Opinion: A crossroads for care at home in CT

Darien Times – Monday, February 24, 2025
By Tracy Wodatch

Most people don’t think about receiving care in their own homes — until they or their loved ones need it. But for thousands of seniors, individuals with disabilities, and people recovering from illness across Connecticut, home-based care is the key to staying in their homes, surrounded by family and familiar comforts. Unfortunately, this essential lifeline is now at risk: the agencies that provide home care are struggling to survive because state funding has not kept up with the rising cost of providing care.

Other than temporary federal relief through ARPA funding during the pandemic, Connecticut has not meaningfully increased Medicaid rates for Home Health services in more than two decades. Meanwhile, costs for labor, fuel, and essential supplies have continued to rise. This outdated funding model is making it increasingly difficult for agencies to retain staff and keep their doors open. At the same time, last year, the state approved a 26% wage increase for independent personal care attendants (PCAs) under SEIU’s (union) contract, but agency-based home care providers were left out entirely, even though they do largely similar work and serve overlapping populations in need. This imbalance is making it harder for agencies to find and keep caregivers, putting services at risk for those who rely on them.

A growing aging population, a growing need for care

Connecticut’s population is aging rapidly. By 2030, nearly one in four residents will be over age 65. More seniors than ever before will need home-based care to help them remain independent and avoid institutional settings.

Without adequate funding, Connecticut will not have the workforce or resources to meet this growing demand. If providers are forced to close or limit services due to low reimbursement rates, families will have fewer options, and more seniors will be forced into nursing homes and hospitals — places they don’t want to be and where care is far more expensive.

The cost of inaction: Higher costs for everyone

When home care services disappear, people have no choice but to turn to hospitals and nursing homes, which are far more expensive and already stretched thin. A study published in the Journal of Medical Economics found that home care can significantly reduce hospitalizations and health care costs by providing care in a lower-cost setting and keeping people healthier at home.

Without fair funding, agencies will continue to close, caregivers will leave for higher-paying jobs elsewhere, and thousands of people will be left without the support they need. Connecticut is at risk of losing some of its nearly 12,000 skilled Care at Home workers to neighboring states with higher reimbursement rates. States that pay more can recruit workers more easily, worsening Connecticut’s workforce shortage and further limiting access to care for those who need it most.

This issue was underscored in the recent Connecticut Medicaid Rate Study Phase 2, which found that Medicaid rates in Connecticut are significantly lower than those in comparable states and fall far below Medicare benchmarks. By failing to keep up, Connecticut is pushing its workforce away and making it harder to sustain high-quality home-based care.

Conn. needs a sustainable solution

It is time for Connecticut to stop putting home-based care at risk year after year. To ensure long-term stability, the state must:

Adjust Medicaid reimbursement rates to fairly support Home Health, Medication Administration, and Homemaker-Companion services.
Implement annual Medicaid rate increases indexed to the federal Consumer Price Index (CPI) to keep up with inflation.
Ensure agency-based providers receive rate increases in line with the state’s SEIU PCA wage adjustments.

Investing in Care at Home is the right thing to do — for families, for caregivers, and for Connecticut’s health care system. Without action, more people will lose access to care, more families will be left without options, and the cost of care will continue to rise for everyone.

The time to act is now. Connecticut cannot afford to wait any longer.

Tracy Wodatch is the president and CEO of the Connecticut Association for Health Care at Home.

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