County looks to recruit new aides for care of seniors

HUDSON–The Columbia County Board of Supervisors Health and Human Services Committee has agreed to pursue a program to alleviate the shortage of personal care aides (PCAs) for county senior citizens.

PCAs provide assistance with housekeeping, cleaning, meal preparation, grocery shopping, laundry, and–if necessary–bathing, dressing, grooming, toileting, walking and feeding. For medical procedures such as taking blood pressure, a home health aide (HHA) or nurse is required. County residents qualifying for HHAs “get help from other services, such as Visiting Nurses,” said Michelle Kraham, assistant administrator of the County Office for the Aging, by telephone September 26, the day after the most recent committee meeting at which the decision was made. The county helps people get the PCA service through the county Department of Social Services and the Office for the Aging.

The County arranges for PCAs through agencies it contracts with, but it has more people who need PCAs than these agencies have available. As a consequence some eligible people have been waiting for a PCA for over a year. So the committee agreed to try a program whereby the county would subcontract directly with PCAs, with nurses from the county Department of Health training and supervising the aides. These PCAs would be paid by the county as contractors not employees; they would not be on the county’s staff.

Also, the would serve only those people who have no PCA now, Ms. Kraham explained. Those already receiving agency PCAs will continue to do so, and the county will continue to contract with the agencies.

The county plans to test the proposed program for six months by subcontracting up to five PCAs, each for up to 20 hours a week.

PCA shortages affect the entire state, Office for the Aging Administrator Kevin McDonald said at the September 25 Health and Human Services Committee meeting. In Columbia County, the his office has a list of seniors waiting for an aide that has numbered 15 to 20 “throughout the past year.” A similar list compiled by the Department of Social Services—according to DSS Commissioner Bob Gibson–currently has four people waiting for a PCA.

Both Jack Mabb, the county director of public health, and Hudson Fourth Ward Supervisor William Hughes (D) gave examples of people waiting months for PCAs in New Lebanon and Hudson-Greenport. Mr. Hughes mentioned an elderly woman who can function fairly well by herself but this winter was “homebound” with “nobody to look at her.”

Mr. Gibson said that there had been “a drop off in requests” for PCAs, which he believes is the result people have “given up.”

The agencies with which the county contracts currently pay the aides between $9 and $14 an hour, with no reimbursement for travel expenses, according to Mr. McDonald and Mr. Gibson. In the trial program, the county would pay the subcontracted PCAs $16 an hour plus travel.

“Sixteen dollars an hour won’t do it,” said Supervisor Richard Keaveney (R-Canaan). “You’re competing with assisted living places, nursing homes, and private arrangements. Some people from here work as aides in Massachusetts for $20 to $25 an hour in cash. They want it in cash. Even if they also work as nurses on the books elsewhere.”

Mr. Gibson said that the five directly subcontracted PCAs might be just a start. A successful program could need more. If more requests for PCAs were fulfilled more quickly, the number of requests could increase, and thus the need would increase, county officials say.

Mr. Hughes said, “We have one of the best nursing programs” in the area and he suggested tapping it.

Supervisor Maria Lull (R-Chatham) spoke of The Village Movement, which “helps seniors stay living in their home.”

Mr. Hughes also raised concern that some aide “screening mustn’t be very good.” Some aides “go through the medicine cabinet,” he cautioned and said that at night, if the patients are medicated to sleep, some aides “do other things.”

Supervisor Patrick Grattan (R-Kinderhook), who had already been discussing the PCA shortage with county agencies, said, “The goal is for each community to have a group of people who can take care of people who need them.”

Now that the Committee has approved the plan, Ms. Kraham said September 26, the pertinent departments can start planning details, such as recruitment.

The next meeting of the Health and Human Services Committee will be Tuesday, October 17, at 4 p.m. at 401 State Street.

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