Who Absorbs the Hours?

When a state policy assumes care "could go uncompensated," it is describing a person. When paid hours fall, care doesn't stop-it is absorbed silently by working family caregivers at the expense of their jobs, income, sleep, and household stability.

By Mark Fukae - Director of Advocacy - Professionals Who Care

On Friday my phone rang at work.

It was my mother's caregiver. My mother had just had staples removed after a fall and wanted to hear from me, so I stepped away from my desk for two minutes. Many of the professionals in our community know that call.

This week Colorado's health department presented five proposals to limit paid personal care and homemaker services in Medicaid. Three fall directly on families: a limit of about 7 paid homemaker hours a week from family caregivers, moving about 5,500 children's personal care out of the Community First Choice program, and a limit of 7 paid personal care hours a week for parents and guardians of children.

These are proposals, not decisions.

The Department deserves credit for naming its own risks. At its roundtable it said one proposal "could create a bigger reliance on uncompensated care, unpaid care." Its written summaries say that "families may provide some care without payment," and, for the two proposals aimed at family caregivers, that "HCPF does not have paid family caregiver data."

For working caregivers, that last line matters. Many people who are paid to care for a family member gave up another job to do it. When those paid hours fall, the care usually doesn't stop. What falls is the family's capacity to keep it going: the income, the sleep, the job they might have returned to. And at work, most caregivers don't talk about it. That silence keeps them out of the data at work, just as they're missing from the data at the state.

I've asked the Department to track what happens to members whose hours or caregivers change, to publish the full math for every proposal, and to keep an exception when no appropriate alternative caregiver exists.

If you work and care for someone in Colorado, the Department's feedback survey closes Sunday, October 11: https://docs.google.com/forms/d/e/1FAIpQLSeDNIIo0MKVZQDkbMHacoCeI3hGmm0gomt2Ne2z4L6-6yNEvA/viewform.

The Caring Costs Survey at casiadvocacy.org/research is where your experience at work gets recorded.

Read and Listen to the full essay and Podcast: [https://therevenueneutralcaregiver.substack.com/p/the-research-desk-3?r=6a52ih]