Roundtable in Kingston focuses on home health care issues
And it's a good thing they were there.
Stevenson and Bezdziecki offered testimony to the panel that included Rep. Brenda Pugh, R-Dallas Township, and Mark Grochowski, representing Sen. Lisa Baker, along with home health care professionals who face those challenges every day and are concerned about the future. Laura Ness, deputy executive director for Hearts for Home Care, moderated the roundtable.
The community roundtable discussion was hosted by Hearts for Home Care at the Kingston VFW on Wyoming Avenue. The event brought together state legislators, home care families and health care professionals to discuss the growing challenges in home care — including workforce shortages and funding gaps — and to explore legislative solutions.
"Our communities and our residents deserve to have choices," Rep. Pugh said. "Allowing people to stay in the comfort of their homes is an option everyone should have. Children who require additional assistance deserve to receive an education. We understand that facilities are a necessity and appreciate everything they have to offer; however, there also needs to be options for those that want to stay in their homes."
During the roundtable, Pugh said she listened to the concerns of front-line care workers, specifically on the issues of low reimbursement rates and fair compensation.
"I appreciate the hard work these care workers give every day," Pugh said.
But it was Stevenson and Bezdziecki who brought the issues out in a very personal manner.
"Without the care I receive, I'd be lost," said Bezdziecki, 30, who has been a quadriplegic since age 14. "I need assistance for everything I do — showering, getting dressed, transferring. If I didn't have home care, I have no idea what I would do."
Bezdziecki said Stevenson has been his caregiver for much longer than previous caregivers, who he said were changing weekly.
"It was horrible," Bezdziecki said. "Every time a new person came in, they would have to learn everything about me, and that takes time to get it all right."
Stevenson agreed, adding, "Every time the learning process has to start over. The caregiver has to learn everything about the client — what their likes and dislikes are, what meds to take and when, if they have any wounds that need to be addressed, where they keep their stuff, what they enjoy. There's a lot to learn."
Ness offered information on key issues.
Home health aide care in Pennsylvania:
—51% of home health aides and other direct care workers in the state rely on public assistance programs, earning below 200% of the federal poverty line (source: PHI).
—In his recent budget address, Gov. Josh Shapiro indicated that he plans to increase HHA rates for the 6% of Pennsylvanian home care beneficiaries that hire aides themselves.
—A recent study commissioned by the state has indicated that Pennsylvania should immediately increase PAS rates by 23%.
—The state's home health aide funding is lower than every surrounding state and comparable state, including Iowa, North Carolina, New Jersey, West Virginia, Maryland,Delaware, Ohio and New York.
—Other settings (i.e., hospitals and nursing homes) and other industries (i.e., fast food, retail, Amazon, etc.) can pay better wages, and many aides are attracted to jobs in those industries. As a result, there are not enough caregivers in-home care to care for all the individuals in Pennsylvania that need it.
—2023 data from Genworth shows that the average cost of personal in-home care in the state is $4910 per month while the average cost of nursing home care is $11,163 per month. That means institutional care is 127% more costly for Pennsylvania families and the State Medicaid program (source: Genworth).
—Home care can save Pennsylvania Medicaid funds if properly invested in. Home care advocates are asking the state to increase reimbursement rates by -22% so that home health aides in Pennsylvania can earn a comparable wage and providers can recruit and retain more reliable aides to care for vulnerable individuals in their own homes.
In-home nursing:
—There are 13k private duty nursing (PDN) clients in the state and, on average, more than 25% of those shifts go unfilled.
—Pennsylvania's PDN rate has only been adjusted 3x in 30 years and has not kept up with inflation.
—Pennsylvania home care advocates are asking for the state to standardize nursing rates so that all state home care nursing programs are funded the same.
Caregiver workforce shortage
—Low wages and demanding workloads: Home care workers often face low pay and demanding workloads, leading to burnout and a shortage of qualified caregivers.
—Lack of state funding: Insufficient state funding for home care services exacerbates the problem, making it harder to attract and retain caregivers.
—Impact on Access to Care: The shortage of caregivers directly impacts the ability of individuals, especially seniors and those with disabilities, to receive the care they need in their homes.
Bias favoring institutional care
—Prioritization of hospitals and nursing homes: There's a perceived bias in the healthcare system that favors institutional care over home care, despite home care being a patient-preferred and cost-effective option.
—Need for advocacy: H4HC advocates for increased awareness and understanding of the benefits of home care to shift this bias and ensure that home care is prioritized.
Challenges in home care
—Lack of specialized training: Many home care workers lack specialized training in specific conditions, such as heart failure, which can impact their ability to provide effective care.
—Coordination of care: Coordinating care between different health care professionals and ensuring seamless communication can be a challenge in home care settings.
—Transition and hand-off communication: Errors in transition and hand-off communication across multiple caregivers can negatively impact the quality of care received in the home.
—Safety Concerns: Home health nursing can present safety challenges, such as handling aggressive patients, exposure to infections, or dealing with unsafe environmental conditions.
Reach Bill O'Boyle at 570-991-6118 or on Twitter @TLBillOBoyle.
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