BIRMINGHAM, Ala (May 18, 2022)—There’s a new coalition of homecare providers and associations taking on the home health nurse and caregiver shortage. The Home Care Workforce Alliance (HCWA), which is seeking to improve recruiting and retention in the home caregiver workforce, kicked off its initiatives with a conference call today. 

“America will soon consist of more old than young [people],” said Vicki Hoak, CEO of the Home Care Association of America (HCAOA). “Someone turning 65 today has a nearly 70% chance of needing long-term care and support. The question is, can they receive it when they need it and where they want it?”

Hoak added that while the workforce increased 151% between 2008 and 2018, that growth isn’t keeping pace with demand. There’s a predicted shortage of 151,000 caregivers by 2030, increasing to 355,000 by 2040, she said. 

David Totaro, chief government affairs officer for BAYADA Home Health, shared that two out of three home health cases referred to the company are currently being declined. He said workforce issues have been a problem for the company’s entire 47-year history, but the past few years have been much worse.

“Nurses and aides are leaving for higher pay and due to burnout,” Totaro said. “Wage inflation is crippling us. Retail is paying more than we can. We can all agree our caregivers deserve better than this.”

HCWA also announced the “Voices for Care at Home” campaign, which seeks to bring together all the stakeholders in in-home care—home health and hospice agencies, nurses, aides, family members and industry associations—to push for change. As part of that launch, three professional caregivers and two family caregivers were invited to share their experiences.

Cindy Nap, whose son Ben suffered cardiac arrest and subsequent brain injury at the age of 16, said, “We often don’t have coverage at all. Sometimes it’s a nurse call out, and there’s no one to cover due to the shortage.” She said she and her husband often have to make difficult decisions on who will miss work when this happens. 

Pearletta Cashman, a home health aide with 30 years of experience, called for better education and training for caregivers. “We need training to upgrade [ourselves] because there’s always new regulations to keep up with. 

This need for training was echoed by Bill Dombi, president and CEO of the National Association for Home Care & Hospice (NAHC). He added, however, that professional caregivers also need more respect and recognition for the work they do. 

“They’re working at the top of their license and often alone,” Dombi said. “We have a multidimensional issue related to the workforce shortage. There is no one cause, and no one solution. This is not the first generation to have problems, but we want to make it the last.”


HCAOA, NAHC and BAYADA are the inaugural members of the new alliance, which is actively seeking additional members, including providers, family caregivers and other associations. The alliance is hoping to create a unified voice for change

“This is about reform and there are many reforms at many levels that need to happen, said Hoak. “It’s so multidimensional that we need to be sure we have different kinds of people involved.”

Dombi said the alliance will be reaching out to other organizations soon, and hopes they will respond affirmatively to add their voices.

Learn more at homecareaction.com.