HARRISBURG, PA — A battle for budget dollars is brewing in Pennsylvania, and this time, the spotlight is on the people who care for the state’s most vulnerable: its home care workers. After a contentious budget process that left the vast majority of these essential workers out of a significant pay increase, advocates are sounding the alarm and pushing for a massive investment in the next fiscal year.
The core of the issue lies in the state’s approach to funding. While the 2025-2026 state budget was finally signed into law after a months-long impasse, many home care industry groups were deeply disappointed. The spending plan included $21 million to boost the hourly rate for a small sliver of the workforce—those 6% of caregivers who are hired directly by their patients. This move is expected to raise the state payment for that group from about $13.51 to over $15 per hour, an increase advocates called a “critical step” for those 8,500 workers.
However, the remaining 94% of home care professionals, who are employed through agencies, received no corresponding boost, a decision the Pennsylvania Homecare Association (PHA) sharply criticized, saying lawmakers were “abandoning the 94% of caregivers.” The PHA, which represents over 700 providers, argues that this oversight deepens an already catastrophic workforce crisis.
The state’s current average hourly reimbursement rate to agencies for personal assistance services is only $20.63, a figure industry leaders point out is the lowest among all of Pennsylvania’s neighboring states. This low rate forces home care agencies to offer uncompetitive wages, typically ranging from $14 to $18 an hour, which are frequently eclipsed by entry-level retail and fast food jobs.
The real-world consequence is a staggering staffing shortage. More than 400,000 Pennsylvanians rely on in-home care, but due to low pay and high turnover—with eight out of ten direct care workers reportedly leaving the industry within a year—the state sees over 112,500 care shifts go unfilled every single month. For seniors, medically fragile children, and people with disabilities, this means missed care, increased risk of hospitalization, and families being forced to quit their own jobs to fill the gap.
Advocacy groups are now mobilizing for the 2026-2027 budget cycle, armed with data. A study commissioned by the Shapiro administration itself recommended a significant increase in reimbursement rates. In response, the PHA is formally requesting the legislature invest a major figure, upwards of $800 million, to raise Medicaid rates by 23% and stabilize the crumbling system. The organization believes anything less will worsen the crisis as Pennsylvania’s senior population continues to grow rapidly. The message to Harrisburg is clear: the care crisis is here, and it’s time for the budget to reflect the true value of this essential workforce.