Milton family highlights urgent need for private-duty nursing funding in Delaware

MILTON, Del. — Delaware families who rely on private-duty nursing say a deepening workforce shortage is leaving medically fragile residents without the care they need, prompting renewed calls for higher state reimbursement rates.

On Tuesday, state Rep. Alonna Berry, newly elected in December, visited the Milton home of Zach Valentino, a 35-year-old living with tuberous sclerosis and epilepsy. Zach depends on round-the-clock skilled nursing to remain safely at home with his mother, Lori Valentino, and longtime LPN caregiver, Robin Laffey.

Berry’s visit was organized by Hearts for Home Care to give lawmakers a direct look at the mounting strain caused by stagnant Medicaid reimbursement rates and ongoing nurse shortages.

“There’s a real lack of nurses,” said Judeth Smith, division director at BAYADA Home Health Care. “We’re not able to compete pay-wise with hospitals and facilities, so it’s hard to recruit and to retain.”

Home-care agencies say low reimbursement rates limit what they can pay their nurses, pushing many into higher-paying hospital jobs and leaving families facing unpredictable schedules, open shifts and stress.

Smith said raising rates would help stabilize the workforce. “An increase in pay would help us recruit and retain our nurses. There would be more filled schedules for clients and their families,” she said.

For families like the Valentinos, the gaps in staffing have real consequences. Lori Valentino said she frequently has to cancel or rearrange critical appointments when shifts go uncovered. “I have personal appointments I already made, and I have to change my entire schedule because we have a nursing shortage — especially doctor appointments, which are kind of critical,” she said.

Berry said the visit underscored the need to strengthen Delaware’s home- and community-based care programs as lawmakers head into budget season. “I was really moved to be able to come here today,” she said. “Being able to come into this family’s home and learn about the care Zach needs shows how important it is that we support programs like this.”

Advocates say increased funding in the upcoming state budget will be critical to keeping residents with complex medical needs in their homes — and out of hospitals and institutions.