<p>Home care is one of the fastest-growing segments of the long-term care sector. Even so, the segment is still made up of mostly small businesses, a new report reveals.<br></p>



<p>Overall, about 78% of home care providers employ fewer than 50 workers, according to a Tuesday report from PHI, a New York-based direct-care workforce advocacy organization.<br></p>



<p>In the context of the coronavirus, the findings underscore the need for additional support for mom-and-pop home care providers, many of whom are currently struggling to source and pay for personal protective equipment (PPE) for their workers.<br></p>



<p>&ldquo;Because we are dealing with many small businesses, they are having trouble getting the necessary masks, gloves, sanitizers, gowns, etc.,&rdquo; <a href="https://homehealthcarenews.com/2019/11/new-hcaoa-executive-director-looks-to-grow-membership-strengthen-home-cares-data-capabilities/">Vicki Hoak, executive director of the Home Care Association of America (HCAOA)</a>, told Home Health Care News. [According to preliminary results from a recent HCAOA poll], 13% of our members said they have insufficient PPE.&rdquo;<br></p>



<p>Washington, D.C.-based HCAOA represents nearly 3,000 companies that employ more than 500,000 caregivers.<br></p>



<p>Rapid growth and a highly fragmented home care landscape have made it difficult for states to identify and meet provider needs during the COVID-19 emergency, according to Stephen Campbell, data and policy analyst at PHI.<br></p>



<p>&ldquo;The lack of coordination in the home care sector means that many providers have to navigate this crisis alone,&rdquo; Campbell, the author of the report, told HHCN in an email. &ldquo;They often compete against each other to get a hold of personal protective equipment, among other critical supplies. This is especially problematic for the many small businesses in the home care sector, which might have limited resources.&rdquo; <br></p>



<p>Overall, the home care industry saw 22,200 new establishments from 2007 to 2017.<br></p>



<p>In part, the increase is due to a growing demand to age in place among older adults. <br></p>



<p>&ldquo;For the last decade, we have seen the shift of people wanting to remain in their homes as they age,&rdquo; Hoak said. &ldquo;Many times, older adults have chronic conditions that require assistance. In order for them to stay at home, &hellip; they turn to an outside organization, like a home care agency.&rdquo;<br></p>



<p>Despite the high demand for home care services, the financing structure of home care is inadequate, according to the report.<br></p>



<p>The majority of financing for home care and other long-term care services comes from Medicaid, which systematically underfunds long-term care, PHI argues.<br></p>



<p>&ldquo;One of the main reasons is that, as a means-tested social assistance program, Medicaid is funded through general tax revenues rather than through universal payroll contributions,&rdquo; PHI wrote in the report. &ldquo;Therefore, Medicaid programs must always compete with other state budget items, like transportation and education.&rdquo;<br></p>



<p>Looking ahead, policymakers have started to develop proposals focused on improving publicly financed long-term services and supports in the U.S., according to the report. <br></p>



<p>&ldquo;As a leading example, <a href="https://homehealthcarenews.com/2019/05/new-long-term-care-law-could-lead-to-a-home-care-business-boom/">Washington State has established a Long-Term Care Trust</a> that,</p>



<p>beginning in 2025 will provide a daily benefit of $100, up to a lifetime benefit of $36,500, to people who require assistance with three or more activities of daily living,&rdquo; PHI noted.<br></p>



<p>Other states, such as Maine and Michigan, have also begun considering long-term care social insurance programs. <br></p>
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