We had the opportunity to sit down with the CEO of HCAOA, Jason Lee, to chat about the state of the home care industry. Read on to learn more about his thoughts on the challenges the industry is currently facing as well as legislation the association is focusing on. 
If your agency is not a member of HCAOA, Rosemark is, and we often provide important information across our social channels that HCAOA shares with us. During our conversation, Jason went over some important reasons home care agencies should consider joining the association as well as why involvement in the legislative process is vital for the industry.
Q: What are the biggest challenges you’ve seen in the home care industry and what issues is HCAOA working on at this time that home care agencies should pay attention to?
A: It’s been nearly a year since I took on the role of CEO at HCAOA. Over this period, one of the most significant challenges we’ve encountered is the ongoing struggle with workforce recruitment and retention. We’re hearing at chapter meetings that clients are being turned away because there’s not enough staff, and some agencies are turning to untrained people to fill those gaps. Our goal is to partner with agencies to find ways to build out the workforce and provide training resources to help fill that gap.
Another challenge we’ve been grappling with is the Medicaid Access Rule, which stipulates that 80% of funding must go toward wages and 20% toward overhead costs. While the intention behind this rule is to ensure fair compensation for caregivers and it sounds great on paper, 80/20 is arbitrary across the board, and the effects of implementing the Rule will vary across different states. That’s been a huge challenge, so we’re pushing for that Rule to be done in a more thoughtful way.
Because it’s an election year, we’re seeing a lot of rules roll out at the same time so the administration can create a track record. The Medicaid Access Rule, Overtime Rule, and Non-compete Rules all came out at the same time. It’s a challenge for the industry to have all those rules come out at once.
Q: What makes you most excited to be at HCAOA?
A: My background in the association space has equipped me with the insight and drive to tackle these issues head-on, and I am committed to driving meaningful progress within the home care industry.
What excites me the most is seeing how things work from both the agency side and the caregiver side. Seeing how caregivers become part of the family and hearing stories like those of Eulodia Ortiz who was the 2023 Caregiver of the Year are what made coming to HCAOA really exciting and have made it so rewarding.
I knew coming in that I would love the mission, the people, and the partners. Just being in the overall space, and knowing that, at the end of the day, we’re having such a positive impact on the community is incredibly fulfilling. It’s a fact that we’re going to see an exponential increase in the elderly population over the age of 65. The family-caregiver ratio is going to decrease over time. It’s a 7:1 ratio now, and it’s going to drop to 3:1, so there will be a huge gap in how many people will need care and the number of caregivers that will be available to provide that care. I’m excited to be a part of the solution.
Another thing I’m excited about is changing the dynamic among families so that you’re not just saving for retirement, but you’re also investing in yourself and your family members and preparing because a lot of home care costs are out of pocket. Right now, most people think about retirement in the context of enjoying and maintaining their lives once they stop working and doing things like traveling and spending time with family. Most of those things assume that they will remain in good health. It’s important to prepare financially for those times when caregiving is needed when their health is impacted by age and other factors. I think it’d be great to get to a point where home care is just built into the fabric of living, and there’s not that shock when the moment arrives where it is necessary.
When I was interviewing for this role, my family was actually experiencing home care for my mom and aunt. I was able to see firsthand the benefits of it, but also that we were not prepared to navigate that. So I’m looking forward to helping people navigate that, build home care more into the family’s framework, and channel the passion of our members and the caregivers they hire.
Encouraging families to save for home care is important, but it’s also vital to help them value home care. People don’t bat an eye at spending $100 on having someone clean their house, but they balk at that price when it comes to hiring caregivers to take care of their family members. We need to start changing that mindset and educating families on the importance of hiring skilled caregivers for their family’s needs.
Q: How can agency owners and staff get involved to help HCAOA make more progress with these priorities?
A: Several things come to mind.
- Be a part of Advocacy Day: We’ll have our Advocacy Day on the hill again in April 2025, and we always encourage members to join us for that because advocacy is so important. We also have voter voice action alerts on our website, where people can send letters to their members of Congress in support of certain bills.
