HCA estimates that the financial toll of COVID-19 on home care in New York State is at least $200 million. Agencies are coping with unreimbursed cost spikes for personal protective equipment. (By one account, PPE prices have skyrocketed over 1000%.) Workforce and caseload capacity fluctuations, higher operating and service costs, substantial depletion of revenue due to service disruption, and other factors have consumed the home and community-based care system.
While Congress has rightly come to the aid of hospitals, home care remains comparatively unaided.
Loan and prepayment programs — mostly emphasizing Medicare home health services but not Medicaid home care, whereas both need support — have provided some assistance but not to a degree necessary for sustaining home care operations mid-crisis.
In a letter to New York’s Congressional Delegation last week, HCA President and CEO Al Cardillo appealed for funds to home care in the next Congressional aid package, noting that prior relief measures have yielded billions in support for hospital needs while “home care’s fiscal chasm” in COVID-19 relief “has been substantially unaided by these measures.”
HCA recognizes that the state faces a multi-billion-dollar budget gap. Indeed, the Governor has warned of cuts as much as 20% absent the mitigating factor of federal aid.
Cuts to home care are cuts to the public health system battling on the frontlines of the pandemic. These community-based providers need stabilization, not cuts. While meeting this need is no doubt a formidable challenge in the current fiscal environment, it can be achieved — and recent history gives us some precedent — with the right coordination between the federal and state governments.
HCA especially appeals to the Legislature to stop further cuts to home care, given the present crisis.