The Home Care Crisis In The Hoosier State:

CW: Death

Becky Sinkovic needs some help at home. Sinkovic was born with a form of dwarfism which means that she has shortened limbs and several spinal conditions, including scoliosis. She lived independently until seven years ago following a series of back surgeries.

Her mother, a nurse, signed her up for Medicaid to supplement her Medicare coverage. Medicaid pays for home healthcare services which were helpful to Sinkovic. The services were beneficial because her mother had ovarian cancer.

Sinkovic’s best friend moved in to help care for the both of them. While her friend worked, they paid someone $21 an hour to provide care for a few hours. Sadly, only months afterward, her mother died. After her mother’s death, Sinkovic often experienced incontinence because nobody from the home health agency would show up.

She is one of the thousands of people in Indiana who need home healthcare. Like the rest of the U.S., there is a critical shortage of home healthcare workers in Indiana. In 2018, Indiana had an estimated 43,460 home health aides and personal care assistants, generally known as the direct care workforce, according to the Alzheimer’s Association 2022 study. Indiana will require 59,990 workers by 2028, a growth of 37.5%.

Indiana spent 35% of its Medicaid long-term services and supports funding on home- and community-based services in 2019, well below the national average of 59% and the second-lowest in the country.

According to a 2017 report from The Arc of Indiana, Indiana’s direct care workforce experienced 45% turnover due to low wages. The average employee was 38 years old but had only three years of experience in the field.

Direct support staff enables disabled people to live in their communities. I have received PCA services through Medicaid for over a decade. PCA services allowed me to move out of my family’s home. I have lived in my apartment since 2020. My PCA prepares my meals and helps me with hygiene. However, he also takes me to the grocery store, restaurants, and the mall. Last week, we went to the mall to finish Christmas shopping and had lunch.

Unfortunately, across the country, it is often difficult to find and retain home healthcare providers. This is due in part to low wages. Last year, home healthcare workers in the United States were paid an average of $13.02 an hour, according to the Bureau Of Labor Statistics.

I’ve experienced this shortage firsthand. In my first three semesters of college, I had three different PCAs. It was frustrating because all I wanted was a college education.

The direct care workforce enables millions of disabled people to live in their communities. Our lives would be very different if we didn’t have the appropriate support. Disabled people should be able to attend college, work, and go anywhere in their community. We don’t have to stay home. Nobody should have to live in a nursing home. Care can’t wait because people will die without it!


Downard, Whitney. “Thousands of Disabled Hoosiers Need Home Health Aides; There Aren’t Many.” Indiana Capital Chronicle, States Newsroom , 22 Dec. 2022,

“Home Health and Personal Care Aides: Occupational Outlook Handbook.” U.S. Bureau of Labor Statistics, U.S. Bureau of Labor Statistics, 8 Sept. 2021,

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