Delaware Association for Home and Community Care’s proposal calls for a 25.5% increase in private-duty nursing rates and a 10% increase in personal care service rates. Association Executive Director Sue Getman estimated the respective costs at $7.3 million and $19.3 million.
Providers and families say higher payments would help retain nurses and aides who support people receiving care at home
DOVER, Del. — Delaware home-care providers are asking the state to increase reimbursement rates in the next budget, saying higher payments would help keep nurses and aides with the families who depend on them.
The Delaware Association for Home and Community Care estimates the requested increases would cost the state $26.6 million, according to WMDT’s report on testimony at the Nov. 10 public budget hearing at the Delaware Public Archives in Dover.
The proposal calls for a 25.5% increase in private-duty nursing rates and a 10% increase in personal care service rates. Association Executive Director Sue Getman estimated the respective costs at $7.3 million and $19.3 million, WMDT reported.
Those amounts are the association’s estimates, rather than figures confirmed by the state. www.wmdt.com
The appeal comes as the Department of Health and Social Services develops its fiscal 2028 spending request. For providers, the issue is retaining workers. For families, it is maintaining dependable care that allows loved ones to remain at home.
Families describe the stakes
Providers, nurses, parents and disability advocates testified about the importance of consistent care and the disruption families face when a nurse leaves, according to WMDT.
Heather Holveck, the grandmother and legal guardian of a child with disabilities, described the uncertainty that comes with possible staff turnover.
“Knowing that there is a potential that even our current nurses could leave is terrifying for him because then we’re starting over,” Holveck told WMDT. www.wmdt.com
The testimony highlighted how reimbursement decisions can affect daily life for people who rely on in-home support. Retaining familiar caregivers can help families preserve established routines and relationships.
Different services, different rate histories
The providers’ appeal also raises questions about how Delaware has adjusted payments for different types of home care.
State records, however, describe more recent increases for some services.
In February 2024 testimony to the Joint Finance Committee, the Division of Medicaid and Medical Assistance said it would implement personal care service increases retroactive to July 1, 2023. dhss.delaware.gov
That testimony does not establish whether the increases applied to every service or provider covered by the current request. The scope of the 18-year statement remains unconfirmed, and it cannot be applied broadly to all home-care payments based on the available records.
The association is seeking separate increases for private-duty nursing and personal care services, making the distinction between those payment categories important to evaluating the request.
State proposes additional funding
DHSS’ Nov. 10 budget presentation includes approximately $2.6 million for a first-phase home and community-based services rate increase among its discretionary requests for fiscal 2028.
The presentation does not explain how that proposal relates to the association’s request or which portions of the providers’ proposal it might address.
DHSS also identified improving services for people with complex needs and lowering health care costs among its priorities. budget.delaware.gov
The providers’ request will compete with other spending proposals as the governor and lawmakers develop the budget.
What happens next
The November public hearings help shape the governor’s recommended budget, which is released in January.
Joint Finance Committee hearings follow, with legislative budget work continuing through the spring and final budget bills considered in June. www.budget.delaware.gov
For families who testified, the request puts a personal question before budget writers: whether the payments supporting care at home are sufficient to keep the workers they rely on.
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