OP-ED: Everyone deserves a safe and affordable home

Dr. Scott Snyder
Alliance for Low-Income Personal Care Home Advancement
LOGO medical

Phillip lives at a personal care home in central Pennsylvania. The staff is his family. They remember his birthday, help him with his medications and make sure he gets to doctor’s appointments. No one else visits him, and he has no place else to go.

Yet, the heating system at Phillip’s personal care home is on its last leg — and they don’t have the funds to replace it. 

Pennsylvania’s network of personal care homes has long provided housing and services for adults like Phillip who need help with their daily activities — but don’t require nursing home-level care. These services are critical: Pennsylvania’s senior population is growing at a rate 20 times faster than the overall population.

The state currently provides a $37 daily Supplemental Security Income (SSI) payment to support low-income individuals in need of that care. But that payment hasn’t increased since 2006, and if we don’t take action now, homes such as Phillip’s will close and more than 5,000 individuals like him will be left with much more expensive care options — or no care options at all.

I’m part of a dedicated group of volunteers across Pennsylvania working to change that.

There are 1.5 million homeless individuals in the United States and many more with unstable housing. This is clearly a human crisis — and a financial one. People with unstable housing are more likely to have chronic health conditions and less access to regular medical care. When they enter our local hospitals, their lack of housing means they frequently stay weeks (and sometimes months) after their discharge date — because they have nowhere else to go.

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These are called “avoidable bed” days, because these patients do not need hospital care, yet they remain in a hospital bed for long periods of time. One Pennsylvania hospital saw more than 4,000 avoidable bed days — at a cost of more than $9 million. Those costs reverberate throughout our health care system, and also mean fewer beds for patients with urgent needs.

Our volunteer-led organization, the Alliance for Low-Income Personal Care Home Advancement (ALPHA), was formed to address this issue. We’re a public-private partnership to support Personal Care Homes that serve low-income older adults and persons with disabilities. Our first step was to identify the causes of this problem and work with community partners to develop innovative solutions.

We helped personal care homes develop business plans, quality improvement and best practice programs; strengthened social work and prescription drug support; and provided training to help patients with behavioral health challenges. The ALPHA initiative and two partner projects were recently awarded the “Living the Vision” award from the Hospital and Healthsystem Association of Pennsylvania — its highest award — for improving patient experience, improving the health of populations and reducing costs.

Even with all these improvements, however, it’s a harsh truth that the state’s $37 SSI supplement to support this care is barely enough to board your dog for the day, provided you bring the food and medicine. It’s certainly not enough to help low-income adults with complex health needs.

More than 300 personal care homes have closed since 2008. Without an increase in the state supplement, these homes will cease to exist altogether.

Our ALPHA volunteers are working across Pennsylvania to ask our state officials to increase the state supplement to $76 a day over several years. Even with this increase, personal care homes will remain much less expensive than other long-term care options — and dramatically less expensive than keeping patients in the hospital unnecessarily.

There are individuals like Phillip in every community in Pennsylvania. By 2025, one in five Pennsylvanians will be aged 65 and older. They will be our family members. They will be us. The financial cost to provide the necessary care will be astronomical and will impact all of us.

Saving personal care homes allows us to maintain a critical, and less expensive, link to our long-term care system. Please reach out to your state elected officials and ask them to support this effort. 

Ask them to support a phased increase in Pennsylvania’s SSI supplement to $76 a day. Because taking care of our most vulnerable seniors is both a moral and financial imperative.

— Dr. Scott Snyder is advocacy Chair for the Alliance for Low-Income Personal Care Home Advancement.