Caucasian Overworked, sad, tired, female healthcare worker sitting on the floor of a hospital corridor

A key leader of the newly unveiled Home Care Workforce Action Alliance doubts Congress will pass legislation this year that would funnel billions of dollars to home- and community-based services, and expand the direct caregiver workforce and improve the worker crisis.

William Dombi, president of the National Association for Home Care and Hospice, told McKnight’s Home Care Daily Pulse the Biden administration’s Build Back Better plan has taken a back seat to the other priorities in Washington, such as the war in Ukraine. While partisan politics in Washington are also lowering the legislation’s odds of getting passed this year, Dombi isn’t giving up on it.

William Dombi headhot
William Dombi

“The message we’re getting is Build Back Better is not a message you want to use anymore,” Dombi said. “But we have to stay persistent on this; we have to stay committed to moving it forward. Not everything in Washington happens immediately.” 

Partners wanted to help solve caregiver crisis

Meanwhile, Dombi said the Home Care Workforce Action Alliance, which he helped kick off Wednesday with the Home Care Association of America and Bayada Home Health Care, is working aggressively to recruit a variety of stakeholders. Those stakeholders could include Medicare Advantage plans and the Service Employees International Union, which has been actively organizing direct care workers. He said the alliance could eventually include other long-term care providers, such as nursing homes, but for now the group wants to focus solely on the home.

“We have a different view,” Dombi explained. “We think the top of the nursing profession is delivering care independently in people’s homes, operating without the immediate need of tools and personnel or an institutional care setting like a hospital.” 

The launch of the alliance comes at a time when the home care industry is under increased stress from a larger number of sicker patients and a shortage of caregivers.

Desire for home care

A new report released Thursday adds more fuel to the argument that home care needs more workers. The report, from software solutions company CarePort, found more post-acute care patients are opting for home care instead of skilled nursing when leaving the hospital. In 2019, patients were split evenly between the two options. However, in March of 2021, home healthcare accounted for 60% of post-acute referrals versus 40% for skilled nursing.

The increased demand has been a significant challenge for agencies that aren’t properly staffed. The report found home health acceptance rates have decreased 15% in the past two years due to the worker shortages. Waiting to get into home healthcare could be dangerous for patients. CarePort data found that the risk of hospital readmission rises by 3% each day after a patient is discharged and is not seen by a home health provider.