Vulnerable South Carolinians Are at High-Risk of Losing Their Home Care Services

Published On: May 17, 2022
There are 36,087 medically fragile South Carolina Residents who depend on home care services to live independent, healthy lives in the comfort of their homes. These healthcare services range from the basics of everyday living, to extensive, skilled nursing care. And although it is a well-known fact that home care is both cheaper and patient-preferred over facility based care, our healthcare system is set up with an intuitional bias, with more state funding going towards nursing homes and long-term care facilities rather than home care services. This lack of state funding coupled with a higher demand of home care due to COVID, has now ledto the worst workforce shortage the home care industry has ever seen. And the worst part about it, it’s the most medically fragile individuals and their families who suffer from this the most. 
Below are three separate South Carolina residents and their families who are feeling the effects of how inadequate state funding is affecting their access to care. Read about what they wish the State would do to help this critical issue.

La Mondre Torohn Pough

La Mondre Torohn Pough from Columbia, SC.

48-year-old La Mondre Pough from Columbia, South Carolina knows firsthand how essential home health aides are to his life. As someone who has lived with profound disabilities due to spinal muscular atrophy since he was just two years old, La Mondre needs 24/7 care to help with the most basic daily tasks, but he is only authorized 66 hours of care per week under the state funded personal care services (PCS) program. Despite this already limited care coverage, La Mondre has been receiving even less coverage due to a critical in-home caregiver workforce shortage.

La Mondre in his own words explains, “I need help with everything. Bathing, feeding, getting dressed. You name it, I need help with it”.

Because of the aides that care for him, La Mondre is able to live an independent and successful life and work as the CEO of Billion Strong, which advocates for and supports people with disabilities. He can live an amazing life thanks to the compassionate and skilled home health aides who care for him. These in-home caregivers also allow him to be an inspiration to others, helping him attend speaking engagements and continue to be a well-know advocate in his community.

Not only are home health aides valuable to La Mondre personally, but also to his family.

La Mondre explains, “Home care services means independence, it means options, it means freedom for my family and the security knowing that I am well taken care of.” He also understands the lack of care coverage is a direct result of the low wages his aides receive due to inadequate Medicaid funding to state home care programs.

He shares, “This is not a unique situation by any means, this is a problem everywhere. People deserve to be able to work full time and support their families, to support themselves. To earn a good living helping others live a good life. That’s what this is about. This is something that we must address.”


Savannah Crowley

Savannah Crowley from Ruby, SC.

Four-year-old Savannah Crowley of Ruby, SC lives with severe disabilities and high acuity medical needs caused by Spina Bifida and Hydrocephalus ASD (autism spectrum disorder). Due to the severity of her diagnoses, Savannah is currently approved for 62 hours of in-home care under the state funded Medicaid Private Duty Nursing (PDN) program. However, the shortage of home care nurses in SC has made it challenging for Savannah and her mother, Kristy, to find this life-saving coverage.

Kristy believes that caring for medically-fragile children is her life’s calling. Through several of South Carolina’s programs Kristy has been able to foster and adopt many medically fragile children over the course of the last ten years that would otherwise not be able to grow up in a loving family setting. Currently, Kristy cares for seven children, with four of them being medically fragile and requiring in-home care.

It has been difficult to make sure all children, including Savannah, get the approved and necessary coverage they need. Right now, Kristy has three home care providers just to help to try and cover all the hours her children because there just aren’t enough nurses in the industry. Additionally, Ruby, South Carolina is in a very rural area, right on the border of North Carolina and the home care nurses must use their own money on transportation to get to Kristy’s house. This critical shortage of nurses has even forced Kristy to quit her job as a preschool teacher since she could not find enough reliable in-home nursing coverage to care for her children at home. She sometimes struggles to even go to doctors’ appointments, relying on her family’s help, when and if they are even available.

“At the end of the day it’s these children that are at risk when home nursing care isn’t available,” she says. “They are truly incredible and I learn so much from them every day. I hope that the State recognizes why they need—and deserve—to grow up in a loving home.”

Weston Clardy

Despite his cerebral palsy diagnosis, 7-year-old Weston Clardy from Easley, South Carolina, has experienced the love, independence, and care in the comfort of his home, 

Weston Clardy from Easley, SC.

thanks to in-home nurses. At just one-years old, Weston qualified for in-home care, allowing him to grow up in his home with his mother, Stephanie Clardy, like any other child would. However, if it weren’t for the state funded, private duty nursing (PDN) program, Weston ─ who is a complex case, needing a tracheotomy to breath and eat ─  would have most likely been forced into a skilled nursing facility.

While Weston is thankfully able to live at home, his mother Stephanie, who is a single mother, has faced many challenges when it comes to securing home care nurses. Weston qualifies for 66 hours/week of care coverage, but only receives 30. Stephanie has shared that she has had trouble staying at one job due to the lack of available nurses, which then causes her to have to take on the hours herself to care for Weston. This has caused her to have to make some major changes in her life. Stephanie, who used to be a foster mom to medically fragile children, had to stop fostering children due to the lack of coverage. 

Stephanie, who has gone so far to get coverage that she has advertised on social media, said she received great responses. But once nurses heard the wages in comparison to what they could make in a hospital or facility-based setting, they couldn’t accept the position due to the significant wage difference. This pay difference is directly because the State determines the Medicaid rates for home care programs like the one Weston qualifies for, PDN. This program is in desperate need of additional funding in order for home care providers to simply recruit and retain their nurses.

Stephanie explains, “As a single mom, I can’t provide for Weston and pay my bills without working. I can’t work because I don’t have a nurse to provide the care to Weston. We need your help!”


The Solution:

At the end of the day, providers cannot recruit and retain enough caregivers due to inadequate state funding leaving the most vulnerable families to suffer.

To put the shortage in perspective, home care providers have had a 56% turnover rate of private duty nurses in 2021. Most nurses can make double the hourly rate in a hospital compared to home care ─ $23.50 vs. $49.99 ─ even though they are doing the exact same job with the same professional requirements.

Home care providers are at risk of closing their doors unless a serious investment is made to these programs. Without it, 36,087 medically vulnerable South Carolinians like La Mondre, Savannah, and Weston will be at risk of losing all home care services and will be forced into facility-based care, which would cost the State more than three times the amount of in-home care.

Although the Department of Health and Human Service’s (DHHS) has already committed to allocating American Rescue Plan Act (ARPA) funding to streamline these programs and given small increases to the Medicaid reimbursement rates, it is just not enough.

So here is what advocates across South Carolina are asking from the legislature: to allocate an additional $10/hour of Medicaid funding across all home and community-based service programs in their upcoming budget. Without this additional funding, those like La Mondre, Savannah, and Weston will be unable to remain independent, surrounded by friends and family, and will be forced into much more costly, facility-based settings.


Advocacy Matters!

Despite the fact that many people in government and regulatory positions agree that home health care is a cost-effective, patient-preferred solution, it continues to be prioritized below institutional care. Not investing in home care will decrease the supply of qualified workers, increase turnover, and compromise the quality of home care services. At Hearts for Home Care, we help those that care about home care by enabling YOU to get involved at the capacity in which you’re able to do so.

Email us at [email protected] or visit our website  in order to learn more about the home care advocacy community and find opportunities to get involved.

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