Support North Carolina’s Home Care Workers

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Keep Medically-Fragile North Carolinians at Home ─ Fund Home Care Programs

Background on issue:

Home care services help keep more than 56,000 medically-fragile North Carolinians safe and healthy at home and out of costlier and more potentially dangerous settings like institutional facilities. Since the onset of the pandemic in spring 2020, state lawmakers have been tremendous supporters of in-home care. By temporarily increasing funding for home care programs, NC has allowed thousands of residents to continue to access skilled nursing and home health aide services through COVID. Through June 30, 2022, NC Medicaid will temporarily continue the COVID-add on rates with a rate of $23.84 per hour for aide services.

But unless additional funding is provided to make $23.84 the permanent rate starting July 1, 2022, and further increasing the rate by $2.00 to make it $25.84, the aide rate will revert to the legislative rate of $19.56 per hour. That cut will have a devastating impact on the home care industry – during our industry’s most severe workforce shortage in many decades.

Ask: We propose an investment of $81M to get direct care worker wages to where they need to be to recruit and retain quality staff.  We propose to make permanent the temporary rate of $23.84 permanent (expires June 30, 2022) and add an additional $2.00 (8.39%) to increase the Medicaid aide rate to $25.84.

We are concerned that rolling back the personal care rates by 18.3% will destabilize the industry and put Medicaid beneficiaries at risk.  The severe workforce shortages, wage disparities, inflation at decades high levels, COVID-fatigue, and a rapidly changing labor market has caused a drastic shift in the home care landscape. Without legislative action, these cuts will destabilize home care and put Medicaid beneficiaries at risk – during our industry’s most severe workforce shortage in many decades. We need your help.

Rationale for permanent temporary rates and further investing in home care: 

The severe workforce shortages, wage disparities, inflation at decades high levels, COVID-fatigue, and a rapidly changing labor market has caused a drastic shift in the home care landscape.

  • 18.3% reduction is not sustainable in an industry with a severe aide wage disparity. Providers are competing with healthcare and other industries, like fast food and retail, which pay over $15 per hour compared to an average of $11.91* per hour for home health aides.  Medicaid has previously indicated that wages should move wages towards $15.00 per hour. However, providers cannot increase wages on temporary rates. Providers are using the temporary rates as bonuses, because providers do not know the permanent rate.  (*PHI stated rate)
  • Turnover today is over 60%, and 25% of aide authorized hours go unstaffed every week, and referrals are declined in record numbers, 16% of aide cases declined since October 2021, leaving families without care and at risk for institutionalization. 
  • Workforce pipeline is constricting and running dry. In 2021 providers recruited 30% fewer aides compared to pre-pandemic 2019. That number spikes to 53% fewer recruited in 4Q-21 over the same period. We’ve been all hands-on deck for two years – staff are tired and leaving home care. Without a workforce North Carolina’s must vulnerable population is at risk. 

Invest: Support $81 Million in Home Care Funding

For more facts on this issue, click here.
To view the BAYADA commissioned Morning Consult Survey, click here.