Pennsylvania’s recently passed state budget places the state’s home-based care workforce in a precarious position, according to industry advocates.
Last week, Pennsylvania Governor Josh Shapiro signed the 2025-2026 budget, which includes funding for only 6% of home-based care workers. It’s a move that the Pennsylvania Homecare Association has described as “abandoning the 94% of caregivers.”
“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,” Mia Haney, CEO of Pennsylvania Homecare Association, told Home Health Care News in an email. “The legislature has guaranteed more hospitalizations, more nursing home placements, and higher costs for taxpayers.”
Prior to the budget’s approval, Dave Totaro, chief government affairs officer at Bayada Home Health Care, called out Pennsylvania, along with other states, as a growing area of concern.
“Some of our states, like North Carolina and Pennsylvania, still don’t have a 2025 budget approved, and it’s beginning to hurt significantly, even before the Big Beautiful Bill is implemented,” he told HHCN in October.
Critics say the budget approval worsens the state’s already struggling home-based care landscape.
Currently, over 400,000 individuals depend on home-based care services in Pennsylvania. However, more than 112,500 shifts go unfilled, which leaves many without access to care, according to the Pennsylvania Homecare Association.
“This budget ensures that those numbers will grow even more dire,” Haney said.
What’s more, the state’s Medicaid reimbursement rate sets personal assistance services at $20.63 per hour. The association noted that this rate is among the lowest in the region, as neighboring states pay roughly 25% to 75% more for these services.
As a result, home-based care providers report difficulties recruiting and retaining caregivers.
The Pennsylvania Homecare Association made several recommendations for lawmakers, citing two independent, taxpayer-funded studies.
The organization recommended that the state increase rates for home-based workers by 23%, equivalent to $800 million in funding.
The Pennsylvania Homecare Association is also pushing for lawmakers to pass a 10% increase in reimbursement rates for personal assistance services since the start of the year. This would cost about $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 said.
Ultimately, the association points out that neither the state or the federal budget is offering the stability that home care needs.
“Instead, both left providers and families operating in uncertainty, unsure whether support will come next year or not at all,” Haney said. “For states like Pennsylvania, already lagging behind the rest of the country, that uncertainty widens the gap. Every year we fail to act makes it harder to rebuild a workforce and a system already stretched to its limits.”