PITTSBURGH (TNS) — On Thursday afternoon, in a quiet tavern on Mount Washington, state legislators and advocates sounded the alarm about the sustainability of Pennsylvania’s home care system.

“The demand for this industry has increased, and it’ll continue to be there,” said state Sen. Wayne Fontana, D-Brookline, seated at a folding table inside Bigham Tavern. “Everyone has to know that there’s a need.”

For many older adults and people with disabilities, home care is critical for accessing the support they need. But during a roundtable hosted by the advocacy group Hearts for Home Care — which brought together lawmakers, care professionals, and family members — speakers warned that workforce shortages and inadequate funding threaten the future of care for the state’s aging population.

Presently, more than 400,000 seniors and medically fragile Pennsylvanians rely on in-home care, according to the Pennsylvania Homecare Association.

Research shows that most older adults prefer to age at home rather than move into nursing homes or assisted living facilities. A recent report from the United Home Care Workers of Pennsylvania found that one in four Pennsylvanians will be 65 or older by 2030. To meet a rising need, the state would need to recruit roughly 250,000 home care workers. Without intervention, advocates warn, many older adults could be forced into institutions due to a lack of available care.

Among those who spoke Thursday was Brandon Daveler, who has been paralyzed for more than two decades and said home care providers have been essential to his quality of life.

“I’ve lost several nurses over the years to other jobs,” he said. “I’d like to bridge that gap.”

Low wages and limited benefits are major drivers of turnover in the home care workforce, research shows, in addition to declining federal support. Since 2020, the Centers for Medicare and Medicaid Services have reduced Medicare home health care funding each year, according to research from Hearts for Home Care.

“The federal funding is an automatic drawdown, so we are looking for additional investments in the home care industry,” said Laura Ness, deputy executive director of Hearts for Home Care.

State Rep. Jessica Benham, D-South Side, said it is “critically important” that Pennsylvania allocate more funding to home care in order to recruit and retain workers. She also emphasized the importance of involving health care unions in the conversation.

“Bringing everybody to the table, making sure we’re all on the same page in terms of what we’re asking for in the budget, what sorts of terms we’re tying to additional funding — I think these are important conversations to have,” she said.

Advocates also say Pennsylvania legislators have contributed to this crisis by failing to increase reimbursement rates for caregivers. Pennsylvania’s Medicaid reimbursement rate for Personal Assistance Services is only $20.63 per hour, while every bordering state pays between 25% and 75% more, according to data from the Pennsylvania Homecare Association.

“The longer the state waits [to step in] the worst the compounding effect will be,” said Rob Lattin, area director of Hearts For Home Care. “The Commonwealth is behind.”