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Survey blames shortage of at-home care providers on certificates of need

CHARLESTON, W.Va. -- Cumbersome certificate of need requirements are contributing to a shortage of in-home personal care providers for senior citizens, members of the House Committee on Senior Citizen Issues learned Wednesday.

Attorney Andrew Ellis said that companies seeking to provide in-home care services not only have to get a certificate from the state Health Care Authority, but must get a letter from the Bureau of Medical Services verifying that the services to be provided will not impose an additional financial burden on the state.

"I have clients out there who have the ability to provide personal care services, who have staff to provide personal care services, but can't get the certificate of need required by law," he said.

One client, whom he said had hoped to provide services in a 12-county area of Southern West Virginia, was denied a certificate after the Bureau of Medical Services sent a letter stating that there would be "nominal additional cost" to the state.

Meanwhile, an informal survey of 52 registered personal care providers around the state found that that virtually all had limited availability of services, and had waiting lists ranging in time from weeks to months, depending on the services requested.

In the survey, conducted Feb. 27 to March 11 by TSG Consulting, the personal care providers were asked about the availability of services for a hypothetical great aunt in her late 70s who lives alone and has no family in the immediate area.

In the request, the woman requires basic grooming and care in the morning and evening, and on weekends and holidays.

Nearly 60 percent of the providers surveyed provide services only on weekdays. Only two offered services on holidays.

Nearly 95 percent of providers also indicated that services are available only during normal office hours, usually either between 8 a.m. and 4 p.m. or from 9 a.m. to 5 p.m.

Likewise, fewer than 40 percent of providers indicated they could provide in-home visits twice a day, and those visits were generally predicated on the hypothetical aunt's "home" being close to the provider.

Providers generally indicated they could begin offering services within a month, although waiting lists for state-supported programs such as Lighthouse and FAIR ranged from three months to one year in most cases.

More than half the providers surveyed indicated they have private-pay options, with hourly rates ranging from $8.50 to $16.50 an hour, with the average being $13 an hour.

Phil Shimer with TSG and a former deputy director and acting director of the Bureau of Medical Services, said the survey indicates there is an issue with access to personal care services.

"A lot of people who need services in the evenings are kind of out of luck," he said. "What we generally found is extended hours are just not available."

Shimer said that, with the state's rapidly growing age 65 and older population, demand for personal care services will grow.

"This is an issue now, and it's not an issue that's going to go away," he said.

Committee Chairman Larry Williams, D-Preston, said he will request a legislative interim committee study to determine whether certificate of need requirements are limiting numbers of personal care providers.

Reach Phil Kabler at philk@wvgazette.com or 304-348-1220.


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