Jul 29, 2014
Partly Cloudy

Home Health and Adult Day Organizations Call for Hike in State Reimbursements

Home Health and Adult Day Organizations Call for Hike in State Reimbursements

Two state associations, representing over 50 home health care and adult day organizations, are calling for support of legislation to increase reimbursement for critical adult day and home care services.  The proposed legislation seeks a 10 percent increase in reimbursement (the last update was in 2008) to support the care and services these agency staff provide, and also to better account for increased frailty and acuity of adult day participants. 


“One of the goals of our state is to rebalance our long term care system and enable older people to remain safely in the community for as long as possible,” said LeadingAge RI Director James Nyberg.  “We need to ensure that there is an infrastructure of cost-effective, long-term care services to meet the demand created by the growing number of frail and acute participants that we are (and will continue to) see in adult day centers.  Right now, the flat daily rate of $52.98 –which was set in 2008 -- falls far short of operational and staffing costs and there is no additional reimbursement for participants with more complicated diagnoses like dementia.”  (Adult day centers are required to have a full-time administrator, an on-site nurse and C.N.A. staff, activity staff and case managers.  They also provide two meals and a snack, personal care nursing care and care coordination.)


“During the past six years, the cost to deliver health care services in the home have significantly risen. Without a rate increase to cover increased costs, such as utilities, staff wages, employer compliance to the Affordable Care Act, and proposed hikes to the state’s minimum wage, many home health care agencies will be at serious financial risk resulting in limitations to access to quality health care services,” said RI Partnership for Home Care Executive Director Nicholas Oliver. “This legislation is not just about the financial stability of home and community-based health care service providers, it’s a value proposition to the General Assembly. The value of allowing more of our state’s chronically and terminally ill to live safely and cost-effectively in their homes (and in the community) with quality health care support versus the increased taxpayer financing of nursing home placements for those that could remain in the comfort of their homes is what is at stake,” added Oliver. 


The groups cited rising costs of transportation, heating prices, insurance and rent among the factors that have increased operating costs dramatically over the last six years. 


 If enacted, the proposal would refine the reimbursement methodology to reflect costs, acuity and quality by increasing the base rate for both Medicaid and Co-pay funded home health care and adult day services by 10 percent and to begin to implement acuity adjustments for adult day participants with more complex needs. 


Several adult day centers belonging to LeadingAge RI and home health care and hospice provider agency members of the RI Partnership for Home Care are planning on testifying on behalf of the bill when it is heard before the House Finance Committee on April 30th. 



About LeadingAge RI


LeadingAge RI (leadingageri.org) was founded in 1989 and represents a continuum of long-term care providers in Rhode Island, including not-for-profit nursing homes, assisted living facilities, and senior housing providers, as well as adult day health centers.  The mission of the association is to advance excellence in the field by fostering innovation, collaboration, and ethical leadership; advocating for sound public policy; providing education, collaboration, and professional development; valuing older people and their right to make choices; and promoting a continuum of services. 


About RI Partnership for Home Care


Established in 1990, the Rhode Island Partnership for Home Care (riphc.org) is the only association in the state dedicated to “advancing quality health care at home”. RIPHC represents home care, home nursing care, and hospice provider agencies licensed by the Rhode Island Department of Health to serve patients and clients in every Rhode Island community. RIPHC is committed to promoting quality home health care service delivery, ethical health care business practices, and positive patient and client outcomes to ensure that access to home health care and hospice remains an integral component of our state’s acute and long-term health care system.


# # #

Don’t miss updates from Patch!