The value of services provided by personal care and home health aides is immeasurable, which is why every effort must be made to strengthen the home- and community-based care system ["Home care aides deserve fair wages," Opinion, March 7].

Unfortunately, Medicaid and Medicare reimbursement policies fail to fully recognize the value of such care. Providers have had years of reimbursement cuts. As a result, rates lag relative to the actual costs of delivering care, particularly on Long Island, where providers face county mandates to pay nearly twice the state minimum wage.

As writer S.E. Watts points out, the federal labor department is considering extending federal minimum wage and overtime guarantees to home care workers. A large increase in overtime pay that is not supported by greater government reimbursement would present major concerns for patients, aides and providers.

If overtime costs skyrocketed, providers would not be able to offer overtime hours, which disrupts continuity of care for patients and earnings potential for aides. More alarming is that elderly and disabled New Yorkers may be forced to ration care and other necessities if the cost of home care increases.

My organization appreciates the independence that home-care services provide and the value of the workers providing such care. The first priority must be to preserve and enhance access to care through adequate government reimbursement.

Christine Johnston, East Greenbush

Editor's note: The writer is president of the New York State Association of Health Care Providers, a trade association.