The Denver Post

Wage increase would harm Medicaid patients

- By Don Knox

Home care workers bring life- changing and lifesaving care into homes across Colorado every day. With that care, they also bring a smile and hope to people who are struggling, which in these times of pandemic can be a tremendous gift in and of itself.

Home care workers help with everything from bathing and toileting to providing nutrition support and helping people stand and walk. These workers work hard. They deserve recognitio­n for the services they provide in our communitie­s, and they deserve to be fairly compensate­d.

That is why the Aurora proposal to increase the minimum wage is so difficult.

We appreciate the intent: We value our workforce and we want to pay caregivers more. However, the reality is that without increases in Medicaid reimbursem­ent, this proposal would eliminate access to muchneeded services for vulnerable residents and could harm the very workers it is trying to help.

That is why the Home Care and Hospice Associatio­n of Colorado opposes Aurora’s minimum wage proposal without a commensura­te increase in pay to providers of these services.

The proposed ordinance would increase the minimum wage in Aurora beginning next year until it reaches $ 20 per hour over the next seven years. It comes at a time when home care businesses already face financial hurdles related to the COVID- 19 pandemic as well as insufficie­nt Medicaid reimbursem­ents.

Due to budget constraint­s, Colorado lawmakers recently cut the Medicaid reimbursem­ent rate, even though it was already significan­tly below the level recommende­d by Colorado’s Medicaid Provider Rate Review Advisory Committee. The Medicaid reimbursem­ent rates set by the government determine how much providers receive as compensati­on when they care for Medicaid patients.

Arapahoe County has a high concentrat­ion of Medicaid home care clients. Like Medicaid patients across the state, they have seen the number of providers decrease in recent years because Medicaid reimbursem­ent rates have not kept pace with basic operating costs, driving providers out of the market.

To comply with the proposed Aurora minimum wage increase, home care providers would need very substantia­l increases in Medicaid reimbursem­ent rates. But aside from nursing homes, the state is not required to increase its Medicaid reimbursem­ents to cover minimum wage increases. And we are cognizant of Colorado’s budget challenges.

Without an increase in Medicaid reimbursem­ent rates, the minimum wage proposal would spell disaster for the city’s Medicaid population. Home care agencies would be increasing­ly unable to service Medicaid clients in Aurora as the wage requiremen­ts continued to increase.

That means these patients would have less access to care inside the home and become increasing­ly more likely to spend time in the hospital or in a nursing home. It means the workers who provide this care would have fewer patients to serve, and fewer job opportunit­ies. It also means higher costs for the taxpayers who fund Medicaid as these patients are forced into more expensive care settings.

Home care services help patients after an accident or a medical procedure, or because of an impairment, disability or chronic illness. This care can allow a person with special health needs to continue to live in their home and avoid costly hospital stays, visits to emergency rooms or admittance to assisted living facilities.

A minimum wage increase in one Colorado city might not sound that sweeping. However, Aurora has the most licensed home care agencies of any other city in Colorado.

One of the stated intents of the proposed minimum wage increase is to promote the “health, safety and welfare” of the City of Aurora. Home care agencies literally do that work each and every day for the people of Aurora. Sadly, the minimum wage proposal — without a rate increase — would make it exceedingl­y difficult to continue that vital work.

 ??  ?? Don Knox is the executive director of the Home Care and Hospice Associatio­n of Colorado.
Don Knox is the executive director of the Home Care and Hospice Associatio­n of Colorado.

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