Aging in place. It’s what most Americans want as they get older: to stay in their own homes and maintain independence for as long as possible. But concerns about safety, getting around, or performing daily activities sometimes necessitate the need for home care in order to avoid moving into an institutional care facility.

Driven by an aging population, the home care industry has become an essential pillar of the healthcare system offering non-hospital care solutions to support individuals who require assistance with daily living or managing chronic illness.

With over 4.5 million individuals currently employed as home health aides or personal care aides in the United States, providers from across the country participated in National Home Care Advocacy Day April 9 on Capitol Hill to ensure legislators were aware of the latest industry needs.

“Home care is getting more and more focused in the continuum of healthcare,” said Mitch Opalski, CEO of Synergy Home Care of Arlington/Alexandria. “Awareness is a big part of our advocacy. It's important that people know that home care is vital in keeping people healthy and out of the hospital.”

To avoid institutional care, older adults or those with disabilities may need one or a combination of two types of home care: home care and home health care. Home care refers to non-medical care such as homemaker services (laundry, cooking, etc.), assistance with daily living activities (walking, bathing, etc.), personal care, or companionship.

Home health care must be prescribed by a doctor or nurse practitioner and is delivered by licensed medical professionals such as registered nurses or physical therapists. Medicaid and Medicare are the largest payers in home health spending in the United States, but much is also paid out of pocket.

“The second reason that we're on the Hill is to specifically ask Congress to support legislation that helps our industry,” Oplaski said. “What we're focused on right now is the cost. Our kind of care is only covered by one type of insurance – a specific long term care policy that not many companies do and most people are not aware of. So families are left paying out of pocket. If you can't afford it you don't get the care or it's done by a family member or you go on Medicaid. What we're telling Congress is if there's no government program to pay for our kind of care, if it's not covered by Medicare, give us some other kind of relief.”

Opalski and other home care advocates from across the state had meetings with congressional representatives, including those from U.S. Sen. Mark Warner’s office.

Advocates lobbied in support of the following pieces of legislation:

* The Credit For Caring Act (118th Congress - S.3702, H.R.7165):  Allows an eligible caregiver a tax credit of up to $5,000 for 30 percent of the cost of long-term care expenses that exceed $2,000 in a taxable year.

* Lowering Costs for Caregivers Act (119th Congress - H.R.138): Allows individuals to use tax-free health savings accounts (HSAs) and flexible spending accounts (FSAs) on medical expenses for their parents and loved ones.

* Homecare for Seniors Act (118th Congress - H.R.1795): Allows tax-exempt distributions from health savings accounts to be used for qualified home care services such as assistance with eating, bathing, and dressing.

“As people get older they get more chronic diseases that need to be managed,” Opalski said. “Our aides are the ones who are best at doing that. It could save the healthcare system a lot of money by keeping people out of acute care settings like nursing homes and the hospital by overseeing medication compliance, good nutrition, exercise, and mental stimulation. What we are asking for is not a burden on the government and is not going to be an additional cost to the federal budget.”

An AARP report found that family caregivers spend, on average, 26 percent of their income on caregiving expenses or over $7,200 annually. Family members and others who provide care for veterans spend on average $11,500 of their personal income on out-of-pocket costs related to caregiving each year.

“We fought for two years to get the Elizabeth Dole Act passed regarding home care services for veterans,” Opalski said. “The advocacy works. It takes time but still it's worth it to take a day out of our busy lives and go on the Hill and try to keep home care somewhere in the mix.”

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