[Cdpaanys] Text from Politico article on CDPA/workforce crisis

[Laura Cardwell]

*Storm Amid Pandemic*
BY SHANNON YOUNG
05/04/2020 05:04 AM EDT

When the coronavirus outbreak hit New York, home care worker Julia Roye was
faced with two options: Stay home with her family and ride out the
pandemic, or move in with her client.

Roye primarily relied on public transportation to commute from Queens to
the Oyster Bay home of her client, Sandra Lamb. She decided to hunker down
with Lamb so she could continue working without putting her or her client’s
health at risk.

“Sandra deserves the best,” she said in an interview. “How could I not be
here?”

Lamb, who requires 24-hour care, told POLITICO that without Roye and a
second aide who is also staying with her, she would likely be forced to
enter a nursing home — a terrifying prospect as the coronavirus sweeps
through those facilities, killing thousands.

“I can’t even explain the stress,” she said.

In Brooklyn, Jose Hernandez also has been confronted with the prospect of
receiving services at a nursing home or hospital setting, following the
recent death of a long-time personal care assistant from complications
related to Covid-19.

“If I don’t have coverage, I’ll end up in an institution or burdening the
hospital system, which is completely overloaded right now — putting myself
at risk of contracting coronavirus, and I am a high-risk individual: a
high-level quadriplegic with compromised lungs,” he said.

These scenarios are playing out across the state as many home health aides
exit the workforce amid the pandemic to care for sick relatives, watch
after children now out of school or quarantine themselves after Covid-19
exposure, leaving people who depend on such care with few options.

Industry advocates argue that the coronavirus outbreak has exacerbated
issues posed by low wages and recent budget changes to programs like the
Consumer Directed Personal Assistance Program, creating a “perfect storm”
of sorts in home care.

A Home Care Association of New York State survey from early April found
that many home care and hospice agencies were experiencing “worrisome
workforce capacity issues," with high percentages of staff in quarantine or
skipping work due to fear of exposure to the coronavirus. Nearly
three-quarters of respondents reported decreases of 1 to 10 percent in
their home health workforce capacity.

HCANYS spokesperson Roger Noyes said that while the findings reflect “a
snapshot in time,” they also highlight how the lack of support on issues
like transportation and child care affects home health workers.

“This crisis, in so many ways, has put into stark relief issues that have
been long-standing needs and shortcomings,” he said in an interview.

A study released last week, meanwhile, found that while home care workforce
recruitment is growing rapidly, it isn't keeping up with demand, and
retention has been issue. The pandemic has exacerbated those issues.

“It was a difficult scenario prior to this virus that has just gotten
harder,” said Bryan O’Malley, executive director of the Consumer Directed
Personal Assistance Association of New York State, which commissioned the
study.

The association has asked state Medicaid Director Donna Frescatore to
suspend requirements that newly hired personal assistants undergo health
assessments, provide documentation of up-to-date vaccinations and a test
for tuberculosis during the emergency — screenings which, the group argued,
aren’t being prioritized due to Covid-19 testing.

Department of Health spokesperson Jonah Bruno said guidance issued in March
and early April waived annual health reassessments for personal assistants.
The regulation, however, remains in place for personal assistants who have
not previously been screened.

“The Department is available to work with consumers and fiscal
intermediaries to ensure services are available to persons in the CDPAP,”
he said in an email.

Bruno added that DOH is “committed to providing [personal assistants] with
the supplies and equipment they need, from hand sanitizer to face masks,
gloves and gowns” during the pandemic.

Hernandez, who is “juggling” aides and sharing staff with friends in CDPAP,
said that enhanced unemployment benefits and the exposure risks presented
by home care are also making it more difficult than normal to recruit home
care workers.

“You have the federal government and New York state talking about ‘hazard
pay’ for doctors and hospitals, nurses, police officers,” he said. “My aide
died and the only thing he has gotten is a cremation and a bill for his
family.”

O’Malley, who has opposed Medicaid budget changes, said he understands the
state’s current “financial perils.” But, he argued, the Cuomo
administration must restore $45 million in recent cuts to the Home Care
Workforce Recruitment and Retention fund, as well as raise and maintain the
wage of personal assistants statewide.

“There is no justification to cutting our frontline health care workers —
workers that we are celebrating nightly at 7 o’clock by going out on our
balconies, going out on our front stoops and applauding,” he said at a news
conference last week.

Home care advocates have further contended that CDPAP, which has been on
the state’s chopping block for months, could take on a greater role in the
wake of the pandemic.

“No one could have predicted that we would be facing this pandemic when we
went into this budget,” said Emina Poricanin, a lawyer who represents
fiscal intermediaries across the state. “The personal assistance program
has been the most stable form of care in this pandemic."

Lamb said while she’s been able to retain her home care services for now,
the lack of emergency planning for home care — including no hazard pay to
encourage personal care assistants to not leave their jobs — makes it seem
“like the situation was set up to fail.”

She said it was critical to recognize the "vital role" of home care. “We
cannot keep on being the one budget line that they look to to cut when
trying to balance their sheets," she said.
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