Thursday, September 19, 2013

Healthcare Transition Burdens Disabled Clients

In September 2011 these demonstrators expressed concerns about Clinton County privatizing its home health care services.


"If we don't fight, agitate, and prod, then we will be forgotten and the system will be shaped by those who don't care all that much about us as people." - Robert Poulin, NCCI Executive Director (email interview)

Getting out of bed.  Taking a shower.  Doing laundry.  Going shopping.  Everyday activities that an able-bodied person doesn't think twice about.

But for many disabled people those everyday activities are difficulties they can't handle alone.  Home healthcare services are vital to their lives.

A number of changes have caused problems for the disabled trying to received the services they need.  Long delays have resulted, making their lives even more miserable.

The Clinton County Department of Social Services (DSS) has received complaints about the matter.

One part of the problem is a decision made about two years ago by the county legislature to shift from operating its own service to HCR Home Care, a private company.  A transitional period is underway, causing the system to slow down.

Robert Poulin, executive director of the North Country Center for Independence (NCCI), is one advocate dealing with the situation.  In an email interview he explained his agency's role with home health care is through a program administered through DSS called Consumer Directed Personal Assistance Program (CDPAP).

Robert explained: "The CDPAP program has experienced some dramatic delays in the past six months as the demand for the program has grown..."

He said that other factors are involved besides the switch to HCR.  "The Medicaid Redesign plan and the Affordable Care Act have created a great deal of change and uncertainty."

Also, Robert said, during the switch to HCR New York State initiated a hiring freeze.  Retiring nurses were not replaced.  Now there is only one nurse at DSS to handle all assessments.  He added:  "My understanding is that the DSS nurse has more than 120 cases to work with."

Thus a bottleneck with assessments through one nurse and HCR adjusting to its new role have put disabled clients on hold, sometimes for months.

A disabled person contacted me via email about this situation.   Due to an injury adding to pre-existing physical limitations the client couldn't take a shower for long periods of time.  The client needs an able-bodied aide to help get out of bed and provide assistance with using the shower.

Home healthcare does save money, Robert Poulin noted, as compared to nursing homes and hospitals.

He observed: "The system is stressed, but that doesn't mean that it's OK for our needs to go unmet. We have to continue with advocacy efforts every day and do our best to shape a changing system to something that benefits us."

Robert concluded: "This is the time for our voices to be heard, this is the time for complaints to be filed, this is the time for us to demand that the system changes to not only save money but to also better serve our needs."

For more information contact NCCI at (518) 563-9058.  Website: .

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