Home care is more than health care. It’s a mother’s sigh of relief when a trusted nurse enters her home to ensure safe and effective care for her medically complex child, or a husband holding his wife’s hand as she receives comfortable end-of-life care in the bed they’ve shared for decades. These small moments remind me of what home care is really about: connection and dignity when we are at our most vulnerable. By supporting home care and hospice professionals, we are ensuring that every American will have the right to choose to receive care in the place they are most comfortable — at home.
Home care and hospice services support more than 500,000 medically fragile families in Texas, providing a life raft of stability in situations that can bring life-altering ups and downs. These families rely on home care — as does our healthcare system. A 2016 study found that home health nursing care reduced total hospital admissions and readmissions for medically complex children. And with reduced hospital visits for preventable, manageable medical needs, more than $33 billion could be saved, benefiting the entire health care continuum and every American who pays into it.
Yet today, home care agencies and the patients they serve are struggling. In Texas, Medicaid reimbursement rates for attendant care, set by the Texas Health and Human Services Commission through funding provided by the legislature, have remained stagnant for the last 16 years. Consequently, home care agencies are severely underfunded, with home care nurses making 12% less on average than hospital nurses and direct service workers earning between $8.11 to $9.50 an hour.
If legislators fail to address this significant funding deficit yet again during the upcoming session, the home care workforce will continue to exit the profession and seek other employment and the fallout will be borne by the families who rely on home health care. Working parents will be forced to quit their careers to provide 24/7 care for their medically complex children. Years-long waitlists for critical home care services will continue to grow. Seniors will be forced to leave their homes for more expensive institutional care prematurely. Hospital beds will continue to fill, as patients with manageable medical issues have nowhere else to turn. Home care agencies, unable to keep up with rising costs, will have to close their doors, and we will all pay the price.
Texas lawmakers must come together this session to raise pay rates for home care providers, making our industry competitive when hiring and keeping pace with inflation. As Texas celebrates all-time highs in average hourly wages, hard-working home health attendants, who so often become part of the families they serve, have been left behind, earning starting wages of just $8.11. This work is deeply personal and often difficult, and attendants who dedicate their lives to serving their community should never have to worry about the cost of a tank of gas to drive home from their patient’s house or working a second or third job to ensure they can care for their own children.
As we celebrate Home Care and Hospice Month this November, I’m reminded why I continue to show up and advocate for the home health industry and the hundreds of thousands of Texans we serve. Life is unpredictable, and you never know when you or a loved one will need ongoing medical care. When that time comes, I believe that you should have a choice in where you receive that care. I am fighting to ensure our industry survives so that we will still be here to provide health care in the place you love most — home.
Editor’s Note: The above guest column was penned by Rachel Hammon, a registered nurse and executive director of the Texas Association of Home Care & Hospice. To learn more about TAHCH, visit savehomecare.org.