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Investing in personal care assistants is critical to health care in Minnesota

Because the health care coverage our clients receive is through Minnesota’s Medicaid program, the rate which the state will pay for services is capped by the Legislature, and these rates are barely enough to cover the cost of care.

REUTERS/Jim Young
PCAs are essential not only to Minnesotans with disabilities and older adults, but also to Minnesota’s health care system.
Richard is a 60-year-old man living in Apple Valley. He is a single father of an 18-year-old son, a soccer coach, college graduate and a gainfully employed technology engineer. Richard’s successes in his profession, in his community and as a father would not be possible without Wendy, his personal care assistant (PCA).

When he was 17 years old, Richard was attending his high school graduation party and dove into shallow water. He struck the bottom of the lake hard, leading to a c5 spinal cord injury, which resulted in a diagnosis of quadriplegia. Richard now uses a power wheelchair for mobility and receives eight hours per day of PCA services, empowering him to be fully capable of managing the affairs of his life.

While some of Richard’s employees have come and gone over time, Wendy has supported him for 20 years. She assists Richard with getting out of bed, helps him conduct range of motion exercises, dresses him and positions him in his wheelchair. Without Wendy’s consistent and competent service, Richard would likely be forced into an out-of-home institutional setting, where he would lose his self-directed life. Richard’s relationship with his son would be disrupted; his participation in community activities would be discontinued; and he might lose his job, making him completely dependent on public supports. Wendy and her fellow PCAs enable Richard to enjoy a genuinely inclusive life in his community.

PCAs are essential health care workers

PCAs are essential not only to Minnesotans with disabilities and older adults, but also to Minnesota’s health care system. As the COVID-19 pandemic has stressed our hospital systems, PCAs — who are among the lowest-paid employees in our state — are helping keep the highest-risk populations out of Minnesota’s ICUs and long-term care facilities. 

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PCAs make much lower wages than almost all essential health care workers. Minnesota’s PCA program is administered by the Department of Human Services (DHS) and is available to individuals of all ages who meet the federal definition of disability. The minimum wage currently agreed upon by DHS and the home care union, SEIU, is $13.25 an hour for many PCAs. For PCAs not covered by the SEIU contract, the average minimum wage is estimated to be $12 per hour.

The state must help

To acknowledge the critical work performed daily by PCAs, Accra, the largest nonprofit provider of home care services in Minnesota, voluntarily increased our PCA wages by 20 cents per hour. Still, it is not nearly enough. The state must do more to support these critical workers.

John Dahm
John Dahm
Because the health care coverage our clients receive is through the state of Minnesota’s Medicaid program, the rate which the state will pay for services is capped by the state Legislature, and these rates are barely enough to cover the cost of care. By virtue of its size and the efficiency of its business model, Accra is able to offer the very modest pay raise of 20 cents an hour to its employees, but any meaningful increase must come from the Legislature. 

While there is currently a proposal before the Minnesota Legislature to increase the reimbursement rate for PCAs, its prospects are uncertain, given the state’s current budget deficit. And yet to not make this investment, to fail in support of these vital workers, is to risk jeopardizing a system that saves the state tens of millions of dollars every year by keeping our most vulnerable friends and family healthy and in their homes. 

If our clients are unable to get the help they need to live in their own homes, they will be forced to live in long-term care facilities – which are the highest cost option for the state, and currently the facilities hardest hit by the virus. COVID-19 has killed more than 1,100 Minnesotans at nursing homes and assisted-living facilities, accounting for almost 80% of the statewide deaths attributed to the pandemic. Treating people in their own homes whenever possible is critical to protecting their dignity, their safety and our centers of care during the pandemic.

Minnesota needs to keep our health care system working for everyone. We can’t afford to jeopardize the care of at-risk Minnesotans. Wendy and Richard are counting on us to do the right thing.

John Dahm is president and CEO of Accra.

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