Petition for Home Care Business Owners: 
Protecting Small Businesses, Caregiver Jobs, and Quality Care.

 

 
To: State Legislators and the Indiana Family and Social Services Administration (FSSA)

Indiana's home care system is at risk. The proposed changes to reimbursement policies could undermine the foundation of personalized care that thousands of Hoosiers rely on every day. We, the undersigned, urge you to adopt a balanced approach that supports caregivers, sustains small businesses, and ensures uninterrupted, high-quality care for our most vulnerable communities.

While the proposed 60% pass-through rate for Structured Family Caregiving (SFC) may suit its stipend-based structure, applying a similar 70% pass-through model to hourly Attendant Care services presents significant challenges for providers, caregivers, and the families they serve.

 

The Problem

A mandated 70% pass-through rate for hourly Attendant Care wages risks destabilizing the very system it aims to support. While well-intentioned, this policy fails to account for the operational realities of small home care providers and creates unintended consequences, including:

• State-Level Costs: Increased regulatory oversight and compliance monitoring will impose additional costs on state systems without delivering proportional benefits to care recipients or providers.

 

• Small Business Closures: Insufficient margins to cover operational costs, including training, compliance, and insurance, could force small agencies to shut their doors. This would disproportionately impact rural and underserved areas, leaving families without access to critical services.

 

• Wage Inequities: Without careful planning, this policy risks creating pay disparities where less-qualified roles receive similar or higher compensation than certified professionals. This discourages professional development, threatens quality of care, and undermines the incentive to pursue advanced certifications.

 

• Increased Administrative Costs: Requiring providers to segregate expenses by service type adds unnecessary complexity. Many small agencies may need to purchase costly software or hire additional staff to comply, rendering operations unsustainable.

 

• Caregiver Shortages and Overtime Limitations: Federal labor rules prevent differentiating pay for hours worked, which could force providers to limit caregiver hours or reduce overtime availability. This would reduce caregiver income, create scheduling challenges, and make it harder to fill shifts on weekends and holidays.

 
Our Solution

We call on FSSA and state legislators to reconsider these policies and collaborate with stakeholders to develop sustainable alternatives:

1. Delay Implementation
Postpone the rollout of the proposed policy to allow for input from providers, caregivers, and families. This collaboration will ensure that the policy reflects the needs of all parties and avoids disruptions.

 

2. Forming a Stakeholder Advisory Panel
Create a panel of providers, caregivers, and families to review and provide feedback on the policy. Regular meetings will address challenges and ensure the policy reflects diverse needs while minimizing disruptions.
 
Why This Matters

Behind every home care agency is a family depending on their services. Behind every caregiver is a commitment to compassion, dedication, and the well-being of those they serve.

The proposed changes threaten the stability of Indiana’s home care system by jeopardizing caregiver livelihoods, forcing small business closures, and disrupting care for the most vulnerable in our communities.

This issue goes beyond wages—it’s about safeguarding access to quality care, protecting caregivers, and preserving the small businesses that are the backbone of home care in Indiana.

Indiana has an opportunity to do better. With thoughtful, sustainable policies, we can create a system that prioritizes caregivers and families while maintaining the viability of the essential services they rely on.

Sign this petition to demand a smarter, fairer approach to home care reimbursement. Together, we can ensure that Indiana’s most vulnerable continue to receive the compassionate, reliable care they deserve.