out via broadcast, print, and non-traditional media outlets. As a result of full-time public affairs efforts in 2019, state governments heard us loud and clear, and often made policy changes in order to help alleviate the issues BAYADA staff, clients, and families faced.

Below, see a list of media that BAYADA’s GAO was able to gain through its partnership with RCG in 2019:

Federal/Industry-Wide

Home Health Care News: Immigration Reform, Minimum Wage Increases Top of Mind for BAYADA

Home Health Care News: Medicaid legislation introduced in Congress

STAT News: Health aides’ low wages threaten home health care, a necessity for millions

Modern Healthcare: More middle-income seniors face financial insecurity

Home Health Care News: Industry Insiders: Don’t Overlook CMS’s Dual-Eligibles Directive

Home Health Care News: Immigration “Pathways” Vital to industry’s future

Home Health Care News: BAYADA Hits 1M Clients Served. Here’s Why Hitting 2M Will be More Difficult

Modern Healthcare: Nursing home staffing levels often fall below CMS expectations

Everyday Health: Demand on the Rise for Home Healthcare

Authority Magazine: The Future of Healthcare: “First and foremost, reprioritize long-term care into the home setting” with David Totaro of BAYADA Home Health Care

Delaware

Delaware Public Media: Advocates call on state lawmakers to raise Medicaid reimbursement rates

Delaware State News: BAYADA Pediatrics director awarded national honor for advocacy work

Indiana

RTV 6: Hoosier families want more resources for home health care

WTHR 13: Gasping for Care: Indiana families desperately seek care amid home nursing shortage

New Jersey

NJTV & NJ Spotlight: Shortage of Home Care Nurses on Horizon

My Central Jersey: NJ’s shortage of private duty nurses taking toll on families

NJ 101.5: A home health care nursing shortage is looming in NJ

NJ Star Ledger: Prefer to age at home in N.J.? It will soon be even harder | Editorial

Pennsylvania

Bucks County Courier Times: BAYADA Home Health Care’s Langhorne office recently nominated Melissa Husted, of Morrisville, and Winnie Gittens, of Philadelphia, for the Pennsylvania Home Care Association’s 2019 Direct Care Worker of the Year Award

PennLive/Patriot News: Advocates call on lawmakers to make home-based care services more accessible for seniors and disabled

Generocity: BAYADA transitions from for-profit to nonprofit to save its mission-driven culture

Pittsburgh Post-Gazette: An old refrain: Better wages, conditions a must for direct care workforce

PennLive/Patriot News: An opportunity to do the right thing for vulnerable Pennsylvanians: Raise home health aides’ wages

WXPI & WPGH: Lack of home health care aides impacting local patients

Pittsburgh Post-Gazette: Increase funding for home care providers

Pittsburgh Tribune Review: Donna Pierantoni: Home care crisis’ impact on disabled adults, seniors

Rhode Island

Valley Breeze: Aging Out: Local family says vulnerable son fell through state’s cracks

Valley Breeze: Family frustrated after near-miss on losing care hours

Providence Business News: Anxious R.I. families await decision on special medical coverage

South Carolina

Post & Courier Gazette: Lowcountry home health care experts speak on the need for more workers in the field

Summerville Journal: Helping Mason: Family of Police Officers with Sick Child Loses Home Nurse Right Before the Holidays, need to raise Medicaid Reimbursement Rates in SC for 2020

GAO SC: Much-Needed PDN Rate Increase Helps Keep SC Medicaid Skilled Nursing Offices Open!

GAO Director Melissa Allman and SC office employees, field employees, and clients & families made all the difference in ensuring that medically-fragile residents could continue to access home care

Over the past several years, home care offices across South Carolina have struggled to stay sustainable due to low state Medicaid reimbursement rates for in-home nursing services. As more and more providers shut their doors, GAO and our advocates continued to fight towards a solution so that South Carolina’s most vulnerable residents could continue to access the skilled care they needed to stay at home.

After aggressive advocacy and a public affairs push throughout 2019, our concerted efforts are beginning to pay off! After more than a decade without a nursing increase, the state recommended a 15% increase, effective July 1, 2020. After further advocacy efforts focused on the urgent need for an immediate increase, including articles profiling affected families in the media, the SC Department of Health & Human Services (DHHS) issued the initial 5% increase be effective January 1, 2020. This 5% increase will generate nearly $230,000 in additional annual revenue.

