Agencies serving Medicaid seniors rip plan for independent caregivers | The Columbus Dispatch

Agencies providing home-health and hospice care to low-income seniors are urging state officials to drop a plan that also would allow self-employed workers to offer those services.

[Indie Prov]

As an Independent (self-employed) Provider of home health care for six years, I can testify that every person I have cared for was treated VERY well. Agencies I worked for before becoming self-employed through Care Star (Medicaid of Ohio) do not pay well enough for a single person like me to earn a living.

[my community too]

Here's the problem with the self employed in home staffing ... grandma hires her grandaughter through PASSPORT funds because she feels comfortable with having someone she knows and grandtr can't find a job and needs the money. Then grandtr has a day (or two or three)when she "needs" to go Christmas shopping or to visit a friend all day and asks grandma if she can skip today;s bathing and changing of the sheets on the bed. Grandma loves her grandtr and says, "Sure honey, I know you have other things that you need to do." But when it comes time to complete the attendance report for the payroll (and the elderly do have to confirm that services were rendered), grandma knows the grandtr needs the money so she goes ahead and signs the form saying she was there that day, I've seen it happen.
And though there are many good, reliable independent caregivers out there, what happens when they are injured or ill and cannot provide service? I once had an independent home health aide break her leg and it was almost two weeks before we found a sub. Agencies usually have others who can sub in fairly quickly.

[SuLee]

Agency workers (through Medicaid) are often incompetent. They don't show up. They sleep on the job. They don't even know how to operate a microwave or prepare a simple grilled cheese sandwich. One my mother had couldn't even start the vaccuum cleaner.

While I agree that there are many problems inherent with private contracts, perhaps a little competition would force the "agencies" to:

1) do better background checks on its workers
2) hire competent people
3) pay more than minimum wage to hire competent workers.

[Observer]

Competition is the name of the game. I support the use of independent providers who then stand the opportunity to make a livable wage. Most of the agencies pay very poorly after management and owners take their cut.

[social worker]

The plan has already been in place, through the CHOICES program under PASSPORT. Clients are required to have a "back up plan" in case their primary worker is unavailable, sometimes that is with another family member, and sometimes with an agency. Ultimately this comes down to Consumer choice. All people requiring services should be able to choose who does the work.

[lwd]

There likely will be problems with independent aides, but there are already problems with the agencies. Often a family caregiver has the choice of giving up or limiting employment to care for a family member, or, use those dollars to pay someone who may or may not be trusted to do a good job. More oversight of ALL caregivers seems to be the logical answer. Agencies do NOT pay their workers a living wage, require them to transport with no insurance reimbursement (don't ask, don't tell in case of an accident or liability), make no allowance for long distances to travel for an hour's work, etc. Fraud of all sorts is rife, but clients will not say anything for fear of losing their independence. Home visits are often very telling as to who is really receiving appropraite care. "As ye do to the least of these ......." comes to mind, also.

[You must be Joking]

You would be idiots to allow Independent Aides. No supervision, no oversite, no back up for when things will go wrong....Thefts from the homes will increase, theft of personal property and prescription drugs will increase dramatically. Allowing Independent Aides in Medicaid was just like saying here is 10-20 % of the budget for your personal use and no one will be able to ask you for it back later. Fraud fraud fraud when will you people learn.

[Columbus IT Worker]

I think it is a great idea and I am sure the biggest concern here is not the safty of the patients, but the income for the agencies and the union employees they hire.

[L Berry]

The possible real reason that State Agencies are against the Independent Care Givers might just be "Unions". Remember that under soon to be Ex-Governor Strickland's administration Unions were mandated for Care Giver Agencies. Goc Strickland is/ was a Union at all costs Liberal. He had law changed to allow The Unionization of Care Givers. So now all Care Givers must pay Union dues and are represented by Unions reguardless of their wishes.
So it's no big surprise to find that the same Administration that forced Unions on Care Giver Agencies is bad mouthing Independent care givers.

