As COVID-19 cases rise in the U.S., more in-home care providers are starting to struggle with dwindling stockpiles of basic protective equipment for workers.
Overall, roughly 88% of medical personnel in more than 200 U.S. cities do not have a sufficient supply of personal protective equipment (PPE), according to a recent survey conducted by the U.S. Conference of Mayors.
In an effort to address this shortage within the in-home care space, the National Association for Home Care & Hospice (NAHC) and other U.S. industry associations recently penned a letter to the Federal Emergency Management Agency (FEMA), the federal entity in charge of distributing PPE. In that letter, stakeholders asked that in-home care providers be given priority status for PPE, along with hospitals and long-term care facilities.
While national in-home care associations turn their attention to federal efforts, several state-based associations are tackling the PPE shortage on a local level.
In California, home health, hospice and private-duty home care aide services have all been impacted by shortages, Dean Chalios, president and CEO of the California Association for Health Services at Home (CAHSAH), told Home Health Care News.
“It is obviously a huge issue in California, as it is in the entirety of the nation, at all levels of health care,” Chalios said. “Our agencies simply need an adequate supply to protect their providers and patients. They need just enough … having too much is unethical, while having too little is risky.”
CAHSAH is a Sacramento-based nonprofit association that represents California’s home health, hospice and non-medical personal care providers.
In reaction to the PPE shortage, in-home care providers in California are reaching out to vendors and usual supply chains. Meanwhile, in some counties, local public health departments have begun sending providers supplies upon request, according to Chalios.
Still, a dire supply of N95 masks, regular masks, goggles, gloves and gowns have caused providers in the state to branch out. Many have come up with creative solutions on their own.
“I’ve heard interesting stories about providers reaching out to construction supply stores, baby supply stores, restaurant supply stores, beauty supply stores and wherever they can get masks and gloves,” Chalios said. “One agency even reached out to a tattoo parlor because they had gloves. It’s all hands on deck.”
In-home care providers and trade associations in the state of California are not alone in seeking out alternative PPE supply sources.
It’s a role that has fallen on state associations elsewhere, too, Tim Rogers, president and CEO of the Association for Home & Hospice Care of North Carolina, told HHCN. Rogers also serves as the president and CEO of the South Carolina Home Care & Hospice Association.
“State associations have become the conduit,” he said. “We’re going out and finding creative ways, outside of our traditional means of [procuring] PPE, on behalf of home care and hospice.”
Providers in North Carolina and South Carolina recently drew inspiration from New York Gov. Andrew Cuomo in their efforts to come up with unconventional solutions.
“Gov. Cuomo talked to runway designers about creating masks because New York wasn’t getting enough PPE,” Rogers said. “We’ve been in touch with the CEO of David’s Bridal, who has 900 seamstresses on hold at home in North Carolina. We sent this recommendation to North Carolina Emergency Management, which is in charge of vetting vendors.”
The South Carolina Home Care & Hospice Association is an industry organization that encompasses about 85% of home health providers and roughly 65% of hospice providers in the state. Meanwhile, the Association for Home & Hospice Care of North Carolina is a nonprofit trade organization that represents roughly 800 home health, hospice, palliative care, personal care and private-duty nursing providers in the state.
In Michigan, providers have turned to social media in order to find supplies, Barry S. Cargill, president and CEO of the Michigan HomeCare & Hospice Association, told HHCN.
“We have utilized social media to find personal protective equipment that people had, but was not being used,” Cargill said. “In some cases, someone may have bought supplies thinking they needed it, and then realized they didn’t.”
The Michigan HomeCare & Hospice Association is a state trade association for home-based care providers that represent 240 member organizations.
Non-essential medical providers have also been a source of PPE, according to Cargill.
“All of our businesses have now closed down as a state executive order,” he said. “This meant that all of the non-essential medical services, such as dentists who have supplies or personal protective equipment were able to make those available to their community.”
One issue that has cropped up amid the supply shortage is traditional suppliers placing certain in-home care providers at the bottom of their priority lists based on past purchasing, according to Rogers.
“Agencies who’ve had longstanding relationships with their suppliers are hearing that if they haven’t had a specific threshold of orders in the last six to eight months, they aren’t on the priority list,” he said. “It’s become a competition, and that’s been a real problem in the supply business.”
Another issue the shortage has caused: Caregivers are becoming concerned about whether they should enter the home without PPE, according to Cargill.
“We do have some who are concerned that if they don’t have the appropriate equipment, they shouldn’t go in and see the patient,” he said. “That’s where the guidance from the [Centers for Disease Control and Prevention] has been helpful.”
The CDC is reportedly considered expanding the requirements of who should be wearing masks due to an increasing number of symptom-free coronavirus cases. The current CDC recommendation is that people who are sick or caring for others who are sick should be wearing masks.
State associations have also seen clients of their provider members cancel appointments, which in some cases may be appropriate, according to Cargill.
“They are concerned about letting anybody into their home,” he said. “That is where agencies have had to get on the phone to work with families to make the decision as to whether a visit is necessary in order to protect and sustain the life of the patients.”