Home Health & Hospice Week

Public Charge Rule Review May Help Staffing Crisis

With policy proposals such as an increased minimum wage and enhanced unemployment benefits in the offing, home care providers fear the Biden administration will kick them when they’re down when it comes to staffing. But a newly signed executive order may offer some relief in this area.

Background: Under former President Trump, U.S. Citizenship and Immigration Services planned implemen­tation of a rule in October 2019 limiting which immigrants could receive green cards. Under the rule, immigrants would be denied green cards based on use of public benefits including Supplemental Nutrition Assistance Program (SNAP), Medicaid, and various public housing programs, among others. Due to litigation, USCIS actually implemented the rule in February 2020. However, federal courts have issued injunctions against its use in some areas, while appeals courts have issued stays still allowing the rule’s usage. The matter depends on litigation pending before the U.S. Supreme Court.

Now, President Biden signed a Feb. 2 executive order requiring a review of the rule. The U.S. Secretary of State, Attorney General, Secretary of Homeland Security, and “the heads of other relevant agencies, as appropriate, shall review all agency actions related to implementation of the public charge ground of inadmissibility,” the order states. “They shall, in considering the effects and implications of public charge policies, consult with the heads of relevant agencies, including the Secretary of Agriculture, the Secretary of Health and Human Services, and the Secretary of Housing and Urban Development,” Biden says in the order.

“Within 60 days … the Secretary of State, the Attorney General, and the Secretary of Homeland Security shall each submit a report to the President describing any agency actions … and any steps their agencies intend to take or have taken” to address concerns about the public charge policy, the order says.

The order follows through on a campaign promise. “Trump’s public charge rule … runs counter to our values as Americans and the history of our nation,” then-candidate Biden’s campaign website noted. “Allowing immigration officials to make an individual’s ability to receive a visa or gain permanent residency contingent on their use of government services such as SNAP benefits or Medicaid, their household income, and other discriminatory criteria undermines America’s character as land of opportunity that is open and welcoming to all, not just the wealthy.”

60% Of Home Care Workers Rely On Public Assistance

If the public charge rule is rolled back as expected, it could be a big boost to home care providers that have been scrambling to hire enough workers to meet rising demand during the pandemic.

“Due to low reimbursement rates offered by government programs like Medicaid or the Veterans Administration, compensation for home care workers is limited and a majority of them qualify for some form of public assistance,” notes the National Association for Home Care & Hospice. “About 30 percent qualify for SNAP and 30 percent qualify for Medicaid,” NAHC says in its member newsletter.

“A reversal of this policy by the Biden administration should help increase the home and community-based services workforce at a time when home care demand is rising,” NAHC President Bill Dombi praises.

Demand is rising as clients as their relatives strive to avoid facility stays if at all possible. “Once COVID hit we started picking up a lot of clients because a lot of family members are wanting to take their families out of nursing homes,” Jadawnya Bostock, owner of We Care Home Care in the Atlanta area, told Fox News. “They’re wanting them to be home because now they can’t visit them due to COVID.”