Biden’s Home Care Legislation Acknowledges an Imperfect System

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New presidents bring policy changes, and Biden’s administration is no exception.

Biden seems acutely aware of America’s aging population and the economic disparities that complicate their care.

First outlined during his presidential campaign, “The Biden Plan For Mobilizing American Talent And Heart To Create A 21st Century Caregiving And Education Workforce” is an acknowledgment of both the growing home care and child care crises in the United States.

It then delves straight into strategies to combat an aging population’s need for quality, dignified assistance.

Benefits of the New Plan

A Much-Needed Increase in Caregiving Jobs

With the increasing demand for home care, agencies are in constant need of more caregivers.

Home Health Care News states, “In order to keep up with their demand for home care services and general preference for aging-in-place, the home care industry will likely need to fill at least 4.2 million more caregiver jobs by 2026.”

Biden’s plan, which will expend $775 billion over 10 years on caregiving and early childhood education combined, intends to increase the number of caregiving jobs by 1.5 million.

It may not be enough, but it’s a start.

An increase in caregivers also allows non-paid family caregivers to return to the workforce—a void that can be marketed and staffed by home care agencies.

A Boost to Working Conditions

Recruiting caregivers in a historically underpaid and underappreciated environment can feel like an uphill battle.

By expanding existing, though often exclusive, state legislation, Biden and Harris are using the Domestic Workers Bill of Rights Act to help caregivers unionize, receive benefits, and earn higher wages.

According to Caring Senior Service, “Biden also hopes to expand opportunities for caregivers to receive further training or credits to help them expand their skills and advance as professionals.”

By standardizing and improving job quality and expectations, caregiving can become a more desired career, and elderly patients will benefit from increasingly qualified, better-supported caregivers.

More Home Care Opportunities and Clients

Despite an exponential need, accommodating home care isn’t necessarily easy.

According to NPR, “…41 states have waiting lists for home and community-based health services, totaling nearly 820,000 people, with an average wait of 39 months.

Additionally, Medicare can be far too limited. “Medicare covers home-based health care services only for older adults and people with severe disabilities who are homebound and need skilled services from nurses and therapists.

The Biden plan aims to loosen this bottleneck by increasing Medicare funding to states and expanding access to non-medical home care coverage. Verbiage from the plan indicates:

Biden will allocate $450 billion to give more people the choice to receive care at home or in supportive community situations or to have that choice for their loved ones. He will help states offer cost-effective options for affordable primary and preventive care, and affordable support services like help with meals, transportation, home safety, and quality day programs for older Americans.

As these changes come into effect, home care agencies can soon step in to fill the need of those seeking at-home care.

Possible Negative Ramifications for Home Care Agencies

With happier caregivers, home care agencies will find a greater abundance of willing caregiver candidates. Also, with an increase in elderly clients, business for Home Care agencies should be stable for the foreseeable future.

But there remain possible hiccups.

According to the Washington Post, “…many experts in long-term care worry even the hefty price tag is not sufficient to prepare the nation — and particularly middle-class families — for the coming boom in the number of elderly Americans.

NPR reports: “Even advocates of Biden’s proposal acknowledge it doesn’t address the full extent of care needed by the nation’s rapidly growing older population. In particular, middle-income seniors won’t qualify directly for programs that would be expanded.

It’s clear Biden’s plan may not be enough to completely eradicate the caregiving shortage our nation is facing. Middle-class families may fail to see any improvement at all.

Despite good intentions, a lot of work remains.

The Drawback of Unions and Increased Regulations

While unions, increased benefits, and improved wages greatly benefit caregivers, home care agencies may struggle to adapt to the resulting budget changes.

Additional regulations, like predictive scheduling and modified caregiver contracts could also deal a significant blow.

According to Home Health Care News, “…non-solicit and direct hire clauses in caregiver contracts can be crucial for in-home care providers.

These clauses protect home care agencies from becoming inconsequential or obsolete. This can be a disadvantage to everyone, especially when agencies work hard to offer a protective, professional middle-ground between caregiver and client.

The same article states: “Predictive scheduling would be tough for home care providers, given the volatility of each patient situation. It essentially mandates giving out schedules to caregivers beforehand and requires payment of penalties for any modification to that schedule.

