By Dave Totaro
In considering the future of the American healthcare system and the impact of COVID-19, it is important to remember an area that is often unrivaled in terms of quality of care but remains overlooked and underfunded: home care.
Trends and surveys show that patients and their families prefer care at home rather than in nursing homes or other institutional settings, but our current system is not staffed enough to handle this dramatic increase in demand. Home helpers, nurses, therapists, and many other home care workers keep more than 8 million Americans independent in their homes, along with their families, and outside of facilities such as hospitals and nursing homes. Despite the necessary, sensitive, and often emotionally and physically demanding work these caregivers do, in large part they are acutely underpaid due to Medicaid reimbursement rates, which have not increased in many states in over a decade.
The home care community has been campaigning for an increase in funding for long-term care for decades. Federal Medicaid’s regulations, enacted in the 1960s, create an institutional bias that makes it easier for Medicaid-eligible seniors and people with disabilities to access home care rather than health care. While it is important to note that nursing homes are a very necessary part of the long-term care system, the pandemic has shed light on the dangers of such facilities and, as a result, has only helped to increase the demand for home care.
As a silver lining to the devastation caused by COVID-19, I believe 2021 will bring home recognition as the future healthcare environment. More and more state and state lawmakers and the general public are seeing the inherent benefits of home health care: it’s more affordable for families and government Medicaid programs, and saves an average of $ 30,000 per year for every senior distracted by a long-term care facility home care. It keeps vulnerable populations in their communities independent and enables medically vulnerable children to grow up with their loved ones at home.
President-elect Joe Biden’s current health plans appear to be moving in the right direction, including elderly care, childcare and better jobs for home care workers in a $ 775 billion package. The package includes a plan to eliminate the home care waiting list, currently over 800,000 people, and promoting fair wages for mostly female, lower-income home health workers. As with many big plans, this is easier said than done, and changes need to be made at all levels of government to catalyze significant improvements.
First, lawmakers have to deal with obsolete funding for government home care programs. Many states have not raised funds for private nursing and personal care programs in years, and the funds required to cover costs, including wages, training, services, and supplies of caregivers, are below the actual cost of providing services and supplies of the nursing staff with the required services like protective equipment.
Without adequate funding, providers like BAYADA cannot provide wages that enable us to recruit and retain the workforce necessary to keep pace with growing demand and a rapidly aging elderly population. Second, Medicaid programs need to be rewired so that the home, not the individual’s facility, is the “default” care setting. Finally, the federal government can update the overarching laws of Medicaid and Medicare to make home care easier for families.
Given the fantastic potential for positive change on the horizon, I urge you to reach out and let your lawmaker know – whether you know someone in need of care now or whether you know you would rather age in your own home in the future want you to, and should, take care of home care.
David Totaro is Chief Government Affairs Officer at BAYADA Home Health Care, Inc..
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