Deb Ritcey is CEO of Granite State Independent Living.

It’s encouraging to see strong bipartisan support and collaboration around efforts to extend the Medicaid expansion program in New Hampshire.  It’s an essential piece of the services provided by Granite State Independent Living (GSIL) to many Granite State families who rely on our services to ensure those with disabilities can live an independent life.

GSIL plays a unique role in the lives of hundreds and hundreds of disabled men, women and children, as the only provider in New Hampshire for State Plan Medicaid Personal Care Attendants or PCAs.  

PCAs are responsible for working with consumers on assistance with dispensing medications, helping with daily hygiene, household chores and errands, assistance with toileting, dressing, bathing, meal preparation, and other basic daily needs.  These wonderful men and women are the difference between our consumers living a life of independence in their own homes or risking facing a life of institutional care.

We are deeply proud of the service we provide to families, but we can’t do it alone. Economic trends have created challenges we now struggle to overcome.  At the center of our challenge is the reimbursement rate we receive from Medicaid in New Hampshire for PCAs.  Put simply, the rates are lagging well behind virtually all other hourly jobs in the state.  These low reimbursement rates make it doubly challenging to attract workers in an economy where workforce recruiting and retention are top challenges for everyone.

According to the New Hampshire Fiscal Policy Institute, this has been a priority issue for Personal Care Assistants for years.  A survey conducted by NHFPI in 2019 concluded that 80% of the time, services to families cannot be fully offered because of unfilled positions.  We can’t provide everything we want because we simply don’t have the people to do the work.

This is a four-year-old survey and the challenge is widening.

PCAs play a vital role in the lives of the disability community.  They often cover the critical work that is reserved for licensed care providers.  They are a less expensive approach to ensuring Granite Staters living with disabilities can live their lives in their homes on their terms and with independence.  We can help many more families if we have more PCA workers. 

Our recruitment efforts can only go so far with a limit on the pay they receive for this care. GSIL currently covers 60% of the authorized hours to fill the gap in needs; we don’t have the funds or the people to do more.  To cover all authorized hours and meet demand, GSIL would need roughly 450 additional PCAS.  We currently employ 494. We need a rate increase of 26% to cover costs.

New Hampshire lawmakers have recognized this need in the past and have raised the rates, but frankly, there are better-paying jobs everywhere putting us at a competitive disadvantage.  On behalf of the consumers who rely on GSIL, I urge lawmakers to revisit the reimbursement rates for PCAs in Medicaid.  

I applaud the hard work being done by New Hampshire lawmakers to protect Medicaid services for families who need them.  We know there are tight deadlines for action.  There’s a great deal of work to be done to preserve and protect these vital services. My hope is that within all of this work, New Hampshire’s state leaders will see an opportunity to make a major impact through a small investment in the workers who provide so many of these critical services in our communities. 

Please raise the reimbursement rates for Personal Care Assistants who serve our families through Medicaid.  It will make all the difference in the world.

]]>