Our state and country faced great losses and challenges during the COVID-19 pandemic. Our health system has been strained, and many Coloradans have suffered economic repercussions and the devastating loss of loved ones.

Unfortunately, there was a huge spike in COVID cases in December, with Colorado hospital stays reaching their highest level since the pandemic began.

During this holiday season, we were concerned about the loss of time we spent with loved ones. During this time of struggle, I hope we can pause and be grateful for the promise of a vaccine and other blessings.

Don Knox

I hope we can also thank those who work on the front lines to care for those in need, including the unsung heroes who may not be as visible because they don’t work in hospitals or doctor’s offices. I am speaking of home health and personal care workers bringing care straight to some of the Coloradan’s most vulnerable homes.

During the pandemic, these workers provided basic care for the patients they live in so anxious and high-risk patients can stay in their home and outside of crowded hospitals and nursing homes.

In many ways, home health officials have also been the relief valve for hospitals and nursing homes, allowing these facilities to focus on patients with more severe health needs by taking care of the home where possible.

Home care workers provide skilled care, as well as physiotherapy, occupational therapy, speech therapy and other skilled services. Personal care workers help people with special needs stay in their homes by assisting with mobility, bathing, dressing, using the toilet, feeding, medication reminders, and around-the-home chores.

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During the pandemic, these workers provided vital daily support and assistance to patients across the state – as always. They have helped the elderly, adults and children with chronic illnesses, people with disabilities or impairments, and patients who have recovered from an accident, surgery, or illness such as COVID-19.

As with other companies, the pandemic hit home health officials hard. Many have faced sudden and drastic loss of income.

Elective surgeries have been canceled for an extended period of time, reducing the demand for home care, often provided during the recovery period after these procedures. In the meantime, other patients have postponed routine and preventive care because they found it uncomfortable to let someone into their home.

When the demand for care returned, these agencies had to procure expensive and hard-to-find personal protective equipment and conduct critical additional training and testing for staff to keep the provider and patient safe. They needed to create incentives for staff to care for COVID patients and suspicious COVID patients who needed home care, and they needed to find a way to address staffing gaps caused by school closings, the need to quarantine staff and the constant attendance that arose were competition for qualified health professionals.

Many also faced the almost insurmountable challenge of low Medicaid reimbursement rates. These rates were already below the recommended levels that led to the pandemic and were further lowered by the state of Colorado during the pandemic due to budget issues.

While the introduction of vaccines offers hope, the pandemic is still huge with us, and the challenges that home health officials and their staff are facing continue, especially given the low Medicaid reimbursement rates.

Agencies supported by larger health systems can make care more charitable, but many smaller agencies are in a precarious financial position when they care for the state’s most vulnerable patients without compensation or at a loss.

How long can these agencies continue this practice? If they are pushed out of business, who will take care of endangered Coloradans?

Our federal and state leaders cannot let the funding dwindle further. Reimbursement rates at both state and federal levels need to keep pace with ongoing cost increases to ensure that home care workers receive the benefits, wages and support they need to continue their important work.

This has never been more important: Given government budgetary and public health challenges, policy makers play an important role in providing critical support for the continuation of safe and affordable home care through higher reimbursement rates.

During the pandemic, home care has been a lifeline for some of Colorado’s most vulnerable residents, who rely on them to stay strong and healthy both physically and mentally. During this pandemic and beyond, the use of in-home therapies can reduce depression and dangerous weight loss, and implement critical preventive and rehabilitative measures that reduce costly illness and hospital stays.

In times of need, domestic workers have shown that they care. It is now our turn to ensure that reimbursement provides adequate support to workers and continues to provide high quality care for the patients they serve.

Don Knox is the executive director of the Home Care and Hospice Association of Colorado.

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