Quote from Not_A_Hat_Person
Medicaid should pay for more home health aides and nurses. It's often cheaper to care for an older person in their own home than in a facility.
Agree but there lies the rub.
COL in NYC and much of NYS can be quite dear and the state already has one of if not the highest Medicaid spending in the country. Finding quality CNAs to do homecare is difficult and many of the best work for private agencies or families that pay more. You've got some Medicaid and Medicare pts who have 24/7 care (two shifts of CNAs), which is expensive. HHAs around here in general aren't thrilled with working one single 24 or several day shifts because they aren't paid overtime, just for (IIRC) eight or twelve hours of the 24 on the assumption the pt will be asleep half the "day".
Personally think in some cases smaller group settings may work out to be cheaper and provide better care. This would allow pooling of resources such as nursing and support personnel. It would also provide greater chances for social interaction. Have heard from many, that all the HHAs assigned to care for their loved one wants to do is remain indoors and watch television.