Once a week for the last couple of years, a home
care worker named Lori has shown up at Steve Viera’s house to do laundry, carry
in food, clean and generally help the disabled veteran live his life.
Viera is a former sheet metal worker who served
in the Navy in the Middle East from 1979 to 1981, so the U.S. Veterans
Administration pays for the visits. It’s just a short few hours, but for Viera,
a divorced New Haven resident, it’s a lifeline.
“If it wasn’t for them I wouldn’t exist,” the
59-year-old Viera said to me Friday.
Lori works for Companions & Homemakers Inc.,
a large, statewide agency that had more than 200 home care clients through the
VA until recently. Starting Oct. 1, Companions lost that work for reasons that
make little sense.
Lori is still coming to help Viera every week,
but under murky circumstances, as Companions — probably not being paid for the
visits — tries to sort out what’s happening.
The VA home care system changed under the sweeping
MISSION Act in 2018. Home care for veterans such as Viera, which was arranged
by local VA offices, is now organized by giant third-party administrators. In
the Northeast, that’s Optum, a health services business owned by
UnitedHealthcare.
And as we might expect when centralized
bureaucracies grow because of grand, flawed visions of efficiency, this reform
includes useless rules. To participate in the VA program, home care companies
must now certify that they’re medical providers.
Trouble is, they’re not medical providers under
a strict federal definition. Claiming they are could put their separate
Medicaid business — a huge amount of their revenues — in jeopardy.
“We will not lie under oath,” said Linda
Grigerek, the Companions & Homemakers president.
Her company has lost two-thirds of its VA
clients, about $1.2 million a year of work, as a result of the rule she can’t
meet, even as the VA and Optum apparently struggle to find caregivers.
Although the VA did not confirm that it’s having
problems filling the needed shifts, Companions & Homemakers is still
working with more than 60 of the former clients because, Grigerek and other
executives said, the VA has not found others to do the work under the new
rules.
We all understand, of course, that business
conditions and contract requirements change and that causes disruption with
winners and losers. If this profitable company loses a few clients and other
firms pick them up, that’s all part of the landscape, not my concern or the
nation’s.
But this change is nettlesome because it
represents a boneheaded government screw-up for no clear benefit. The home
assistance companies — about 600 registered in Connecticut, many of them
mom-and-pop firms — are not providing medical care such as blood pressure
screenings and administering drugs.
That’s a different level of care, not covered by
the low-cost contracts for caregivers who spend hours at a time with clients.
The VA pays $16.48 an hour to home care providers in Connecticut for most
contracts, meaning the workers typically make barely more than the minimum
wage.
So all we have is a needless ruse creating chaos
for vulnerable clients.
“There are other businesses that have signed a
contract,” Grigerek said. “I don’t know if they know they’re lying under oath.”
Two of those smaller firms, which are on board
in the new system, did not return calls Friday.
Late Friday, U.S. Rep. John B. Larson, D-1st
District, sent a letter to Robert Wilkie, secretary of the Department of
Veterans Affairs, offering help in straightening out the issue. “The local VA
has assured us that there will be no disruption of care,” Larson said in the
letter he sent after Companions & Homemakers reached out to him. “However,
this change has undoubtedly caused a disruption in the lives of the veterans
impacted by it.”
Two spokeswomen for the VA were unable to
provide an explanation of the situation late Thursday or Friday. A call and an
email to Optum were not returned.
But as Larson said, it’s unclear how many
caregivers have been replaced by new firms. Viera said the head of a home care
agency has called him about 20 times, hoping to recruit Lori away from
Companions & Homemakers. “He wants to talk to her and try to convince her
to come to him. I can’t give him her number,” Viera said.
Among other issues, he said, Lori — whose last
name I’m not using because I didn’t reach her — would lose seniority she has at
Companions, and would make less money with the new agency, he said she told
him.
“She wants to work, she wants to help me. She’s
like emotionally involved with her clients. She calls up to check on me to see
if I’m okay,” Viera said, noting that’s not true of all caregivers. As for
jumping to a new firm, “She’s not gonna unless they come up with money and pay
her, which is the American way.”
That raises a related issue of controversy. With
the state budget adopted in June and signed by Gov. Ned Lamont, home care agencies
such as Companions & Homemakers lost the right to enforce so-called
non-solicitation agreements with their caregivers. That means as of this year,
the agencies can’t stop employees from poaching the very clients they’re
serving, as they’re serving them, to take the work away.
Most of us would agree it’s unseemly for
employers to impose non-compete agreements on low-wage workers, preventing them
from working for competitors. Advocates including Sen. Chris Murphy have fought
for states and the federal government to outlaw noncompete clauses, and the
state of California has set an outright ban.
That’s good policy. But Connecticut barring the
non-solicitation agreements — with no debate in a hidden paragraph in the state
budget — was bad policy, a measure too far.
Groups such as New Haven Legal Assistance, which
have fought for an end to non-compete agreements for low- and moderate-wage
workers, have not sought an end to non-solicitation agreements — although James
Bhandary-Alexander, a staff attorney there, said the solicitation issue may not
pose a significant threat.
Grigerek at Companions & Homemakers says it
does threaten the company — and insists the VA issue is a perfect illustration,
as competing firms try to hire her caregivers for the very clients she had.
“There’s just nothing to protect the work that we do,” she said, matching
caregivers with clients and providing back-up support.
All of this represents gray areas of law and
government practice, and Grigerek said she’d prefer to work with the state to
clear up the non-solicitation ban.
As for the VA transition, it will work out fine
for disabled veteran clients in the end, as these things do. But the medical
designation for non-medical work is frustrating for affected families and firms
because, at the rates they’re paying, the VA is not getting medical care,
period, no matter what the documents show.
Linda Stewart, a Bristol resident and part-time
caregiver for Companions, lost a client in the changeover and isn’t leaning
toward signing up with the new firm, for just over $11 an hour and travel
expenses not covered.
“I enjoyed working for him,” Stewart said,
adding, “He has issues with trusting people because he has PTSD.”
dhaar@hearstmediact.com
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