New York – Al Cardillo, President of Home Care Association of New York State State
Every day, the professional and compassionate work of home care enables highly needy, complex, and service-intensive patients to maintain their health and quality of life at home.
Every day, home care works miracles for patients and solutions for the health care system.
Every day, home care responds with individual and family support in a manner and venue unlike any other service.
In COVID, the miracles, dedication and impact of New York’s home care agencies and personnel are at unprecedented levels. Workers have risked their own health and safety beyond measure, have kept patients in safe and essential care at home, and have continued to transition from hospital-to-home those who are post-acute, rehabbing and chronically ill, including many who are COVID-afflicted. Home care is serving core roles in hospital decompression, surge mitigation and assistance across the continuum in addition to the extensive in-home care it provides. Agencies are also voluntarily acting as receiving and distribution sites to further render protective supplies to hundreds of fellow agencies in cases where, stunningly, no formal structure was instituted by government’s incident command to deliver these essentials to the home care sector.
As the pandemic entered and has surged in New York State, home care has responded from the outset, resilient and masterful in the management and delivery of care through enormous challenges. Home care has faced: lack of priority access to personal protective equipment from the state/regional incident command structure; patient and family resistance to medically needed in-home care fearing COVID contagion; affliction of health personnel by COVID as well as impact from COVID isolation measures, school closures and family illness; reduced health personnel availability for service delivery; rocketed costs, lost revenue and no relief funding; multilayers of regulations and procedures taking endless periods to waive, and some still awaiting needed flexibility; and more.
An overarching challenge has been policymakers’ and incident commanders’ major lack of understanding of home care and core aspects of the service. This includes the need and complexity level of the patients, management and human issues in service delivery, and the overall vital role that home care serves in COVID response and in the system as a whole. This serious knowledge gap has been an underlying factor across all of the individual challenges, and especially now in the effort to secure desperately needed financial support in federal and state COVID aid. Agencies, particularly in the COVID epicenter of New York, continue to shoulder massive costs and losses in their unwavering response to COVID, and must be supported for sustainability through COVID and for home care’s pivotal role beyond.
In addition to advocating daily assistance for our agencies and frontline personnel in COVID, our state association – the Home Care Association of New York State – has also proactively sought and received Mother Cabrini Foundation funding to create new COVID interventions through home care. These initiatives, which we are now preparing to launch, will: train home care clinicians across New York State to conduct COVID testing at home, which will promote early care, mitigation of morbidity, prevention, worker and family safety, and more accurate measurement of COVID incidence and prevalence; and, also create a statewide Virtual Senior Center (VSC), building upon the VSC pioneered by our member agency Self-help Community Services in NYC, to provide vital psychosocial and health connection for the isolated homebound. A third initiative, currently in development, will partner HCA with hospital association partners to create a statewide Hospital-Home Care Collaborative for COVID and beyond.
We salute the incredible and compassionate work of New York’s home care agencies in COVID – and every day. We respectfully ask policymakers, payors and the public to do the same, and to reinforce their salute with the tangible support agencies need to sustain their vital and heroic service.