Medical Assistance would cover home care and homemaker services under new, bipartisan bill

Many people in need of home care services cannot get them.

Staffing also poses a problem due to low wages and reimbursement rates for providers.

Sponsored by Rep. Ginny Klevorn (DFL-Plymouth), HF585 would establish care evaluation as a service covered under Medical Assistance, and require the Human Services Department to institute homemaker service rates under Medical Assistance disability waivers.

It would also modify homemaker service rates under the state’s Elderly Waiver program that provides home and community-based services not normally covered under Medical Assistance to enrollees at risk of nursing facility placement.

“We have had many conversations over the years about a shared goal to increase access to the services that support older Minnesotans and individuals living with disabilities and complex health needs to remain living in their home and with their own families as long as it is possible,” Klevorn said.

The House Human Services Policy Committee orally approved the bill Monday with no negative voices heard and referred it to the House Human Services Finance Committee.

From short-term care for individuals returning home from a hospital or nursing home to continuous care for those with ongoing needs, home care provides day-to-day assistance, as well as medical- and health-related services.

However, Kathy Messerli, executive director of Minnesota Home Care Association, said low pay rates in the industry do not amount to a livable wage. “Many agencies unfortunately have discontinued offering homemaker services because they simply cannot hire anyone at such a low wage.”

Sarah Skorburg, care coordinator at Thomas Allen Inc., echoed this sentiment.

“I’ve been in my current role since September 2022 and have yet to see a client on my caseload be successfully set up with homemaker services,” she said.

At the moment, care coordination offers no Medical Assistance reimbursement. Susan Morgan, chief operating officer at Accra Care Inc., explained what these unpaid services look like.

“It might be to track down necessary equipment or medications that a client was not sent home with from the hospital,” she said. “Another example is realizing that a client is in need of better nutrition, so the nurse orders them Meals on Wheels.”

Home care agencies absorb the cost of care evaluations too, Morgan said. Despite taking more time, they are reimbursed equally to a regular home visit.