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LaMondre Pough is helped by nurse Janet Tinch before a podcast rehearsal on March 1, 2023. John A. Carlos II/Special to The Post and Courier
LaMondre Pough is helped by nurse Janet Tinch before a podcast rehearsal on March 1, 2023. John A. Carlos II/Special to The Post and Courier
Every morning at 7 a.m., LaMondre Pough, a 49-year-old Columbia native, welcomes his first attendant care nurse into his home in Irmo.
By 10:30, after the nurse has helped him eat breakfast, bathe and put on clothes, he's ready for work, parking his power-wheelchair at his computer desk where he will stay until the late evening.
Pough works long hours as the CEO and founder of Billion Strong, a global nonprofit dedicated to helping people with disabilities. He is also a public speaker, advocate and, most recently, a podcast host and interviewer.
Throughout the day, Pough receives visits from two more home health nurses, totaling 11 hours of at-home nursing care per day.
Pough lives with spinal muscular atrophy, a genetic disorder characterized by weakness and deterioration in muscles used for movement. Over time, the disease begins to weaken more and more muscles.
"I'm a full-time wheelchair user," Pough told The Post and Courier. "I can't bathe or feed myself."
"Every facet of my life, except mental capability, is affected by my disorder," Pough added.
Pough's motor capabilities are slim, only being able to control his right hand and hold his head up.
"And my life is dope," Pough said. "I just need accommodations."
Since the COVID-19 pandemic, thousands of adults and children in the state with disabilities who depend on in-home nursing and personal care services have felt the brunt of a growing nursing shortage.
Many of them left the profession during the pandemic due to low wages and lack of standard benefits like health insurance and retirement.
The shortage has created a revolving door of nurses and personal care assistants for people in the state who've been approved for in-home assistance through Medicaid, and who rely on this type of care to maintain their daily lives.
"Oh my God, it's been too many to count," Pough said, referring to the number of attendants he's had since the pandemic started.
One concern is that South Carolina’s low Medicaid reimbursement rates for home care services have produced a severe wage disparity between in-home nurses and nurses working in health care facilities, creating staffing issues for providers trying to recruit and retain enough nurses and caregivers.
Many of the people receiving in-home care were approved for multiple hours of nursing services per week. And with qualified nurses leaving the field for higher-paying jobs at businesses such as Amazon and fast food companies, patients are left with unfilled care coverage and risk the ability to remain cared for at home.
The average hourly rate for a home care nurse in South Carolina ranges from $11 to $13.
Recently, Pough along with home care employees and family caregivers met with state lawmakers about the impacts of home care programs and the challenges created by the severe wage disparity.
Melissa Allman, director of government affairs for BAYADA Home Health Care, a home nurse provider, said the state's low Medicaid reimbursement rates for home health nurses not only affects the patients but their family members as well.
Allman said for many caretakers who are parents and have children that require multiple hours of nursing services per day are unable to work full-time jobs due to the shortage.
This is the case for Kristy Crowley in Ruby, S.C. Crowley worked as a teacher's assistant for children with special needs before adopting her two children, Jaden and Savannah, during the pandemic. Both her kids require extensive at-home medical care. Jaden lives with Down syndrome and Savannah is a total-care patient, being completely bedridden, nonverbal and has to be fed through a tube. Savannah also experiences frequent seizures.
With a revolving door of nurses and many unable to make the drive to her rural town in Chesterfield County, Crowley was forced to leave her full-time job.
Crowley said her nurses have declined coming to her home because the providers don't reimburse them for miles driven.
"I've even offered to pay the mileage costs for some of the nurses myself," Crowley said.
For the nurses who continue to care for patients at home despite the low wages, both Crowley and Pough said they have a passion for the work.
"That's the difference," Crowley said.
Crowley said her current nurse who helps with both Jaden and Savannah's care frequently declines offers to work at higher-paying facilities.
Pough said nurses like these know that if they don't do the work, there's a good chance there will be no one to do it.
For the ones who come to his home, "they know if they don't get me out of bed, I may not get out of bed at all," Pough said.
To find information on home care services or how to get involved, visit heartsforhomecare.com.
Follow Zharia Jeffries on Twitter @Zharia_Jeffries.
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