[Hello fraud]

Sad. Can't wait to see the resulting effect: increase in numbers of forgetfully naive elderly being $$ ripped off/physically neglected, at the hands of unregulated (keyword), "independent" noncertified/unlicensed 'helpers'.

For gawds sakes. WHAT in the hell do you think was the purpose to create/form (clearinghouse) home health aide agencies in the first place? FOR CREDENTIAL purposes. TRACKING purposes.

Ohio is nuts. And cheap. And dispresectful of the elderly- if nothing else. And Backwards. Period.

[social worker]

The State is who is approving the independent workers (Ohio Dept of Aging). Home Health Agencies are privately or coroporate owned. Nothing to do with unions on this one. Again, this is really about consumer choice in who cares for them.

[FreeloaderFred]

Is this the start of a "turf protection" war?
If the agencies were truly watching for the interests of the seniors, they should be campaigning for licencing, certification and inspection of the independents.

[FreeloaderFred]

Hello fraud wrote:

Sad. Can't wait to see the resulting effect: increase in numbers of forgetfully naive elderly being $$ ripped off/physically neglected, at the hands of unregulated (keyword), "independent" noncertified/unlicensed 'helpers'.
For gawds sakes. WHAT in the hell do you think was the purpose to create/form (clearinghouse) home health aide agencies in the first place? FOR CREDENTIAL purposes. TRACKING purposes.
Ohio is nuts. And cheap. And dispresectful of the elderly- if nothing else. And Backwards. Period.

The key watchword here is "unregulated".
We've seen what happens, even with school busing, where providers are not regulated and checked up on regularly. This includes both individuals and organizations.

[rollingmyeyes]

There is so much fraud concerning Independent Providers (IP's). I have a 45-year old male quadriplegic neighbor who lives in an assisted living facility and WANTS to stay in bed 24/7 (he does have a van he drives when he FEELS like getting up). He has a 20+ female as an IP who comes in painted on clothes (jeans and daisy duke cutoffs), manicured nails (hands and feet) and even wears her bathing suit in the summer. She "works" for 2 hours @$24 for the first hour,$12 for the next; leaves for 2 hours; returns for 2 hours at the same rate of pay as above and "works" two more hours; leaves for 2 hours; returns to "work" 2 more hours. Do the math -$108 for 6 hours of "work". She does no laundry, she does no cleaning, makes a cake every once in a while. No one can tell me what she can do or is needed for every 2 hours, for 2 hours. But to get that $24 the first hour, the IP has to be away for 2 hours when they leave. Coincidence? One can make a living while working for an agency but they are accountable to someone and maybe won't be able to afford to drive a BMW or Mercedes. I've seen IP's driving Lincolns and have handicapped parking permits hanging inide the vehicle. They need to go! They are so fraudulant, it isn't even remotely funny.

[tom the traveler]

Those of us who do not qualify for Medicaid usually hire "non-agency" help.

What is good enough for us should be good enough for those on Medicaid.

[tom the traveler]

Hello fraud wrote:

Sad. Can't wait to see the resulting effect: increase in numbers of forgetfully naive elderly being $$ ripped off/physically neglected, at the hands of unregulated (keyword), "independent" noncertified/unlicensed 'helpers'.
For gawds sakes. WHAT in the hell do you think was the purpose to create/form (clearinghouse) home health aide agencies in the first place? FOR CREDENTIAL purposes. TRACKING purposes.
Ohio is nuts. And cheap. And dispresectful of the elderly- if nothing else. And Backwards. Period.

Why the hell should the poor who qualify for medicaid get more expensive health aide agencies than the rest of us who do not qualify for medicaid.

I have hired help to help me with my dad and none of them are from an agency because I pay out of pocket.

If it is good enough for my dad who worked and saved all his life and does not qualify for medicaid, then is should be good enough for the poor who do.

