When it comes to Connecticut’s health care system, there’s one truth our state leaders can’t afford to ignore: Care at come is among the most cost effective, compassionate, and sustainable services within our broader public health landscape.

Helping Connecticut residents receive care at home reduces hospital admissions, prevents costly complications, and ensures continuity of care over time. By reaching people where they live, we help close gaps in access and save the state millions of dollars, especially for our most vulnerable populations.

“Care at home” refers to the full spectrum of home-based services in Connecticut, including skilled medical home health, non-medical homemaker-companion care, and end-of-life hospice care.  Together, these services allow individuals to recover, remain independent, and age with dignity in their own homes, surrounded by family and familiar comforts.

However, despite these benefits and despite the thousands of state residents currently relying on care at home, our state now finds itself at a crossroads of inaction. The reason is simple: while there is strong support to invest in care at home, some leaders in Hartford are hesitant to act due to the current uncertainty at the federal level regarding health care funding. While these lawmakers may be well-intentioned (hoping to understand the federal impact on our state system before making decisions), waiting to act would push Connecticut further into to a crisis.

Here’s the reality: Medicaid-supported personal care at home costs the state far less than institutional care. Caring for an individual at home costs roughly $3,300 per month ($55/day). Compare that to nearly $10,000 per month in a nursing home facility. That’s a savings of nearly $80,000 a year per person. Home-based care isn’t just more dignified; it’s more fiscally responsible.

Skilled care at home offers even more cost savings to the state.  Two striking examples are:

• Behavioral health nursing visits to ensure those with mental illness or substance- abuse disorder are taking their medications and stable in the community—average cost per day for community care is $100 versus $1,000 per day for a hospital stay.
• Complex care nursing is another critical care-at-home service for children and adults who have medically complex conditions requiring highly skilled, in-home nursing care (feeding tubes and tracheostomy tubes or ventilators to help them breathe, live, and grow safely in their homes with their families). Average cost for care at home is $1,000/day vs average cost for institutional care is $10,000/day.

And yet, Connecticut’s care at home programs and services are hanging by a thread. Many Medicaid care-at-home rates have not been adjusted since 2007. In addition, we are losing workforce because neighboring states—Rhode Island, Massachusetts, New York— are all offering significantly higher rates, drawing caregivers across state lines.

Lack of workforce and inadequate reimbursement rates means fewer options for families, fewer workers to care for the elderly and people with disabilities, and more clients stuck in hospitals or moved to nursing facilities, costing the state and taxpayers more money. It also means devastating consequences for the thousands of workers—predominantly women and people of color —who rely on this profession to support their own families.

Studies show that delivering care at home reduces unnecessary hospitalizations and emergency visits, helping individuals stay healthier while saving the state millions.  Investing in care at home is the smart thing to do – economically, socially, and morally.

In this context, waiting for Washington is not a strategy. It’s a dangerous gamble —and the odds are stacked against the people who need care and the workers who provide it. If state leaders fail to act now, they will be part of the problem for not tackling a solution.

We don’t need to look to Washington for answers—we already have them. The answer is simple. Implement the following rate increases now: 13% for personal care services and a 10% for skilled home health, followed by 10% annual increases over the next three years to catch up with inflation. These are not extravagant requests. They are critical to preserving a care model that works for Connecticut economically, socially, and morally.

Making these changes is not only in the best interest of state residents and workers, it will also help insulate us from potential federal cuts. If federal cuts come to fruition, Connecticut’s ability to care for its most vulnerable residents will depend on the strength of our home care system. These services are the backbone of our health care infrastructure, quietly delivering consistent, high-quality care that keeps people out of hospitals and nursing homes.

By investing now, we create a resilient system that can absorb future shocks and continue delivering essential care when other parts of the safety net are strained.

If state leaders are serious about fiscal responsibility, economic equity, and preserving care that works, the time to act is now. Because when the federal cuts come —and they likely will —Connecticut won’t have the luxury to scramble. If we don’t invest now, we won’t have a workforce left to provide the most cost-effective care we have.

Care at home is not a problem to be solved, it’s the solution. But only if we choose to act now.  Connecticut can’t wait for Washington, and our residents can’t wait for care.

Ann M. Olson, RN, is the Executive Director of Yale New Haven Health-Health at Home. Bree Sanca, RN,is Vice President of Behavioral Health Clinical and Pediatric Operations, Elara Caring.