One of the important and invaluable functions of Council on Aging (COA) in its efforts to serve older adults, caregivers and those with disabilities in southwestern Ohio is to advocate on their behalf.
COA’s senior leaders and management team members work continuously to identify – and often to anticipate ahead of time – issues that may impact the health and well-being of its constituents. They also work on potential solutions, which might be a change in a state rule governing a program COA administers or an increase in a state or program budget. Whatever the solution is, bringing it to fruition often begins with a strategic advocacy effort.
For example, in the last year, COA has successfully advocated for an increase in the hourly rate paid to home health aides through state-managed Medicaid long-term care waiver programs, including PASSPORT, which COA administers.
Home health aides provide very personal care, enabling older adults to remain safe and independent in their homes. They also help fill in gaps in care for family caregivers who are juggling multiple responsibilities. Unfortunately, home health aides have left their jobs in recent years in search of stability, higher wages and opportunities for advancement. These obstacles are also what have kept new workers away.
COA joined with its fellow Area Agencies on Aging (AAAs) in Ohio through the Ohio Association of Area Agencies on Aging (o4a) to advocate for an hourly rate increase for home health aides in Ohio’s 2024 budget.
First, COA hosted a roundtable with elected officials to let them hear firsthand from people directly impacted by the home health aide shortage, including home health agencies, family caregivers, older adults and home health aides themselves.
“The message from our roundtable was clear,” said COA Government Relations Manager Nan Cahall. “Home health aides deserve higher, competitive wages and we should be looking for opportunities in state-run programs to eliminate rules and requirements that drive up costs without improving outcomes for older adults.”
COA went on to participate in an o4a social media campaign meant to educate state legislators and keep the issue top of mind as the state budget was being debated and approved. Cahall actively communicated with legislators in COA’s service area about the issue as well. In addition, she testified in front of the Ohio House Finance HHS Subcommittee in Columbus, sharing with lawmakers the impact the home health aide shortage is having on older adults in Ohio and the reasons for this crisis, including low wages.
This concerted, statewide advocacy effort resulted in a win for older adults and their caregivers, with the final 2024 Ohio budget including funding for rate increases for home health aides. As of the end of October 2023, the Ohio Department of Medicaid was working to update program rules that will increase hourly rates in Medicaid waiver programs for home health aides by an estimated 40%.
In another effort to help ease the effects of the home health aide shortage, COA has been looking for opportunities to expand the consumer directed care option in some of its programs. In consumer directed care, older adults (or someone they designate on their behalf) can hire someone they know to provide their care. COA and its subsidiary home52 developed AddnAide, an app that allows older adults who need and qualify for in-home care services to connect with people who are willing to provide that care.
AddnAide expands the consumer directed model of care, in which older adults can hire their own caregivers instead of using a traditional home health agency. The traditional model of consumer directed care works well for older adults who know someone within their personal network who can provide their care. However, this model excludes many older adults who have limited social circles. AddnAide is attracting new individuals – from a variety of backgrounds – to this critical workforce and expanding the pool of caregivers older adults can choose from to meet their needs.
Since its launch in 2022, older adults in the Elderly Services Programs in Hamilton and Warren counties have been successfully using AddnAide to connect with aides in our community, and, other AAAs in Ohio have expressed interest in using the app as well. COA is readying the app to license to other organizations. In doing so, COA reviewed Ohio’s rules related to licensure of home health aides and determined they were vague.
COA’s Cahall initiated conversations with legislators to amend the current rules to ensure personal homecare providers (such as those who might use AddnAide to find work) would not be required to hold a state license.
“During conversations with our legislators, I worked to ensure they understood the importance of AddnAide in opening a non-traditional channel for older adults to hire aides, and that over-regulation could hinder the program’s success in Ohio,” Cahall said.
COA’s advocacy efforts paid off, with language being added to the state rule that exempts from home care licensure individuals who would provide services to an older adult hiring them directly through AddnAide and other consumer-directed programs.
These recent successes have not occurred in a vacuum; they are due in part to COA’s year-round relationship-building and advocacy efforts, which are also supported by the agency’s Community and Government Relations Committee. The committee is comprised of active Board of Trustees members who play an important role in supporting, developing and strengthening the COA’s relationship with legislators and other elected officials.
“COA has an excellent reputation in southwestern Ohio and throughout the state, and our committee members are great partners in helping maintain this reputation through ongoing and consistent advocacy efforts,” Cahall said.