Why Client Advocacy Matters

 

BAYADA client Carly (front) is pictured here with NJ Assemblyman Anthony Bucco (right) during a legislative home visit, which served to familiarize the assemblyman about how home care affects his constituents. Carly and her mother Christina (left) also testified at a legislative hearing in Trenton about the need for increased Private Duty Nursing (PDN) rates.

 

 

 

 

 

 

 

 

 

 

 

 

 

Client advocacy matters more than that of home care industry professionals. While home care professionals can share facts and figures about home care with legislators, it is clients’ stories that truly paint the picture of what home care means to legislators’ constituents.

Whether a home care client is an infant, senior, or any age in-between, it is very likely that the nursing or aide services that they rely on is from a Medicaid or Medicare program.  What this means is that government officials are the ones making the decisions on care regulations and reimbursement rates rather than those who are regularly affected by home care.  Home care providers must accept these rates and regulations and provide care to the best of their abilities based on what the government has set forth rather than on what is actually best for clients and their families.

Home care employees regularly see that many of the government reimbursement rates for home care are low and have not been increased in years. This has a domino effect in that if providers can’t bring more revenue in, they can’t pay higher rates to attract more staff to care for current clients or for new clients who will need care in the future.

Many areas of our country are starting to age and will need caregivers to allow people to live in their homes instead of in facilities, yet projections indicate fewer people want to be professional caregivers due to the industry’s low wages. Additionally, more nurses are choosing employment in other types of settings, which makes it difficult for many home care clients to have adequate nursing coverage because facilities such as hospitals can pay nurses a higher wage.

As elections come and go, we see changes in our government leaders and with these changes come the possibility of healthcare policy changes. These changes can be sudden and unpredictable, and these changes often threaten funding cuts to important programs such as Medicaid or Medicare. Any funding cuts to these programs would be devastating to home care providers and to program beneficiaries.

The interesting thing is that the representatives and senators who we vote for at the state and federal level make these decisions, and few of them have strong healthcare backgrounds.  In addition, it is their job to represent all of the people from their respective districts to the best of their abilities. While provider employees can share their voices through legislative meetings, clients’ and their family members’ advocating and sharing their stories matter most.

Clients who benefit from home care and their family members have their own special stories to tell.  As the end users of nursing and aide services, clients and family members have the first-hand knowledge of how the Medicaid and Medicare programs are working and what could be done to improve them.  Clients names, faces, and shared stories paint a far more detailed picture of home care than industry professionals can with facts and figures. When legislators vote on issues related to home care, clients stories are better-remembered, and legislators are much more likely to vote for favorable home care policies with these in mind.

“I’ve been an advocate for my wife, who is 100 percent dependent, for 16 years,” said Mike Pollock, the husband of a client who advocates to protect home care for his wife and all who need services.  “Thanks to Medicare and Medicaid and BAYADA, I’ve been able to care for her at home.  Although Medicare and Medicaid are excellent resources, they have their issues.  An excellent resource for solving these issues are our elected officials,” Pollock said.  “In fact, elected officials are the only people capable of fixing issues that arise within Medicare and Medicaid. But they can’t help if they don’t know what we as family caregivers are dealing with every day.  Never hesitate about reaching out to them. It’s been my experience they are eager to help,” Pollock concluded.

By putting advocacy into action and connecting our clients to their elected officials, there is a far better chance that Medicaid and Medicare will be protected and grow with the needs of our clients. Please email me at rhynick@bayada.com for more information related to client and family advocacy and what you can do to help protect and strengthen the home care industry in your state and at the federal level.

The Power of Advocacy: Home Care Employees Share Impassioned Testimony to Advocate for Nursing Rate Increases

Home health care advocate testifies in front of Delaware Joint Finance Committee 2018
BAYADA RN Victoria Carter advocates for higher reimbursement rates by providing moving testimony in front of the Delaware Joint Finance Committee

On February 21, seven BAYADA Home Health Care employees, one of whom is a parent and caregiver of a medically complex child, testified in front of a dozen Delaware state legislators and nearly 80 community members to advocate for a Medicaid reimbursement rate increase for registered nurses (RNs) and licensed practical nurses (LPNs).

