Budget Proposal Could Worsen Home Care Crisis

A rule being proposed as part of the 2010-11 New York State executive budget would remove approximately 5,000 patients from Personal Care programs by capping hours of care in those programs to an average of twelve per day. Home care clients with care needs over that amount would be required to receive their care from Certified Home Health Agency, a Managed Long Term Care Program or under the Nursing Home Transition and Diversion waiver instead.

Because their employers are under contract to city or county government, workers in the most Personal Care programs are subject to living wage laws which mandate a minimum wage and benefits. However, workers employed under subcontracts to other programs are not, and receive an average of $3.50 - $5.00 less per hour in wages and benefits.

This proposal would result in $2 per hour wage cuts and the loss of family health insurance for more than 10,000 workers. It is the difference between a full time annual salary of $20,800 with benefits and one of $13,000 likely without benefits, between getting by and falling into hunger and homelessness.

Click here to read about protests of the 12 hour cap.

In addition to providing essential care for many seniors and people with disabilities, the Personal Care program is also a model of efficient spending and transparency, with almost 80% of the hourly Medicaid rate employers receive going directly to wages and benefits. In the subcontract system, by contrast, over 50% of the Medicaid money put into the system is siphoned off in profits and administrative fees before it reaches the bedside of the home care client.

HomeCareCrisis.org has been working to shed light on the fraud, waste and abuse that characterize a portion of the subcontract industry. As the population ages, the need for quality home care will only grow, but New York's home care system is in crisis. Skyrocketing spending has become unsustainable. High rates of worker turnover due to poverty wages and no benefits may jeopardize the quality of care. A lack of reporting and transparency prevents consumers and taxpayers from seeing how their money is spent or comparing quality among different providers.

Transferring thousands of patients and their caregivers from a transparent, efficient system with low worker turnover to a shadowy, inefficient subcontracting system will only worsen the crisis.
Click here to download our factsheet on the 12 hour cap

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