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Financial pressure, inadequate support threaten survival of NYC’s homecare industry

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The New York City's homecare industry has been finding it difficult during this pandemic.

Despite the recent projected growth, the industry finds it hard to survive financially.  

In New York, which was the earliest U.S. epicenter of the COVID-19 pandemic, home health care workers, who go into the homes of elderly residents and those with disabilities, were on the front lines of battling the illness.

The health workers often put themselves at personal risk to care for their patients in a safer, more secure environment than hospitals and nursing homes.

AARP recently reported that 90% of people aged 65 or older prefer to stay at home to living in an assisted care facility. 

To address the aging Baby Boomer population and provide more necessary affordable care for them, the Bureau of Labor Statistics projects that job opportunities in home health care will boom by 36% – requiring another 1.2 million new aides to train and enter this career field – by 2028. 

This expansion is necessary to care for more New Yorkers, but financial pressure and the refusal of the state and federal governments to provide adequate support, threaten the survival of the industry.

Since the start of the outbreak, more than 51,000 residents and employees of nursing homes and long-term care facilities have died, representing more than 40 percent of the total Covid-19 death toll in the United States.

At the same time, the home care industry and the medical aids it employs have helped keep vulnerable New Yorkers safe, and its workforce continued to provide consistent service, even throughout the worst days of the crisis.

However, the industry, its employees, and patients, are now facing a new grave risk: financial devastation from unfunded safety mandates.

The homecare industry battled financial pressure before the pandemic. There had always been trouble due to the rigorous federal and state reimbursement and care restrictions. 

It has always faced financial hurdles, such as the refusal of federal and state programs to reimburse agencies for necessary work overtime, state mandated travel pay, and personal protective equipment (PPE) for health care aides and even patients, required for the workforce to remain in the field throughout the pandemic. 

“Our clients, who might otherwise be placed into nursing homes want to remain safely in their own homes, while still requiring daily and in some cases round-the clock care, but the federal and state reimbursement process places the burden of all these extra costs squarely on the homecare agencies,” says Jacob Rosenberg, Member of Home Healthcare Employers Association, Inc. 

“Currently the institutional nursing home sector is being investigated by Congress for its failures and tens-of-thousands of patient deaths during the first three months of the Coronavirus crisis.

"Policy makers need to recognize that this is a time when there could not be a more dire need for more resources – not less – to allow people to remain in their own homes to convalesce and receive care," Jacob added

He further stated that home care is a much more affordable option, but if reimbursement policy squeezes health care aides and agencies out of the industry — especially during this Covid-19 crisis – it is the patients and their families who will suffer in the long-term. 

Given the significantly lower cost of care, versus a patient being institutionalized in a full-time nursing facility, there is clearly a need for industry staffing capabilities to expand. 

It was reported that lacking a level financial playing field, home health care agencies in New York State may be unable to meet the needs of the state’s aging population, leaving families needing for elderly loved with only one more expensive option, full-time nursing care facilities. 

“Homecare is also the safest and most affordable option for our elderly and disabled loved ones,” says Agnes Shemia, Member of Home Healthcare Employers Association, Inc.

She added that “The bottom line is that homecare agencies will shut down if they have to continue to make payments they can’t afford to their aides and are not reimbursed by the state.”

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