That advocacy piece – giving a voice to our members – and understanding how associations work excites me. We have a great board, and working in collaboration with them excites me as well.
In regards to legislation, we’re continuing to educate members of Congress and CMS, as there are parts of the 80/20 Rule that we fully support, such as quality measure sets that would improve the dynamic of home care. We just think provisions like the 80/20 part would undercut that.
We’ve been working on the Elizabeth Dole Home Care Act which allows Veterans Affairs to spend 100% of institutional care on home care now instead of just 65%. That passed overwhelmingly in the House, so now it’s weighing Senate action, but it’s part of a larger piece of legislation – the Elizabeth Dole 21st Century Veterans Health Care and Benefits Improvement Act. The package is promulgated by the House and Senate Republicans and Democrats. We think it’s close to moving forward, and there are continued discussions. We’re hoping it will move quickly and we’re pressing because we’re running out of time due to it being an election year.
We have been working on the immigration piece and working on the EB-3 visas and trying to get home care within schedule A. We’ve been meeting with the Senate HELP Committee and other channels. Despite immigration holistically being a bit of a third rail, we feel like visas on the policy side are something where we could get some bipartisan movement.
There’s an important workforce element in this. A third of the home care workforce is composed of immigrants, so it’s important to leverage opportunities like the visa program to ensure we continue to bolster that workforce.
We’ve had some great work on the state side. If legislators really wanted to help with wages, they should increase Medicaid rates on the state level. One of the key wins we’ve seen through our Georgia chapter is increased Medicaid rates. That was signed into law by the governor this year, and that’s something that other states can emulate. We have an upcoming call with our colleagues in Connecticut to discuss maybe replicating that in some way.
We’re continuing to provide the educational component as well. We have a scheduler webinar coming up. We’re looking at other education pieces to help with the workforce side. We keep an eye on technology, and we have a number of technology-related associate members who provide a number of solutions that we can put forward to our members.
- Attend Chapter Meetings: For states where we have chapters, we encourage our members (and non-members) to attend the chapters’ virtual and in-person meetings whenever possible. These meetings usually cover advocacy and regulatory updates, as well as other issues impacting the industry and topics geared toward enhancing our members’ businesses.
- Get involved as an HCAOA Member: We’re hosting our annual conference in October in Seattle/Bellevue, and we host regular chapter meetings that help bring everyone together to build that sense of community. Having regulators at our chapter meetings has been very helpful, allowing agencies to connect with them and get solutions.
I encourage members to reach out to us with any feedback or suggestions. We also released a membership survey at the beginning of August to gather input on how we can better serve our members.
- Non-Members can help, too: For agencies that are not members of HCAOA, they can still view our newsletters on the website and stay informed about ongoing legislation and changes within the home care space.
Q: The National Home Care Conference is coming up in October in Seattle/Bellevue. We’re very excited to be an exhibitor this year and hope we’ll have time to drop in on some of the sessions. In your opinion, what are some of the “don’t miss” events at the annual conference?
A: I was 3 weeks into my CEO role at last year’s conference, so I’m really looking forward to taking more in this year and enjoying the energy in the room.
There will be a lot of opportunities to meet with vendors in the exhibit hall, chat with your peers about what’s going on in the industry, share ideas, and get re-energized by attending the educational sessions.
Our goal, again, is to create a sense of community and provide invaluable learning moments for our attendees.
I’m excited to be heading to Seattle because my family and I took many trips there in my youth. HCAOA also has a robust Washington state chapter, and we’re looking forward to partnering with them for the conference.
I’m really looking forward to hearing our keynote, John O’Leary, speak. He spoke at our conference years ago, and he has a remarkable story that I can’t wait for others to hear as well. We also will have an amazing technology session about how AI and technology are changing the face of care at home.
We want people to network, learn, and have fun at the conference so they leave feeling inspired and energized and with a notebook full of takeaways they can use to improve their operations, grow their business, or reach whatever goal they’re seeking to attain.
For more information on the home care industry and HCAOA’s involvement in policy or how your agency can get involved, read more about agency membership.