[tom the traveler]

rollingmyeyes wrote:

There is so much fraud concerning Independent Providers (IP's). I have a 45-year old male quadriplegic neighbor who lives in an assisted living facility and WANTS to stay in bed 24/7 (he does have a van he drives when he FEELS like getting up). He has a 20+ female as an IP who comes in painted on clothes (jeans and daisy duke cutoffs), manicured nails (hands and feet) and even wears her bathing suit in the summer. She "works" for 2 hours @$24 for the first hour,$12 for the next; leaves for 2 hours; returns for 2 hours at the same rate of pay as above and "works" two more hours; leaves for 2 hours; returns to "work" 2 more hours. Do the math -$108 for 6 hours of "work". She does no laundry, she does no cleaning, makes a cake every once in a while. No one can tell me what she can do or is needed for every 2 hours, for 2 hours. But to get that $24 the first hour, the IP has to be away for 2 hours when they leave. Coincidence? One can make a living while working for an agency but they are accountable to someone and maybe won't be able to afford to drive a BMW or Mercedes. I've seen IP's driving Lincolns and have handicapped parking permits hanging inide the vehicle. They need to go! They are so fraudulant, it isn't even remotely funny.

The fraud is that those on medicaid get better home health than the rest of us.

Medicaid is the biggest budget buster in Ohio's 8 billion dollar hole.

Why do the poor get this benefit and the rest of us pay out of pocket for "non agency" care.

[Jim]

my community too wrote:

Here's the problem with the self employed in home staffing ... grandma hires her grandaughter through PASSPORT funds because she feels comfortable with having someone she knows and grandtr can't find a job and needs the money. Then grandtr has a day (or two or three)when she "needs" to go Christmas shopping or to visit a friend all day and asks grandma if she can skip today;s bathing and changing of the sheets on the bed. Grandma loves her grandtr and says, "Sure honey, I know you have other things that you need to do." But when it comes time to complete the attendance report for the payroll (and the elderly do have to confirm that services were rendered), grandma knows the grandtr needs the money so she goes ahead and signs the form saying she was there that day, I've seen it happen.
And though there are many good, reliable independent caregivers out there, what happens when they are injured or ill and cannot provide service? I once had an independent home health aide break her leg and it was almost two weeks before we found a sub. Agencies usually have others who can sub in fairly quickly.

Some of these home care agencies overbill for incompetent employees. The reason the wages are so low is that these agencies are the middle man and suck medicaid and medicare dry. A friend of mine used to bill this stuff and used to kick this back all of the time to the employees who tried to overbill hours. Even the Big Boy such as Ohio Health do the same thing by getting into this business. Dont let them fool you folks, some of these folks are as bad as the nursing home lobby.

[Jim]

tom the traveler wrote:

<quoted text>
The fraud is that those on medicaid get better home health than the rest of us.
Medicaid is the biggest budget buster in Ohio's 8 billion dollar hole.
Why do the poor get this benefit and the rest of us pay out of pocket for "non agency" care.

This type of thing was covered in the Health CareBill.

[A Volunteer]

Hello fraud wrote:

Sad. Can't wait to see the resulting effect: increase in numbers of forgetfully naive elderly being $$ ripped off/physically neglected, at the hands of unregulated (keyword), "independent" noncertified/unlicensed 'helpers'.
For gawds sakes. WHAT in the hell do you think was the purpose to create/form (clearinghouse) home health aide agencies in the first place? FOR CREDENTIAL purposes. TRACKING purposes.
Ohio is nuts. And cheap. And dispresectful of the elderly- if nothing else. And Backwards. Period.

Wrong, Ohio does care. That is the reason almost 60% of the State Budget is spent on the elderly, disabled, and the very young. Unfortunely, states which don't care dump ther real needy upon Ohio. Ohio, has a network of paid and volunteers who check on this care. The Network could always use more volunteers. What are you doing?