Home care providers looking for permanent rate boost

The Massachusetts Statehouse. Photo courtesy of Wikimedia Commons.

By Jusneel Mahal

Boston University Statehouse Program

Home health aids and other support personnel are the often unsung key to older people being able to remain in their homes as they age. But with employees at some fast-food outlets and retail chains able to earn more than home health workers, lots of positions for vital services go unfilled. 

The 2023 state budget includes a rate add-on that will provide more money to home care agencies for the fiscal year, but representatives from the sector who spoke at an Executive Office of Health and Human Services hearing this week say further reforms are needed to make permanent changes to the rate-setting structure for home and community-based services. 

“Not enough people want to go into the home care field — there are plenty of open positions,” said Julie Watt Faqir, executive director of the Home Care Aide Council, a trade group representing home care providers, in an email. “The hourly pay at places like Target and Walmart and Dunkin’ are higher in many cases than what the reimbursement rates will allow employers in the home care field to pay home care workers.”

Service providers at the agencies include homemakers, personal care attendants, and home health aides. Homemakers make an average of $15.97 per hour in Massachusetts, while home health aides make $18.27.

The changes included in the state budget provide a rate add-on of $3.56 per hour for MassHealth-covered home health aide services and a $3.96 per hour increase for homemakers and personal care services. Faqir said the rate add-on would fund hourly wage increases for workers in the sector.

The Enough Pay to Stay Coalition, which includes Faqir’s group and two other trade associations in Massachusetts – the Home Care Alliance of Massachusetts and Mass Home Care – lobbied the Legislature for the rate add-ons.

Jake Krilovich, the executive director of the Home Care Alliance of Massachusetts, said one-year add-ons are not a great approach because they are temporary. “They go from state budget to state budget, and that leads to uncertainty for providers where they do not know if the add-on will continue past the next state budget,” said Krilovich.

The rate add-ons went into effect as an emergency provision on September 2, and cover services from July 1 of this year through June 30, 2023.

“We need the add-ons to try and pay workers more to attract more workers, but in the meantime, we’re working on bills that address structural reform and how rates are set,” said Krilovich.

Harrison Collins, the director of legislative and public affairs of the Home Care Alliance of Massachusetts, said the coalition is drafting a bill that would provide more secure rates for health and home care workers.

“I couldn’t imagine my wage depending on a rate-add on every year, but that’s the world we live in, and that’s what goes on in this kind of sector,” said Collins. “It’s the people that need the service that end up getting hurt because the demand isn’t met.”

This story originally appeared in Commonwealth Magazine.

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