BREAKING: DHHS is committed to including the remaining 10% to be effective July 1, 2020. If the provision is passed into law as planned, then PDN services will see a total 15% increase from 2019 levels (5% increase effective January 1, 2020, and an additional 10% targeted for July 1, 2020), resulting in nearly $690,000 in additional annual revenue.

Further increases are needed to ensure access to care for all vulnerable South Carolinians. These major steps forward would not have been possible without sharing our collective voices to showcase the importance of care in the home care and the need to regularly maintained viable reimbursement rates.

Thank you to all of our South Carolina offices, leadership, clients, and families that shared their stories and advocated for this important increase!

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.

25 BAYADA Advocates Gather for Inspiring and Record-Breaking Legislative Day in Columbia, SC

Top left & bottom right: 25 BAYADA employees and clients joined the South Carolina Home Care and Hospice Association’s second annual Legislative Advocacy Day
Top right: Stephanie Black, Vickie Nelson, Dave Totaro, and Melissa Allman meet with Senator Thomas Nelson (center)
Bottom left: BAYADA Rock Hill (ROC) office employees pose in front of the SC capitol. Left to right: Nurse Michelle Ghent, Director Jenni Cairns, and nurse Cathy Medeiros (2017 LPN National Hero)

On March 6, 24 energetic BAYADA employees and one BAYADA Assistive Care State Programs (ACSP) client gathered in South Carolina’s state capitol for a day of meaningful and heartfelt advocacy. The South Carolina Home Care and Hospice Association (SCHCHA) hosted its second annual Legislative Advocacy Day, and this year, a record-breaking total of nearly 60 advocates attended!

BAYADA’s advocates joined other attendees and walked the halls with a clear message: Investing in our Nursing Medicaid Waiver programs will save the state money and keep our medically fragile children, disabled adults, and seniors home with their loved ones and out of higher cost facilities.  We care about home care, and so should you!

With their passionate message in hand, advocates spoke with over 50 legislators about the importance of home care. This year we were able to speak to all key lawmakers in both the House and Senate to ensure our message was heard by as many ears–and the right ears–as possible.

“Advocacy can’t be effective with only one person working towards a goal–one voice can only go so far! That’s why I am so proud to work in South Carolina, where so many of our office employees, field employees, and clients recognize the importance of sharing their voices too. The more impassioned people we have involved, the more of a difference we can make on behalf of all South Carolinians that rely on home care,” said GAO director Melissa Allman.

BAYADA employees were excited and inspired by the impact they made that day. Thank you to the many participants for the difference you make on behalf of all South Carolinians that rely on home care to stay independent in their communities!

BAYADA’s Government Affairs Office Expands into Georgia!

BAYADA’s Government Affairs Office (GAO) is excited to announce its expansion into Georgia! BAYADA’s current footprint in Georgia includes two pediatric offices and one adult office, which employ 253 field staff and 28 office employees, and care for 131 clients combined. Expansion into the Peach State means that GAO can begin directly lobbying state lawmakers for better home care policies and reimbursement rates, and can begin to directly involve Georgia staff, clients, and families in advocacy efforts.

BAYADA had its first advisory council meeting with Georgia leadership on July 24th to discuss the issues that Georgia’s service office regularly face and how GAO can best support their needs. The advisory council is chaired by Chief Government Affairs Officer Dave Totaro and comprises of BAYADA leadership in the state, GAO Director for South Carolina and Georgia, Melissa Allman, and Area Director Lee Dobson. The advisory council meets regularly to determine legislative priorities, discuss progress towards our goals, and determine next steps.

Dahlia Division Director Tammie Craddock stated, “We are so excited to have the support of GAO so we can finally be the advocates that the adult nursing population in Georgia deserves!  We know that the choices are limited for clients who age out of the Georgia Pediatric Program, but the need still exists. We are hopeful with the help of GAO we can generate a greater impact on lawmakers and assist families by providing more options for in home care after the age of 21.”

Be sure to check out GAO’s biweekly Heartbeat to see new updates on our progress in Georgia!

Thank you to all our Advisory Council Members for your input and participation! We are excited to work towards better rates and policies on behalf of all Georgia’s staff and clients!

