Masked home care worker, appearing tired, sits on the steps leading up to a building.

The National Association for Home Care & Hospice and the Home Care Association of America are headed to Capitol Hill Tuesday and Wednesday with a new list of recommendations to alleviate the nation’s direct care worker crisis.

On Monday, the two provider organizations unveiled a new industry report that provides a roadmap for attracting and retaining direct care workers, creating career pathways to advancement and ensuring an ample supply of home nurses. 

“This report is just the first step to addressing the home care workforce shortage, but it is a significant one,” Vicki Hoak, CEO of HCAOA, said in a statement. “It encapsulates the industry’s commitment to elevating the profession of caregiving and urges other stakeholders and policymakers to join us in solving this problem.” 

The report is the fruit of the Home Care Workforce Action Alliance, which NAHC, HCAOA and the home care firm Bayada Home Health Care formed last May to tackle the shortage. It  specifically singles out the shortage of home care registered nurses as a particular concern. Although the home care workforce doubled to approximately 2.4 million caregivers between 2010 and 2020, the number of home care nurses decreased during that period. 

“The supply of nurses and home care aides is not sufficient to meet the demand for their services, which means America’s most vulnerable population suffers,” NAHC President William Dombi said in a statement. “Family caregivers are already stretched beyond the limit, leading them to take unpaid leave, lose wages, and suffer from care burnout. This also leads people to seek care from costlier settings, such as hospitals and nursing homes.” 

Action items

To increase the supply of nurses, the report calls on Congress to use American Rescue Plan Act funds to forgive student nurse loans; make permanent telehealth waivers; waive 60-day recertifications regulations for nurses providing care under Medicaid; expedite, simplify and prioritize background screenings on new nurses and allow for nurse certification reciprocity across state lines. 

While there has been an increase in home care workers in the past decade, the industry will still need an additional 1.2 million by the end of the decade, according to PHI National, which tracks the industry. To attract more workers to the industry the report recommended making onboarding and training easier for new hires, enhanced mentoring at the agency level, replacing weekly and bi-weekly play with daily pay or on-demand access to earned pay and a pathway for immigrants to enter the direct care workforce. 

Advocacy efforts 

Tuesday’s March on Washington, which NAHC is organizing, will be the first in-person event since 2019. More than 100 providers are expected to attend with hundreds more taking part virtually. On Wednesday, HCAOA will hold its National Home Care Advocacy Day in the nation’s capital. HCAOA will be advocating for a handful of bills that would move more care into the home and address the direct care crisis. Those bills include the Better Care Better Jobs Act, HCBS Access Act, Credit for Caring Act, Homecare for Seniors Act and the Elizabeth Dole Act.