Workers who provide home care for seniors in North Carolina do a grueling, difficult job, and they’ve been doing it for very low pay for a long time
In a little-noticed provision in the budget approved by the General Assembly—over Governor Cooper’s veto—they’ll get some relief. The budget increases the Medicaid reimbursement rate for in-home care services from $13.88 to $15.60 per hour.
Allen Freyer, director of the Workers’ Rights Project at the NC Justice Center, says this is a good first step. While the Medicaid reimbursement is paid out to the workers’ employer, Freyer says he’s confident that much of the increase will end up in workers’ pockets.
Bill Lamb, executive director of the nonprofit Friends of Residents in Long-Term Care, says low wages create huge turnover for providers, causing staffing problems that directly affect the quality of care seniors receive.
“When you can get more money turning over hamburgers at McDonald’s than you can turning people over in a bed, you’ve got a problem,” Lamb says.
According to an NC Justice Center report
, the national average Medicaid reimbursement for home care is $18.82.
Representative Josh Dobson, a Republican from McDowell County, led the effort to get the increase. He says it was long overdue, with some caregivers who have been working for the same rates they had been getting before the Great Recession.
Dobson says that while the increase is still short of what is needed—by 2050, North Carolina will have more than 2.8 million residents over sixty-five— he’s optimistic that North Carolina will get there soon.
Lamb says nearly every older adult would prefer to stay at home as long as possible, as opposed to moving to a nursing facility. Home care, he points out, costs about half as much as a nursing home per year.
“Almost everyone will say their preference is to stay at home for as long as they can. Home care allows them to do that,” Lamb says.