Pa. can’t leave out the disabled and the seniors who need care
By including in the state’s new budget funding for care that keep individuals with disabilities at home, Gov. Josh Shapiro is allowing more individuals to live a safe life at home and avoid long-term institutional placement. That’s very good news, but not for everyone.
The governor has only proposed to increase funding for individuals with intellectual disabilities and autism (the ID/A population). He and state lawmakers should not forget another important population that deserves to access home care: Pennsylvania’s seniors and residents with physical disabilities.
Neglected populations
The Personal Assistance Services (PAS) program — the home care program that keeps older Pennsylvanians and those with disabilities at home and out of congregate institutional settings — has not seen an adequate funding increase in the past decade. By increasing funding for home care for only one segment of the disabled population, the Commonwealth is essentially signaling that it values one population’s ability to access care and stay home over another population’s.
I’m writing as a division director at BAYADA Home Health Care, a nonprofit that provides in-home personal assistance services (PAS) to adults with disabilities and seniors. These are people we know, who have been neglected in the Governor’s proposed budget.
Direct care workers (DCWs), also known as home health aides (HHAs), that deliver PAS services are critical to residents who need daily living supports. And while the work they do is inarguably noble and important, it is notoriously not well-paying. HHAs that care for seniors and adults with disabilities through the PAS program make only $11-13 per hour. That’s less than the $13.35 state average for home health aides across all populations.
Homecare’s benefits
This is due to the state-determined funding formula for the PAS program. In the past 10 years, funding for the PAS program has increased by only 12%, while inflation has increased prices by more than 30%. Investing in home care for all populations that need it makes financial sense: Not only do more people want to be cared for at home, but they and the state benefit when they stay out of institutional settings like hospitals and rehabs.
Not only is home the patient-preferred setting for care. It’s also the costeffective option. According to a 2021 Genworth analysis, nursing home care in PA costs at least twice as much as health aide services. This means that, for the cost of every Pennsylvanian that is cared for in a nursing home, the State can serve more than two people in their own home.
Pennsylvania cannot continue to ignore our growing senior populations. We are one of the most rapidly graying states in the country. The needs — and therefore the financial benefits to the state — of caring for people at home will only grow.
As someone who has been in the home care industry for 18 years, I can tell you that HHAs who care for Pennsylvania’s medically-fragile adults and seniors do lifesaving work that is takes a great emotion and physical toll. It is not easy work and it is not easy work to do year after year, especially when their wages stay the same while the cost of living steadily rises.
A deserved wage
Home health aides deserve a fair wage. Home care providers that care for the PAS population rely on the state funding formula to cover all costs of care, and they cannot increase wages to stay competitive without the state doing its part.
Gov. Shapiro has made an important step in the right direction by bolstering funding for home care for the ID/A population. But the state must remember its legal obligation of providing accessible care for aging residents and those with physical disabilities too.