Most home health agencies in New York have seen their workforce decline by up to 20% due to COVID-19, a new survey revealed.
More than 80% of 176 home health and hospice providers surveyed March 31 said the virus has reduced up to a fifth of their workforce, a Home Care Association of New York State poll found. A lack of childcare services is also preventing aides, nurses, therapists, social workers and other employees from working, increasing labor costs amid already razor-thin margins, the association said.
Meanwhile, almost 80% of New York's home health and hospice providers continue to have a difficult or extremely difficult time getting personal protective equipment like masks, gloves and gowns for their staff.
Nearly half of home care staff are reusing masks, in accordance with Center for Disease Control and Prevention guidelines, 21% of agencies have prevented face-to-face visits when PPE isn't available, 19% of staff are completing patient visits wtthout masks, 14% are making their own and 7% are resigning or not providing services without proper gear, according to the survey, prompting The Home Care Association of New York State to call for priority access to protective equipment.
DeSharna Johnson, who has been a home care worker since 2003, said the 91-year-old woman with Alzheimer's that she cares for cannot prepare meals and clean herself without help.
"Social distancing does not apply to us," Johnson said on a webinar last month coordinated by the Service Employees International Union.
About a quarter of home health agencies surveyed had between one and 20 aides test positive for COVID-19. Most home care agencies (80%) said that at least one patient was refusing care due to fear of exposure.
Keeping frontline healthcare workers healthy is imperative, otherwise operations will come to a grinding halt, said Carri Chan, associate professor of business at Columbia Business School.
"Staff is the bottleneck," Chan said Tuesday evening on a supply chain webinar coordinated by the school.
Providers of all types are grappling with staffing and supplies shortages across the country.
The federal government is distributing supplies from its national stockpile, but deliveries have been slow and inconsistent. President Donald Trump recently compelled production of vital equipment and supplies via the Defense Production Act, although opaque and misleading guidelines have slowed the process, experts said.
Hospitals said they have received conflicting guidance from federal, state and local authorities on criteria for testing, defining elective procedures to delay, use of PPE and getting supplies from the national stockpile, according to a recent HHS' Office of Inspector General report.
Telehealth can help mitigate PPE shortages and staffing constraints as well as boost COVID-19 containment efforts, prompting the Trump administration to expand Medicare reimbursement and relax privacy requirements for telehealth services. But the regulatory easing is still too limited, said Al Cardillo, Health Care Association of New York State president.
"One other important area of urgent need is greater flexibility and reimbursement under Medicare for remote-monitoring technologies–like home telehealth–that can be used to manage patient care and extend the point of contact to in-home patients remotely in certain circumstances or phases in the care plan," he said in prepared remarks. "While New York's Medicaid system has rightly allowed such flexibility for telehealth services and billing, the same must be done under Medicare so that these powerful tools can be brought to bear more uniformly for safety reasons."
