CPC Statement on Home Care Reform | Chinese-American Planning Council
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CPC Statement on Home Care Reform

Aug
31

***FOR IMMEDIATE RELEASE***

Date: August 31, 2022

Press Contacts: Wayne Ho, President & CEO | (212) 941-0920 x 143 | who@cpc-nyc.org

CPC Statement on Home Care Reform

New York, NY – The Chinese-American Planning Council Home Attendant Program Inc. (CPCHAP) provides critical, life-saving home care services to Medicaid patients, who cannot afford such services otherwise. CPCHAP has no choice but to provide home care by following New York State Medicaid rules and requirements, as well as Department of Labor laws, court decisions, and union agreements. We have long called for the State to replace 24-hour home care cases with two 12-hour split shifts, which would be best for both workers and patients. While we conceptually agree with the spirit of Intro 175, reforming 24-hour home care requires changes to labor law and Medicaid funding at the State level, not the City level. This would cost more than $1 billion in Medicaid each year to implement statewide, which is a small portion of the State’s $220 billion budget.

Like the other hundreds of nonprofit home care agencies around the State, Medicaid funding rules prevent CPCHAP from doing this on our own without committing Medicaid fraud or abandoning our patients, who are older adults and disabled people. The State has determined and enforced 24-hour cases since the 1970s. Home care regulations and compensation are determined by the State, contracted by the NYC Human Resources Administration (HRA) and Managed Care Organizations (MCOs), and backed by the Court of Appeals decision and 1199SEIU union agreements. Home care agencies do not, and cannot, determine these regulations and compensation. Home care agencies do not have the authority to end 24-hour cases because of these regulations and the Patients’ Bill of Rights. The State decides on the authorization of converting 24-hour cases into two 12-hour split shifts.

We are committed to doing right by our workers, and we have been advocating for State-level reform for all home care workers for since 2017. CPCHAP is a high-road employer that consistently passes audits on worker compensation by the State and City, and CPCHAP was the first nonprofit home care agency advocating for systemic reform for both home care workers and patients. CPCHAP has only 49 24-hour cases, which is less than 1.6% of our 3,000 home care caseload and which is less than 0.5% of the State's 11,000 24-hour cases. CPCHAP has also requested split shift authorization on all existing cases, but the State has consistently declined split shifts for the majority of our cases. 

The NYS Department of Health, via Medicaid funding through the NYC Human Resources Administration and Managed Care Organizations (MCOs), assigns 24-hour live-in care for patients with acute needs. However, according to the NYS Department of Labor, Medicaid only pays for 13 hours of these shifts, with the understanding of eight unpaid sleep hours and three unpaid meal hours. Because CPCHAP is a 100% Medicaid funded agency, the State provides for 13 hours of reimbursement for each 24-hour case, which CPCHAP then provides directly to the home care worker. When home care workers have interruptions, CPCHAP has implemented an easy-to-use system for compensating our home care workers for those interruptions, which is not reimbursed. In fact, CPCHAP paid $2.7 million for overtime, interruptions, transportation, and other compensation, which was not reimbursed by Medicaid and which led to a $2.4 million deficit last fiscal year.

CPCHAP has earned a reputation as a “go to” preferred agency among home care workers because we uphold the rights and dignity of each of our workers and because we provide their preferred shifts to the extent that caseload and Medicaid allow. On average, our home care workers have been with CPCHAP for 5-10 years, and 80% of our workers have previously been employed by other home care agencies. In a recent survey, our home care workers rated CPCHAP as 8 out of 10 in their satisfaction and reported that they are highly satisfied with CPCHAP because we reimburse for time that other agencies do not. Reflecting the sentiments of a true representation of CPCHAP home care workers, one wrote the following, “I’ve worked for this agency since 2017, and I can honestly say this has been the best company that I have ever worked for and with. They treat everyone like family and they do not discriminate. No matter your age, race, or gender, this agency makes you feel like you’re part of their growing process and family.”

The 13-hour rule, or only paying for 13 hours of a 24-hour live-in shift, is unsustainable and unfair to home care workers, who deserve to be fully compensated for every hour in their patients’ homes. CPCHAP is in full support of ending our 24-hour shifts and providing two 12-hour split shifts going forward and would do so ourselves if we could; however, despite our best attempts, we have been unsuccessful because of State policies and Medicaid regulations. We will continue to work with allies, workers, and patients to advocate for the Governor and State Legislature to end 24-hour shifts and to ensure Fair Pay for Home Care, which will build a just and caring economy in New York State. We are doing all we can to do right by home care workers, serve patients, and reform the Medicaid system.

Learn more about CPCHAP and its advocacy efforts here.

