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Senator Bob Casey Chairman U.S. Senate Special Committee on Aging Senator Tim Scott Ranking Member U.S. Senate Special Committee on Aging Via email: SFR@aging.senate.gov RE: U.S. Senate Special Committee on Aging (“the Committee”) March 23, 2022 Hearing on “An Economy That Cares: The Importance of Home-Based Service” This statement is submitted by the Florida Health Justice Project (FHJP), a nonprofit health advocacy organization whose mission is expanding access to healthcare with a focus on Florida’s most vulnerable populations. Accordingly, we prioritize work on behalf of low-income frail and disabled seniors who require Medicaid home and community-based services (HCBS) in order to remain safely at home and out of an institution. Among other things, FHJP has published an advocate’s guide and a consumer video that explain this complex and critical program for vulnerable Floridians and their families. We also work with clients on individual appeals and with those who wish to share their stories underscoring the lack of resources in this critically underfunded program. On behalf of our clients, storytellers and the other marginalized Floridians who need Medicaid HCBS, we extend heartfelt thanks to you and your staff members. We understand that you are all incredibly busy, and we are extremely grateful to the Committee for holding this hearing. We are especially grateful that you invited Alene Shaheed to testify. FHJP has worked with Alene for several years–both on resolving her individual appeal when her managed care plan cut her services and on the systemic issue of enrollees suffering ongoing gaps in services. Alene’s testimony eloquently described what it’s like to go days at a time without any home health aide coming to help with the basic activities of daily living. She was also profoundly clear about the fact that Medicaid home health workers must be paid more in order to resolve the problem. The suffering caused by untenably low worker pay is obviously a national problem, and any meaningful effort to improve the situation will require Congressional action. Given the import of the program and the urgent need for increased resources, FHJP and two of our state partners shared this letter with Senators Rubio and Scott, as well as all of our Florida representatives on July 13, 2021. The letter, which was signed by over 400 Florida organizations and individuals, noted that most people who need Medicaid HCBS end up on a waiting list, currently over 60,000 Floridians. It also described how the severe underfunding of home health workers is hurting those who, like Alene, managed to get off the waitlist and enroll in one of the state’s HCBS programs, but who still cannot get the care they need. As Alene testified, this results in dire situations as profoundly vulnerable program enrollees, including those who are incontinent and need assistance to change, bathe etc., are left without any help for days. Another former FHJP client, Shirley, who was bed-bound following a stroke, relies entirely on home-health aides to operate the special lift to get her out of bed. Like Alene, her Medicaid managed care plan is unable to find aides to take care of her on the weekends, forcing her to stay in bed for the entire weekend and increasing her risks for bed sores and skin infections. We also appreciated the Committee’s focus on the need to adequately compensate family care caregivers, and/or provide sufficient funding for home care workers so that family members can rejoin the workforce. Another former FHJP client, Thelma, illustrates this need. Thelma quit a good job to care for her elderly mother who requires 24/7 care. Especially in light of all the nursing home deaths due to COVID-19, Thelma adamantly refused to put her mother in a nursing home and there was no alternative other than to quit her job. Although Thelma was promised 41 hours of pay, the managed care plan continued to cut her hours as her mother’s Alzheimer's progressed and her health worsened. Although FHJP successfully represented Thelma in an appeal, most enrollees whose services are denied, terminated or reduced, do not receive free legal assistance, and the vast majority either do not file an appeal or they lose their pro se appeals. We are grateful that both Florida senators (copied on this letter) are on the Committee, and we are hopeful that they will play a role in helping to secure needed additional resources. Senator Casey, we are also grateful that you underscored the fact that most seniors who need HCBS were once middle class, and that most long term care in this country is provided through state Medicaid programs. We also want to underscore that home-based services provide a much less expensive alternative to nursing facility care. The March 23 hearing did a wonderful job in documenting the national need for increased Medicaid HCBS resources. The Better Care Better Jobs Act (BCBJA) will help provide states with funding to build the necessary HCBS infrastructure and support front line workers and family caregivers. We urge the Committee to keep educating other members of the Senate on the need to pass this investment as soon as possible. Thank you again for all your time and all that you do. Please do not hesitate to contact me if you have any questions. Sincerely,
s/Miriam Harmatz Miriam Harmatz harmatz@floridahealthjustice.org 786-853-9385 Florida Health Justice Project Advocacy Director & Founder Cc: Senator Marco Rubio, c/o Varela, Jaime (Rubio) <Jaime_Varela@rubio.senate.gov> Senator Rick Scott, c/o Hots, Jared (Scott) <jared_honts@rickscott.senate.gov> Download Here Comments are closed.
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The Florida Health Justice Project, a nonprofit organization, recognizes that access to quality and affordable health care is a human right and engages in comprehensive advocacy to expand healthcare access and promote health equity for vulnerable Floridians.
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