The Delaware Joint Finance Committee met to hear the Department of Health and Social Services’ (DHSS) annual budget request in what ended up being a crowded room that drew so many members of the public that overflow seating had to be provided in the cafeteria, where a live video feed of the hearing was streamed. Though a few of these advocates were initially hesitant to speak in front of legislators- let alone such a crowd- what kept them going is their commitment to advocating on behalf of home care nurses, their clients, and their clients’ loved ones.

These advocates’ testimonies detailed their personal stories of why the committee should include additional funds to DHSS’s budget to be used to increase the state’s reimbursement rates for RN and LPN care by about 25%. Delaware’s current rates have not been increased in more than ten years, and these current rates are not adequate to keep up with demand for in-home nursing care because of the pressure that low rates place on providers’ ability to recruit and retain quality nurses. With a rate increase for RN and LPN care, providers would be able to attract more nurses to deliver the in-home care that pediatric, adult, and senior home care clients need.

BAYADA registered nurse Jen Saulsbury shared a moving story about two of her pediatric clients and the impact that nursing turnover rates, which stem from Delaware’s low reimbursement rates, has on them. She shared a crayon-drawn card from one of her pediatric clients to accompany her story, which nearly brought the committee to tears.

Committee co-chair Representative Melanie George-Smith and Senator Nicole Poore vocalized their support of increased reimbursement rates for RN and LPN care. It goes to show that advocacy is a powerful force in creating the changes necessary to support home care employees, clients, and their families.

Top left to bottom right: Danielle Myers, Jennifer Scott, Alice Knott, Amanda Brady, nursing student Morgan Luther; Jennifer Saulsbury, Victoria Carter, Shannon Gahs

Advocacy is powerful. The stories that these advocates shared in front of the committee were not those of data, numbers, and dollar signs, but rather their unique, passionate perspectives of why this issue is so important that it deserves legislative attention and action.

Advocacy doesn’t necessarily involve testifying in front of a crowded room. It can be sharing your unique story or picture with us, writing an email to a legislator, or participating in a meeting to talk about issues you face every day. A state-funded nursing rate increase cannot happen without getting other passionate individuals involved. If you would like to find out how you can to advocate for better home care laws and regulations, let’s talk about how you can get involved. Email me today!

Delaware Rate Floor Bill Passes House Committee

Submitted by Shannon Gahs, Associate Director, DE Government Affairs (GAO)

Following compelling testimony by clients Nancy and Christopher Lemus, Delaware Association for Home and Community-based Care (DAHCC) President Bob Bird, Delaware Pediatrics (DP) Associate Director Mandy Brady, and myself, the House Health & Human Development Committee passed a bill that would set a minimum reimbursement rate paid by Medicaid managed care organizations (MCOs) to home health care providers for skilled nursing services.
Representatives asked probing questions, sparking true debate over the measure. The vote was 10-0 with 4 additional members absent. The bill must still pass the full House, the Senate Health, Children & Social Services Committee, and the full Senate. The legislature closes on June 30. If this bill passes, MCOs would not be able to pay any less than the Department of Health and Social Services (DHSS) pays for the same care, giving DHSS the ability to ensure access to needed services.

Nancy Lemus giving testimony at the hearing

Delaware: Moving Forward In 2017

Submitted by Shannon Gahs, Associate Director, DE Government Affairs (GAO)

Governor John Carney took office in January, inheriting a budget deficit of $350 million.  As a result, the General Assembly is reviewing all planned expenditures for 2017.  I attended public hearings on all parts of the budget affecting the Department of Health and Social Services and testified on the need for a rate floor in Medicaid-contracted services.