Ryan Jacobsen of Coeur d'Alene, regional director for Addus Health Care, said his firm provides home care throughout the state and has 560 employees. "We are part of the solution," Jacobsen told JFAC. He called for more collaboration with home-care agencies to set appropriate standards to help patients avoid institutionalization. "My concern is that further reductions in home care programs ... are putting the ongoing viability of home care agencies in danger," he said.

Greg Renshaw told lawmakers, "I've been a quadraplegic for over 20 years due to an auto accident." He said he was a young man and "gainfully employed" before the accident, just starting a family. Now he's paralyzed from the neck down. Renshaw said he receives home-care services from Addus, but recent changes have boosted his cost-share payments for those services $580 a month. "With that cost of share, that just puts me into a bind," he said, saying he's now in danger of losing his home. Renshaw said he doesn't want to end up in a nursing home. "Bottom line is quality of life - let me keep mine, please," he pleaded.