At COVID Hearing, HCA President Describes Miraculous Work of Home Care and Major Challenges Needing Redress

Testifying at an August 10 state legislative hearing on long term care and the COVID-19 emergency, HCA President Al Cardillo highlighted home care’s response to patients’ needs, as well as systemic challenges that have impeded this vital work — challenges which now demand redress.

His testimony drew upon the miraculous support “unlike any other service” that home care renders every day — in the pandemic, now, as with home care’s longstanding role outside of a public health emergency.

“These pivotal home care and hospice roles have been exponential throughout the pandemic,” he noted in his written remarks available here. “They have helped sustain the health and the lives of patients, functionality of the health system, and provided key support in virtually all spaces of the system.”

Home Care First policy

Cardillo also called on the Legislature to adopt a New York “Home Care First” policy. This would involve resetting the referral structures, state program policies, and finance provisions so that care at home is a first consideration for patient care, where suitable. HCA is in the process of advancing multi-level legislation along these lines.

Indeed, as we’ve reported to you in recent headlines, the public overwhelmingly supports this direction, especially with rising unease about care in congregate settings.


Cardillo also described a chronicle of challenges impeding home care’s work. He reiterated the fact that while home care staff and providers are deemed by law to be ‘essential personnel,’ systemic gaps have fallen short in providing the kinds of ‘essential supports’ needed to match this vital role. Among these major challenges are:

  • Personal Protective Equipment (PPE) access and PPE supply prioritization for home care and hospice, equivalent to other sectors.
  • Equitable financial support to offset losses and meet workforce and patient care needs.
  • Sharing with industry representatives and front-line agencies the emergency survey data that the state is collecting from providers. This data is crucial for purposes of ‘situational awareness,’ so that the home care and hospice provider community is as informed as possible about basic trend lines necessary to respond to the COVID-19 crisis in real time. (As noted elsewhere in this month’s newsletter, a bill sponsored by Senator Gustavo Rivera seeks to address this issue of reporting transparency.)
  • A lack of knowledge and, at times, exclusion, of home care or hospice from considerations in the coordinated incident command or policy response structure. This includes regulatory changes that have overlooked home care from the kind of help which is necessary. Also, new policies have been designed in such a way that is impracticable for the uniqueness of the home care setting, where workers report to the patient’s home (not a “campus” location) and where complex travel, social encounters, and environmental conditions are completely different from other settings.
  • Long-standing staffing shortages exacerbated by the pandemic due to fears among staff about taking on cases and potentially becoming sick, as well as school closures that have challenged and put new stresses on working parents, among other factors.

HCA thanks Senators and Assembly Members for their questions and interest on issues ranging from workforce supports to our Home Care First proposal. Legislators also asked important questions about very specific regulatory fixes that need resolution, like flexibility on practitioner orders for home care. (See the July Capitol Report for a summary of this critical issue that remains unresolved.)

HCA is also pressing at the federal level for many of these similar areas of supports, as reflected in a letter led by New York’s U.S. Senator Kirsten Gillibrand and colleagues (see related story here).

HCA is happy to further brief your office on all of these critical issues. Please reach HCA’s Director for Public Policy and Advocacy Alyssa Lovelace at