Home Care Information
What is Home Care?
The scope of home care is broad. It encompasses a wide array of both health and supportive services delivered at home. Clients cross the spectrum of care-from seniors who need assistance with activities of daily living in order to remain in their homes, to new mothers, discharged quickly following childbirth with a few post-partum nursing visits for mom and newborn, to post-surgical patients needing assistance with wound care, to the chronically ill who are maintained with skilled supervision, support services and equipment.
Frequently, the term "home health care" is used to refer to skilled clinical treatments, such as the services of a registered nurse, or physical therapist, or to receive in-home glucose monitoring or intravenous therapies. In fact, the generic term "home care" is a more apt description of the range of both medical and supportive services designed to bolster the post-acute, chronically ill, disabled, and elderly populations that home care providers serve. For such patients, homemaking, personal care for nutrition and hygiene, and adaptive devices to prevent slips and falls are as important to their rehabilitation and functioning as the more sophisticated health technologies that are also delivered at home. Both in-home clinical care and support services are cost effective by reducing hospital stays and by preventing or delaying institutionalization in a nursing home. New York's Medicaid home care program provides this wide range of services to the homebound sick and elderly patients throughout the State. And of course, thousands of New York State residents purchase home care services privately and others receive home care services through private insurance coverage in both indemnity and managed care benefit plans.
The average home care visit costs significantly less than a day of nursing home or in-patient hospital care. Clearly, home care is the solution to increasing health care costs, offering opportunities for achieving real cost savings for a broad variety of patients. Erie County has and must continue to look to home care as the primary source of long term care services to keep patients in their homes and communities. In an effective continuum of care we should expect to see increasing levels of home care utilization, not as a result, of "over-utilization" of home care, but as a result of shifting utilization away from more costly settings into home care. So, who are these unsung heroes who help provide a quality of life to those receiving home care at such a cost savings.
Home Care Paraprofessionals
Personal Care Aides
Personal Care Aides (PCAs) provide services to persons needing some or total assistance with everyday tasks, including such things as personal hygiene, dressing, feeding, walking, meal preparation, light housekeeping, and laundry. PCAs provide services to help clients stay in the home and live independently. PCA employees are required to attend a 40-hour basic training course and attend in-service training throughout the year.
Home Health Aides
Home Health Aides (HHAs) are the highest level of paraprofessional in home care. HHAs are responsible for health-related as well as personal care tasks. These health-related tasks include monitoring the client's health status by taking temperature, pulse, respiration, and blood pressure, and assisting with basic health tasks that allow the client to remain at home.
Skilled Nursing (LPN/RN)
Skilled Nursing (LPN/RN) - Home care nurses provide treatments, trach care or vent care and skilled monitoring following signed doctor orders.
Types of Home Care Agencies
New York State licenses or certifies a variety of home care program types. Home care agencies and programs differ in the services they provide and the State agency that oversees their operation.
Licensed Home Care Services Agencies
Licensed Home Care Services Agencies (LHCSAs) offer home care services including all levels of nursing care, various therapies, home health aides and personal care aides to clients who pay privately, have private insurance coverage or are covered through a variety of government payers. Many LHCSAs also deliver services under contract with local departments of social services or other service-authorizing agents. In particular, services through the Medicaid Personal Care and Private Duty Nursing Programs are delivered in this way. Licensed agencies also sub-contract with other home care providers to deliver services to beneficiaries throughout Erie County. LHCSAs may offer a full range of services from skilled to paraprofessional or may choose to focus on the delivery of one service or population, such as high-tech pediatrics or aides to seniors.
Certified Home Health Agencies
Certified Home Health Agencies (CHHAs) provide care and support services to individuals who, for the most part, have home health care needs for a limited duration. They are generally reimbursed through Medicare and/or Medicaid.
All together, there are approximately 30 home care agencies in Erie County. In addition to professional nurses, therapists, and assistants, home care agencies hire and train workers as home health aides and personal care aides, and offer these paraprofessionals additional opportunities for career growth.
What are the benefits of home care?
First, many (if not most) patients would rather be home than in a heath care facility. As long as they do not need constant supervision or intensive medical treatment, these patients are usually happier and more comfortable in the familiar surroundings of their homes. In addition, it is generally accepted that, the home is actually a better environment for recovery or convalescence. Certain medical conditions, broken bones, for example, improve more rapidly and more fully at home. Of course, I said earlier, home care is alot less costly than traditional, institutional care. Consider this; home care can reduce health care costs by 40% or more compared to hospitalization
Is Home care always a viable option?
Patient's needs differ, so the answer to this question really depends on the specifics of each situation. But home care has been endorsed by many health care professionals. In fact, the American Medical Associations Handbook on Home Health Care states:
"Home health care has demonstrated that it is an effective and less expense means of providing health services as an alternative to more costly institutional care."
According to the United States General Accounting Office, most people over the age of 65 with convalescent illnesses could receive better care at less cost in their homes, compared to hospitals or nursing homes. It should be noted that home care is not only for adults. Sick or disabled children, as well as healthy children with sick or disabled parents are often care for by home care professionals. So, home care is most definitely a viable option in a great many cases. In fact, home care may even be the ideal choice, medically, emotionally and financially. Whether or not it is the right option in a particular case is up to the doctor, the patient, the patient's health care team, and the family.