Again, while these changes may be advantageous to caregivers, they may not be in the best interests of patients or home care agencies. An alternate solution, while difficult to pinpoint, may prove more beneficial as a whole.

Community-Based Solutions vs. Home Care

Biden’s new plan also supports an increase in community-based services—more affordable alternatives to home care. While these services don’t qualify as nursing homes, they may reduce home care opportunities.

This push for more community-based care includes improved staffing at Veterans Affairs facilities. Biden’s goal is to: “Create tens of thousands of jobs providing care to veterans by filling severe occupational shortages and vacant positions at almost every U.S. Department of Veterans Affairs facility.

Home care agencies may find an opportunity for caregiver staffing at these proposed sites. Otherwise, it could hurt business.

A Crisis Identified—with Hopeful Solutions

Throughout this administration, everyone impacted by the legislation will need to remain vocal about their newfound struggles and successes.

The issues surrounding home care will likely remain complicated. But they will need to remain one of the nation’s top priorities—with the government working diligently to refine solutions.

Overall, Biden’s plan is a progressive attempt to tackle the issues that have become increasingly crucial—if not a nationwide emergency.

We can hope that patients, caregivers, and home agencies alike soon benefit.

Wyoming

Supported: YES

Wyoming has chosen to use an open vendor model in which the state sets the standards for EVV, and providers may either use their existing EVV system or choose one that best meets their needs.

AxisCare has developed a direct integration with CareBridge, Wyoming’s EVV aggregator, so providers may continue to use AxisCare as their EVV and management solution.


Illinois

Supported: YES

Illinois has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Illinois’s contracted aggregator, which will allow agencies to easily send required visit information.

Minnesota

Supported: YES

AxisCare meets the state ‘s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with HHAeXchange, Minnesota’s chosen aggregator, which will allow agencies to easily send required visit information directly to HHAeXchange. 

Michigan

Supported: YES

The Michigan Department of Health and Human Services has decided to go with an Open Model that allows providers to choose their own EVV system, as long as it meets federal EVV regulations. They are in the process of choosing an aggregator system that will accept data from all EVV systems.

AxisCare meets all state and federal EVV requirements, so providers may continue to use AxisCare as their EVV and management system.

Massachusetts

Supported: YES

Massachusetts has chosen an open model, but has not selected the aggregator.  AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution.  

Maryland

Supported: NOT AT THIS TIME

Maryland has chosen a closed model where AxisCare is currently not able to provide EVV data to the state.   Providers can choose to use AxisCare due to the many advantages but you must use ISAS to collect EVV required data.

 

Maine

Supported: YES

Maine has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Maine’s contracted aggregator, which will allow agencies to easily send required visit information.

Louisiana

Supported: YES

AxisCare meets the state ‘s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with LaSRS, Louisiana’s chosen aggregator, which will allow agencies to easily send required visit information directly to LaSRS. 

 

Kentucky

Supported: CONTACT US

Kentucky has chosen an open model with Tellus serving as the aggregator.  AxisCare has not developed the integration with Tellus for Kentucky yet (AxisCare supports Tellus integration in other states), but if your organization is interested in using AxisCare, please contact us. 

 

Kansas

Supported: NOT AT THIS TIME

Kansas has chosen a closed model where AxisCare is currently not able to provide EVV data to the state.   Providers can choose to use AxisCare due to the many advantages but you must use Sandata to collect EVV required data.

Iowa

Supported: YES

Iowa has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, CareBridge) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with CareBridge, Iowa’s contracted aggregator, which will allow agencies to easily send required visit information.

Indiana

Supported: YES

Indiana has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Indiana’s contracted aggregator, which will allow agencies to easily send required visit information.


Idaho

Supported: YES

Idaho has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Idaho’s contracted aggregator, which will allow agencies to easily send required visit information.

Missouri

Supported: YES

AxisCare meets the state’s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Missouri’s chosen aggregator, which will allow agencies to easily send required visit information.


Hawaii

Supported: YES

Hawaii has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Hawaii’s contracted aggregator, which will allow agencies to easily send required visit information.

 


Georgia

Supported: YES

Georgia has chosen to use an open vendor model in which the state sets the standards for EVV, and providers may either use their existing EVV system or choose one that best meets their needs.

