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April 27, 2021

Acting on COVID Lessons, King Seeking to Improve Home Healthcare Quality, Strengthen Its Workforce

Maine’s 20,000 direct-care workers provide critical care in the state, but the average wage for homecare providers is between 11 and 13 dollars per hour

WASHINGTON, D.C. – U.S. Senator Angus King (I-Maine) has introduced three pieces of legislation aimed at improving the quality of home care by providing career support and advancement opportunities for home healthcare providers. Senator King’s proposals specifically aim to address shortcomings in training for home health workers and open new pathways for career advancement. These efforts seek to stabilize the field, which has been stretched thin by the pandemic and already suffers high turnover rates due to unpredictable hours and low wages. Strengthening the nation’s home care is vital to Maine, which is the oldest state in the nation and already has more than 4,400 workers in the home health care services industry.

“The pandemic has put the monumental contributions and sacrifices of America’s healthcare providers front and center,” said Senator King. “This includes our home healthcare providers, who undertake major challenges to support their patients, giving our older mothers, fathers, and neighbors the freedom to remain at home while addressing healthcare challenges. In an aging state like Maine, home care is absolutely vital to our healthcare system – which is why I’m committed to working alongside my colleagues and our healthcare providers to strengthen this industry and ensure it has the workforce it needs for long-term success.”

“We applaud Senator King for his leadership in strengthening the direct care workforce,” said Jodi M. Sturgeon, President of PHI. “These three bills would bolster training and career paths for direct care workers throughout the country, ensuring they have the proper skills, knowledge, and career advancement opportunities to deliver high-quality care to older adults and people with disabilities.”

“Maine, like other states faces a critical shortage of direct care workers in all settings including home care,” said Brenda Gallant, R.N., Executive Director of the Maine Long-Term Care Ombudsman Program. “Whenever possible, older adults and adults with disabilities who need care, tell us they want to remain at home. However, this is only possible when there  are home care workers available to provide the care that is needed. We must do everything we can to attract and retain a quality home care workforce through greater access to training as well as by providing career advancement opportunities. These workers are essential to the well-being of so many Maine people. Senator King’s legislation will do much to help in building a stronger home care workforce not just in Maine but across the country.”

"Saint Joseph's College applauds Senator King's enduring commitment to provide support to the critically-needed, yet under-paid and under-trained home health care workforce in Maine,” said James S. Dlugos, Ph.D, President of Saint Joseph’s College of Maine. “As a college that grows leaders ready to sustain their communities - especially in health care - we enthusiastically support any legislation that helps Maine's rapidly growing older population thrive. The same spirit has led us to develop our Institute for Integrative Aging, and our Center for Nursing Innovation. Through these innovative models, we host multiple holistic wellness programs to combat isolation and loneliness among older Mainers, and build career ladders for home health care workers through both formal and informal education and training programs." 

Due to inconsistent hours, low wages, and a lack of support and training, home healthcare agencies regularly face challenges in retaining workers. In the United States, the median annual salary for a home health aide was $24,200 in 2018, just above the $16,460 federal poverty level for a family of two. In addition, unique training requirements for various roles can result in providers feeling underqualified to handle high-needs patients; for example, up to 83% of caregivers report working with memory loss patients, but only 65% report having formal training to work with this population. Senator King’s legislative proposals would address these issues by focusing funding on homecare workforce development.

Specifically, the three bills introduced by Senator King would:

·              Expand Medicaid’s Federal Medical Assistance Percentages (FMAP) to include training programs for home care workers. The Social Security Administration (SSA) currently has a 75% federal match for the training of medical personnel but the definition does not include training for home care workers. This legislation (S. 1190) would expand the definition to allow for training programs for home care workers to be reimbursed. Representative Debbie Dingell (D-Mich.) will be introducing companion legislation in the House of Representatives.

·              Provide funding for both local governments and non-governmental agencies to expand existing training models that bring new home care workers into the industry. The Affordable Care Act allocated funding for the Personal and Home Care Aides State Training (PHCAST) program, and Maine was one of six states to receive these funds in 2010. PHCAST spurred the development of programs that focused on the upskilling of home care workers, but today, many lack funding to continue. Under Senator King’s legislation (S. 1192), priority would be given to rural healthcare providers.

·              Establish funding to create projects that provide advancement opportunities for existing members of the home care workforce. Senator King’s legislation (S. 1196) would create funding through the Health Resources and Services Administration (HRSA) to help individuals already working within the home healthcare field with opportunities to pursue increased education and training to facilitate career advancement. The program would be similar in structure to PHCAST, but would instead allocate funds for projects that focus on career ladder development. Additionally, the legislation would include an add-on payment through Medicare for those who complete the extra training.

Senator King has consistently supported building a strong homecare workforce, and is a key member of the Bipartisan Policy Center’s Rural Health Care Task Force, leading a nationally-televised forum on the issue last year. He is a cosponsor of the Palliative Care and Hospice Education and Training Act, which would increase the number of permanent faculty in palliative care at accredited allopathic and osteopathic medical schools, nursing schools, social work schools, and other programs. Senator King is also a cosponsor of the Home Health Care Planning Improvement Act, sponsored by Senator Susan Collins (R-Maine), which would allow Medicare payment for home health services ordered by a nurse practitioner, a clinical nurse specialist, a certified nurse-midwife, or a physician assistant.


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