OPINION: Caregivers are the genuine pro-lifers in Idaho

It’s said there are three kinds of people: caregivers, those receiving care and those who will need care. Yet, the direct care system, which assists the disabled and those who are 65 years old or older via Medicaid, has a severe worker shortage.

Idaho Gov. Brad Little said, “Idaho is a state that encourages strong families as the bedrock of society.” However, families can’t be strong if they can’t care for their loved ones or risk financial ruin if they do. Life is precious during the entire life span, not only in the womb. Life is much more than a heartbeat. If pro-lifers would get as concerned about the portion of life following birth as they are regarding the time between conception and birth, perhaps we could elevate the sanctity and quality of life for all.

Politicians must focus more on the worth of people and less on party dogma or their corporate campaign donors. Voters must do a better job of electing thinkers over stinkers or our problems will continue to compound.

In Idaho, compensation for direct care workers (certified nursing assistants, home health or personal care aides) is often abysmal and the work is difficult. Their pay is partially determined by a Medicaid reimbursement rate set by the state, which for some direct care jobs has been stagnant for more than a decade. Workers often stay for a while, then move on to higher paying jobs with better benefits. There is a huge shortage of about 3,000 direct care workers in Idaho.

A longtime friend of mine who was born with cerebral palsy recently had his quality of life reduced because of this shortage. He lived happily for many years in his own apartment with partial assistance from home care aides employed by a private agency through a Medicaid program. At times, though, he didn’t know from day to day if an aide would be available. His parents and siblings tried to fill in. But they were unable to continue long-term because of their work and family schedules as well as his parents’ age and health-related issues.

Finally, the agency told him there was no aide available. He now lives in a nursing home, which costs the state more than in-home support, and has lost a great deal of his self-determination.

The Utah Legislature enacted a law allowing family members of an individual receiving Medicaid waiver services to be paid up to 40 hours per week to provide in-home direct care. In Idaho, you cannot be paid directly if you are a family member. You must be employed by a Medicaid-approved provider, which is just one more barrier. An improved Medicaid reimbursement rate for direct care workers, allowing family members to be independent providers and training for family members must become a true legislative priority in Idaho. We also need a caregiver registry allowing employers and clients to see if a caregiver had prior accusations of abuse, neglect or incompetence.

Additionally, drafting more supportive family and medical leave legislation in Idaho will help. There are many gaps in the federal Family and Medical Leave Act, which provides for 12 weeks of unpaid leave for limited situations. The key here is “unpaid leave.” Not many can afford to go 12 weeks without pay and not all employers provide paid sick leave or vacation time.

To get FMLA leave, you must work one year with a company that has 50 or more employees, a government agency or a private/public school — and have worked at least 1,250 hours in 12 months.

Maine, Minnesota, Oklahoma, Illinois, Louisiana, Utah and Nevada have bolstered family leave provisions. Also, some private companies are stepping up by providing flexible hours, work from home opportunities, part-time shifts, elder-care consultants or paid leave. In 2025, Maine employers and employees will split a 1% payroll tax to fund a family and medical leave program, which pays for 12 weeks of care leave each year. A similar payroll premium program will go into effect in 2026 in Minnesota, also allowing people to care for someone not related by blood or marriage. Oklahoma has a caregiver tax credit that began Monday.

Other states provide training for family member caregivers, respite services so caregivers can have a day off and have increased the number of Medicaid waivers for in-home care to chip away at the waiting list.

Our Legislature needs to quit wasting time on culture-war nonsense and get down to solving real problems like the ones in the caregiving system. The Idaho Department of Health and Welfare’s Division of Medicaid is asking for $41.8 million in continuing funds to improve reimbursement rates for care providers in Children’s Services, Adult Developmental Disability and Aged and Disabled programs. Of that, the state general fund would cover $12.5 million while the federal government would fill in the balance with $29.3 million.

For those who constantly complain about federal funds being used in Idaho, consider that your federal tax dollars will come back to support this truly pro-life request.

Gee, of Lewiston, is a retired special education teacher.