Chairwoman Madden convened the House Aging and Older Adult Services Committee for an informational session on home and community‑based services, where leaders of statewide home‑care trade groups told the panel that low Medicaid reimbursement, high turnover and closed managed‑care networks are restricting access to care for older Pennsylvanians.

Mia Haney, chief executive officer of the Pennsylvania Home Care Association and executive director of the Pennsylvania Association of HCBS Providers, told the committee that ‘‘home care is a person‑centered service’’ and that the sector serves roughly 300,000 Pennsylvanians annually across all 67 counties. Haney said the currently published Medicaid reimbursement rate for personal assistance services—$20.63 per hour—is insufficient to cover operating costs, training and wages.

The shortfall, Haney said, contributes to an industry‑wide turnover rate of about 79 percent and to an estimated 112,000 approved shifts missed each month. ‘‘We are in crisis and we cannot afford to wait,’’ she said, urging the committee to press for completion of a recently completed state rate study currently under executive review.

Lauren Ness, deputy executive director of Bayada Home Health Care and president of the board of the Pennsylvania Home Care Association, described how wages shape staffing choices. Citing Bureau of Labor Statistics data, Ness said the average pay for a Pennsylvania direct‑care worker is $13.35 an hour and that neighboring states commonly reimburse similar services more than $4.50 an hour higher. ‘‘We cannot blame our workforce for crossing the border when able to go and do the same work that they love for much higher pay,’’ Ness said.

Committee members asked about specific drivers of cost and possible policy responses. Haney and Ness described differences among lines of service—personal care (nonmedical, shift‑based care), home health (episodic skilled visits), private duty nursing and hospice—and noted that Medicare commonly covers home health and hospice but not long‑term personal assistance. Haney referenced a Genworth cost comparison showing average monthly in‑home care costs near $5,000 versus nursing home costs near $10,000.

Witnesses told lawmakers that Community Health Choices (CHC), Pennsylvania’s Medicaid managed‑care program for adults eligible for both Medicaid and Medicare, has helped coordinate services but also added complexity. With multiple managed care organizations (MCOs) operating under CHC, providers face differing contract rules and, in many areas, closed networks that keep some new or smaller agencies out of CHC panels. That dynamic, they said, pushes some providers to accept only private‑pay clients or to leave CHC markets altogether.

The witnesses also described training, recruitment and funding efforts. The Pennsylvania Home Care Association operates a free online learning platform with more than 80 videos; the association recently received a Department of Labor and Industry grant to train about 1,300 people new to direct‑care work. Haney and Ness said some providers offer benefits, referral bonuses and creative incentives, but added that administrative and compliance costs consume a share of the current reimbursement and reduce what can be directed toward wages.

Several committee members raised workforce pipelines and cross‑sector recruitment. Lawmakers suggested engaging programs that connect able‑bodied adults to work opportunities; witnesses said providers often are ineligible for some workforce programs because they cannot meet wage thresholds set by those programs without higher reimbursement rates from the state.

No formal committee votes were taken during the informational session. Haney and Ness offered to meet with members and staff to discuss specific legislative proposals and to provide further data once the state’s executive review of the rate study is complete.

The committee announced an upcoming informational meeting to hear from local Area Agencies on Aging on Monday, Feb. 3 at 10 a.m.