March 27, 2013

Hope seen in state budget for home-health care


---- — PLATTSBURGH — As New York legislators close in on Monday’s budget deadline, there is a ray of hope for home-health-care providers such as North Country Home Services. 

It was feared that 2 percent across-the-board Medicaid-payment reductions would continue through 2015.

“It looks like it has only been pushed to March of 2014,” said Gina Pounds, registered nurse and office manager for the Plattsburgh-based Clinton County office of North Country Home Services.

“The cuts will continue through 2014 but will end there, which is good news. I think our letter writing, our signature campaign, hopefully, got some points across in our efforts. We have some very, very caring home-care workers. They love the job they do. We are a vital employer and important link to these people staying in their own homes. They are frail, elderly, and they need to be cared for in some fashion. If not at home, it would be a nursing home.”

North Country Home Services is “dedicated to supplying services to clients enabling them to remain as independent as possible, at home, when undergoing stress and/or hardship due to illness, disability, injury or limitations due to age,” according to its mission statement.

About 365 home-health aides help clients remain in their homes in Clinton, Essex and Franklin counties.

In Clinton County, 101 aides perform 3,200 hours per week of authorized home care.

“In an effort to target our legislators, we did a letter-writing campaign,” Pounds said. “Our home-health aides wrote letters. They signed petitions. We got 71 signatures on a petition that went to (Sen.) Betty Little, (Assemblywoman) Janet Duprey, Gov. (Andrew) Cuomo and Assemblyman (Daniel) Stec.”

Several years ago, Cuomo instituted a Medicaid Redesign Team made up of physicians, hospitals, health-care providers and agencies to look at ways the state could be more efficient with Medicaid dollars and save money.

“There were different players from around the state,” said Rebecca Leahy, executive director of North Country Home Services.

“They wanted to have all Medicaid recipients by 2016 be covered under managed-care companies. What it means, different companies like Fidelis Care and United Healthcare provide Medicaid managed care. They look at a client and determine what care is needed, and they are referred to agencies that provide those services,” she said.

North Country Home Services’ rates per hour are set by the state. 

“The Medicaid Redesign Team cut rates across the board by 2 percent,” Leahy said. “They decided that and went retroactive to the beginning of 2011. Two percent of Medicaid moneys paid to us or other agencies had to be paid back.”

This Medicaid recoupment was the difference between the initial rate paid and the cuts, plus interest.

“For North Country Home Services, an estimate over the last year and a half, our portion was $750,000,” Leahy said. “They recouped $750,000. We haven’t seen any increase in our Medicaid rates since 2009.”

Over the intervening years, the agency has had increased costs in doing business, payroll and mileage.

“We were very concerned this year,” Leahy said. “These cuts were negatively impacting our balance and our ability to pay our aides and meet our expenditures.”

The need for care, whether managed or not, will only increase, Pounds said.

“We’re seeing an increase in those authorizations coming into our agency and an increase in clients coming into the waiver programs.

“Due to managed care taking over traditional Medicaid, we have seen an increase in the Traumatic-Brain Injury Medicaid Waiver Program and Nursing Home Transition and Diversion Waiver Program,” Pounds said.

“We want to continue to provide the quality of service they deserve to our elderly and disabled population, but it’s continuing to get more difficult with continued budget cuts to health care.”

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