Dear Editor,

At Silver Angels, we provide individuals with a home-based choice to meet their long-term care needs. TennCare, the state’s Medicaid program, had the vision to create the CHOICES program more than a decade ago to support Tennessee Seniors and individuals with disabilities who want and deserve to age in their homes instead of moving into a nursing home.

But now, rising administrative costs, staffing shortages, and low reimbursement rates are combining to drive CHOICES non-medical home care providers away from the program — and the health and well-being of those who depend on these services the most are being threatened. Hundreds of Tennesseans in need of these services are already being denied services due to these constraints.

While we applaud our lawmakers for creating this option for Tennesseans 11 years ago, the state has not increased the reimbursement rate for non-medical home care providers since the program began.

Every client we see is different. While the core of what we do stays the same, each client has a different set of needs that we must meet during our time with them. We have clients that only require housekeeping support and we have some that have extensive needs like bathing, dressing, eating and toileting. We play an important role to help people stay in their homes and age in place.

Governor Lee and members of the Tennessee Legislature need to know that non-medical home care providers deserve adequate reimbursement for their services and Tennessee’s seniors and individuals with disabilities deserve choices on where they age.

Let’s work together to support the additional funding needed to save and sustain Tennessee’s CHOICES program to allow these members of our community to stay in their homes. To help us in this fight please reach out to Governor Lee and your legislators today to help save this program!

Lori Snow, Director of Marketing and Business Partnerships

Jennie Hornsby, Director of Legislative Services

Silver Angels of Tennessee, LLC

Dear Editor,

On behalf of the recent COVID vaccination mandate, I must first say that I’m entirely in favor of receiving these vaccines.

I regularly recommend these to my patients. I also recommend these to my colleagues, my friends, and my family. I actively do this unto this day.

I believe the Biden Administration has taken a deleterious misstep by forming such a mandate. Although seemingly well intended, I believe this mandate — even prior to being fully enacted — has already begun to inflict harm rather than offer any benefit.

It’s well known that a large percentage of our population has been undecided about whether to receive these vaccines...yet, or if at all. Since the introduction of this mandate, you might find that a significant number of our fellow Americans are now outright opposed to receiving any COVID vaccine. If you offer a listening ear to many of these individuals, you will be offered the chance to understand that their reasoning is often based on the common distrust of institutions that entertain the practice of public coercion via legal mandate.

I believe it’s safe to say that most people prefer to make their own medical decisions. Many people are opposed to this form of forced compliance pertaining to whether a person wishes to receive a certain immunization or not. This seemingly small decision would become so crucial that it might jeopardize the economic stability of his or her own household. This decision is not one that any man or woman should be coerced to face.

Such a mandate, being so inappropriately justified and executed by the executive branch of our federal government, would be likened to something of the nature of opening a new Pandora’s box. We should consider, at minimum, the following:

Where, then, do we draw the line? That is, what else in the future will we attempt to justify a mandated personal decision related to action vs. inaction in the realm of personal and community healthcare?

For example, should a person be punished for natural consequences due to his non-compliance with management of his hypertension? If he suffers a stroke due to non-compliance with his medications, he might very well present in the emergency department of his local hospital. He will utilize resources that must be shared with those who have been compliant with their treatment plans.

Should we then coerce to be compliant — on a federal or state level — those who have been non-compliant with medical management? After all, statistically, they will be more likely to suffer harm themselves, or delay/prevent resources from being accessed and utilized by those who have been compliant.

Again, where do we draw the line? What else will we allow to be forced on our patients?

Should we jeopardize the overall wellbeing, due to forced unemployment, of those who would be considered “non-compliant” with federally mandated immunizations? Is that our role as clinicians? Is that the role of our federal or state government? From the perspective of an American citizen, such a mandate is incongruent with our standards of freedom in the United States.

From the perspective of a medical provider, to enforce this rule on others, with the repercussion of non-compliance being unemployment, would be in blatant disregard of some of the most important aspects of medical ethics: beneficence and patient autonomy. The proposed enforcement of such a mandate would undermine our role as clinicians, disregard patients’ rights, and discredit the quality and personalization of healthcare that we offer to our patients.

From the perspective of a Christian, both “the vaccinated” and “the unvaccinated” are our neighbors.

John Bonham, PA-C


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