NY Times: The Home Care Nursing Shortage and Its Toll on Families with Medically Fragile Children

Capitol Report | June 2021

An expansive page-one story in the New York Times earlier this month examined the nursing shortage in home care and its emotional, physical, and economic impact on families with children needing medically complex care.

HCA has repeatedly advanced legislation to address the root causes of home care’s nursing shortages — for medically fragile kids, as with adults. These persistent shortages threaten unnecessary institutionalization, depriving patients and families of the option to receive cost-effective care at home. Indeed, that option was enshrined as a fundamental right by the landmark Olmstead decision 22 years ago this month. (See related story here.)

For kids on ventilators, feeding tubes, or with other complex-care needs at home, the stories are particularly wrenching, as the Times documents. Many parents are taking around-the-clock shifts attending to their child’s care needs while juggling work schedules that cause unimaginable physical, emotional, and economic stress. For many, the complex health and safety needs of their child require the support of a trained professional for everything from pain management to therapies to infection control and so much more.

But as HCA notes in the Times article, the rates of reimbursement for home care “effectively establish a benchmark of workers’ compensation that competitively disadvantages this field” — and the disparity is no more pronounced than in the services provided to care for medically fragile children.

Among many other actions to address this issue, one measure advanced by HCA in each of the past few years of legislative session would compel the state to conduct a competitive labor market analysis for home care. This proposal would get to the bottom of what benchmark compensation levels are necessary to attract and retain staff across the various home care disciplines and regionally across the state. Coupled with this analysis is an imperative for the state to establish rates of reimbursement and funding accordingly: to overcome the competitive disadvantages to home care and ensure workforce sustainability to meet need.

As reported elsewhere, HCA is also recommending several avenues of support for home care’s workforce utilizing funds from the enhanced Federal Medicaid Assistance Percentage (FMAP) pool that was appropriated in this year’s state budget.

To learn more about HCA’s workforce support proposals, please contact HCA’s Director for Public Policy and Advocacy Alyssa Lovelace at alovelace@hcanys.org.