Talking Home Care: NAHC’s Calvin McDaniel on the 2018 Midterm Elections

November 19, 2018

Kelleher and McDaniel

On this week’s edition of Talking Home Care, we are joined by Calvin McDaniel, Director of Government Affairs for the National Association for Home Care & Hospice (NAHC). Calvin oversees NAHC’s legislative priorities on Capitol Hill, and collaborates with the Alliance and other state associations on shared, industry-wide priorities.

Our discussion recaps the 2018 Midterm Elections and what to expect in the 116th Congress, which will be seated in January 2019. Enjoy!


You may listen to the podcast by clicking the play button below, downloading it directly, or subscribing through iTunes or Google Play. (Length: 29 minutes; Size: 23.2 MB). If you enjoy it, please give us a five-star review so others can find it.

Host: Patricia Kelleher is the Executive Director of the Home Care Alliance of Massachusetts.

GuestCalvin McDaniel, Director of Government Affairs for the National Association for Home Care & Hospice (NAHC).

2018 Midterm Elections Recap (Updated Monday, 11/19):

  • Democrats regained control of the US House of Representatives, gaining 37 seats so far and holding a majority of 233 seats to Republicans’ 198 seats.
  • Republicans held control of the US Senate picking up two seat as and expanding their Senate Majority to 52 seats to Democrats’ 47 seats. The Mississippi senate seat is heading toward a run-off election on November 27th.
  • On the state level: Democrats flipped nearly 400 state legislative seats nationwide, flipped seven Republican-held governor seats, and took full control of the legislature and Governors’ mansion in seven states.
  • Lastly, three states: Idaho, Nebraska and Utah voted to expand Medicaid. And a fourth state, Maine, elected a democratic governor, who will likely do the same.
  • Overall, nearly 116 million voters cast ballots, representing over 40% of eligible voters and represents the largest midterm voter turnout in 104 years.
  • It is expected that Representative Richard Neal (D-MA) will become the Chairman of House Ways & Means, and Representative Jim McGovern (D-MA) will become the new Chairman of the Rules Committee. This greatly increases the Massachusetts’ Congressional Delegation influence on Capitol Hill.

The most important takeaway from our conversation with Calvin is that HCA members should prepare for an incredibly active two years of advocacy. Take hold of your responsibility to engage your elected officials on behalf of your organization and join us in the fight on the many issues facing our industry. Be it an email to a legislator, inviting them to your offices for a tour or on a home visit, or taking time to join us in D.C. for one of the many fly-in events, it takes an army of voices to accomplish a common goal. To get involved, email Jake Krilovich.

Return to www.thinkhomecare.org.


Home Care Month 2018: Building a Workforce for the Future

November 2, 2018

Today marks the start of Home Care Month. This is the first of several blogs post reflecting on the current issues impacting the industry.

Every day in this country, 10,000 baby boomers turns 65. This new generation of “elders” are unlike any other to come before it. Economists suggest that these baby boomers control 70% of all US disposable income, yet a large percentage are not well prepared financially for retirement, with savings far below what they are projected to need to “sustain their quality of life.” Thanks to medical advances, these aging boomers should have a longer life expectancy than even the generation before them. They are more educated. They are accustomed to speaking up about their health care needs and they are technologically savvy. And without a doubt, they will be looking for a long-term care delivery system that meets their needs, allows them to age in place with some degree of financial security and with little dependence on their children (whom many boomers are still supporting!).

In short, they will want a high-quality, cost-effective, technologically-advanced home care delivery system. As we celebrate home health care month in Massachusetts and around the country, let’s look at some of what we need to do to make sure we have that in place.

Starting with Workforce Issues

This chart from a recent report from global health care consulting firm, Mercer, depicts what many have written about: There is a huge gap between the availability of a home health aide/personal care workforce and patient need. Massachusetts is among the states expected to feel it the most, and the graphic speaks to how much has to be done in this area.

Home health agencies – dependent on heavily regulated Medicare and Medicaid funding for most of their services – are increasingly unable to offer wage and benefit packages that allow them to compete within the health-care or service-delivery sectors. Added business costs such as the state’s EMAC assessment and mandated paid sick leave make it harder for private home care companies to keep costs affordable and attract workers. Already, many report more demand than they have the workforce to meet.

To ensure an available, productive, and healthy workforce we support:

  • Repealing the onerous EMAC assessment on agencies whose workers access public insurance (Medicaid);
  • Providing premium assistance or pooled purchasing of health insurance for direct care workers;
  • Adequately adjusting Medicaid reimbursements to cover living wages and benefits; and
  • Investing now in the creation of a meaningful, long-term care workforce training, with nurse and aide training funds.

Looking at Technology

There are many who think some of the workforce demand can be offset with the new technologies emerging to support aging at home. These include sensor devices that can detect a multiplicity of conditions and situations including missed meals or medications, a problematic change in weight or blood pressure, or a fall. According to a recent report by the MA state Auditor’s office:

The potential for technological change to impact the labor requirements for home health/direct care workers is considerable. As low cost technologically-based products become available it is likely that these emerging products and services will serve as both substitutes for and complements to home health/direct care occupations.

Most of these technological devices require a receiver to get and act on the collected data. While in some cases this may be a family member, it should also be noted that home care agencies are appropriately poised to be the monitor of remotely transmitted systems, sending a nurse or aide to visit only as indicated. As workforce issues intensify, we would like to see and support:

  • More insurance coverage, including Medicare and Medicaid for remote monitoring devices
  • More modeling of partnerships between private home care companies and technology vendors to test the market for, and price, care extender technologies as part of a private home care plan of care.

Home Care Month is a time to honor the contributions of home health workers who are the lifeline to health care for some many home-bound elders, for isolated and struggling families and for the disabled. Let’s also use this opportunity to listen to and respond to their needs.

Return to www.thinkhomecare.org.


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