FOUR WAYS LONG-TERM CARE CAN
WEATHER THE NEXT EMERGENCY
TIMESLEDGER | QNS.COM | SEPT. 17 - SEPT. 23, 2021 19
COVID-19 has shaken
communities worldwide.
Despite strenuous
efforts by caregivers
and medical professionals
alike, people needing longterm
care and living in communal
care settings have suffered
gravely.
According to a New York
Times database, almost
one-third of U.S. coronavirus
deaths have been tied
to nursing homes and other
long-term care facilities. As a
post-pandemic world nears, a
new question emerges: What
can be done to safeguard longterm
care before the next public
health emergency?
Understand the options
Communal living - especially
for populations with
higher risk - increases the
odds of disease transmission.
However, nursing homes and
communal care facilities are
often the default for long-term
care in the United States. One
safe alternative is home and
community-based services
(HCBS), which enable people
to receive long-term services
and supports as they age or
live with disabilities.
With HCBS, people can remain
in their own homes and
hire caregivers they know and
trust. This approach is often
called self-directed services
or self-direction. People using
self-direction decide who
provides their long-term support
services as well as when,
where and how. From personal
care to meal prep, transportation
to skilled medical services,
self-direction puts the
person receiving services, or
their designated family member,
in control.
The Centers for Medicare
and Medicaid Services (CMS)
encourages HCBS. During
the pandemic, HCBS has
helped reduce transmission
of COVID-19. Some companies
specializing in self-directed
care also found less disruption
with HCBS. At GT Independence,
a company that
supports self-direction, COO
Holly Carmichael reported
no service interruptions and
found more people choosing
self-direction for safe and
stable long-term care.
CMS also notes that HCBS
provides gainful employment
to family members or friends
who are already providing informal
care. Fortunately, selfdirection
is recognized in all
50 states, although programs
and names vary; local aging
and disability service offices
provide guidance on getting
started.
Follow and enforce CDC safety
protocols
Regardless of where someone
chooses to receive care,
strictly following CDC safety
protocols helps to instill habits
that protect the well-being
of those receiving long-term
support. Personal protective
equipment (PPE), such as
masks, should be used by people
needing support and any
caregivers who reside separately,
whenever and wherever
services are provided. Also,
distancing people receiving
services from caregivers who
are unwell or who have been
exposed to viruses minimizes
risks.
As guidelines rapidly
evolve, especially for those
who are vaccinated, those receiving
care and their caregivers
are encouraged to visit
the CDC website for the latest
recommendations.
Encourage paid sick leave
Caregivers typically don’t
receive paid sick leave, which
often has unintended consequences.
Without paid leave,
caregivers may feel financial
pressure to work while ill. Not
only may this slow their own
recovery, but it increases the
risk of exposing the person
they care for to illness.
The Families First Coronavirus
Response Act (FFCRA)
has made it possible for people
receiving long-term services
and support to provide paid
sick leave to their employees
or caregivers due to pandemic
related reasons. Regular
caregivers can address their
health, protect their employer
and avoid financial stress. At
the same time, people receiving
care can work with their
self-direction partners to find
substitute care. Such partners
may maintain networks of vetted
caregivers to ensure continuity
of service and support.
The FFCRA has been a lifeline
for many caregivers, and
it has already been extended
twice. Lawmakers should be
encouraged to make paid sick
leave a viable option for caregivers
beyond the pandemic.
Prioritize HCBS options
HCBS programs have
proven successful in terms of
quality of life and cost effectiveness,
but caregivers and
programs need recognition
and support to ensure people
understand their options.
A 2018 Bureau of Labor Statistics
report indicated the
average healthcare support
worker made $28,720, and
a Paraprofessional Healthcare
Institute study shows
homecare workers average
$13,300 a year. Increased
pay would help retain and
attract qualified caregivers.
Direct-support professionals
are needed to reduce
HCBS waitlists for safe and
effective services.
More people are experiencing
the positive impact of
HCBS. Prioritizing this option
can reduce strains on local
healthcare systems while
reducing stress and financial
burdens on families. Funding
can help inform people
of their choices, get them
enrolled and expand benefits
for participants. It can also
help cover transition costs
from institutional settings to
an individual’s home, helping
remove the cost barrier.
The American Rescue
Plan has allocated more
funding for HCBS programs
nationwide and participants
and caregivers have the opportunity
to influence their
state and local representatives
on how to best improve
the program in their areas.
COVID-19 took long-term
care providers by surprise.
By learning from experience
and working to expand access
to HCBS, families and
caregivers will have better
choice and control to minimize
impacts next time.
— Courtesy of BPT
WELLNESS