By Jason Umpierrez
When most people think of in-home caregivers and private duty nurses, they usually think about seniors, but there are also thousands of children throughout Pennsylvania who rely on in-home care and private duty nurses, sometimes from the moment they wake up. From kids who rely on a feeding tube or thrive only with the support of a ventilator to kids who suffer from epilepsy, cerebral palsy or spina bifida — every child has different needs and deserves specialized care.
Access to that care, though, can be incredibly difficult to obtain, and already, more than 112,500 caregiver shifts — including 27% of authorized hours for pediatric patients — go unfilled, largely due to the lack of staff.
Unfortunately, this crisis is only getting worse. That’s because in-home nurses and home health aides are leaving the state or leaving the industry in droves because they can secure higher paying jobs elsewhere. We need our elected officials in Harrisburg to act before this crisis deepens.
This is a problem that the governor and our legislators need to solve because it’s a public policy problem. Individual states determine how much they will reimburse in-home nurses for their work with Medicaid beneficiaries, and Pennsylvania’s reimbursement rate is one of the lowest in the region. In many cases, fast food restaurants or convenience stores are able to offer better pay.
I see the direct impacts of this crisis every day as a director at a pediatric home health agency in Berks County. Nurses are in high demand and can often make more money in facility-based care settings. That makes it nearly impossible to recruit and then retain a workforce of qualified nurses and in turn, it’s becoming very difficult to ensure all those kids get the care they need. And for this population, lack of care often means an ER visit and hospitalization.
A 2024 independent study by the Menges Group evaluated the cost of investing in shift nursing services in Pennsylvania. The results showed that an investment in nursing that increases the number of nurses available for care is almost entirely offset by the high costs of facility care for these patients. By investing in home-based nursing care, we are avoiding more costly institutional care and we are keeping children and families together where they want to be — home.
Unfortunately, the governor’s budget proposal failed to include an increase for nursing services, so now we need Democrats and Republicans in the Legislature to work together and stabilize our caregiver workforce in this year’s budget.
From both an economic and a health care perspective, Pennsylvania simply cannot afford to not make long overdue investments in our absolutely essential caregiver workforce. Harrisburg cannot kick the can down the road any farther — the crisis has arrived.
This isn’t a partisan issue, either. Republicans and Democrats alike represent families who rely on in-home caregivers and private duty nurses, so we need them to work together.
Some of Berks County’s elected officials can play a key role, too: State Sen. Scott Martin is the chair of the powerful Senate Appropriations Committee, Sens. Chris Gebhard and Tracy Pennycuick are members of the Appropriations Committee, and state Rep. Jamie Barton serves on the House Appropriations Committees.
This is about stabilizing an essential workforce in our state that supports hundreds of thousands of jobs and returns $4.5 billion in tax revenue every year. More importantly, it’s also about doing the right thing and providing necessary care for those in our communities who need it most, from babies and children to seniors. The time to act is now.
Jason Umpierrez is a Regional Director for East Coast Angels of Care Pediatric Home Health.
