‘Humongous’ wait

Government-funded home care is hard to get, even for those approved to receive it. “There are many people who need and qualify for the services, but they’re not available because so many agencies can’t afford to provide it for [the Medicaid reimbursement] rate,” said Marcia Tetterton, who directs the Virginia Association for Home Care and Hospice.

In Virginia, the Medicaid reimbursement rate for home care is $12.53 an hour, while the cost to provide it can run as high as $19.50 an hour, leaving companies to either make up the difference or — more commonly — pay their aides lower-than-average wages.

Many choose to serve only private-pay patients: Seven out of the 16 home-care businesses in the Roanoke area accept Medicaid, according to LOA’s 2007-08 directory for long-term care. (Medicare covers home care only temporarily and for skilled-level care, such as post-surgery wound-dressing.)

“We can’t accept Medicaid because they don’t reimburse enough money to allow us to pay our caregivers a living wage,” said Darrell Egle, co-owner of Helpful Hands Home Care Services in Roanoke.

At the New River Valley Agency on Aging, long-term care ombudsman Janet Brennend regularly fields calls from people who qualify for the benefit “but can’t get personal care on a consistent basis because there just aren’t enough bodies to provide the service,” she said.

Many of the callers qualify for nursing-home care, Brennend added. “But they don’t want to go. Home is familiar to them. And besides, what they’re trying to do by staying at home would ultimately save the state money.”

State funding cuts eliminated $30,000, or 8 percent, from Family Service’s home-care budget in 2002. Funding has since remained flat while costs have risen and the need doubled, according to adult services director Cathy Thompson.

The current roster of 53 Roanoke area clients is down from the 70 being served in 2001, “and even that was a drop in the bucket,” Thompson said.

The waiting list is so long that at least twice a year supervisor Mary Johnson calls to tell someone that he or she will be receiving services — only to find out the person has already died.

“Our waiting list grows humongous just after the holidays when the kids have been in to visit,” Johnson said. “They need services right away and they’ll say to me, ‘It’s not like this in New Jersey. Why can’t she get this?’ ”