Leaders across the senior care sector have banded together and are urging Congress to back legislation that will increase access to care services. And help is long overdue, they argue.
For decades, aging services have been underfunded in the U.S., according to Katie Smith Sloan, president and CEO of the Washington, D.C.-based LeadingAge, the association of nonprofit providers of home health and other aging services. Sloan addressed the topic on Wednesday during a media briefing.
“Our system is under growing strain,” she said. “Federal and state reimbursement rates are chronically inadequate to cover the costs of quality care and services — or to pay a living wage for our professional caregivers.”
As a result, there are millions of seniors who are unable to access the affordable care and services they need.
“In many cases, the care that allows older adults to stay at home, which is what many of us want to do, is only available to those who can pay out of pocket,” Sloan said. “At the same time, many older adults in this country live largely on social security with little or no savings — with too many that may be forgoing care, medicine and sometimes even food to afford the cost of a safe place to live.”
Seniors’ inability to access care now could eventually lead to the need for costlier care for preventable health events down the line, according to David Totaro, chief government affairs officer of Bayada Home Health Care.
“We see people who can’t access home care, then end up back in the hospital or in a nursing home, both of which are more costly to the state,” he said. “And [that] is exactly where the individual and the family — nine times out of 10 — doesn’t want to end up.”
Moorestown, New Jersey-based Bayada is one of the largest home health providers in the country. As part of the nonprofit’s network, it has more than 360 offices in 22 states.
In order to address these challenges, Congress needs to make an investment into essential aging services, according to Sloan.
“A strong aging services infrastructure is as critical to our nation as rebuilding roads and bridges,” she said. “Legislation must provide the substantial home health, affordable housing and technology support needed to help millions of older Americans. It’s the humane thing to do.”
Along these lines, LeadingAge has thrown its support behind the Biden administrations’ recent American Jobs Plan proposal, which calls for Congress to inject $400 billion into home- and community-based care services.
As a home-based care provider, Bayada has seen the impact of underfunding firsthand.
“For every person who can get home care, unfortunately, another one who needs it can’t,” Totaro said. “Either because they can’t afford it, or, in many cases, because we don’t have enough workers to take on those cases.”
For example, the company had to turn away 1,500 people who were seeking home-based care services in its New Jersey market because Bayada didn’t have enough staff to serve them.
Totaro noted that Bayada saves New Jersey an estimated $30,000 per individual annually when the company is able to provide home-based care services.
Still, companies like Bayada rely on government funds in order to pay their employees a living wage.
“Without more reimbursement, we just can’t pay workers more,” Totaro said. “We’re not like your local pizza shop, where you can just increase the price of pizza if the cost of making that pizza increases. As it stands today, we simply cannot compete with hospitals and retail industries like fast food, … which often pay even more in wages.”
The COVID-19 emergency has only compounded these challenges, with the cost of care increasing.
While Totaro commends Congress for its support throughout the public health emergency — namely through CARES Act funding — he believes there is more that can be done.
“We need Congress to reverse the outdated Medicaid policies from the 1960s that make it very difficult to immediately access home care,” Totaro said. “This is care where people most want to receive it. Secondly, from our states, we need higher reimbursement rates for these basic services, so that we can more easily hire and, more importantly, retain additional qualified staff.”
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