Source: North Jersey.com
By the time Isatu Bundu, a home health aide, arrives at the apartment of her third client of the day, she’s ridden five buses.
The 22-year-old full-time nursing student works three days a week as a home health care aide, usually leaving her Prospect Park home at 6:30 a.m. to begin her commute to clients in Ridgefield and Englewood.
Her clients, like 94-year-old Rose Taylor, are cared for by the Visiting Homemaker home health aide service of Bergen County, a non-profit agency whose mission is to find and train a workforce to tend to the basic living needs of a growing population of elderly. The majority of the agency’s workers rely on public transportation to get to and from the three to four homes they visit in a day. They start at $9.50 an hour, and even after years of service, can’t hope to make more than $15 an hour.
More often than not, it’s the working poor who take care of society’s shut-ins — the vulnerable looking out for the even more vulnerable.
But these tenuous arrangements are strained these days. The non-profit agencies are in danger: a victim of government and market changes from managed care reforms to the rise of national elder-care chains.
Bergen County’s Visiting Homemaker agency and Passaic County’s HomeCare Options are among the few non-profits that remain afloat and are still accepting Medicaid clients. But their operators say their futures could be in jeopardy if they can’t find a way to make up for the shortfalls that followed substantial cuts in Medicaid reimbursements three years ago.
The financial foundations of the non-profit home care providers came unglued in 2012, when New Jersey turned over management of its Medicaid-financed home health aide program to four insurance companies. The move was billed both as a cost-saver and a way to meet the state’s goal of shifting long-term care out of institutions and into homes and communities, where many older people want to remain.
The insurers, it was said, would do a better job of deciding who needed round-the-clock care and who could be cared for at home. But within months, the managed care companies cut reimbursement rates to the agencies that train, hire and deploy home health workers from $15.50 an hour to as low as $13.80.
Ed Remsen, executive director of the Visiting Homemaker agency, recently found a donor to subsidize an Uber program for the agency’s workers, who often must turn down jobs in northern Bergen County because there aren’t adequate bus routes. But he warns,“We’re losing money like crazy…If we don’t change the business model, we’ll be out of business in two to three years.”