Letter to the Editor: 

As senior director of workforce development for the Pennsylvania Homecare Association, I am deeply concerned by Gov. Josh Shapiro's proposed 2025-2026 state budget, which critically overlooks our 270,000 direct care workers. 

While the budget proposes a minimum wage increase and additional funding for participant-directed services, it completely fails to address 94 percent the broader home care workforce crisis including caregivers and nurses. The governor spoke about “opening doors to opportunities,” yet his budget actively closes doors for hundreds of thousands of direct care workers who provide essential services across Pennsylvania. 

The proposed budget leaves Medicaid reimbursement rates at $20.63 for the personal assistance services.  By the time employers pay taxes, insurance, workers compensation, rent, and other expenses, what is left for our direct care workers does not adequately recognize the critical work they perform.  Imagine not being able to get a shower tomorrow because there are not enough workers to visit you.  Imagine not being able to get out of bed without support and relying on a paid worker to literally start your day.   

By not comprehensively supporting our workforce, we risk leaving vulnerable populations without necessary care and potentially forcing more individuals into nursing home settings. 

Our dedicated healthcare professionals deserve dignified compensation and recognition. They are the backbone of Pennsylvania's home healthcare system, providing compassionate, life-changing support to thousands of residents.  

We urge policymakers to reconsider this budget and prioritize our essential direct care workforce. 

Becky Jacobs 

senior director of workforce development  

Pennsylvania Homecare Association