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Funds are key to fill growing gap in home health and nursing care

Home health care aide Tricia Gagnon steadied her client, Al Wolfe, as he exercised inside his Peabody home.Jessica Rinaldi/Globe Staff

Staff can’t fill need for in-home and day services

Thank you for the Oct. 10 editorial, “Raising wages for an overlooked workforce: home health caregivers.” Our workforce providing in-home assistance, day services, and small congregate homes has dipped far below what’s needed. There was already high turnover before COVID-19, and now the inability to fill hours at in-home or in congregate settings represents a staffing gap of more than 35 percent. Can you imagine such a gap in your life?

We estimate that more than 3,000 people still have not returned to day services, leaving the people we serve isolated and caregivers overwhelmed after 30 months of the coronavirus pandemic. A census of personnel at day programs for those with autism, Down syndrome, and other developmental disabilities is below pre-COVID staffing levels. For example, MassHealth’s Dayhab program reports 7,200 staff; pre-COVID numbers approached 10,000. In-person attendance at Department of Developmental Services day supports (as of June 2022) was reported at 78 percent, but that doesn’t tell us how many people are back full or part time.

The individuals most affected are the ones who require one-to-one assistance for mobility, eating, bathing, and nursing care or are at risk of hurting themselves or others.


Funding is needed for services, as your editorial notes, and for those who require in-home care, flexibility in the use of the funds.

Leo V. Sarkissian

Executive director

The Arc of Massachusetts


Demand for nursing home care will only grow

In your editorial “Raising wages for an overlooked workforce: home health caregivers,” you wrote about the need to make pandemic-related wage increases for home health aides permanent. We agree, and the same is true for vital nursing home staff who have seen wages grow by 19 percent due to one-time government supplemental funding.

Our dedicated and diverse staff is committed to providing compassionate round-the-clock care to more than 32,000 residents who can no longer be cared for safely at home. They are asked to help with the most intimate tasks — toileting, bathing, getting dressed, and more. They are the ones holding residents’ hands in the middle of the night and laughing with them during the day.


Since most of our residents rely on MassHealth to pay for their care, a nursing facility’s ability to invest in resident care and our workforce is directly linked to government funding that is well below the actual cost of quality care.

Currently we have 7,000 direct care nursing positions open. More than 60 percent of nursing homes in the state are not taking new admissions due to staff shortages, and worse still, many homes have closed and others will follow. This comes as demand for nursing home care is predicted to grow exponentially in the next decade.

These investments are critical to ensuring that consumers and families have access to quality nursing care now, and in the future.

Tara Gregorio


Massachusetts Senior Care Association