Senate Republican leaders and home care providers called on the state Department of Social Services Monday to release a 1.7% increase in Medicaid funding to the agencies to help them provide better care to their clients.
Agencies that employ the home care workforce are struggling due to the pandemic and the lack of funding to hire quality employees to take care of the elderly and disabled in their homes, Senate Republican Leader Kevin Kelly said.
“People want to remain at home,” Kelly said. “They want to age in place with dignity.”
DSS is working on releasing the funding, agency officials said Monday. But the 1.7% increase approved by the legislature and a 1.8% increase from American Rescue Plan Act funds, which would total a 3.5% increase in Medicaid reimbursements to home care agencies require a legislative hearing and federal approval, David Dearborn, a spokesman for DSS, said.
“Actually DSS is working on a number of fronts to increase pay for home care staff, pending legislative and federal approvals,” Dearborn said. “A legislative hearing is anticipated in January.”
The agency is also working on providing a 5% one-time lump sum payment to providers and a 6% rate increase to reflect the increase in the state’s minimum wage, which would be retroactive to August 1, Dearborn added.
Later in the day at an unrelated event, Gov. Ned Lamont said he would use his executive powers to waive the hearing process and get the rate increases out the door.
“If they feel comfortable, let me do it by executive order. I can do it today and get the money out the door very quickly,” Lamont said.
Small home care providers have been struggling with costs during the pandemic even as the legislature approved the 1.7% Medicaid increase which would fund raises, fuel, the delivery of meals to homes and other services needed by the homebound, Kelly said.
“If we don’t provide this increase to providers, the providers won’t be providing the services,” Kelly said.
He estimated that home care through Medicaid cost the state about 30% of what it costs to send someone to an institutionalized setting such as a nursing home.
The reality is that there was a workforce shortage prior to the pandemic, said Tracy Wodatch, president and CEO of the Connecticut Association for Healthcare at Home. The association represents about 25 agencies who hire employees to act as companions and homemakers, she said. The 1.7% increase does not involve workers who provide medical services in-home such as nurses, occupational and physical therapists or social workers, she said.
Since the pandemic, the need for care providers who can do light housework, see to meals and other daily living tasks has grown because people are trying to avoid going into institutional settings, Wodatch said.
“The Connecticut Association for Healthcare at Home and its home health and non-medical home care providers have been working on these rate increases for the past year,” Wodatch said. “We have been in constant contact with legislators, DSS and OPM (state Office of Policy and Management) on the critical need for increased home care rates as outlined in the attached ARPA proposal.”
Unfortunately the approval process for any state and federal funding requires many steps, and the state is waiting for conditional approval of the entire plan from the national Centers for Medicare and Medicaid, Wodatch said.
“Although this is a long wait period – July to now-, once approved, the providers will be receiving much needed dollars to support higher wages and more workforce to keep the growing number of people in the community where they want to receive their care,” Wodatch said.
The 1.7% increase works out an additional $4.6 million a year for agencies that provide home care services. The raise will be retroactive to July 1 – but the agencies need the money or they risk closing, which would lead to fewer people being able to access home care, Kelly and Sen. Paul Formica, R-East Lyme, said in a letter sent to DSS Commissioner Deidre Gifford Monday.
“We are very concerned that growing financial pressure will force small providers to pull out of the state’s home care program because they can no longer afford to provide care with Medicaid,” said in the letter which was signed by 50 home care agencies.
The state is looking at a caregiver crisis, said Jonah Francis who owns Pansy Homecare. His agency is having a hard time retaining staff, he said. “They want better hours, a better work environment and better pay,” Francis said.
The Medicaid reimbursement rate is $16.88 an hour, Francis said, but the minimum wage in Connecticut is $13 an hour. His company must pay for employee taxes, overhead and training with the remaining $3.88 an hour, he said. “I think we all believe our care providers should be receiving more,” Francis said.
