Commentary: Investments in home health care can't wait
We're about to see the largest generation of elderly adults in history. But who's going to take care of them?
Joseph Pecora | April 20, 2023 | Article appeared in The Times Union
As budget negotiations proceed between Gov. Kathy Hochul and state lawmakers, there’s a looming crisis that should not get lost in the heated discussions over housing, bail reform and energy. That crisis involves the shortage of home health care workers, their chronically low pay, and what’s about to become the largest generation of elderly adults in history.
In 2023, it is estimated that 760,000 New York residents will need home care, yet there are expected to be only about 286,000 home care workers available. And according to a report by the Fiscal Policy Institute, nearly 1 million New Yorkers will require home care by 2035 – and unless wages are increased, there will be a shortage of 1.47 million home care workers in the state.
Simply put: While the population of adults needing home health care is growing exponentially, the workforce of dedicated caregivers is not growing to match.
Several factors are widening this gap in supply and demand, but chief among them continues to be the lack of competitive wages for health care workers.
Home care paraprofessionals in New York make 40 percent less than their peers in nursing care facilities. They make 25 percent less than school bus drivers, a part-time job. They could earn more working for Amazon, but they choose to help some of society’s neediest. As a result of the economics, fewer individuals are entering the home health care workforce, and the turnover rate is enormous.
These workers are just as much a vital component of the overall health care industry as any registered nurse or doctor, yet they are offered only a regulated, near-poverty wage for their dedication and service to our society’s most vulnerable people.
Their challenging working conditions lead to high turnover, which is disruptive for patients, their families and the caregivers themselves. The existing labor shortages make finding replacements for those caregivers even harder.
The state needs to help firmly establish the role of a home caregiver as a solid career, rather than a temporary job until some other better-paying employment comes along. A true career ladder needs to include elevating wage tiers based on levels of training and seniority.
By 2035, over 4.6 million New Yorkers will be over age 65, a 29 percent increase in the next decade. If the projected home care shortage is not addressed, it would not be surprising to see an even larger number of New Yorkers leaving the state to live elsewhere.
It comes down to our state leaders committing to meaningful wages and benefits to home care industry professionals. By paying these workers what they are worth, the oncoming shortage can be averted. Only then will our seniors, who want and deserve the chance to stay in their homes to age gracefully, rest in confidence that someone will be at their door every day to care for them in their later years, without having to be forced into a more costly institutionalized nursing or long-term care facility.
For the past three years, New Yorkers were challenged by the life-changing and life-threatening consequences of COVID. This is our next health care challenge: New York must show people thinking of entering the home health care profession that a meaningful and well-paying career can grow from their choice to serve the elderly and most vulnerable in our society.
Joseph Pecora is president of the Home Healthcare Workers of America.