New budget offers hope for home-based elder care – Concord Monitor

Every week, about 18,000 hours worth of requests for care go unanswered at Granite State Independent Living, due to a severe staffing shortage.

The statewide non-profit organization sends caregivers into the homes of disabled residents to help them maintain a high quality of life. Requests going unfilled include help cleaning homes, making meals, bathing and even getting out of their wheelchairs.

Deborah Ritcey, the organization’s CEO, said their clients are sometimes forced to choose which services are most important to them – often getting out of bed and getting dressed – while other requests, like help getting moving around during the day, are pushed to the wayside.

“They could have nobody in the home all day and somebody might come back at 8 or 9 at night to feed them dinner and put them back in bed,” she said. “They could be in their home sitting in the wheelchair all day with no help. That’s how far behind we are.”

To fill the overwhelming number of hours of requested care, her organization would need to employ an extra 470 workers, a seemingly impossible number in an industry with wages sometimes lower than those of McDonald’s employees.

“It’s not sexy,” she said. “What we do is not something that a young generation is signing up for.”

For the first time in many years, the state’s budget offers Ritcey hope.

This year’s state budget, which was signed last week, includes a number of provisions that fund alternatives to nursing home care, like a 15% increase in Medicaid reimbursements for the types of personal care services GSIL offers.

Douglas McNutt, the Associate State Director of Advocacy for AARP NH, said over the years, some critical parts of home-based care system have atrophied as funding has waned.

Adult medical daycare facilities, which offer an affordable place for older, disabled people to stay for several hours while their family members are at work, have been grappling with low Medicaid reimbursement rates for years. As a result, McNutt estimates that half a dozen have closed in the last five years – Concord’s last center closed in 2018, after it fell tens of thousands of dollars behind on bills.

This year’s budget offers relief to the remaining centers by increasing the daily reimbursement rate from $54 to $74.

New Hampshire has historically focused its funding for elderly care on nursing homes while programs centered around home care have often scraped by with modest budgets. However, after COVID-19 ravaged many of the state’s nursing homes, some benefits of home-based became more apparent, Ritcey said. She said during the pandemic, none of her consumers were hospitalized due to COVID-19.

The real benefits of home-based care extend beyond the pandemic, she said. Adults living in their homes still have the freedom of choice – when to get up in the morning and how to spend their days.

“People say I would rather die in my bed, than go into a nursing home,” she said. “I think there’s a time in a person’s life when a nursing home is absolutely the best place for them. Our consumers are not ready for that next level of care.”

Ritcey said the extra funding won’t solve the industry’s severe staff shortages, but it’s a step in the right direction.

“Does it fix it? No, it doesn’t fix it. These employees are still underpaid for what they do,” Ritcey said. “Does it help? Immensely.”