Home Health Care Crisis Campaign in the Adirondacks
Please read the Testimony given to the NYS Assembly:
Mercy Care was established in 2007. Our mission, sponsored by the Sisters of Mercy, is
to enhance the fullness of life of elders living in their communities.
Mercy Care implements its mission with direct service to elders through our Friendship Volunteer, Volunteer Parish Nurse Programs, Caregiver Advocate Program and its Aging in Place and Caregiving Community Empowerment Task Forces.
The community itself supports our mission. Mercy Care serves the whole community and is funded solely through charitable contributions and grants. Our services are provided free of charge and are freely given by our more than 100 dedicated volunteers who provide informal supports and health education to more than 135 elders living in our Tri-Lakes Adirondack communities of Lake Placid, Saranac Lake, and Tupper Lake. Mercy Care receives no reimbursement for its services.
The Home Health Care Crisis Impacts Everyone. Many people in this room may have experienced caring for a loved one—an aging parent, an elder neighbor, a Veteran, or a loved one with a disability. Having access to adequate, available, and affordable home care impacts everyone in our communities—for those needing and giving care.
In 2014 Mercy Care and its collaborating partners of health and human service agency professionals in Essex and Franklin Counties developed the Caregiving Community Empowerment Action Plan, “Giving and Receiving Care in the Adirondacks.” We concluded that the community itself would need to create the conditions to respond to the unmet needs.
To illustrate the need, for the period between January and August 2015, the major provider of home care assistance in Essex and Franklin Counties had 6500 hours of unfilled but authorized hours of care. In other words, people clearly needed the care but were not getting it.
There are unique caregiving needs in the Adirondacks—long distances from services, cold and severe winters, and fewer available family caregivers. Many of our young people leave the area for education or career leaving their elders family members behind. There is no public transportation available for home health aides to visit their patients. Home health aides must drive their own vehicles, which must be reliable.
Our Caregiving Working Group understood that we could no longer only identify the crisis, we needed to seek solutions and develop an action plan to address the home health aide crisis in the Adirondacks. Together with our partners, NYS StateWide Senior Action Council, and Franklin County Office for the Aging, we launched the
“Home Health Care Crisis in the Adirondacks Campaign.” We built a coalition of more than 100 organization members throughout the state to raise awareness about the shortage of an adequate home health aide workforce and to seek solutions to remedy the crisis. We attracted front page news articles, editorials, and guest editorials in northern New York newspapers calling for solutions.
Why a Campaign? There is a crisis today of a lack of home health aides which will only get worse. According to the County Data Book, by 2035 the number of senior citizens over the age of 85 in Essex and Franklin Counties will increase by 30 percent. Today 20% of the population in Essex County is over the age of 65. By 2030, the projected number will be 30%--almost 1/3 of the population!
Mercy Care’s Campaign focus is on the person who needs home care, the critical shortage of home health aide workers in Essex and Franklin Counties to serve them, and the viability and sustainability of home care agencies who employ the workforce.
There are costs to inadequate home care. Without sufficient and available home care, elders face delayed discharge from hospitals or require costlier institutionalization rather than preferred and less expensive services at home.
In a study conducted by LeadingAge New York funded by the New York State Health Foundation, it found that the percentage of acute care patients in the Adirondacks discharged to home with home care is 40% lower than the state average because home care services may not be available.
The need for adequate home care for people who need it impacts other public policies such as DSRIP goals to reduce Emergency Room visits and hospital readmissions. Without adequate home care, what will happen to people who need it? A fall? Emergency room visit? Hospital readmission? Skilled nursing facility admission? Caregiver illness?
As I conclude, rather than quote statistics and numbers, which others testifying today with far more expertise than I have will do, I will share a few narrative responses from 50 personal interviews and 200 responses from a community survey directed to people giving and receiving care in Franklin and Essex Counties.
As a primary caregiver, what are your biggest concerns?
- Injury to self or patient
- Elder abuse and neglect
- I physically can’t handle my husband anymore
What are barriers? Caregiver response:
- Respite from full time care unavailable
- Family members are geographically distant
What do you enjoy most about your caregiving role? Caregiver response:
- My husband has had dementia for 7 years. It’s my mission to keep his cognitive skills, speech, writing intact. I try to take him for PT for gait and balance. His neurological deficit is making him weaker and hard for me to handle him. I don’t enjoy all that I do, but I do enjoy the satisfaction that I have done my all for him.
What do you enjoy least about your caregiving role?
- No chance for my loved one to get better.
- Watching the deterioration of someone I love.
- Keeping him on task to go for appointments. It takes 2 hours of frustration for me to get him out the door and then it is very slow going to get into the car.
- That I am all alone and it all falls on me to do.
As you develop public policy to improve home care in NYS, we respectfully ask that you:
- Consider as the highest priority the human dignity of each person who needs home care, regardless of who the payer is, their economic status, or what health conditions they may have. All people who need home care should have the opportunity to receive it.
- Take into consideration the very real and unique caregiving needs of people who need home care in rural and underserved areas.
- Incentivize home care workforce development for underserved areas.
- College Tuition Assistance and Loan Forgiveness Programs tied to years of service as a home health aide
- Sign-on bonuses extending over five years—released in annual increments with a balloon bonus at the end of five years; renewal sign on bonuses for additional five-year period
- A career path for advancement—tuition-free LPN training
- Restructure home care delivery systems to enhance more predictable work schedules
- Reasonable Tire Replacement, car maintenance and repairs allowance
- Ensure programs for home health aides serving in rural areas viability and sustainability of home care agencies.
Thank you for listening to the voices of elders who need and give care in New York State. Please develop an adequate, accessible, and affordable home care program for all New Yorkers who need or give care.
Donna Beal, Executive Director
Mercy Care for the Adirondacks
Before the NYS Assembly Committees on
Health, Aging, Labor, and Task Force on People with Disabilities February 27, 2017