As New York State faces a number of challenges recently that directly impact the state's Consumer Directed Personal Assistance Program (CDPAP), including Governor Hockal's FY 2025 budget and efforts to reduce Medicaid spending, it seems the only constant in the state is change.
Home Healthcare News recently spoke with Evan Ostrowski, CEO of Special Touch Homecare, about the company's 40-year history, service to 150,000 patients, its expansion into New York's Consumer Directed Personal Assistance Program (CDPAP) as a financial intermediary, and how he expects the company to thrive amid these changes.
Below is that conversation, edited for length and clarity.
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HHCN: First, tell us a bit about yourself and your background with Special Touch Home Care.
Ostrovsky: My father founded Special Touch in 1984. I started working there the summer when I was about 15 years old. I started working there full time after I finished grad school in 2004.
My approach was hands-on. I worked in different departments to gain a comprehensive understanding of the company's operations. I focused on recruitment and responding to urgent needs. I then oversaw all HR functions, including hiring and compliance for home and personal care aides.
As CEO, my main goal is to ensure the day-to-day operations of the company run smoothly and efficiently. I am committed to ensuring that all our patients' needs are met and all departments are functioning at their best, and I am constantly looking for ways to enhance and innovate our services. We are constantly exploring new technologies and processes to be at the forefront of home care.
About 10 years ago, we began offering services as a financial intermediary through the CDPAP program, bringing something exciting and new into the company.
We offer services in many languages and customize to suit a variety of cultures. New York City is a diverse city, so it is in our interest to serve these groups and make them feel as comfortable as possible doing business with us.
Besides CDPAP, what other service lines do you have? Do you do Medicare-certified home health or Medicaid-based home and community services?
Most of our services are Medicaid and long term care. We also see a certain number of Medicare patients. Our business includes home care services, home health aides, and personal care aides, which we have been providing since the company was founded. We have also added CDPAP services, where we act as a financial intermediary.
We use nursing services primarily to manage our home care services, but we also charge for visiting caregivers, personal care aides, and consumer-directed programs.
Are there any privately funded elements to this venture?
We do have some patients who pay for their own care, but they are a small percentage of our overall services – probably less than 5% of our patients are self-pay.
What is it like currently running a home care business in New York?
Working in New York is very rewarding. We know we are making a difference in people's lives. We are helping people live in their own homes instead of going to institutions. So we do it because we love it.
Our company has faced challenges in recent years, many of which have to do with pay equity and mandates. We appreciate that these mandates have allowed our caregivers to earn more. Our caregivers have great benefits, including health insurance and time off. When the wage mandates began, it was hard to secure reimbursements to supplement them, but they came.
Regulatory changes improve quality of care, patient safety and other aspects of our operations. We appreciate the Ministry of Health's efforts to improve the quality of care and the services we provide. Having addressed these issues for over 40 years, we are well positioned to navigate new regulatory requirements.
Regarding CDPAP, you are optimistic about the program and your involvement. Can you tell us more about your status with the program as a fiscal intermediary and do you plan to continue acting as a fiscal intermediary in the future?
Our hospital began offering financial intermediation services about 10 years ago. We began researching and providing services to patients who were switching from home care services to the CDPAP program.
We are advocates of this program. It allows people who are unsure about home care services to get the care they need to live a quality life. It also gives them more independence in choosing their caregiver and managing their care. There will be situations where a client's personal assistant can no longer work and they switch from CDPAP to home care services or vice versa. We need to be there for them on both sides. We don't want patients to go elsewhere for other services when we can provide them.
This is the fastest growing area of our business. It's growing so fast in New York that the Department of Health has had a specific accreditation or approval program in place since we started. We are experienced, so we were one of 62 agencies originally approved for the program. Things could change at the last minute, but we love this business, so we hope the changes will allow us to continue operating.
What do you think New York can do to help home care providers and recipients? How can we improve the current state of home care in New York?
The state is committed to providing excellent employee benefits. New York State believes that not only are patients rated highly because they help improve their lives, but that they are also a better economic option than nursing homes and assisted living facilities.
We focus on underserved groups who don't know that services exist or can't find a company that speaks their language. We just got a grant from the state, and we used that money to build our language proficiency. Providing services in a different language requires special investment. You have to translate everything into that language. You need employees who can work with caregivers and patients. Grants like that help us serve underserved groups. That grant also helped us provide bonuses to people who are coming from or coming to areas that are not easy to get to. It may be a one-time thing, but we want things like that to continue.
