Opinion: Calls for help by raising PCA reimbursement rates were heard


Published: 06-16-2023 6:00 AM

Deb Ritcey is president & CEO of Granite State Independent Living.

For even the most attractive of available jobs in today’s market, the competition for workers is unlike almost anything we have seen in New Hampshire. Especially challenging is the service industry. When the local fast-food restaurant can offer a better wage than a personal care attendant through Granite State Independent Living (GSIL), the only provider in New Hampshire for State Plan Medicaid Personal Care Attendants or PCAs, it’s hard to be optimistic.

GSIL advocacy coordinator Ryan Donnelly told state lawmakers that shortages of direct care workers are forcing our consumers to make difficult choices. Some have made or are considering moving into nursing homes for care because the workforce shortage makes it too difficult to hire and retain home care workers.

According to the U.S. Chamber of Commerce, New Hampshire is one of a handful of states in the category of “most severe” worker shortage. For every 100 jobs available in our state, there are 42 workers. Our state unemployment rate is below 3%. Many have documented what has been described as the “Great Resignation” following the pandemic, where millions of people left their job and chose a different path or left the employment landscape completely.

This is why GSIL approached lawmakers to ask for funds to raise the wage rates within Medicaid to combat the shortage and offer new incentives to PCAs. Thankfully, lawmakers heard us and acted, investing $15.7 million in wages for PCAs, which qualifies for a federal match to make our pay scale more competitive. This money can be used for Medicaid services, providing new resources to those who need it. Senators Cindy Rosenwald and William Gannon were early supporters of this effort and Senate President Jeb Bradley was a strong ally who helped guide that proposal into the state budget.

House leaders on both sides of the aisle embraced this policy and included it in their own budget blueprint. It is now part of the budget headed to the governor for signature. (And special gratitude to NH Medicaid Director Henry Lipman who advocated for us from day one.)

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It is deeply encouraging to see strong bipartisan support and collaboration around efforts to help GSIL consumers stay in their homes. This is an essential piece of the services provided to many Granite State families who rely on our services to ensure those with disabilities can live independent lives. With this pay raise, we can better compete in the workforce.

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 risk facing a life of institutional care.

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. With this increase in funds, we can double down on recruitment, and we will.

I applaud the hard work being done by New Hampshire lawmakers to preserve Medicaid services for families who need them. Our consumers and our team at GSIL deeply appreciate that New Hampshire’s state leaders voted to empower independence. This critical and timely investment in the workers who provide home-based services in our communities makes a difference in people’s lives.