July 7, 2020
Home Health Q&A
The Independence Center (The IC) is widely known in the region for its Independent Living services. However, its commitment to people with disabilities doesn’t stop there. Through its Home Health division, it helps senior citizens, as well as other adults and children with disabilities, live full, independent lives in the community by providing in-home health care. But not everyone understands what Home Health is or how it can benefit them or a loved one. So we sat down with Indy Frazee, Home Health Administrator, and Tracy Hiester, Home Health Operations Manager, to learn more.
What is Home Health, in a nutshell?
Indy Frazee (IF): Home Health is long-term care for clients who need assistance in their homes. The IC is both a skilled and unskilled agency.
What’s the difference between the two?
Tracy Hiester (TH): Skilled care is physician-directed and defined as a function that can only be done by someone who is licensed, like a Certified Nurse Aide (CNA) or Registered Nurse (RN). This can include showering, bladder care, bowel care, wound care, and medication reminders. Unskilled care is personal care provided by a Personal Care Attendant (PCA) or a Personal Care Worker (PCW), who is not required to have a license. It is client-directed and can include assistance with an individual’s activities of daily living (ADLs), as well as tasks similar to a CNA.
Can you tell us more about activities of daily living?
TH: Those are the things we all do on a daily basis. So, every day you get up, you get dressed, you bathe, you have to eat, you have to use the restroom. But depending on the situation, you may need some help doing those things, and that’s where caregivers come in.
What are the different types of caregivers and what do they each do?
TH: At The IC, we have CNAs, PCAs, PCWs, and Homemakers. CNAs are caregivers who are licensed by the state and provide care within their scope of practice. A PCA has duties very similar to a CNA, although they have more flexibility in the care they can provide. The duties of a PCW are more of a stand-by assist. For example, the client may be able to get dressed on their own, but they may have a hard time with buttons or zippers. A Homemaker does tasks like laundry, meal prep, general housekeeping, and going to get groceries.
If someone is looking for a caregiver, do they have to use someone already on staff at The IC?
IF: Not always. Certain Medicaid Home and Community-Based Service (HCBS) Waivers allow a service called In-Home Support Services (IHSS), which are services provided by a family or friend\ caregiver and paid for by Medicaid. In fact, out
of 250 caregivers at The IC, almost 200 are family or friend caregivers. We also have a veteran-directed care program in our Home Health department called Veteran in Charge that allows veterans to pay a family or friend as their caregiver.
How do people pay for in-home care?
IF: At The IC, we mainly work with people who have Medicaid and Medicaid Home and Community-Based Services (HCBS) waivers. But we have some clients who have long-term care insurance and we also accept private pay. Vets who are part of Veteran in Charge can have their in-home care paid for by the VA Health System.
Is there a difference in working with a nonprofit like The IC versus a for-profit agency?
IF: Yes. We have a full array of Independent Living services that clients can access, including peer support groups, assistive technology specialists, plus employment services and independent living skills classes. And from a caregiver perspective, we offer benefits that not every agency does.
TH: Our benefits package is very competitive. We offer paid time off, and those who work 30 hours or more a week qualify for health insurance. I also think we give excellent customer service and go above and beyond for both our clients and our caregivers.
What do you like best about your job?
TH: The people! I love the population that we serve. My number one reason for why I do what I do is the impact we make. I love keeping people at home. And I love the caregivers, too.
IF: Like Tracy said, I enjoy being able to actually see the impact on the people we serve. I come from the finance world and you don’t see that impact. It’s the whole reason I moved into the nonprofit sector, to know that my role is contributing to a larger impact.