Shortage of home health care workers has Nebraskans who need it concerned

April 27, 2023, 3 p.m. ·

Jody Faltys works on her edits and other work on a tablet in her office.
Jody Faltys edits books and does other work on her tablet in her home office. (Photo by Aaron Bonderson, Nebraska Public Media News)

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Nebraska health care advocates say there aren’t enough home health care professionals in the state. Since the start of the pandemic, it’s estimated that 33 percent more Nebraskans are being referred to health care at home because of the overcrowding at hospitals. That’s according to Janet Seelhoff, Executive Director for the Nebraska Association of Home Healthcare and Hospice.

Despite this, Seelhoff said the actual amount of people receiving medical or personal aid at home has dropped.

“We're definitely seeing our home health providers having to turn away referrals because of a combination of things. One is they don't have as much staff as they had,” Seelhoff said. “And then, there's also other factors such as soaring inflation and rising fuel costs that have really had a significant impact on our home health care community.”

The agencies that employ home health professionals sometimes aren’t able to pay a competitive wage, she said.

“Traveling nurses are earning at least twice the amount that our home health agencies are able to pay,” Seelhoff said.

Many agencies cover costs through Medicare and Medicaid reimbursements which includes employee wages.

“And the Medicaid reimbursement rates are not keeping pace with actual costs of care,” Seelhoff said.

She said cuts in Medicaid benefits will likely have an impact on the thousands of Nebraskans receiving home health care on Medicaid.

“I’ve noticed it…”

Jody Faltys is a book editor and promoter from Lincoln. Faltys is quadriplegic and uses a companion to help with her daily life. But the agency she uses isn't able to assign people as timely as they used to.

“I've noticed it in the last year, definitely,” said Jody Faltys.

Faltys, a Board of Director for the League of Human Dignity, said the short staffing is caused by pay.

“When your starting pay is $15 - 16, you get higher pay at fast food — at stocking shelves at Walmart,” Faltys said.

As someone who doesn’t need a registered nurse at her apartment, she said the agency makes things work.

“They've always found somebody,” Faltys said. “Before, if you would say, ‘I don't feel comfortable having a guy do a visit,’ they would respect that. Now they're telling us, ‘I understand and we'll do our best not to send a guy to a woman's house. But if we don't have anybody else, you're going to have to take a guy.’ And that's what you do.”

Faltys said veterans and seniors might have an even more difficult time. Many of these folks need trained nurses who are often flocking to the more lucrative traveling nursing field.

A nationwide shortage

The Nebraska Department of Health and Human Services said they don't have records tracking the amount of people employed by home health agencies. A DHHS spokesperson wrote:

"Unfortunately, the nation has experienced a nationwide labor shortage in the medical field for years that was only made worse by the recent COVID-19 pandemic. The State of Nebraska has not been spared by this national trend."

DHHS said they are “working aggressively to fix the problem at its root, by recruiting more people into the medical field and retaining them.”

DHHS identified the following initiatives to help with the storage:

The National Bureau of Labor Statistics expects the amount of open home health positions will increase nearly 37 percent by 2028.

Meanwhile, LB 46 introduced in the unicameral this session would appropriate funds for the DHHS to study the health labor market.

If the current landscape remains unchanged into next year, Faltys fears she won’t be able to live independently and may be forced to move. Faltys said she hopes federal relief funds can be used to incentivize home health work.