ANDOVER,HAMPSHIRE/UNITED KINGDOM-NOVEMBER 6 2019:A district nurse visits a ninety-four year old patient at his home to treat for pulmonary edema and head/brain injury.

Challenges Facing Home Health Caregivers During COVID-19 Pandemic

By Vicki Hoak

The pandemic has emphasized the value of home health caregivers. Their contribution has been overshadowed for decades, but now it is very clear how important their work is to the well-being of older Americans, people with disabilities, and medically-fragile children.

As families were urged to stay at home to stop the spread of COVID-19, home care agencies and their staff became all the more important for preventing the spread of COVID-19 and protecting the most vulnerable from the disease. Home health aides offer clients one-to-one care and continual monitoring of changes in conditions — all in the safety of one’s own home.

At the start of the pandemic, home care agencies quickly pivoted to provide extensive training on infectious disease control, care protocols, client monitoring, and the proper use of PPE.

However, like many Americans, some home care workers are struggling to access the COVID-19 vaccine. We at the Home Care Association of America (HCAOA) have urged members to reach out to their state officials to include home care workers among the priority group for vaccine distribution. Caregivers play an essential role in the fight against coronavirus, and deserve to be among the first to receive the vaccine like any health care worker. We also recognize that nearly 40 percent of frontline workers are hesitant to get the vaccine. Our association has been very focused on providing education to our frontline workers to urge them to get vaccinated.

Demand for home health care has grown in light of the COVID-19 pandemic. Surveys show that most Americans want to receive care in their home; that number has grown significantly since the beginning of the pandemic. But the home health care industry faces a severe shortage of workers who can answer the need of this country’s growing elderly population.

According to former CMS Administrator Seema Verma, the pandemic has shone a light on this country’s over-reliance on nursing homes and the need to improve access to in-home care. Of course, nursing homes will always have a place in the health care continuum, however bringing care home — whether it be medical, end-of-life, or personal care — is the preference of most Americans.

In fact, about 90 percent of seniors would prefer to age in place, and increased access to home care would make that desire a reality. As a country, we must allow individuals to choose where they age, whether that be in their own home, an assisted living facility or retirement community.

To do so, we must look at public policies that make it more difficult to access care in the home. We must address wages, Medicaid reimbursement, education, respect and career advancement and immigration if we are to make progress.

Workforce issues continue to plague the home care industry, and challenges to meet demand for home care services are at an all-time high. Livable wages, training, and respect are all components of the solution. In addition, we are also looking to work with the large immigrant population to train and match their skills with people who need care at home to help ease the current vacancies in our home care aide ranks. Raising the minimum wage is a first step, but we also recognize and advocate for similar increases under the Medicaid program.

Medicaid policy should be changed to not only have nursing home care as an entitlement but also in-home care. Home care is a win-win for both government and consumers. For government, it’s cheaper than nursing home care and it’s where people want to be as they age — in their own homes.

HCAOA strongly supports the Credit for Caring Act. This legislation recognizes the important role family caregivers play in keeping an individual at home. The bill, yet to be introduced this session, would provide a non-refundable tax credit for working family caregivers. Previously it has been a $3,000 credit, but the new legislation is expected to increase to $5,000. Most home care is provided by family members today, and so recognizing and supporting their efforts makes for good public policy. We hope the Biden Administration will support this effort.

The new administration provides ample opportunities for improving access to in-home care. However, state governments also play an important role in licensing, Medicaid, and other regulations. Whether it is medical care or personal care, innovative models are being tested to accommodate people’s wishes to stay at home.

However, not enough attention has been paid to financing options, regulatory barriers, and reimbursement for both family and, in particular, professional caregivers. For too long they have been devalued, yet the pandemic has proven their worth as they have helped to keep thousands of seniors safe and at home. All Americans should have access to home care, and they should be assured that care is coming from a qualified and trained home care worker.

Vicki Hoak is the Executive Director of the Home Care Association of America. Vicki is a dedicated and long-time advocate for the home-based care industry. She expanded her influence from the state level, serving as CEO of the Pennsylvania Homecare Association for 20 years, to the national level when she joined HCAOA as Executive Director in November 2019.

This post is part of our digital symposium, In Their Own Words: COVID-19 and the Future of the Health Care Workforce

The Petrie-Flom Center Staff

The Petrie-Flom Center staff often posts updates, announcements, and guests posts on behalf of others.

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