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Home care companies face multiple different sets of challenges as talks of minimum wage increases have started from the Biden administration. Although we all agree that caregivers need to be paid more for the wonderful work they do, our government needs to look at the many issues at hand associated with home care, and not just use the Cinderella approach.

Home care agencies across the entire nation can certainly increase wages, and that additional cost to businesses will simply be passed on to the end-user, the person receiving the care. Home care is already private pay, in essence, coming out of the patient’s savings.

Where does the government think the money is going to come from for the cost of care …..Prince Charming? The ‘If the shoe fits wear it’ approach won’t work in Illinois and other states around this great nation simply based on the different factors including costs of operation of small businesses and the different payer sources home care receives.

I believe the government needs to look at the reimbursement rate from Medicaid under which many homecare agencies are contracted to provide care for. Medicaid services, which I might add, are reimbursed at a substantially lower rate of pay than the non-Medicaid normal hourly rate for care. If the rate of pay for the caregiver would increase to possibly $15 an hour, and the current reimbursement rate in Illinois is slightly over $21 from the payer source, Medicaid, how can a business owner make this work? Are our elected officials not aware of the costs associated with small business operations such as licensure, unemployment taxes, state taxes, workers compensations, general liability, umbrella policies, phones, rent, scheduling software, advertising, recruitment costs, training, association affiliations, accounting fees, office staff, local business permits………Shall I continue?

If indeed home care is tasked with the monumental task of providing care to the million and millions who need it- keeping in mind the massive shortages of caregivers, and I won’t even mention the pandemic - then perhaps thinking outside the box is necessary. Can Medicare not be contracted for home care also? Why not contract both payer sources at a fair rate of compensation so that agencies can make a profit and caregivers earn a decent wage (which reflect the current cost of living)? No one opens a business to lose money, and I believe we are all in agreement that we pay our fair share of taxes. Adding the burden of wage increase without first addressing the caregiver’s shortage and recruitment issues is where the challenges begin, and where change is needed most. Slapping it on top of the already struggling small business owners is not the answer, and in turn, will cause multiple agencies to close their doors.  Aishling D. Kelly

CADDCT, CFRDT, CMDTP

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