 

華人策劃協會關於改革家庭護理服務的聲明

 

華人策劃協會家庭護理中心(CPCHAP)為無法負擔家庭護理服務的醫療補助患者提供關鍵並且能夠拯救生命的服務。CPCHAP別無選擇，必須遵循紐約州醫療補助的規則和要求，以及勞工部法律、法院裁定和工會協議。長期以來我們一直呼籲州政府採用兩個12小時分班制來取代24小時家庭護理，因為對工人和患者來說都是最好的。雖然我們在概念上認同Intro 175的精神，但改革24小時家庭護理需要在州級改變勞動法和醫療補助資金，而不是在城市層面。若得以在全州範圍內實行，每年則將花費約10億美元，但與該州2200億美元的預算相比相對很少。

 

與同州的數百家非營利家庭護理機構一樣，醫療補助資助規則阻止CPCHAP在不犯下醫療補助欺詐或不拋棄我們大多為老年人和殘疾患者的情況下，自行完成這項工作。自1970年代以來，州政府已確定並實行24小時家庭護理案例。家庭護理條例和補償是由州政府決定，再由紐約市人力資源管理局(HRA)和管理式護理組織(MCOS)簽訂合同，並得到上訴法院和1199SEIU工會協定的支持。家庭護理機構不可以，也不能決定這些條例和補償。由於這些規定和《病人權利法案》，家庭護理機構無權結束24小時家庭護理案件，而是由州政府來決定授權將24小時的案件改為兩個12小時分班制。

 

我們致力為我們的工人做正確的事情，自2017年以來，我們一直倡導由州政府帶頭改革家庭護理人員制度。CPCHAP是一家持續通過州和市政府對工人薪酬審查的良心雇主，亦是第一家宣導為家庭護理人員和患者對系統進行革新的非營利家庭護理機構。CPCHAP只有49個24小時案例，佔我們全部3000個家庭護理案例中不到1.6%，也不到全州11,000個24小時案例的0.5%。CPCHAP曾要求州政府授權並允許所有現行案件實行輪班制，但大多數案件都如一貫的被拒絕。

 

紐約州衛生部通過紐約市人力資源管理局和管理式護理組織(MCOs)提供的醫療補助資金，為急需的患者分配24小時住家護理。然而，根據紐約州勞工部的規定，假定有8小時的無薪睡眠時間和3小時的無薪用餐時間，醫療補助只需支付13小時的輪班費用。由於CPCHAP是一個100%由醫療補助資助的機構，州政府為每個24小時案例提供13小時的補償，然後由CPCHAP直接提供給家庭護理人員。當家庭護理人員在工作上遇到突發事情時，CPCHAP實行一個簡單易用的系統來補償我們的家庭護理人員，而這是沒有報銷的。事實上，CPCHAP為加班、突發事件、交通和其他補償支付了270萬美元，這些補償沒有得到醫療補助的補助，導致上一財年出現240萬美元的赤字。

 

CPCHAP在家庭護理工作者中贏得了首選機構的聲譽，全因為我們維護每一位工作者的權利和尊嚴，也因為我們在工作量和醫療補助允許的範圍內根據他們的優先選擇提供相應的工作時間表。平均而言，我們的家庭護理人員在CPCHAP工作了5-10年，80%的員工之前曾受雇於其他家庭護理機構。在最近的一項調查中，我們的家庭護理人員將CPCHAP的滿意度評為8分(滿分10分)，並在報告上指出他們對CPCHAP感到非常滿意，因為我們會補償其他機構不能報銷的時間。有一位CPCHAP家庭護理工作者寫道：「自2017年以來，我一直在這家機構工作，打從心底地說，這是我待過最好的公司。他們待每個人就像對待家人一樣，並沒有歧視。所有人不論年齡、種族或性別，加入了這家機構後都會讓你感覺自己是他們成長過程和家庭的一部分。 」

 

13小時規定，或僅支付24小時住家輪班的13小時費用，對於家庭護理工作者來說是不可持續的，也是不公平的。他們在患者家中的每一小時都應該得到全額報酬。CPCHAP全力支持結束24小時制度，並採用兩個12小時分班制，如果可以的話，我們自己就會這樣做；然而，儘管我們盡了最大的努力，但由於州政策和醫療補助的規定，我們還是沒有成功。我們將繼續與盟友、工人和患者合作，倡導州長和州立法機構結束24小時制並確保家庭護理獲得公平薪酬，以在紐約州建立一個充滿公正和關懷的經濟環境。為此，我們正盡我們所能為家庭護理人員做正確的事，服務客戶並堅持改革醫療補助系統。

 

按此處了解更多有關 CPCHAP 及其主張。