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| Home Health, Hospice, Policy

The Home Care Workforce Crisis: An Industry Report and Call to Action

January 1, 1970

The Home Care Workforce Crisis: An Industry Report and Call to Action

The workforce shortage in home-based care has reached crisis proportions and the gap between the numbers of patients and families seeking assistance and the availability of workers to provide that care is accelerating at an unsustainable pace.

Our acute health and long-term care sectors depend on the availability of the home care workforce as well. The accessibility of home-based care is essential to their ability to move patients out of inpatient settings, maintain bed availability for the most acute, and to contain health care costs. Home health care providers currently report turning away over 25% of referred patients due to staff shortages.


The backbone of this country’s long-term services and support system is the direct care worker. The recently released, National Strategy to Support Family Caregivers, from the U.S. Department of Health and Human Services cited the importance of having an agile, flexible and well-trained direct care workforce to support family caregivers. “DCWs are one of the highest in-demand employment categories of professionals in the U.S. The critically needed expansion of this workforce will not happen without significant changes in how they are recruited, trained, paid and supported.”


Unlike similar reports, this one addresses not only the needs of the direct care worker (DCW) **, but also the supply/demand for home based nurse care.*** This report offers an extensive, though far from exhaustive, menu of policy recommendations and operational best practices to address the workforce shortage in home-based care.

Both HCAOA and NAHC extend our appreciation to the individuals who participated on the workgroups and whose names are listed at the end of the report. They represent the best of the best. The recommendations contained in this report are a “call to action” for our elected officials, policy makers, businesses, and our industry itself. They cannot be achieved quickly or easily but they are essential so that no child, no elder or individual with disabilities who needs care and support in their own home has to go without it.