Justice announces Medicaid rate increase in hopes of improving state’s in-home care worker shortage • West Virginia Watch

Gov. Jim Justice announced Thursday that his administration will increase its funding for state programs that provide in-home care for people with disabilities, seniors and others in hopes of addressing a workforce shortage.

The funding will go toward a 15% Medicaid reimbursement rate increase for providers that serve vulnerable adults and children in state waiver programs. The money is meant to improve pay for direct care workers, who currently earn around $11 an hour, but there is no requirement on how providers spend the money. 

A 2023 survey said West Virginia needed to increase its rate of reimbursement and the worker salary range to $15.50-$18.60 per hour; the new rate increase, which goes into effect Oct. 1, reflected the study’s recommendations. 

“We can get some more bucks to these great people who are absolutely doing God’s work,” Justice said. “I’m just tickled to death to do that.”

Companies that employ direct care workers have said the rate increase, which was well below neighboring states, was necessary to employ and retain its workforce.

Eric Hicks, board president of the West Virginia’s chapter of the Home Care Association of America, anticipated home care wages being increased by agencies statewide. He noted that West Virginia was one of the nation’s most elderly states. 

“This investment allows West Virginia seniors and those with disabilities to age in their homes with dignity,” Hicks said. “Home care saves both families and the state from the enormous costs of long-term care facilities, which the Department of Human Services recently reported poses a $200-plus million annual additional taxpayer risk to the Medicaid program.”

Senior centers across the state, which provide in-home care to elderly residents through Medicaid, have also struggled to keep enough workers. Jennifer Brown, president of the West Virginia Directors of Senior and Community Services, said the rate increase would allow senior care providers to offer competitive salaries. 

“This will enable our members to continue our vital mission of caring for, transporting and providing meals to seniors in West Virginia who are in the greatest need of assistance,” she said. “Our group of providers offers comprehensive services to seniors, prioritizing their well-being over profits.”

In-home care is also a cost-saving measure for the state as paying for long-term care, like nursing homes and psychiatric facilities, is much more expensive

During the May special session, lawmakers gave DoHS $180 million in a reserve fund that they could use to improve Medicaid reimbursement rates. Lawmakers declined to mandate that DoHS spend the money to increase the rates after learning the department had spent money earmarked for people with disabilities on things like in-home COVID-19 tests.

While the Justice administration delayed action on the rate increase, a group home in Martinsburg for people with disabilities, many without family members, announced its closure earlier this month. Companies providing in-home care to seniors laid off workers due to financial loss. 

A press release from Justice’s office did not specify how much the rate increase would cost or where the funding would come from. Spokespeople for Justice and DoHS did not respond to questions for this story by deadline. 

DoHS did not require providers to use a certain amount of the reimbursement amount on increasing workers’ salaries. 

Disability Rights West Virginia Legal Director Mike Folio applauded the rate increase, but said that it was still millions of dollars short of what was needed as the state has infinitely institutionalized more people with disabilities.

“DoHS hasn’t increased rates in more than 10 years and the rate increases are not tied to a wage pass-through to guarantee that the increased revenue will be used to bolster front-line workers’ wages,” he said.  “Hiring and retention are necessary to end the skyrocketing number of involuntary commitments, but the rate increase gives providers free reign to spend the new revenue on management lunches and trips and not on workers’ wages.” 

The state Bureau for Medical Services plans to monitor the impact of increased rates on worker pay and member access to services “to determine if the increased rates are having the desired effect on workforce availability and tenure,” according to a press release.