I also know just how vital it is for my former colleagues to address Pennsylvania’s home care crisis because I’ve seen it firsthand. I saw my mother and my daughter, both now deceased, have their lives extended – at home – thanks to incredible in-home caregivers, but I’ve also seen how difficult, and sometimes impossible, it can be to receive consistent in-home care.

From seniors to children with complex medical needs, more than 400,000 Pennsylvanians rely on in-home caregivers in their day-to-day lives. But there simply aren’t enough caregivers in our state to serve the people who need them. Every single month, more than 112,500 caregiver shifts and 27% of allocated nursing hours in Pennsylvania are missed entirely, leaving seniors and kids at home without the help they desperately need.

This heartbreaking reality is a public policy problem because each state, including Pennsylvania, sets its own reimbursement rates for caregivers who serve Medicaid patients, which in effect sets payment rates for in-home caregivers in any given state. Pennsylvania’s current rate of $20.63 per hour is by far the lowest in the region, and every single state that borders us pays their caregivers 25 to 75% more. If you’re a caregiver, simply commuting across the state border can mean a significant raise, and many fast-food restaurants and convenience stores in Pennsylvania offer better pay, too, so it’s no surprise that this vital workforce is collapsing.

On top of the obvious health and quality of life impacts of this crisis, the economic and budgetary impacts are similarly stark. Pennsylvania relies on the caregiving industry to support nearly 300,000 jobs and bring in $4.5 billion in tax revenue every year, but our state’s workforce is being decimated in front of our eyes.

Gov. Shapiro’s administration commissioned an independent study on this crisis, an important first step, and the results were as alarming as many feared. According to the study, Pennsylvania needs to increase funding for caregivers by 23% this year, which requires more than $800 million in additional spending.

With the budget constraints faced by my former colleagues, I know that kind of increase is likely impossible, but we must start addressing this problem as much as we can in this year’s budget. Kicking the can down the road is what’s gotten us to this crisis point, and by 2030, more than a third of Pennsylvania residents will be 65 years or older, further increasing demand for in-home care.

This isn’t about just throwing money at a problem, either. Investing in our caregiver workforce is also a much less expensive option for both families and the state budget. Consider that in-home care services cost an average of $4,957 per month, while nursing homes cost more than double that, an average of $10,403 per month. In addition, in-home care is the best possible way to help patients avoid costly trips to the hospital and further demand on our already strained health system.

The challenge of addressing this worsening crisis is daunting, but the opportunity for Gov. Shapiro and our elected officials on both sides of the aisle is enormous. By working together, they can provide desperately needed care for Pennsylvania seniors and kids with complex medical needs, stabilize one of Pennsylvania’s essential workforces, and put the state on much stronger financial footing for the future.

Last summer, I retired from the state legislature to be able to spend more time raising my teenage daughter here in Philadelphia, so I’m no longer in a position to cast a vote for additional investments in caregivers. That’s why now, as a private citizen and an advocate, I’m urging my former colleagues in Harrisburg — Republicans and Democrats — to act.

(Stephen Kinsey is a vice president with CareRing Health and Patriot Home Care in Philadelphia. Previously, he represented northwest Philadelphia in the state House of Representatives from 2013-24.)