Advocating for Home Health Workers in the Coronavirus Pandemic

WASHINGTON, D.C. (April 20, 2020)—David J. Totaro, Chairman of the Partnership for Medicaid Home-Based Care issued the following statement today:

“Home and community-based service (HCBS) caregivers are working to contain COVID-19’s spread by helping those most at risk stay healthy and safe at home. The HCBS workforce needs financial and other support to ensure the continuation of these essential services. The Partnership for Medicaid Home-Based Care (PMHC) has developed a proposal for Congressional consideration, which includes an HCBS direct care worker fund, universal presumptive eligibility, and priority access to personal protective equipment (PPE) to help alleviate these concerns.”

“There are over 3.2 million HCBS direct care workers providing essential support services to more than 8.3 million people in the U.S. These essential direct care workers have continued to provide needed care day in and day out under the current state of emergency and provide health sustaining services for seniors and people with disabilities in their homes and who are at increased risk from COVID-19.”

“The HCBS direct care workers providing these essential services are on the frontline of health care, often times putting themselves, and their families, at even greater risk for COVID-19 exposure than other essential service workers by providing these hands-on services in homes and communities across the country. These frontline caregivers may also be providing essential life sustaining services to individuals with an active COVID-19 diagnosis putting themselves in the position of direct COVID-19 exposure and even greater risk to their health.”  

“Unfortunately, given historical low Medicaid reimbursement rates these are not high paying positions with robust benefits. Approximately one in five homecare aides is a single mother, over 90% are female, over 50% are predominantly people of color, and 56% live in low-income households.”

“The establishment of a HCBS Direct Care Worker Fund would provide additional compensation and other relief to stabilize and reward these essential frontline healthcare workers providing in-home care and supports funded by Medicaid, the Veteran’s Administration (VA) and the Older Americans Act (OAA).”

“PMHC is requesting Congress create and fund an HCBS Direct Care Worker Fund to remain available to HCBS providers for increased wages and sick time benefits paid to its direct support professionals that deliver HCBS in recipient homes or communities. The proposal would also allow states to apply for direct payments for identical costs related to direct support professionals working in a consumer-directed model.”

“The COVID-19 virus continues to spread nationally, with the majority of people infected and who have died being 65 and older. Persons with disabilities, whether physical, developmental or intellectual, receiving long-term services and supports are also at significant risk of complications from COVID-19 related illness. Assistance with activities of daily living and instrumental activities of daily living are essential to maintaining the health and safety of persons living at home or in community settings.”

“Failure to receive these health sustaining services will lead to the exacerbation of chronic conditions or disability, leading to emergency department visits and/or hospitalization, the avoidance of which is critical during this crisis. HCBS recipients should not be exposed to greater risk of COVID-19 infection and health care resources need to be prioritized for the care and treatment of COVID-19 active patients.”

Additional information on the HCBS Direct Care Workers Fund and PMHC’s proposal on universal presumptive eligibility and access to Personal Protective Equipment (PPE) can be found in the April 14th letter to Congressional leadership found here.

PMHC is comprised of organizations representing home care agencies, state and national associations, MCOs and other payers, and business affiliates who have come together to improve the quality and integrity of Medicaid funded home and community-based services (HCBS). Recognizing the integral role of home and community-based care in the Medicaid program, PMHC is dedicated to advancing and supporting public policies that strengthen the Medicaid program for recipients and taxpayers alike.