Kathleen Stoll: Home health workers must be considered in funding
How many of us have had a parent or grandparent who has been in the hospital, and when it comes time for them to leave, we face tough decisions about what comes next?
That person we love wants to get back home, not go to a nursing home. But we worry about whether they will get the help they need to stay safely at home. Will there be someone who can check on them daily and make sure they take their medications? Who will help them get take a bath and get dressed in the morning?
Over the summer, Congress is debating what to include in the next package of legislation that makes investments that will help grow our economy, create jobs and help people work.
The focus of the debate right now is the American Jobs Plan package of legislation put forward by President Biden. Generally, it includes what is often labeled as “hard infrastructure” investments: road repair, sewer and water improvements, etc. In this legislative package President Biden also included $400 billion to expand home- and community-based care.
In other words, he recognized the dilemma that West Virginia working families face that I just described. And he recognized the critical need for building infrastructure in this area to meet those goals of growing our economy, creating jobs and helping people work – whether you call it “hard” or “soft” infrastructure.
The need for home and community care services is growing in West Virginia. A new America’s Health Rankings report documents that West Virginia is among the top three states in the nation with the highest number of adults age 65 and older, and many face significant health challenges.
Dr. David Elliott, professor of clinical pharmacy at the West Virginia University School of Pharmacy, pointed out in the report that many older adults receive the medical care they need but lack extended support after returning home, “…. if you look at the reason people end up in the hospital, the reason that they return to the hospital, it’s really not about the hospital care most often, it’s really about the support and infrastructure.”
West Virginians want our family and friends who are aging or have disabilities to be able to live at home with dignity and independence. Yet home- and community care services are often hard to put together — there just aren’t enough caregivers.
The president’s proposed investment would fortify a workforce that must continue to expand to meet a rapidly increasing level of need in West Virginia. The home and community care workforce includes home care workers, personal care attendants, peer support specialists, independent providers working at the direction of a consumer and direct support professionals. This workforce provides vital services yet has been devalued and underpaid for decades.
The fall-out of inadequate wages is workforce shortages. The system is not serving everyone who needs home and community-based care and support.
Currently, older adults who want to age in place and people with disabilities who need support to work, live independently and be part of their communities are left waiting, often placing the responsibility of care and support on family caregivers, forcing them to quit their jobs or cut back work hours.
The workforce and earnings losses related to unpaid family caregiving are significant and well documented. Without the investment in services, unpaid family caregivers will have to continue to fill-in the huge gaps in the system.
What is needed is to expand the home and community care workforce are higher wages and better training to those special individuals who are willing to meet the challenges of this demanding work.
The next legislative package passed by Congress must include significant new funding investments in home- and community-based care systems built on a workforce that is paid a family sustaining wage, includes training opportunities and professional certification, offers career paths and rewards workers’ tenure and experience.
This is an investment that can provide immediate economic stimulus and job creation for our state, and peace of mind to many working West Virginia families.
Kathleen Stoll serves as the Policy Director for West Virginians for Affordable Health Care and operates a policy and economic consulting business, Kat Consulting.