Home care workers bring life-changing and life-saving care into homes across Colorado every day. With that care, they also bring a smile and hope to people who are struggling, which in these times of pandemic can be a tremendous gift in and of itself.
Home care workers help with everything from bathing and toileting to providing nutrition support and helping people stand and walk. These workers work hard. They deserve recognition for the services they provide in our communities, and they deserve to be fairly compensated.
That is why the Aurora proposal to increase the minimum wage is so difficult.
We appreciate the intent: We value our workforce and we want to pay caregivers more. However, the reality is that without increases in Medicaid reimbursement, this proposal would eliminate access to much-needed services for vulnerable residents and could harm the very workers it is trying to help.
That is why the Home Care and Hospice Association of Colorado (HHAC) opposes Aurora’s minimum wage proposal without a commensurate increase in pay to providers of these services.
The proposed ordinance would increase the minimum wage in Aurora beginning next year until it reaches $20 per hour over the next seven years. It comes at a time when home care businesses already face financial hurdles related to the COVID-19 pandemic as well as insufficient Medicaid reimbursements.
Due to budget constraints, Colorado lawmakers recently cut the Medicaid reimbursement rate, even though it was already significantly below the level recommended by Colorado’s Medicaid Provider Rate Review Advisory Committee. The Medicaid reimbursement rates set by the government determine how much providers receive as compensation when they care for Medicaid patients.
Arapahoe County has a high concentration of Medicaid home care clients. Like Medicaid patients across the state, they have seen the number of providers decrease in recent years because Medicaid reimbursement rates have not kept pace with basic operating costs, driving providers out of the market.
To comply with the proposed Aurora minimum wage increase, home care providers would need very substantial increases in Medicaid reimbursement rates. But aside from nursing homes, the state is not required to increase its Medicaid reimbursements to cover minimum wage increases. And we are cognizant of Colorado’s budget challenges.
Without an increase in Medicaid reimbursement rates, Aurora’s minimum wage proposal would spell disaster for the city’s Medicaid population. Home care agencies would be increasingly unable to service Medicaid clients in Aurora as the wage requirements continued to increase.
That means these patients would have less access to care inside the home and become increasingly more likely to spend time in the hospital or in a nursing home. It means the workers who provide this care would have fewer patients to serve, and fewer job opportunities. It also means higher costs for the taxpayers who fund Medicaid as these patients are forced into more expensive care settings.
Home care services help patients after an accident or a medical procedure, or because of an impairment, disability or chronic illness. This care can allow a person with special health needs to continue to live in their home and avoid costly hospital stays, visits to emergency rooms or admittance to assisted living facilities.
A minimum wage increase in one Colorado city might not sound that sweeping. However, Aurora has the most licensed home care agencies of any other city in Colorado.
One of the stated intents of the proposed minimum wage increase is to promote the “health, safety and welfare” of the City of Aurora. Home care agencies literally do that work each and every day for the people of Aurora. Sadly, the minimum wage proposal – without a rate increase – would make it exceedingly difficult to continue that vital work.
Don Knox is the executive director of the Home Care and Hospice Association of Colorado.