Home Health & Hospice Week

Plight of home care providers and patients catches national attention.

The astronomical cost of fuel is causing major problems for home health agencies, their workers and their patients, and the result could be reduced access to home care.

Mainstream news outlets such as The New York Times and WTNH's News Channel 8 in Connecticut have recently highlighted the problem, joining earlier press reports from the Associated Press and NPR's Marketplace radio program (see Eli's Home Care Week, Vol. XVII, No. 24).

Gas prices are taking a huge chunk out of home care workers' paychecks, points out the Times. For example, aide Katie Clark in Union, MI gets paid about $250 per week, but her gasoline bill is about $100.

"Some weeks I have to borrow money to get here [to the client's home]," Clark, a single mother of two, told the newspaper. "They're just like family to me."

Home care nurse Tina Capomolla in Connecticut has to pay about $70 to fill up her tank two to three times a week, she told Channel 8 News.

Capomolla's employer, Visiting Nurse Services of Connecticut, will be paying $130,000 more in employee mileage expenses next year, said VNS' Mark Chudwick.

Paid staff aren't the only ones with second thoughts about working in home care. Agencies are having trouble finding and keeping volunteers in the high gas price environment, the Times points out.

Nurses and especially aides fed up with soaring gas prices are likely to jump ship to institutional employers like hospitals and nursing homes, industry veterans expect. That combined with the high mileage expenses will cause agencies to pull back their service areas, especially in rural areas.

Ray of hope: A lifeline for home care providers in rural areas may be the 5 percent rural add-on. While it wasn't included in the Medicare bill just vetoed by the President and overridden by Congress, reinstatement of the add-on for fiscal year 2009 could come via another legislative route.

"There is a strong disposition on the part of both Republicans and Democrats to find another appropriate vehicle which would allow them to reinstate the rural add-on," reports the National Association for Home Care & Hospice in its member newsletter.

Sen. Debbie Stabenow (D-MI) recently voiced her support for the measure in a floor statement entered into the Congressional Record, NAHC notes. "As a short-term solution, I urge my colleagues to join with me in calling for the Medicare rural home health add-on, which expired in 2006, to be reinstated," Stabenow said. "The rural add-on bonus will have a huge impact on the ability of home health providers to serve seniors, particularly in remote, rural locations."

Keeping patients at home will mean lower government expenses for patients that would otherwise be institutionalized in nursing homes or would go back into hospitals, Elaine Eubank of CareLink told the Times. CareLink is a nonprofit agency that serves six counties in Arkansas.