The Lives Of The Vulnerable: What Will Happen?

Robin Zehntner, 31, of Montana, is a quadriplegic. PCAs assist her with tasks such as brushing her teeth or getting into bed at night. Her PCAs get paid $13.10 per hour through Medicaid. Zehntner isn’t sure when the pay was last increased. One of her PCAs recently completed graduate school and started a new job. A change that Zehntner described as both expected and upsetting. Zehntner only had two PCAs.

The Montana Department of Public Health and Human Services commissioned a study that suggests increasing Medicaid reimbursement rates. The report, dated July 2022, stated that Montana needs an additional $82.4 million to reimburse providers at recommended rates and to account for service expansion.

Unfortunately, Zehntner is one of the millions of disabled Americans who can’t find home health care workers. Nationwide there is a shortage of staff. Families can’t find home health nurses for their medically fragile children, and elderly people can’t get the help they need at home.

Weston Clardy, 7, of Easley SC, has Cerebral Palsy. He has no use of his extremities. He is nonverbal. He needs a machine to assist with breathing and is fed through a feeding tube.

Joshua Bower was born in 2019 after a routine pregnancy and delivery. By four months, though, he was experiencing issues breathing and eating. He was barely 11 pounds at six months old, unable to sit up or roll over, and unable to control his head or neck. He was later diagnosed with Cerebral Palsy. Because their medically complex conditions require specialized care, South Carolina’s Medicaid program approved both children for private duty nursing.

However, the organizations who offer that service claim that although nurses can earn far more money in other health-related fields, they are finding it challenging to hire and keep employees due to the low reimbursement rate and national nurse shortage.

Aaron Bower, Joshua’s father, told Indexx Inc., the company that publishes Greenville Business Magazine, Columbia Business Monthly, and Charleston Business Magazine, “The pay gap is so extreme.” The majority of Weston’s nurses, Stephanie Clardy, said, “said they can’t make a living (on what they’re being paid).

In Minnesota, an elderly couple can’t find home healthcare workers which has left them reliant on each other. Acey, 85, is the healthy one, the organized, enthusiastic caretaker for her 88-year-old husband, Tom. In July, after a long day of showering, dressing, feeding, and taking him to doctor’s appointments, Acey became so exhausted that she had to go to the emergency room. The Hofflanders attribute Acey’s health crisis largely to the absence of qualified in-home care.

The couple spent the majority of this year waiting to be assigned a qualified home-care worker due to a nationwide shortage of workers that was made worse by the COVID-19 pandemic. Acey was left to shoulder the load alone for a period of four months, from April to August, because they were no homecare workers available.

I live with Cerebral Palsy and have experienced this shortage firsthand as well. Finding PCAs to assist me while I was in college was a challenge. There were numerous ways I tried to hire staff. I put an advertisement on Craigslist. My mom posted on social media and contacted the local community college’s nursing program. Ultimately, I went through three different PCAs in three semesters.

The shortage is affecting millions of people across the United States. People from Minnesota to Montana are struggling. This crisis is affecting people who are 5 to 85. People’s lives are at risk without proper care. We need to fix this crisis now because care can’t wait.


Osby, Liv. “South Carolina’s Nursing Shortage Hits Families with Disabled Children Especially Hard.” Greenville Business Magazine, Indexx Inc, 21 Sept. 2022,

Rowland, Christopher. “Seniors Are Stuck Home Alone as Health Aides Flee for Higher-Paying Jobs.” The Washington Post, WP Company, 25 Sept. 2022,

Szpaller, Keila. “Medicaid in-Home Care Client Fears Losing Independence with Low Rates.” Daily Montanan, Daily Montanan, 28 Sept. 2022,

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