We also need grants to support the educational programs we provide to our employees to better care for our patients. The state has provided grants to support training to improve caregiver skills, care competencies, cultural competency, and more. I would like to see more grants because this really helps. Caregivers feel more valued, they can develop their skills, and they can better serve patients.
Since you started, you have cared for 150,000 patients. How do you plan to continue growing?
We have always put our patients first and focused on service and the diverse population of New York City – that's what got us to where we are today and we want to continue doing that.
In terms of what we're doing going forward, we have an aging population, and we have different populations, including patient decision makers, seeking care in different places than they used to. We've put a lot of time and effort into our website to educate those populations. We've also created a new site for the CDPAP program, providing information to help them decide if this program is right for them and to help them contact us when they're ready.
For anyone looking for care for themselves, a family member or a friend, we have information on our social media channels, and if you are in the CDPAP program, you can find information there and contact us when you need help.
Internally, recruitment has always been a big focus for us – myself and my brother hire the majority of our office staff – as having the right people and continually delivering great service is crucial.
Additionally, we are looking to expand our geographic reach. While we primarily provide home care services in New York City and Westchester, we believe it is time to provide services throughout New York State. This requires obtaining licenses and adding new services such as therapy and nursing. We are also exploring areas where we can add to our product offerings to grow as a company.
What do you see as the biggest barriers in terms of geographic expansion and organic growth in your current market?
As we expand into different regions, it's always important to us to get the service right. We don't want to offer a service that is not as high quality as what we offer in New York City.
We have had training programs in New York City for many years that have helped us retain caregivers, and when we moved to Staten Island, we began training and certifying caregivers there, which quickly made us one of the largest home care agencies in Staten Island.
Our goal of reaching new language groups and cultures is difficult, especially when we start small. We need to commit resources, and it's always a difficult, but welcome challenge.
Do you feel like your staffing situation has improved? If so, why do you think that is? Is it due to external factors, internal initiatives, or both?
Interestingly, it was relatively easy for us to recruit when we started recruiting in 2004 without much advertising. Word of mouth was pretty much all we ever needed. Advertising was only for difficult service areas and specific language groups.
COVID-19 made things even more difficult. Many people were afraid to visit patients in their homes, which made staffing difficult during that time. But once that was over, we started getting people who wanted to work for us coming to our offices in New York City. So we went back to a situation where all we had to focus on were the service areas and languages that were challenging. Being able to offer training programs is an advantage for us.
Would you say that one of the untapped areas of opportunity that you've pursued is the language part, being willing to go into areas where there may be a language barrier and train caregivers to be able to serve those clients?
We speak English, Russian, Spanish, and Chinese, and we've been translating everything into those languages for a long time. There are still a lot of groups out there that struggle to find providers who speak their language. We see that as a growth area. If you can become an agency that serves those people, that's a great opportunity. We do that with our home care agency and CDPAP.
Are there any particular technologies that you feel you need to unleash in the future, or technologies that you have recently adopted that will soon become a must-have for providers?
I'm a big believer in having to adopt the latest technology. When it comes to reimbursement, there isn't a lot of extra money to spend on overhead, so we want to do as much as we can for as little as possible and leverage technology to improve the patient and consumer experience.
During the COVID-19 pandemic, we have all engaged in online education. We are currently improving our phone system with a voice-over-IP system to allow easier communication between our in-house caregivers and patients. This is critical as fewer people are coming into the office. We are currently moving from paper charts to digital charts. This allows nurses to connect directly to the office, allowing us to respond more quickly to any issues they see and complete paperwork more efficiently.
From my perspective, I'm looking for things that can automate processes so that I can focus on tasks that require the human touch, like talking to patients and helping them when they have a problem. We see technology as a way to make us more efficient and spend less time on human interaction.
What are you most excited about for the future of Special Touch Home Care?
I'm proud of the work we do to make a difference in people's lives, and this type of aged care will become even more important as we look to the future. I'm excited to see what's going to happen as the population ages and how we can use our services to make aged care even better. Our goal is to help our patients live their best lives.
We look forward to seeing how the health care system changes over time and how patient outcomes improve, and we look forward to dedicating more time and effort to expanding our reach and scope of services.
