by Megan Hart, KHI News Service
A statewide registry is in the works to make it easier for Medicaid patients to find qualified, reliable personal care workers.
That’s good news for Bill Stovall of Topeka and others like him who help direct care for their family members.
Stovall has a long list of complaints against personal care workers who have cared for his sister in recent years, including punctuality problems and a lack of training.
Stovall has directed care services under Medicaid for his sister Carol Miller, 58, for about 10 years. Miller has needed 24-hour care since she had a brain hemorrhage in August 2013, he said, and he has struggled to find people who are willing and able to provide the level of care she needs.
For example, some haven’t arrived on time to relieve the person caring for Miller on the previous shift, and one came with alcohol on her breath, Stovall said. Another care worker apparently didn’t know much about wheelchairs and called him to ask how fast his sister’s non-motorized chair could go, he said.
“I said, ‘It goes as fast as you want to push it,’” he said.
Several Kansas nonprofits are working on the central registry for personal care workers. The Arc of Douglas County, the Kansas Lifespan Respite Coalition and Rewarding Work, a nonprofit based in Massachusetts, hope the website will go live within a year, said Gina Ervay, chair of the Kansas Lifespan Respite Coalition.
Rewarding Work operates similar registries in seven states. People who are looking for work or Medicaid patients who need to hire a personal care worker can create profiles and search for matches.
The system will send regular reminders to workers on the registry to update their information, Ervay said. Those who do will appear at the top when Medicaid patients search for workers, she said, and those who don’t will be removed from the list after a year of inactivity.
A working relationship
According to the Kansas Department of Labor, about 18,190 people were employed in 2014 as personal care workers who care for the elderly and people with disabilities in Kansas.
Their median annual wages ranged from a high of $23,068 in Atchison County to a low of $17,711 in Labette County — meaning median hourly wages would range from about $8.50 to $11 if the person works full-time.
Mike Oxford, director of the Topeka Independent Living Resource Center, said the average hourly wage statewide for personal care services under Medicaid is $9.60, which makes it difficult to find people willing to do the work.
“We’re asking people to do some pretty icky things for about the same amount as delivering pizzas,” he said.
Groups like the Topeka Independent Living Resource Center have lists of people who report they are interested in providing home care services, but the groups don’t have the resources to regularly update them, Oxford said. The result is that a Medicaid patient may have to call quite a few numbers before finding someone who still is available and interested in doing the work, he said.
The statewide registry will better match workers and patients based on services offered, training the employee has or even whether they smoke or have similar interests, Oxford said.
“There’s a lot of social interaction between personal care attendants and people who direct their own care. It’s a relationship,” he said.
Assessed for services
Medicaid, which in Kansas is a privatized program known as KanCare, pays for home and community-based services through various waiver programs that serve people with specific types of disabilities. The three managed care organizations that administer KanCare spent a combined $188 million on home and community-based services in 2013, but their reports don’t specify how much of that spending goes toward personal care services.
For Kansans with disabilities who might need personal care services, the Kansas Department for Aging and Disability Services first assesses their needs, then the Kansas Department of Health and Environment determines if they meet income qualifications, KDADS spokeswoman Angela de Rocha said.
The MCO then assigns a caseworker to work on a plan spelling out what services the patient is eligible for and how many hours a month he or she will receive, she said.
The patient can choose to have a local home health agency make the arrangements or can self-direct care, de Rocha said. When a patient self-directs, the person receiving the services or his or her representative decides whom to hire and is responsible for making sure the worker performs the right tasks within the authorized hours, she said. A financial management services provider handles background checks and tax withholding.
Ervay said the groups behind the registry anticipate about $55,000 in costs to build and market the website, plus $60,000 in annual maintenance costs. They hope that the MCOs will agree to contribute toward the maintenance costs in the future if they can show improved outcomes from quickly matching patients with workers, she said.
“We’re hoping that families are going to more readily find the workers they need to help them continue living in the community,” she said. “If they can’t find the people, that can be a barrier to them living independently.”
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