People who care for seniors and those with disabilities in their homes will get a wage boost in 2022, but even the plan’s biggest supporters called it a first step rather than a crowning achievement.
The Colorado Medical Services Board voted unanimously on Dec. 10 to raise the amount the state pays through Medicaid for home-based care, and to require agencies to use that money to pay the people providing the care at least $15 an hour. Home-based services are cheaper for the state than nursing home care, and older adults tend to prefer to stay in place.
Previously, the state didn’t set a base wage for care workers. Agencies only had to pay the overall minimum wage, which is $12.32 statewide, or their municipality’s minimum if that was higher. State officials estimated about 47% of direct-care workers receive some form of public assistance because of their low incomes.
Federal COVID-19 recovery money will allow the Colorado Department of Health Care Policy and Finance to fund the increase through mid-April 2023. The General Assembly will take on the question of whether to extend it by passing a permanent rate increase, which is included in Gov. Jared Polis’ budget request.
The increase will affect an estimated 10,000 to 15,000 workers, said Lorin Chevalier, founder of People Care Health Services and a board member of the Home Care and Hospice Association of Colorado.
Even as they approved the plan for a temporary increase, some board members raised concerns it wouldn’t be enough to recruit and keep workers in a challenging field where demand is only going to grow as the population ages.
“We’re competing with Starsbucks at $17 an hour and McDonalds at $15,” board member Dave Pump said before the vote. “It doesn’t go far enough, but it is so much better than where we were before.”
Cody Jakubowski, ]a direct-care worker in Denver, said the increase won’t solve the problem of low wages, but it’s progress. While the $15 base wage wouldn’t affect him because his current private-pay clients already offer more, he got involved with the campaign to raise wages because other care workers have family responsibilities that don’t leave them the time to get involved in advocacy.
“Hopefully, it means an easier step to $17 an hour and $20 an hour,” Jakubowski said. “There’s caregivers on Medicaid taking care of clients on Medicaid.”
Jakubowski, who said he lives in his van, called it a strange kind of privilege to have that option for getting by on low wages. For the first time, he has a small savings cushion.
“There’s a pretty good chunk of care workers that have been homeless,” Jakubowski said.
But most direct-care workers he knows have children and can’t reduce their expenses by forgoing rent, he added.
About 87% of home care workers are women, and a higher percentage are people of color or immigrants than in the labor force as a whole, according to a 2019 report from the Paraprofessional Healthcare Institute.
The Joint Budget Committee already voted in favor of the temporary raise, but Rep. Julie McCluskie, the committee’s chair, said it’s too early to know which requests the members will prioritize.
“I think it’s critical in this moment that we be thinking about frontline and essential workers,” she said.
Candace Bailey, director of the Colorado Department of Health Care Policy and Financing’s home- and community-based services division, said the state will study whether $15 accomplishes the goal of increasing the home-care workforce, but she expects more increases will be needed.
The federal COVID-19 recovery funds offered a “unique funding opportunity” to retain more caregivers, said Jessica Corral, participant directed programs contract specialist at HCPF. The state’s population is aging, and the number of people working in direct care hasn’t kept up, she said.
“Older adults and people with disabilities will continue to struggle to access long-term care if we don’t grow the workforce,” she said.
Brenda Lozada, a direct-care provider who lives in Aurora, said she appreciates the efforts to raise the base wage, but $15 an hour isn’t enough to cover the basics in Colorado. She said it helps that she lives near a bus stop, which cuts down on the cost of getting to and from clients’ houses and a nursing home where she works part-time.
“You’ve got people who are working two and three jobs just to keep a roof over their heads,” she said.
Workers caring directly for vulnerable people also need other support such as paid medical leave for sick days, Lozada said. At times, she’s had go into work while not feeling well.
“Me being the sole earner in my family, I had to work,” she said. “When I’m going to work and I’m not feeling well, first, I can’t do my best, and second, I might get (clients) sick.”
While the increase only applies to people caring for clients covered by Medicaid, agencies serving clients who pay out-of-pocket likely will have to raise wages to compete for workers, Chevalier said.
“It establishes, really, a new floor,” he said.
Home care worker Cody Jakubowski, left, participates in a video conference meeting with a union representative from the van where he lives, which was parked at City Park in Denver on Dec. 08, 2021.
Additional increases to the Medicaid rate of $21 per hour paid to agencies are likely needed to fund further wage increases, as well as benefits such as health insurance and mileage reimbursement, Chevalier said. Colorado also should invest in ways to create “career ladders” for home-care workers, who likely can’t afford community college classes if they want to increase their skills, he said.
People often don’t understand how much goes into meeting a home-care client’s needs, and sometimes compare it to babysitting, Lozada said. It’s a job she loves, but it’s not easy: in addition to helping with hygiene care and chores including cooking and cleaning, she has to watch out for any hazards to a client.
In one case, Lozada told a male client who was unsteady on his feet to stay on the couch while she went to get something in the kitchen, and had to run back to catch him when he overestimated his balance and started to get up. Other clients need someone to take an interest in them and provide companionship that they aren’t getting from their families, as well as physical care, she said.
“Babysitting is nowhere near what we do,” she said. “We need to be more respected and appreciated.”
This content was originally published here.
