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  • Rachel Hammon

Don’t leave Texas home care workers behind

Hospice agencies and at-home nurses are facing stagnant funding and rising inflation. They keep patients out of hospitals.

It’s only through hospice and home care services that many patients can receive the care they need without being forced into a nursing home or hospital. From children with disabilities and their parents who navigate these challenges daily to elderly patients who require comfortable, compassionate end-of-life care, the home care and hospice industry and its dedicated nurses and attendants are essential for vulnerable patients and their families every step of the way.

Keeping these long-term patients out of hospitals actually reduces the cost of care, benefiting both state and federal government budgets and taxpayers across Texas. The Agency for Health Care Research and Quality estimates that $33.7 billion could be saved if potentially preventable hospitalizations are averted — quite literally a win-win for patients and taxpayers alike.

But because Texas Medicaid reimbursement rates have not kept pace with rising costs, many patients across the state are no longer able to find the support and care they need. Direct service workers, on average, earn around $9.50 an hour, dictated by reimbursement rates set by the Texas Health and Human Services Commission, based on the money appropriated from the state Legislature. And in-home care nurses make 12% less on average than hospital nurses, with the percentage difference exponentially increasing since the COVID-19 pandemic began.

These low pay rates for home care providers, coupled with rising inflation, industrywide burnout and labor shortages over the course of the pandemic — a crisis recently highlighted by Surgeon General Vivek Murthy that “will place our nation’s health at risk” — have created the perfect storm, leaving home care providers and their patients without the support they need.

Even a recent bonus meant for Texas’ hardworking medical providers excluded private-duty nurses, responsible for providing critical home care to medically fragile children. And though their days aren’t spent in a hospital emergency room and their work isn’t as visible as an ICU nurse, private-duty nurses and other home care workers are front-line workers who support millions of Texas families, ensuring their continuing care will be as comfortable and successful as possible and keeping non-emergency patients out of the hospital. They deserve the compensation and recognition other medical professionals receive.

During last year’s special session, Texas legislators appropriated $178.3 million in grant funds to be split among multiple industries that provide services in the community, including home care and hospice. This action, while a much-needed short-term fix for the industry and its patients, cannot be the end, nor can we continue the stagnant status quo the industry has dealt with for years.

For the home care and hospice industry to survive the post-COVID-19 landscape, Texas lawmakers must act decisively to raise pay rates for home care providers and include these vital workers in future funding, adjusted for rising inflation and workforce competition.

Home care and hospice are vital services that millions of Texans rely on, and we can’t leave behind the hardworking professionals who deliver those services to our most vulnerable, every day. Our state officials must act to increase reimbursement rates for home-based health services or risk leaving behind our home care workers and the families who need them. It’s the smart — and right — move for Texas taxpayers, our most vulnerable citizens and the vital health care providers who serve them.

Rachel Hammon is a registered nurse and executive director of the Texas Association of Home Care & Hospice.

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