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NBC 10 I-Team: Home care pay gap hurting vulnerable families

Rhode Island’s Medicaid reimbursement rate for Registered Nurses and Licensed Practical Nurses working in home care is about 40-percent less than neighboring Massachusetts, and at least $5 per hour less than the statewide average wage, according to industry figures. (WJAR)

Mitzi Page of East Providence is one of the toughest mothers you’ll ever meet.

She’s been caring for her son Kyle, who is profoundly disabled and needs a ventilator to survive, since he was 3.

Kyle will turn 25 next week.

"He has to be watched 24 hours a day,” Page said. “If that [ventilator] goes off, within three minutes, if it's not addressed, he would most likely die."

Many activities, like bathing Kyle or loading him into the family’s van, require two people. That’s where skilled nurses like Walter Ortiz come in.

"I've had other nurse friends say well it's just one patient,” Ortiz said of his work in home care. “But it's non-stop with one patient. Ventilators, alarms going off."

Ortiz has cared for Kyle for more than 10 years, but has not had any raises during that time, he said. The reason? Rhode Island’s Medicaid reimbursement rate for Registered Nurses and Licensed Practical Nurses working in home care is about 40-percent less than neighboring Massachusetts, and at least $5 per hour less than the statewide average wage, according to industry figures.

The pay gap means many of Kyle’s nursing shifts go unfilled, his mother told the NBC 10 I-Team. She recently went 10 days without any nursing help during the day because of the statewide shortage.

“They cannot recruit anybody,” she said of Kyle’s nursing agency. “The state doesn't pay wages enough for home care nursing. So, they can't even get them."

Vincent Ward, who owns and operates Woonsocket-based Home Care Service of Rhode Island and also has a disabled child himself, said the problem has reached crisis levels.

"They're going where the money is,” Ward said of nurses. “The money is in Massachusetts."

While an RN or LPN working in home care in Rhode Island can expect to make about $22 per hour, the same nurse can make up to $40 per hour in Massachusetts, Ward said.

"The way the state saves money, which is really upsetting to me, is because they don't have the nurses to cover all the staffing, the families are going without,” he said.

Home care nurses and families who depend on them are urging Gov. Gina Raimondo and the legislature to close the pay gay. A bill introduced by a bipartisan group of lawmakers would bring Rhode Island into line with reimbursement rates in neighboring Massachusetts and Connecticut. That’s estimated to cost about $2 million next year.

"We hear all the time when we speak of legislative leadership and the governor, show us the money,” said Nicholas Oliver of the Rhode Island Partnership for Home Care.

Keeping more patients at home when possible, rather than in institutions like hospitals or nursing homes, would actually save the state money, Oliver said.

"Why not keep them at home, save taxpayers money, improve patients' quality of life?" he asked.

Page said it’s long past time for the state to find a solution for her son and other patients who need in home nursing care to survive.

"It has to be addressed,” she said. “They have to cut unnecessary things they're giving away in this state. This is not one of them. This is his life. He deserves it."

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