ALBUQUERQUE \u2014 Amanda Salas, a caregiver with Heritage Healthcare Services, has been looking after people in their homes for nearly two decades.<\/p>\n
She assists her clients \u2014 including seniors, people with disabilities and veterans \u2014 with essential activities like bathing, dressing, preparing meals and light housekeeping. Oftentimes, she helps clients stave off social isolation, too.<\/p>\n
\u201cWe\u2019re going into their home at their most vulnerable state. … Whether it be physically, mentally, emotionally, that\u2019s what we\u2019re there to provide care for,\u201d Salas said.<\/p>\n
Earlier this year, however, providing home-based care for New Mexico veterans became increasingly difficult.<\/p>\n
The U.S. Department of Veterans Affairs slashed New Mexico reimbursement rates for home health aide services by 19% between 2025 and 2026. The federal agency now pays $13.50 for a quarter-hour of care, compared to a previous rate of $16.75 \u2014 a change a VA spokesperson said would make payments in the state more consistent with \u201cprevailing market rates.\u201d<\/p>\n
Caregiving agencies, state officials and members of Congress say the cut will reduce access to care for a portion of the state\u2019s 150,000 veterans. They\u2019re calling on the VA to reverse the drop in rates.<\/p>\n
\u201cVeterans are a valued resource to the state of New Mexico,\u201d said retired Brig. Gen. Jamison Herrera, Cabinet secretary of the New Mexico Department of Veterans Services. \u201cThey are the lifeblood of why we have the democracy that we do, and we need to do everything we can to assist them to get the services that they\u2019ve incurred through their sacrifice.\u201d<\/p>\n
\u2018We need to serve them\u2019<\/p>\n
Comfort Keepers of Santa Fe, the local franchise of a nationwide home care company, serves between 55 and 60 clients per week, Director of Operations Judy Sanchez said, and more than two-thirds are veterans.<\/p>\n
\u201cThey have been out there and served us, and now we need to serve them,\u201d she said.<\/p>\n
The agency\u2019s caregivers provide daily living assistance for clients who would otherwise need nursing home care in parts of Santa Fe, Los Alamos, Rio Arriba and San Miguel counties and nearby pueblos.<\/p>\n
\u201cWe can help take them to doctor\u2019s appointments, to get their hair cut, to grocery shop … whatever they need to stay home safely and just live as independently as possible,\u201d Sanchez said.<\/p>\n
Doug Robertson, chair of the Home Care Association of America\u2019s Veterans Affairs Advisory Council, said some 181,000 eligible veterans across the U.S. received federally funded personal care in their homes in fiscal year 2022.<\/p>\n
Veterans Affairs sets the rates for care each year, with rates differing from state to state and, in some cases, city to city.<\/p>\n
In 2025, the VA paid New Mexico \u201chomemakers\u201d \u2014 who provide hands-off companion care \u2014 $11.22 for every 15 minutes of work, the federal agency\u2019s fee schedule shows. That\u2019s $3.46 more than the national average of $7.76.<\/p>\n
For home health aides \u2014 who perform hands-on personal care to assist with clients\u2019 activities of daily living \u2014 the 2025 reimbursement rate was $16.75 in New Mexico, compared to a nationwide average of $11.58.<\/p>\n
Starting Jan. 1, the reimbursement rate for home health aides dropped to $13.50 in New Mexico, according to the agency\u2019s fee schedule. For homemakers, it dropped to $9.05.<\/p>\n
Cuts were even deeper in Texas. In parts of the state including El Paso, Amarillo and West Texas the rate for home health aides dropped from $16.75 to $9.50 between 2025 and 2026. Homemaker reimbursements dropped from $11.22 to $6.37.<\/p>\n
Jennifer Roy, a VA spokesperson, wrote in an email the rates changed as part of an annual review process \u201cto ensure they align with prevailing market rates.\u201d<\/p>\n
\u201cVA doesn\u2019t anticipate this change will have any effect on the census or patient care needs at any VA facility, as the new rates reflect prevailing market rates,\u201d Roy added.<\/p>\n
But from providers\u2019 perspective, Robertson said, the decreases feel \u201csomewhat arbitrary.\u201d <\/p>\n
\u201cThere doesn\u2019t seem to be consistency from one location to the next as to why a rate is what it is,\u201d he said.<\/p>\n
Robertson noted the reimbursement rate for a home health aide in Oklahoma remained steady at $15 per quarter-hour, while rates in the two neighboring states dropped significantly.<\/p>\n
Veterans Affairs officials did not respond to questions from The New Mexican about the agency\u2019s methodology for setting rates.<\/p>\n
\u2018Curtailment of support\u2019<\/p>\n
While a few dollars\u2019 difference might not sound like much, home care agencies rely on the federal funding to pay for a variety of costs, Robertson said.<\/p>\n
The money is meant to cover caregivers\u2019 salaries \u2014 which in New Mexico average around $29,000 per year, according to 2023 data from the Bureau of Labor Statistics \u2014 plus overhead like insurance, employee benefits, taxes, rent and utilities.<\/p>\n
Robertson said the decreases were \u201cvery unusual\u201d and isolated to New Mexico and Texas; though, many states did not see the typical increase to account for inflation. This year\u2019s rates, he added, seem to indicate a \u201ccurtailment of support.\u201d<\/p>\n
\u201cThe cost of business did not decrease on Jan. 1, but the reimbursement for care in these rural communities did,\u201d Robertson said.<\/p>\n
He added, \u201cUnfortunately, I do believe we\u2019re starting to see a reduction in access to home care for veterans in New Mexico, rural Texas as a result.\u201d<\/p>\n
Comfort Keepers of Santa Fe isn\u2019t planning to cut clients or reduce services as a result of the rate reductions, Sanchez said, but the company won\u2019t be able to increase caregivers\u2019 wages.<\/p>\n
\u201cWhenever we go to look at any pay increases, we won\u2019t be able to do much, because we don\u2019t have much left over,\u201d she said.<\/p>\n
That\u2019s a problem for worker retention, she noted, because it means caregiving can\u2019t compete with jobs in other industries.<\/p>\n
\u201cThey\u2019re thinking, \u2018Wait a minute, I can go work at McDonald\u2019s for the same price.\u2019 They end up quitting,\u201d she said.<\/p>\n
The drop in rates comes as the home health and personal care industry faces a range of issues, including a dearth of providers<\/a> and rising demand from New Mexico\u2019s aging population<\/a>.<\/p>\n Rural areas pose a particular challenge<\/a> for the industry: While caregivers may have to drive hours to see clients in far-flung parts of the state, the agencies they work for don\u2019t get reimbursed for drive time, increasing the cost of care.<\/p>\n