OMBP HB1 Page: Page 1640, Class 101, Medical Payments to Providers

BEAS HB1 Page: Page 1437, Class 506 Home Nursing Services

Serious Problems from Too Low Rates for PCAs

The allocation in the Governor’s proposed budget for State Fiscal Year ’09 does not adequately fund the program given the increased demand for Personal Care Attendant (PCA) and Personal Care Service Provider (PCSP) services. The demand for in-home supports continues to grow as New Hampshire’s population ages and seniors and persons with disabilities need more assistance with personal care and want to continue living as independently as possible in their communities. The numbers of consumers served grew 25% between 2007 and 2008. The cost of doing business is escalating much faster than the reimbursement rate. A rate increase is necessary to maintain a quality workforce in New Hampshire that supports our most vulnerable citizens; yes, our mothers and fathers, persons with disabilities and our aging citizens in living cost effectively in their homes. To ensure the delivery of quality services and the development of a workforce needed to meet the increased demand we ask that the legislature restore the 2% Medicaid reimbursement rate increase that was eliminated in the Governor’s proposed budget.

In-Home Support Services are a Cost Effective Use of Medicaid Funds

See back of sheet for why PCAs have saved money.

Requested Action

Add a 3% rate increase for PCAs to the Governor’s Budget for both FY 2010 and FY 2011 on OMBP page 1640 Class 101 and in BEAS page 1437 Class 506. We are willing to support increased revenues to fund this essential service.

Contact

Clyde E. Terry, GSIL, 228-9680 Ext. 1107 Clyde.terry@GSIL.org

Cost Pressures and Why In Home Support Services are Cost Effective

A). At Granite State Independent Living 93.5% of the rate paid to us goes directly to support program costs including workers compensation, insurances, payroll taxes, regulatory compliance such as criminal background checks, abuse and neglect checks, training and other quality assurances.

B). The average cost to the state in FY ’07 for the provision of personal care services for 538 individuals was $9,651,208. Institutional care for those same individuals would have cost $29,590,000. In-home support services saved the State $19,938,792.

(As reported by DHHS)

C.) Personal care attendants and personal care service providers care for New Hampshire’s most vulnerable citizens. The low hourly rate of reimbursement for such providers is negatively impacting recruitment and retention of qualified staff.

D.) Staff turnover increases operational costs as we must again pay for recruiting, compliance and training costs.

E.) In January of 2009 the cost for mandated NH criminal background checks increased from $15 to $25 per request. In 2008 GSIL processed 581 background checks.

F.) Workers Compensation premiums alone are projected to increase to over $525,000 in FY 2010.

G.) Public funding of In Home Personal Care Services is a solid investment. Medicaid dollars spent here prevents more expensive institutional health

care costs for the state.

Summary

In making the tough decisions you face on this budget please do so, as a other, father, child, or sibling who would want to see a loved one provided dignity, caring and independence to meet their most personal care needs. The level of funding in the Governor’s budget is tantamount to a funding cut given the increase in consumers needing services.

We know you care and will look to find a means of raising additional revenue to keep our vulnerable citizens safe.