There is one truth that state leaders can't afford to ignore when it comes to Connecticut's health care system.
Helping Connecticut residents receive care from home reduces hospitalizations, prevents costly complications, and ensures continuity of care over time. By reaching the people they live in, we close the access gap and save millions of dollars in the state, especially for the most vulnerable populations.
“CARE AT HOME” refers to the entire range of Connecticut home-based services, including skilled medical home health, non-medical home makers-companion care, and end-of-life hospice care. Together, these services allow individuals to continue to restore, become independent and aging with dignity in their own home, surrounded by familiar comforts and their homes.
But despite these benefits, our state is currently at a crossroads of inaction, despite the thousands of state residents who are currently dependent on home care. The reason is simple. While there is strong support for investing in care at home, some Hartford leaders are reluctant to act due to current uncertainty at the federal level regarding healthcare funding. While these lawmakers may be intentional (hoping to understand the federal impact on the state system before making a decision), waiting for action will push Connecticut into a crisis.
The reality is: Medicaid-supported personal care at home costs much less state than institutional care. Personal care at home is around $3,300 per month ($55 a day). Compare it to about $10,000 a month at a nursing home. This saves about $80,000 a year per person. Home-based care is more than just dignified. It is more financially responsible.
Skilled care at home provides even more cost savings to the state. Here are two impressive examples:
Behavioral Health Nursing Visits to Ensure People with Mental Illness or Substance Abuse Disorders are taking medication in the community – the average daily cost of community care is $1,000 per day during hospitalization. Complex Care Nursing is another emergency medical service for children and adults with medically complex conditions requiring highly skilled home care (feeding tubes, tracheostomy tubes or ventilators). The average cost of care at home is $1,000 per day. The average cost of conflict care is $10,000 per day.
Still, care and services in Connecticut at home are hanging in threads. Many Medicaid home fees have not been adjusted since 2007. Additionally, neighboring states (Massachusetts, Massachusetts, New York) offer significantly higher rates, leaving the workforce lost as caregivers attract caregivers across state boundaries.
A shortage of workforce and inadequate reimbursement rates result in fewer family options, fewer workers caring for seniors and disabled people, more clients who are stuck in hospitals or moved to nursing facilities, and more clients costing state and taxpayer. It also means devastating consequences for thousands of workers, women and people of color, to rely on the profession to support their families.
Research shows that providing care at home reduces unnecessary hospitalizations and emergency visits, helping individuals stay healthier while saving the state. Investing in care at home is something you should do economically, socially and morally.
In this regard, waiting for Washington is not a strategy. It's a dangerous gamble, with odds piling up for those in need of care and workers who provide it. If state leaders don't act now, they're part of the problem that they aren't working on a solution.
We don't need to look to Washington for answers – we already have them. The answer is simple. The following rates are currently increasing: 13% of personal care services, 10% in skilled home health, then 10% increase per year over the next three years to keep up with inflation. These are not luxurious requests. They are important to preserve the model of care that works in Connecticut economically, socially and morally.
Making these changes will help us isolate us not only for the best interests of our state residents and workers, but also for sequestering us from potential federal cuts. If federal cuts come into effect, Connecticut's ability to care for the most vulnerable residents will depend on the strength of its home care system. These services are the backbone of our healthcare infrastructure, quietly providing consistent, high quality care that keeps people out of hospitals and nursing homes.
Investing now creates a resilient system that can absorb future shocks and continue to provide essential care when the rest of the safety net is tense.
If state leaders are serious about maintaining financial responsibility, economic equity and working care, it's time to act. Because when the federal cuts come, and they are likely to do so, Connecticut doesn't have the luxury of scrambling. If we don't invest now, there's no workforce left to provide the most cost-effective care we have.
Care at home is not a problem to be solved, it is a solution. But only if we choose to act now. Connecticut can't wait for Washington, and our residents can't wait for care.
Ann M. Olson, RN, is the executive director of Yale New Haven Health-Health at his home. RN's Bree Sanka is Vice President of Behavioral Health Clinical and Pediatric Operations at Elara Caring.
