Keep North Carolinians in place with home care funding

Felicia Cunningham is division director Bayada Home Health Care-Kannapolis.

As a nurse that oversees compassionate and reliable care delivery for one of the largest home care providers in North Carolina, I am proud of the work that home health aides, nurses, and other professional caregivers do to keep the most vulnerable and medically fragile residents safe and independent in their own homes. 

Without home care services, nearly 55,000 North Carolina children, adults, and seniors would be at risk. In-home caregivers don’t just keep individuals safe and healthy in their own homes–they keep families together and save the state hundreds of thousands of dollars each year by keeping them out of costlier settings like nursing homes and hospitals. 

I am incredibly proud of the advocacy work that we do at Bayada. For many years, my colleagues and I have worked to show legislators how home care keeps their constituents in their own homes and communities. We strive to be the voice for the many vulnerable and medically fragile residents that are unable to advocate for themselves.

And it feels like we have made a difference: This year, the General Assembly has introduced a bipartisan companion bill that would update home care funding rates to keep direct care workers and nurses in the industry and keep more people at home. This is incredibly important to us because we are in a dire caregiving workforce shortage – and without enough workers, thousands of residents that need these services will not be able to access them.

Current state funding levels are so low that the home care industry is seeing unprecedented caregiver turnover rates and an increasing number of cases that must be turned away, and North Carolina’s most vulnerable populations will continue to suffer without adequate and accessible home care services unless the state includes a much-needed funding boost by the June 30 budget deadline.

Bayada’s mission is to help millions of people worldwide stay at home. But we are unable to keep even our own state’s most vulnerable residents at home because we simply cannot compete for the workforce. 

Nurses can earn more in wages in hospitals and nursing homes. Home health aides are attracted to work in fast food and retail, where they can earn higher wages for less emotionally- and physically tolling work.

Unlike companies that can increase workers’ wages and pass off these added costs to consumers, home care providers like Bayada rely on the State’s funding formula to provide caregivers’ wages and cover all other costs of doing business–including supplies, training, and supervision.

Due to our inability to recruit and retain enough professional caregivers, its North Carolina’s families that suffer: Individuals are unable to access the home care that they are doctor-prescribed and medically authorized to receive, their loved ones must often miss out on work, sleep, and other responsibilities to care for them, and–too often–this leads individuals to seek care in costlier institutional settings like nursing homes and hospitals. 

Right now, Bayada must decline more than 31% of the cases referred to us in North Carolina due to this workforce shortage.

As a state that cares for its neighbors and members of its communities, all of us in North Carolina should be able to agree on one thing: Those that want to stay home should have the option to do so. That’s why it is so important that members of the General Assembly support two key provisions in the upcoming budget: An increase to Medicaid personal care service rates to $30 per hour, and an increase to Medicaid private duty nursing rates to $65 per hour. 

A funding increase would allow home care providers like Bayada to increase wages for our caregiving staff. Better recruitment and retention means that we will be able to take on more cases and keep more vulnerable and medically fragile residents at home. And that’s a win for everyone across North Carolina. 

Felicia Cunningham RN BSN is division director, Bayada Home Health Care-Kannapolis.

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