Home Health & Hospice Week

One state faces class action lawsuit.

A new KFF Health News-New York Times series, “Dying Broke,” examines the issue of aging at home and associated costs. Among other things, the series highlights the difficulty of finding aides for patients with dementia and other ailments and the high cost when they can be found.

“There are severe shortages of home health aides in many parts of the country. Hiring them is costly. And most middle-class people will have to pay for home care themselves if it’s needed for the long haul,” KFF and the Times highlight.

While acknowledging that Medicare doesn’t cover long-term care, the articles paint HHAs as the bad guys in some situations. “Many home agencies erroneously say they can’t send a home aide and will tell a doctor’s office or patient that Medicare won’t pay for one,” the news outlet and newspaper say. “Agencies often refuse to provide someone because Medicare pays a lump sum per patient, meaning the agency isn’t paid more for sending an aide in addition to the nurse or therapist.”

The series fails to mention that agencies have as much, if not more, trouble than individuals finding aides to employ; or that reimbursement rates won’t stretch to cover copious aide visits. See the series at https://kffhealthnews.org/news/tag/dying-broke.

Other mainstream press outlets are taking notice of the problem as well.

In Maine, patients are essentially parked in hospitals, waiting for home care worker access so they can be discharged to home, reports CBS-13 WGME. “The direct care workforce in Maine is in a fragile state,” Maine Center for Economic Policy Analyst Josie Phillips says.

“Even for those who are eligible under MaineCare, the aides just aren’t there,” the TV station notes. Hundreds of people across the state are approved for discharge but cannot find an alternative care setting, including home care.

“Something’s got to give. I mean, people can’t keep living like this,” aide Gabrielle Therriault told the station.

Will State Actions Help?

Meanwhile, multiple states are trying to address this issue by making aide employment more attractive. For example, Maine has issued $3,500 bonuses to 24,000 direct care workers in the state, WGME says.

On the other side of the nation, “California recently enacted Senate Bill 525 … substantially raising the base minimum wage for health care workers,” note attorneys Jyoti Mittal and Elizabeth Staggs Wilson with law firm Littler in Los Angeles. “The minimum wage for all healthcare employees will ultimately increase to $25 per hour, with the first incremental increase above the general state minimum wage to occur on June 1, 2024. The rate at which the minimum wage increases take effect will vary depending upon the size and nature of the employer,” Mittal and Staggs Wilson explain in online analysis.

Covered employees include licensed HHAs. Covered employees include virtually anyone working for a provider, including office schedulers and billing and coding personnel, Mittal and Staggs Wilson say.

However, there is a possibility of securing a waiver. “The law creates a waiver program for certain covered health care employers that believe they cannot comply with the law’s requirements. Employers can seek a temporary pause or an alternative phase-in schedule for the new minimum wage requirements,” the Littler attorneys advise.