AxisCare has developed a direct integration with Tellus, Georgia’s EVV aggregator, so providers may continue to use AxisCare as their EVV and management solution.

 

Alaska

Supported: CONTACT US

Alaska has chosen an open model with Therap serving as the aggregator.  Therap has not provided the detailed specifications yet, but if your organization is interested in using AxisCare, please contact us.

Florida

Supported: YES

AxisCare currently provides direct integration with HHAeXchange and Tellus, so providers may continue to use AxisCare as their EVV and management solution.

 

Delaware

Supported: Coming Soon

Payers in Delaware have selected Sandata and AxisCare is completing the necessary development. We are planning on being fully compliant soon.

 

Connecticut

Supported: NOT AT THIS TIME

Connecticut has chosen a closed model where AxisCare is currently not able to provide EVV data to the state.  Providers can choose to use AxisCare due to the many advantages but you must use Sandata to collect EVV required data.

 


Colorado

Supported: YES

Colorado has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Colorado’s contracted aggregator, which will allow agencies to easily send required visit information.


California

Supported: YES

California has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers and MCOs to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, California’s contracted aggregator, which will allow agencies to easily send required visit information.


Arkansas

Supported: YES

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed integrations with HHAeXchange, AuthentiCare, and CareBridge, Arkansas’ contracted aggregators, which will allow agencies to easily send required visit information.

Arizona

Supported: YES

AxisCare meets the state ‘s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Arizona’s chosen aggregator, which will allow agencies to easily send required visit information directly to Sandata.

Mississippi

Supported: YES

The Mississippi Department of Medicaid has decided to go with an Open Model that allows providers to choose their own EVV system, as long as it meets federal EVV regulations. They are in the process of choosing an aggregator system that will accept data from all EVV systems.

AxisCare meets all state and federal EVV requirements, so providers may continue to use AxisCare as their EVV and management system.

Montana

Supported: YES

Montana has decided to go with an Open Model that allows providers to choose their own EVV system, as long as it meets federal EVV regulations. They are in the process of choosing an aggregator system that will accept data from all EVV systems.

AxisCare meets all state and federal EVV requirements, so providers may continue to use AxisCare as their EVV and management system.

Wisconsin

Supported: YES

Wisconsin has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Wisconsin’s contracted aggregator, which will allow agencies to easily send required visit information.

Rhode Island

Supported: YES

Rhode Island has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Rhode Island’s contracted aggregator, which allows agencies to easily send required visit information.

West Virginia

Supported: CONTACT US

West Virginia has chosen an open model with HHAeXchange serving as the aggregator.  AxisCare has not developed the integration with HHAeXchange for West Virginia yet (AxisCare supports HHAeXchange integrations in other states), but if your organization is interested in using AxisCare, please contact us. 

Washington DC

Supported: CONTACT US

Washington DC has chosen an open model with Sandata serving as the aggregator.  AxisCare has not developed the integration with Sandata for DC yet (AxisCare supports Sandata integration in other states), but if your organization is interested in using AxisCare, please contact us. 

Washington

Supported: YES

Washington has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, ProviderOne) while allowing providers to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with ProviderOne, Washington’s contracted aggregator, which will allow agencies to easily send required visit information.

Virginia

Supported: YES

Virginia has chosen to use an open vendor model in which the state sets the standards for EVV, and providers may either use their existing EVV system or choose one that best meets their needs.

AxisCare has developed a direct integration with Tellus, Virginia’s EVV aggregator, so providers may continue to use AxisCare as their EVV and management solution.

Vermont

Supported: CONTACT US

Vermont has chosen an open model with Sandata serving as the aggregator.  AxisCare has not developed the integration with Sandata for Vermont yet (AxisCare supports Sandata integrations in other states), but if your organization is interested in using AxisCare, please contact us.

Utah

Supported: YES

AxisCare meets the state’s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an export with UEVV, Utah’s aggregator, which will allow agencies to easily send required visit information. 

Texas

Supported: CONTACT US

Texas has chosen an open model with TMHP serving as the aggregator.  AxisCare has not developed the integration with TMHP for Texas yet, but if your organization is interested in using AxisCare, please contact us.

Tennessee

Supported: NOT AT THIS TIME

Tennessee has chosen a closed model where AxisCare is currently not able to provide EVV data to the state.   Providers can choose to use AxisCare due to the many advantages but you must use Sandata, Healthstar, and Time4Care to collect EVV required data.

