Secure caregiving system for most-at-risk

For decades, Minnesota has been on the leading edge of helping seniors and people with disabilities get care in their homes. Not only is this where they want to live, but it also saves money in the long run by keeping them out of more costly settings.

Democrats and Republicans have championed this approach, and that bipartisan commitment to the health, well-being and dignity of Minnesotans with disabilities and older residents is one of the reasons Minnesota consistently ranks so high in quality-of-life ratings. Now, with President Joe Biden's "Build Back Better" agenda, we have the chance to secure this system of care for our grandparents, parents and children.

The president is proposing a $400 billion investment in home care services, and it could not come at a better time, as this proven system of care is under increasing strain. As many people with an aging parent or an adult with disabilities will tell you, if they do not move into a nursing home, the responsibility for care often falls to immediate family members. While home- and community-based services (HCBS) is and remains a popular choice for Minnesota residents, the increasing number of Minnesotans needing care coupled with the difficult nature of the work, and the perennially low wages for caregivers, are pushing this vital industry to a breaking point.

These caregivers, known as personal care attendants (PCAs), are Minnesota's second-largest occupation, with a workforce of 65,000 people, according to Minnesota's Department of Employment and Economic Development. An overwhelming majority of these caregivers are women and people of color.

As the CEO of Accra, Minnesota's largest provider of PCA services, I know the work PCAs do is hard. Every day, they help their clients with activities of daily living like dressing, grooming, eating, bathing, using the bathroom, and more. Throughout the pandemic, PCAs continued to serve their clients at significant risk to themselves and their own families, and they do so for wages lower than what they could earn at a fast-food restaurant.

Because many of our clients receive health care coverage through Minnesota's Medicaid program, the reimbursement rate for services is capped by the Minnesota Legislature and dependent on a mix of state and federal funding. Because the primary financing of PCA services comes from public sources, reimbursement rates limit what companies can pay in wages.

Right now, the current workforce shortage combined with high caregiver turnover due to the type of work required, the personal health risk, and the salary rate offered make it increasingly difficult for companies like ours to recruit people to provide care for Minnesota seniors and people with disabilities.

Without more assistance, Minnesota may soon find itself in a position where there aren't enough home care workers for the people needing care, and this could cause adverse impacts to cascade through our economy.

There is good news, though. Recently Gov. Tim Walz and the Minnesota Legislature worked together in a bipartisan fashion to provide a 10% increase to home- and community-based services. This increase will allow companies like Accra to give PCAs a much deserved and needed increase to the $15.25 an hour that floor PCAs won in their new union contract with the state.

Even better, Biden and several congressional leaders such as U.S. Sen. Tina Smith of Minnesota are advocating for a historic investment in caregiving. This $400 billion nationwide investment will expand home- and community-based services to more people, increase funding for current programs and help PCAs earn a wage that allows them to live with dignity. This investment will help companies like Accra recruit more people to do the vital work necessary to keep our friends, family and neighbors in their homes and out of costlier settings.

Now is the time for us to seize the moment and make this investment to help stabilize our caregiving infrastructure. Every Minnesotan will benefit, from Rochester to Roseau, and Worthington to Grand Portage. Securing our caregiving industry will help make sure that not only our parents and grandparents are taken care of, but that this system will be available for ourselves as well when we're older.

In a time of seeming political dysfunction, Minnesota leaders were able to step up in a bipartisan way and do their part. Now is the time for our federal leaders to do the same and help get this critical investment over the finish line.

Minnesotans everywhere are counting on them.

John Dahm is president and CEO of Accra, a home care provider.