Pennsylvania Home Care Crisis Deepens as Budget Allocates Funds to Only 6% of Workforce
Harrisburg, PA – Pennsylvania’s recently enacted 2025-2026 state budget has ignited a firestorm of criticism from home-based care advocates, who argue the funding plan leaves the vast majority of caregivers unsupported and jeopardizes access to vital services for hundreds of thousands of Pennsylvanians. Governor Josh Shapiro signed the budget into law last week, but its allocation of resources – covering just 6% of the state’s home-based care workforce – has been decried as a critical failure to address a growing crisis.
The Pennsylvania Homecare Association (PAHA) has sharply criticized the budget, stating it effectively “abandons” 94% of the caregivers who provide essential services to seniors, individuals with disabilities, and children with complex medical needs. This lack of support, experts warn, will have cascading consequences throughout the healthcare system.
“When agency workers are ignored, seniors are left alone, children are stuck in hospitals, and families are forced to leave jobs to fill the gap,” explained Mia Haney, CEO of PAHA. “The legislature has guaranteed more hospitalizations, more nursing home placements, and ultimately, higher costs for taxpayers. It’s a shortsighted approach that will exacerbate existing problems.”
Concerns about Pennsylvania’s budget situation were already mounting prior to its approval. Dave Totaro, former chief government affairs officer at Bayada Home Health Care, highlighted Pennsylvania, alongside states like North Carolina, as areas of significant concern. He noted the detrimental effects of budget delays, even before the implementation of the finalized plan. HHCN reported in October on Totaro’s warnings about the impending impact of these budgetary uncertainties.
The Growing Strain on Pennsylvania’s Home-Based Care System
Pennsylvania currently serves over 400,000 individuals who rely on home-based care services. However, the system is buckling under the weight of a severe staffing shortage, with more than 112,500 shifts going unfilled, according to PAHA. This translates to countless individuals facing limited access to the care they desperately need.
The current Medicaid reimbursement rate for personal assistance services in Pennsylvania stands at $20.63 per hour – a figure significantly lower than neighboring states. Data indicates that surrounding states compensate caregivers roughly 25% to 75% more for comparable services, creating a powerful incentive for workers to seek employment elsewhere.
This wage disparity is fueling a recruitment and retention crisis, leaving home-based care providers struggling to maintain adequate staffing levels. The consequences are far-reaching, impacting not only the quality of care but also the overall stability of the system.
PAHA has proposed a comprehensive solution, based on findings from two independent, taxpayer-funded studies. The organization recommends a 23% increase in rates for home-based workers, requiring an investment of $800 million. Additionally, they are advocating for a 10% increase in reimbursement rates for personal assistance services, which would cost approximately $370 million.
“Protecting access to care and supporting the workforce that delivers it must be a top priority for Governor Shapiro, Senator Pittman, Speaker McClinton, and every member of the legislature in the 2026–27 budget,” Haney emphasized. “We need a long-term, sustainable solution, not temporary fixes.”
The lack of consistent funding extends beyond the state level. PAHA argues that both state and federal budgets are failing to provide the stability that the home care sector requires. This uncertainty leaves providers and families in a precarious position, unsure whether vital support will continue beyond the next fiscal year.
For states like Pennsylvania, already lagging behind national averages in home care funding, this instability widens the gap and makes it increasingly difficult to rebuild a workforce and a system stretched to its limits. What will it take to prioritize the needs of vulnerable Pennsylvanians who rely on these essential services? And how can we ensure that caregivers receive the fair compensation and support they deserve?
Frequently Asked Questions About Pennsylvania Home Care Funding
What is the current state of home care funding in Pennsylvania?
Currently, Pennsylvania’s state budget allocates funding to only 6% of its home-based care workforce, leaving the vast majority of caregivers unsupported and the system facing a severe staffing crisis.
How does Pennsylvania’s Medicaid reimbursement rate compare to other states?
Pennsylvania’s Medicaid reimbursement rate for personal assistance services ($20.63 per hour) is among the lowest in the region, with neighboring states paying significantly more – often 25% to 75% higher – for similar services.
What is the Pennsylvania Homecare Association recommending to address the funding shortfall?
PAHA recommends a 23% increase in rates for home-based workers ($800 million) and a 10% increase in reimbursement rates for personal assistance services ($370 million), based on findings from independent studies.
How many individuals in Pennsylvania rely on home-based care services?
Over 400,000 individuals in Pennsylvania depend on home-based care services, but more than 112,500 shifts currently go unfilled due to staffing shortages.
What are the potential consequences of continued underfunding of home care in Pennsylvania?
Continued underfunding will likely lead to increased hospitalizations, more nursing home placements, higher costs for taxpayers, and reduced access to care for vulnerable Pennsylvanians.
Why is the home care workforce struggling to attract and retain caregivers?
Low wages, limited benefits, and challenging working conditions are major factors contributing to the difficulties in recruiting and retaining caregivers in Pennsylvania’s home care sector.
Share this article to raise awareness about the critical challenges facing Pennsylvania’s home-based care system. Join the conversation in the comments below – what solutions do you believe are essential to ensuring access to quality care for all Pennsylvanians?
Disclaimer: This article provides information for general knowledge and informational purposes only, and does not constitute medical or financial advice.
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