The Biden Administration is crafting a major jobs and infrastructure plan for the 21st century. The plan focuses on roads, bridges, broadband technology, and a range of other programs designed to get Americans back to work. One key component of the plan focuses on recognizing that the population of the United States is growing older. The plan hopes to address many elder care concerns for seniors including shifting away from institutional care and more toward home care.
According to the Wall Street Journal, $400 billion of the proposal targets home health care instead of nursing home care. The $400 billion elder care funding component is about one-sixth of the overall $2.3 trillion proposal. The plan could, according to the WSJ, allow independent home health workers who are funded by Medicaid and other federal programs to “collectively bargain” as public employees.
The aging American population
The Centers for Medicare and Medicaid Services (CMS) states that the funds needed to support federal healthcare programs are expected to expand from $3.8 trillion in 2019 to $6.2 trillion in 2028. A major reason for the increased costs is that the “baby boom generation” will be 65 years old or older by 2030. Baby boomers include adults born before 1965. By 2034, it’s estimated there will be more seniors than children for the first time in American history.
Most seniors have health coverage through Medicare. However, Medicare doesn’t pay for most daily home care, such as dressing and hygiene. Medicare also doesn’t pay for long-term nursing home care. Many people are forced to use their own funds for nursing homes, except for those who qualify through Medicaid. And, there are strict requirements to be eligible for Medicaid, including having a very minimal amount of assets, typically $2,00 or less. People with disabilities may also qualify for a Medicaid nursing home. Even for people who qualify for a Medicaid nursing home, however, there may be a long waiting list.
Supporters of the proposed elder care program say that home care and community care are much more affordable than nursing home care.
What advocates of the plan are saying
Nationwide, the employment of personal care aides and home-health providers is estimated to grow by about one-third from 2019 to 2029 – a very steep rate compared to other professions. Currently, according to data from the Bureau of Labor Statistics, home-health workers earn about $25,000 a year.
President of the Service Employees International Union (SEIU) Mary Kay Henry noted that the plan will help an industry mostly composed of women of color. She told the WSJ that the President “has clearly heard the demand of these women—and millions of other essential workers—to be respected, protected and paid.”
Advocates of the proposal say that the Covid-19 pandemic is another reason to encourage a shift away from nursing homes and towards home-health services. A large proportion of the people who died from COVID-19 were residents of nursing homes and other long-term care facilities.
A representative for the National Association for Home Care and Hospice stated that many other countries do pay for home health care through the “public purse so they can have the dignity and independence they deserve,” pointing out that “once upon a time, home was the center of healthcare.”
According to The American Health Care Association and National Center for Assisted Living, the average age of a nursing home resident is 85, and many residents have multiple health problems. According to the Huffington Post, the plan will include help and services for people who are seniors or disabled including:
- Personal caregivers who assist seniors with bathing
- Counselors to assist people with intellectual impairments with finding jobs for independent living
It is also expected to provide help to pay for childcare and preschool, along with a paid family leave program. Most current family leave programs are unpaid.
Advocates of increased funding for home-health care state that:
- It’s mostly women who do the caregiving when a parent or family member needs care. Many women can’t do both caregiving and their paid job. The increased funding for caregiving would compensate the women for these financial sacrifices.
- The higher pay scale would attract more qualified home-health care workers.
- A “care infrastructure” is just as important as other types of physical infrastructures.
Liability for home-health care services
The plan, so far, doesn’t discuss the liability issues facing nursing homes today. Nursing homes can be liable for:
- Emotional abuse
- Financial abuse
- Physical abuse
- Sexual abuse
Many of these same concerns apply to seniors who receive care from independent home-health care agencies:
- The companies that provide home-health services must vet their employees to ensure the seniors are safe and that the care providers are skilled at dealing with the unique set of problems that seniors have.
- There may be issues involving the liability of employees versus independent contractors.
- Companies that provide home-health care will need to have the proper types of insurance in the correct amounts.
- There may be issues involving relatives who provide home care versus non-relatives.
Many of these liability issues will need to be addressed in advance to ensure seniors get the care they need.
If you or a loved one suffered any type of harm due to a nursing home, you have the right to hold the nursing home accountable for abuse or neglect. Here in Chicago, the skilled and experienced nursing home lawyers at Gainsberg Law, P.C help seniors assert their rights. To discuss a nursing home abuse or neglect case, call us at 312.600.9585 or use our contact form to schedule an appointment.