Personal Care Services

Raise State Rates for Home Caregivers

John David Ball has served as chief executive officer of Outreach Health since 2019. He wrote this for The Dallas Morning News.  

Link to Dallas Morning News article: 

For nearly 50 years, my family has worked hard to care for vulnerable Texans in the comfort of their homes. During those decades, my father’s small home care business in Garland has grown to employ 5,000 people, supporting older adults and people with disabilities in each of the state’s 254 counties while remaining family-owned and operated. 

Unfortunately, the vital services we provide to Texans in need are being threatened, leaving thousands at risk. State lawmakers in Austin have a narrow window before they adjourn in a few weeks to help these Texans and our dedicated attendants who care for them. 

Before founding Outreach Health in 1975, my father was a nursing home administrator. He saw firsthand that so many residents could be better served in their homes and communities than in institutional facilities. 

He and his partner started one of the state’s first home care companies with a mission to provide compassionate care to older adults and individuals with disabilities in the comfort and security of their homes. 

Today, tens of thousands of at-risk Texans depend on the Medicaid-funded Community Care Program. Under the program, community attendants provide support for the activities of daily living, such as bathing, cooking, and housekeeping, that so many of us take for granted. 

These attendants often become the most important people in their clients’ lives, keeping them safe, happy and healthy at home. Without these unsung heroes, thousands of Texans would be forced to leave their homes and live in institutions, decreasing their quality of life and increasing the financial burden on the state. 

Unfortunately, the Texas Legislature has not increased reimbursement rates for Community Care in 16 years. Our clients don’t have the means or private insurance to pay for the in-home care they desperately need and rely on Medicaid to receive these services. Similarly, my company and other providers rely on those funds to pay our attendants each month. 

Under the current rates, providers can only offer a median wage of around $9.17 per hour — not nearly enough to hire and retain attendants. With such low wages, it is no surprise that 40% of all caregivers leave the industry each year for better-paying jobs in sectors like retail, fast food or warehouses, where they can easily earn $20 per hour. 

Without community attendants to provide care in the home, the at-risk population we serve will be relegated to seek care in an institutional setting, such as a nursing home, which is also funded through state Medicaid payments and is a mandatory service that the state must provide. While nursing homes offer the appropriate level of care for some, the cost to the state is three times more than services at home: $4,400 a month vs. about $1,500. 

Texans who qualify for Medicaid Community Care are legally entitled to receive these services — the only question is, will they receive them in the comfort of their home, or will it be in a nursing home at a higher cost to taxpayers? 

The Texas Legislature can address this crisis by investing a small piece of its $33 billion surplus to increase Medicaid funding for Community Care. This would raise attendant wages and stabilize these programs that are teetering on the brink of collapse. 

As the owner of a family business, a fiscal conservative, and someone who knows firsthand the profound impact these programs have on fellow Texans, I implore our state leaders to prioritize funding for these vital and cost-saving programs. 

Since my father opened it, our business has been on a mission to provide care to Texas’ aging population, empowering them to live comfortably and safely at home. Without proper funding, many home care agencies, like mine, cannot provide these crucial services to the most at-risk members of our communities. 

We have a moral and economic obligation to provide a livable wage to our hardworking and compassionate community attendants. If we don’t, our older adults will be left with only one option — a lower quality of life at a much higher price to the state and its taxpayers. 

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