Home care providers are scarce for the elderly | Information on the Covid-19 coronavirus
Throughout the winter and into the spring, The Senior Connection in Hailey received approximately two calls per week inquiring about home care services. But since last fall, it can only offer a review and a place on the waiting list.
With COVID-19 restrictions limiting access to homes – and staff already strained by a shortage of available caregivers – the organization stopped accepting new clients in October for its home care services.
The nonprofit is the only home care provider in Blaine County to contract with Medicaid. As of mid-April, it was providing home care services to 32 clients. Half of these clients are insured by state funding Medicaid or by the federally funded Office on Aging. The remaining 50% are “private salaries”, which usually means they are subsidized by The Senior Connection.
Jovita Pina, Senior Associate Executive Director of Connection, is responsible for the Home Care Services program.
“We are honest about our current status in not accepting clients due to the current reopening phase,” said Pina. “In addition, the individual may need services beyond our reach.”
Pina said existing clients do not always receive the number of hours per month recommended by The Senior Connection for private care clients and Medicaid and Office on Aging clients.
“We can’t always accommodate all the hours they need,” Pina said. “We accommodate who we can with the caregivers we have.”
Senior Connection’s home care services help keep seniors in their homes by helping them with activities of daily living such as eating, bathing, dressing, mobility assistance, using the bathroom and continence. Housekeeping services include light housekeeping, laundry, errands and groceries, personal transportation to medical appointments, pet care, and cooking.
Pina said keeping the elderly at home was ultimately more cost-effective than moving them to elderly care facilities, but a shortage of home care professionals is putting the brakes on the model.
“We need more Medicaid providers for home care services in Blaine County,” said Teresa Beahen Lipman, executive director of Senior Connection.
With few available, the organization recommended that older people seek help from family members and religious communities.
When Idaho moves to Stage 4 of COVID restrictions, Lipman hopes to start accepting new clients – a process that requires a home visit and assessment, which cannot be completed in Stage 3. She said that elderly care organizations and private home care providers across the country have been challenged by COVID restrictions.
Meanwhile, the demand for home care services has exceeded expectations, Lipman said. About $ 204,000 was budgeted for home care last year. Total expenses reached $ 250,000. She said $ 35,000 had been spent on home care “bursaries” for private paying clients. (About 90% of private paying customers receive some sort of scholarship, she said, although everyone is required to pay something for the service.)
The Senior Connection charges private clients between $ 27 and $ 30 an hour, depending on their location, Lipman said. Medicaid and Office on Aging clients are not billed for services. These agencies reimburse Senior Connection approximately $ 15 per hour for home care. A caregiver’s starting wage rate is also $ 15 an hour – and, for Medicaid clients, they are prohibited by law from getting more.
Lipman said the regular budget for the home care services program typically calls for 70% of clients to receive a private salary, with the remaining 30% being provided by Medicaid or Office on Aging, reimbursed at the lowest rate. But the number of private paying customers declined during the pandemic, as families took over responsibilities from outside agencies to protect family members from the coronavirus. At the same time, the number of hours of clients insured by Medicaid has increased as they have been allocated more hours by the Department of Health and Welfare.
Now Senior Connection is considering a 50-50 split between private and federally funded customers, which means less money to cover costs. Lipman expects the program’s deficit to reach about $ 56,000 by the end of the year. A local family foundation makes the difference, passionate about home care services because of “personal experience” in their family, she says.
“Without the generosity of our community, this would not be possible,” she said.
Lipman said there are many self-employed home care workers in the Wood River Valley serving families who can afford to spend more than a Medicaid-trained worker earns, making it difficult to find caregivers to take these clients.
“Some people have 24-hour private end-of-life care, or readily available paid staff,” Lipman said. “They are lucky to have it.”
For the less fortunate, Lipman said Senior Connection usually provides a safety net. She said the organization became eligible for Medicaid several years ago after a series of trainings were undertaken to meet federal criteria for high-level services. While this has been a boon for many clients, it can also be a handcuff on hiring. The law limits the remuneration of certified caregivers, which means certified Medicaid providers cannot be reimbursed more than $ 15 an hour for a Medicaid client, Lipman said, which does not encourage certification.
“Our council made the decision not to turn people away,” she said. “But any home care worker in the valley could become a Medicaid provider. I don’t know of any who have.
The care industry will continue to seek more workers, especially in Blaine County, where the population has above average senior numbers. (The average age in Blaine County is 43.2 years. In Twin Falls County, it is 33.3 years.)
“There is more demand than supply of caregivers,” Lipman said. “We know this from surveys. We have two full-time positions to fill, but it has been difficult to recruit and retain staff. “
The Senior Connection will pay prospective caregivers to train at the College of Southern Idaho for the positions and offer a competitive level of compensation, with good benefits, Lipman told Mountain Express.
“You would have a job for life in this industry,” she said.
Another option to help the valley’s seniors is to enroll in the Adopt-a-Senior program, currently on hold pending the lifting of COVID restrictions. She said these volunteers spend time once or twice a week with a senior who could use some company or help around the house or take them by car.
“We are delighted to restart this program,” said Lipman. “One positive aspect of the pandemic is that Western culture has started to pay more attention to its elderly populations.”