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Opinion: Home-based health care is vital during the pandemic and beyond. Let’s support it.

Our state and country have faced great loss and challenges during the COVID-19 pandemic. Our health care system has been strained, and many Coloradans have suffered an economic impact and the devastating loss of loved ones. 

Sadly, December saw a tremendous surge in COVID cases with Colorado hospitalizations reaching their highest level since the pandemic began.

During this holiday season, we have grieved the loss of time spent together with loved ones. In this time of struggle, I hope we can take pause and be grateful for the promise of a vaccine and other blessings. 

Don Knox

I hope we can also show gratitude to those who are working on the front lines to care for those in need, including the unsung heroes who may not be as visible because they don’t work in hospitals or doctors’ offices. I am talking about home health and personal care workers who bring care directly into some of the most vulnerable Coloradans’ homes.

Throughout the pandemic, these workers have provided essential care to patients where they live, allowing scared and high-risk patients to stay in their home and out of crowded hospitals and nursing homes. 

In many ways, home health care agencies have also been the relief valve for hospitals and nursing homes, allowing these institutions to focus on patients with more severe health needs by taking care into the home where that was possible.

Home health care workers provide skilled nursing care, as well as physical therapy, occupational and speech-language therapy and other skilled services. Personal care workers help people with special needs stay in their homes by assisting with mobility, bathing, dressing, toileting, feeding, medication reminders and tasks around the home. 

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Throughout the pandemic, these workers have been providing essential day-to-day support and assistance to patients across the state – as they have always done. They have helped the elderly, adults and children with chronic illnesses, those living with a disability or impairment, and patients recovering from an accident, surgery or illness, such as COVID-19.

As with other businesses, the pandemic hit home health care agencies hard. Many were faced with sudden and drastic losses of revenue. 

Elective surgeries were canceled for an extended period of time, reducing demand for home-based care that is often provided during the recovery period following those procedures. Meanwhile, other patients deferred routine and preventive care because they weren’t comfortable allowing anyone into their home. 

As the demand for care returned, these agencies have had to procure expensive and hard-to-find personal protective equipment and to conduct important additional staff training sessions and testing to ensure care provider and patient safety. They had to create incentives for staff members to serve COVID patients and suspected COVID patients who needed care in the home, and they had to find a way to cover gaps in staffing created by school closures, the need to quarantine staff and the always-present competition for skilled health care professionals. 

Many have also faced the almost insurmountable challenge of low Medicaid reimbursement rates. These rates were already below recommended levels leading into the pandemic and were further lowered during the pandemic by the state of Colorado due to budget challenges.

While the rollout of vaccines offers hope, the pandemic is still very much with us, and the challenges being faced by home health care agencies and their workers continue, particularly given low Medicaid reimbursement rates. 

Agencies that are supported by larger health care systems can provide care more charitably, but many smaller agencies are in a precarious financial position when they provide care to the state’s most vulnerable patients without compensation, or at a loss. 

How much longer will those agencies be able to continue that practice? If they are forced out of business, who will care for vulnerable Coloradans?

Our federal and state leaders cannot continue to let funding languish. Reimbursement rates at both the state and federal level must keep pace with ongoing cost increases to ensure home care workers receive the benefits, wages and support they require to continue their important work.

This has never been more important: As the state faces budget and public health challenges, policymakers have an important role to play in providing critical support for the continuation of safe, cost-effective care in the home through increased reimbursement rates.

During the pandemic, home-based care has been a lifeline for some of Colorado’s most vulnerable residents, who rely on it to stay strong and healthy, both physically and mentally. During this pandemic and beyond, the use of in-home therapies can reduce depression and dangerous weight loss and provide important preventive and rehabilitative care that reduces costly medical conditions and hospital stays.

In our times of need, home health workers have shown that they care. Now it’s our turn to ensure reimbursement adequately supports workers and continued access to quality care for the patients they serve.


Don Knox is the executive director of the Home Care and Hospice Association of Colorado.


The Colorado Sun is a nonpartisan news organization, and the opinions of columnists and editorial writers do not reflect the opinions of the newsroom. Read our ethics policy for more on The Sun’s opinion policy and submit columns, suggested writers and more to opinion@coloradosun.com.

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