Home care is an indispensable part of American life and one of the fastest-growing sectors of the healthcare industry. As of 2015, half a million Californians employed homecare workers. Medical advances and a shift away from institutional care have led to a growing need for home care support. Home care consists of assistance with a number of personal care tasks, such as dressing, bathing, and assistance with eating. Home care allows seniors and people with disabilities to live in their own homes and communities, rather than nursing homes or other facilities. It allows individuals to “age in place,” maintain self-determination, and remain independent. The homecare industry is facing a crisis stemming from problems of unaffordability, insufficient government support, and challenging work conditions that have led to a shortage of workers. These challenges have given rise to low wages or reduced hours and high turnover.

Drawing its findings from surveys with 327 homecare employers, this report provides an understanding of homecare employers’ challenges, needs, and employment practices. It details how a lack of affordability and a shortfall in public homecare funding is affecting homecare employers and workers. A significant number of homecare employers cannot afford all the hours of care they need and must therefore live without all the services they need to live safely and independently.