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By Sarah Taddeo

Invisible Army: Caregivers on the Front Line: Part of an occasional series supported by the Solutions Journalism Network


Nationally, the home care industry will need an additional 450,000 home health care aides by 2025 to keep up with the demand for services, as millions of Baby Boomers advance into their 70s and may require more assistance at home.

But the workforce trend is going in the opposite direction, said Rachel McCullough, political director at Jews for Racial & Economic Justice and co-director of the Caring Majority, a coalition that advocates for seniors, family and paid caregivers and people with disabilities.

New York has the one of the worst projected shortages of the home health aides in the nation, followed closely by other mid-Atlantic and Midwest states like Michigan, Ohio and Pennsylvania.

In New York, 74% of seniors and people with disabilities were unable to retain home care staff in 2021, according to a report by the Consumer Directed Personal Assistance Association of New York.

“The state pays home care workers poverty wages, and they’re leaving the sector in droves,” McCullough said.

The crisis has led to a broad, high-profile push to increase wages for home care workers in New York, and, in the process, elevate the visibility of an industry that allows millions of people to avoid nursing homes and age with dignity.

The home care sector is facing a more acute version of the worker shortage most industries experienced after the pandemic’s peak. As other industries increased wages to lure workers to understaffed restaurants, stores and call centers, the home care workforce suffered further losses.

“The pandemic really took our sector to the breaking point,” said McCullough of the Caring Majority.

As the pandemic revealed the gaps in nursing home safety and staffing, more families sought out home care for their older loved ones. At the same time, agencies were hemorrhaging aides, who were concerned about COVID infection in their work environments and saw better-paying opportunities elsewhere.

More than 45% of direct care workers, which includes home health aides, personal care aides and nursing assistants, live in or near poverty due to wages, according to a 2020 report from PHI, a direct care research group. About half rely on public assistance and lack affordable housing.

“In most regions of the state, you can make more going to work at McDonald’s or Amazon than you can caring for someone,” McCullough said.

New York advocates touted what they saw as a legislative solution to this problem — the Fair Pay for Home Care Act, which would ensure that every home care workers are paid 150% of the minimum wage in their area.

Advocates argued that the proposal, which could be jump-started through American Rescue Plan funding, would have ultimately paid for itself by getting home care workers off public assistance and into higher paying jobs, creating further economic growth.

Gov. Kathy Hochul didn’t include the legislation in her proposed budget in January and advocates pushed hard for it to be included in full in the state’s finalized budget, rallying in Albany multiple times a week and unfolding a 60-foot long wait list symbolizing the number of individuals waiting to get home care.

The state’s final budget, approved in early April, included $7 billion for a statewide raise for home care workers, amounting to about a $3-per-hour raise per worker. But advocates say that’s not enough to turn the tide on the workforce issues the industry faces.

“As New York’s population ages and home care workers continue to flee the sector, we are clear that a significant pay increase — 150% of minimum wage — is the only solution to stem the home care shortage,” McCullough said in a statement as the budget was being finalized in early April.

The pay gap between home care and other industries is evident daily for Lolli Edinger, 51, who wouldn’t be able to make ends meet for her family on her yearly salary.

“If I was trying to live on this, I would have to go get another job,” she said – and she works 50 hours a week as it is, caring for two different individuals in the Hudson Valley.

She makes $13.20 an hour at one job, and $14.75 at the other. She could make between $15 and $17 an hour serving fast food, or $21 an hour driving a bus.


Maggie Ornstein’s mom, Janet, gets about 40 hours of care per week from a home care worker in their Queens home. But “I’m embarrassed that it’s still not enough,” Ornstein said, adding that it’s tough to watch workers care for her mother when she knows they’re getting paid such low wages.

Janet had a brain aneurysm 26 years ago, leaving her in a coma for five months. She spent subsequent years in hospitals and nursing homes before coming home, where she needs regular care from Ornstein or an aide because of her traumatic brain injury.

Ornstein was 17 at the time, and now, at 44, she has since set aside the prospect of having children or a full-time job. She is a part-time college professor, and spends the rest of her time caring for Janet and advocating in the home care policy space in New York and beyond. Her paychecks go entirely to health insurance payments.

Caring for ill or aging family members takes a heavy emotional and financial toll on the caregiver, even when home care workers are available, Ornstein said.

But raising the appeal of the home care field by increasing wages and benefits will send a message that New York supports both home care workers and family caregivers, and that home care is a viable option for aging New Yorkers or those with disabilities.

“You can’t expect people to treat the job like a priority when we don’t prioritize them,” Ornstein said.

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