State Policy Network
2019 SPN Network Award recognizes think tanks for standing up on behalf of home healthcare providers

Over the past 26 years of State Policy Network’s history, we have seen one thing proven time and again: State think tanks can go farther faster when they work together. Starting in 2017, a Network coalition decided it was time to stand up for home healthcare providers in 11 states to end the practice of states taking money from their support checks and giving it to third parties, such as unions.

In these 11 states — previously in more — in-home caregivers who take care of sick family members, children, or friends had been declared “public employees” simply because they receive state support to take care of the needy. This classification has allowed states and unions to engage in the dues skimming scheme whereby states take union dues out of the caregivers’ support checks before the assistance ever reaches the patient, child, or their caregiver. This scheme costs Medicaid patients and their caregivers in an estimated $150 million each year from their Medicaid Home and Community-Based Services waiver funds.

For the Network, 11 states was too many. A Network coalition formed to find a solution so that no parent, relative, or friend would be coerced into paying a union just to care for a loved one. 

Thanks to this coalition’s multi-year effort, a federal rule passed on May 2, 2019, ending the scheme and enabling home caregivers to keep more money in their pockets and provide better care to their patients. Caregivers will still be allowed to join and pay a union if they decide that is the right choice for themselves and their family, but the new rule prevents states from doing this on their behalf.

At SPN’s 27th Annual Meeting, SPN recognized the leadership and success of this Network coalition by presenting the 2019 Network Award to five think tanks who led the charge to connect policymakers to the stories of these home caregivers and end the unfair practice of dues skimming:

“SPN’s Network Award celebrates think tanks joining forces to achieve lasting policy change. The 2019 Network Award, in particular, recognizes the leadership of a Network coalition that gave a voice and a choice to hundreds of thousands of home healthcare providers across our nation,” said Kathleen O’Hearn, SPN’s Senior Director of Policy Advancement. “This multi-year effort of the Center of American Experiment, Freedom Foundation, Illinois Policy Institute, Mackinac Center for Public Policy, and National Right to Work Legal Foundation is proof that we can do big things and change lives together.”

Because victories beget more opportunity, these think tanks and the rest of the Network will continue the critical work of educating policymakers and caregivers about the impact of the rule during the months ahead.

In the meantime, congratulations to these state-based leaders and the generous supporters who made this multi-year effort a success. Through the power of SPN and the states coming together, positive policy change rose from the states to the federal level, giving hope and support to these home caregivers who need it most.