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.

20×2020- An Advocacy Goal

What counts as advocacy? Advocacy is any message, big or small, delivered to state or federal decision makers to express the importance of home care.

This means that as an employee, you could advocate by sending an email or a letter to a legislator, sharing a story about home care on social media, attending your state’s lobby day, or helping a client advocate.

We have seen many times over how these messages add up to bring positive change to our staff’s and clients’ lives. During this year’s Ambassador of the Year Awards, US Senator Debbie Stabenow talked to attendees about how our email campaign in which BAYADA employees sent over 138,000 messages to our federal legislators, stopped Congress’s attempt to cut Medicaid funding. All of your advocacy activities add to our collective message that home care is important and should be prioritized when the government makes public policy decisions.

Don’t be afraid to share your voice to make positive changes for a better and stronger home care industry. To learn more about how you can be involved in advocacy and be part of that 20 percent, please contact me, Rick Hynick, at rhynick@bayada.com.

Advocate Spotlight: Jen Collier


Jen Collier with her local congressman, US Representative Ralph Norman

Hearts for Home Care Ambassador Jen Collier, Transitional Care Manager for the Charlotte Visits (CV) office, recently traveled to Washington, D.C. to join other families on Capitol Hill to advocate for her father and the many other individuals across the United States that receive charitable assistance.  Jen’s father was diagnosed with a rare form of Leukemia for which there are only two medications that can effectively treat the illness.

Jen’s father failed the trial for one of the medications, so he must take the second medication, which exceeds $23,000 per month in out-of-pocket costs.  When he was diagnosed, he owned his own business, but when he lost his business, he lost his insurance.  Working as a new nurse in an emergency department in Gastonia, NC, Jen found herself having to learn how to get him the necessary care as an uninsured client.  She spent most of her time calling oncologists and begging them to take her father as their patient with no insurance.  She also had to find out how to pay for this medication and the 24 others he needed for his other chronic health conditions.

Patient Services, Inc. (PSI) is a charitable organization that helped Jen navigate this complicated process and assisted with the out-of-pocket costs for his medication.  Once he passed the waiting period for disability and got Medicare, his out-of-pocket responsibility still cost him $7,000 per month, even with his supplement. PSI continued to assist Jen and her father with these monthly payments.

Last year, Jen received notification that her father’s financial assistance was in jeopardy due to federal efforts to cut charitable contributions. PSI selected Jen to help them lobby Congress in support of H.R. 3976, which, if passed, would add PSI and other similar companies to the list of those exempt from this law. During her day on Capitol Hill, Jen met with over 10 representatives and their staff to gain support for this bill, which affects not only her father, but many of the patients she works with every day as a transitional care manager.

Jen said “It was a huge honor to be selected by PSI to help gain support for this bill.  PSI is a wonderful organization and I don’t know where my father would be without their assistance.  My director put me right in touch with GAO, and everyone has been so encouraging.  I am so thankful to work for a company that was able to give me the necessary training and support as I navigated this complicated process for the first time.  I am passionate about being an advocate every day for my patients because of what I have been through with my father.”

To learn more about PSI, please visit their website.

To learn more about H.R. 3976, click here.

Nicole Lugo Named South Carolina’s First Ambassador of the Year!


 Nicole Lugo (center) poses with her Hearts for Home Care Ambassador of the Year Award alongside GAO Director Melissa Allman (left) and Chief Government Affairs Officer Dave Totaro (right).

Nicole Lugo, Director of the Coastal Carolina Pediatrics (CCP) office, and her mother, Emily Lugo, recently joined GAO and other state Ambassador of the Year winners in Washington, DC as South Carolina’s first Hearts for Home Care Ambassador of the Year.  Nicole was given this honor due to her instrumental role in securing a policy change for the Medically Complex Children’s Waiver by presenting BAYADA’s “Intro to Pediatrics” program to the Department of Health and Environmental Services.

Nicole’s enthusiasm and passion for advocacy continue to shine on a daily basis. Thank You Nicole, for all you do on behalf of your staff and clients!

To read more about the Hearts for Home Care Ambassador of the Year Awards, please see last week’s Bulletin article

If you are interested in learning more about the Hearts for Home Care Ambassador program or about becoming your office’s Ambassador, email Mike Sokoloski.