South Dakota

Supported: CONTACT US

South Dakota has chosen an open model with Therap serving as the aggregator.  AxisCare has not developed the integration with Therap for South Dakota yet, but if your organization is interested in using AxisCare, please contact us. 

South Carolina

Supported: NOT AT THIS TIME

South Carolina has chosen a closed model where AxisCare is currently not able to provide EVV data to the state.   Providers can choose to use AxisCare due to the many advantages but you must use AuthentiCare to collect EVV required data.

Pennsylvania

Supported: YES

Pennsylvania has implemented an open model in which the state sets the standards for EVV, and providers may either use their existing EVV system or choose one that best meets their needs.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also integrated with Sandata and HHAeXchange, Pennsylvania’s two EVV aggregators, which allows agencies to easily send required visit information.

Nebraska

Supported: YES

AxisCare meets the state’s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Tellus, Nebraska’s chosen aggregator, which will allow agencies to send required visit information.

Oregon

Supported: YES

AxisCare meets the state’s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an export with eXPRS, Oregon’s aggregator, which will allow agencies to easily send required visit information. 

Oklahoma

Supported: CONTACT US

Oklahoma has chosen an open model with AuthentiCare serving as the aggregator.  AxisCare has not developed the integration with AuthentiCare for Oklahoma yet (AxisCare supports AuthentiCare integrations in other states), but if your organization is interested in using AxisCare, please contact us. 

Ohio

Supported: YES

Ohio has chosen to implement an open vendor model in which the state selects a single aggregator (in this case, Sandata Technologies) while allowing providers to continue using their existing EVV systems as long as it meets federal EVV guidelines.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with Sandata, Ohio’s contracted aggregator, which will allow agencies to easily send required visit information.

North Dakota

Supported: CONTACT US

North Dakota has chosen an open model with Sandata serving as the aggregator.  AxisCare has not developed the integration with Sandata for North Dakota yet (AxisCare supports Sandata integrations in other states), but if your organization is interested in using AxisCare, please contact us. 

North Carolina

Supported: YES

North Carolina has implemented an open model in which the state sets the standards for EVV, and providers and MCOs may either use their existing EVV system or choose one that best meets their needs.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also integrated with Sandata, HHAeXchange, and CareBridge, North Carolina’s EVV aggregators, which allows agencies to easily send required visit information.

New York

Supported: YES

New York has implemented an open vendor model in which the state selects a single vendor while allowing providers to continue using their existing EVV systems as long as it meets federal EVV guidelines.

New York has chosen to work with three EVV aggregators: eMedNY, HHAeXchange and CareBridge.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have developed integrations eMedNY, HHAeXchange, and CareBridge which allow agencies to easily send required visit information.

New Mexico

Supported: NOT AT THIS TIME

New Mexico has chosen a closed model where AxisCare is currently not able to provide EVV data to the state.   Providers can choose to use AxisCare due to the many advantages but you must use AuthentiCare to collect EVV required data.

New Jersey

Supported: YES

New Jersey has implemented an open model in which the state sets the standards for EVV, and providers may either use their existing EVV system or choose one that best meets their needs.

AxisCare meets state EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also integrated with HHAeXchange and CareBridge, New Jersey’s two EVV aggregators, which will allow agencies to send required visit information.

New Hampshire

Supported: YES

New Hampshire has decided to go with an Open Model that allows providers to choose their own EVV system, as long as it meets federal EVV regulations. They are in the process of choosing an aggregator system that will accept data from all EVV systems.

AxisCare meets all state and federal EVV requirements, so providers may continue to use AxisCare as their EVV and management system.

Nevada

Supported: CONTACT US

Nevada has chosen an open model with AuthentiCare serving as the aggregator.  AxisCare has not developed the integration with AuthentiCare for Nevada yet (AxisCare supports AuthentiCare integration in other states), but if your organization is interested in using AxisCare, please contact us. 

Alabama

Supported: YES

AxisCare meets the state ‘s EVV requirements, so providers may continue to use AxisCare as their EVV and management solution. We have also developed an integration with HHAeXchange, Alabama’s chosen aggregator, which will allow agencies to easily send required visit information directly to HHAeXchange.