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Pennsylvania is aging fast—and that’s reshaping demand for home care. 

That reality is already showing up in open shifts, caregiver churn, and tighter reimbursement math — in short, a Pennsylvania home care workforce crisis that agencies cannot afford to ignore. 

Policy overhang from the so-called “One Big Beautiful Bill” (also referenced as H.R. 1) adds another layer: some provisions don’t take effect until 2027–2028, but planning (and persuading) starts now. 

This recap translates a fast, policy-dense hour from the CareSmartz360 webinar into a field guide you can use in district offices and budget meetings alike. You’ll hear directly from: 

• Mia Haney, CEO, Pennsylvania Home Care Association (PHA)

  Mia has been steering statewide alignment on messaging, data, and workforce investments.
  

• Laura Ness, Head of Government Affairs, Abby Care

  Laura has laid out how to turn that alignment into wins—one conversation, one data point, and one relationship at a time.

Below are five agency-ready takeaways to help you plan the next 12 months with clarity:

Takeaway 1: Always have a seat at the table in Pennsylvania home care advocacy

Laura opened with a reality check: “If you’re not at the table, you’re on the menu.” She pushed the idea of persistent, multi-threaded engagement: “You have to sit through the whole meal… more of us, quite frankly, need to be at the table.” 

Being present early and often prevents reactive scrambling later. In a split-government environment (House D / Senate R / Governor D), “there’s been a… lack of willingness to invest in this population,” so consistent contact matters.

Takeaway 2: Say less, land more – Messaging tips for Pennsylvania home care agencies

Mia’s playbook is wonderfully un-fancy—and that’s why it works. “Identify talking points… and that they were going to be the only talking points.” Why? “It is very easy to confuse our legislature… our space is complex.” PHA built a “Home Care 101” booklet with “only a couple of key topics per page” and “fourth-grade readability” so staff could actually use it mid-meeting.

She’s ruthless about brevity: “Two to three items on that one page is max… We went through at least a hundred versions.”

Takeaway 3: Build a sticky data spine for Pennsylvania Medicaid policy conversations

Both speakers emphasized data—but with discernment. Laura explained how PHA aligned member data with state studies and outside analyses (e.g., Mercer) to “quantify need, cost, and value.” 

Then Mia revealed the statistic that actually moved minds: not dollars, but missed visits.
“It was 112,500… every single month in Pennsylvania… That is what stuck with them.” Legislators could visualize people waiting—not just budgets.

Meanwhile, Pennsylvania’s demographics pressure is accelerating: “We are the fifth most graying state… [and] the first most graying when it comes to the 85+ with complex needs,” Laura noted. That context helps your numbers land.

Takeaway 4: Put your caregiver workforce at the center of Pennsylvania home care strategy

Mia connected federal policy to frontline reality: “We’re watching work requirements [and] benefits… Medicaid health benefits are supporting more than 310,000 people here… Many of them are your workforce.” 

Losses in Medicaid coverage or SNAP “mean far more out-of-pocket expenses,” pushing caregivers to other industries—“our reimbursement rates just don’t allow us to pay competitively.” Translation: workforce shortages could worsen without policy fixes. In short: the Pennsylvania home care workforce crisis is as much about benefits and social supports as it is about pay.

Crucially, PHA didn’t just ask for money; it invested in people:

• Free “My Learning Center” courses for family caregivers, paid caregivers, HHAs, and participant-directed workers.
• A $600,000 grant to expand training and create HHA certification pathways.
• Advocacy Day with caregivers + clients: “Some of them will move you to tears.”
• Meta/geotargeted ads to mobilize workers: “We saw a phenomenal response.”

Laura tied this to credibility: “By working towards these types of grants… it proves that out for our legislators… ‘What else have you done?’—we can rattle off the list.”

Play the long game – How Pennsylvania home care agencies win on Medicaid reimbursement

Several provisions tied to the “One Big Beautiful Bill” won’t kick in until 2027–2028, Mia noted—“time for advocacy and time for change.” But states are already bracing for compliance costs: Pennsylvania estimates just under $100 million in staffing for work requirements and six-month redeterminations—“Where does that money come from?” When dollars get squeezed, “securing reimbursement rate increases… may be more challenged.”

Mia’s framing is sanity-saving: “Advocacy is a journey… just because you didn’t get what you asked for does not mean that you didn’t win.” This year might deliver regulatory efficiencies; next year, a rate bump; the following, a workforce grant. 

Laura underscored the compounding effect: “Start early… next year we have the same crop of legislators, which means… a much higher level of education.”

Here’s the formula Mia and Laura just handed agencies:

• Show up. (“Sit through the whole meal.”)
• Say one thing well. (Two–three points per page; 4th-grade readability.)
• Prove it. (Pick one stat—like missed shifts—that people can’t unsee.)
• Invest first. (Training, certifications, grants—“money where our mouth is.”)
• Play long. (“There may be a yes somewhere else.”)

Final note

That’s how you turn today’s headwinds into next year’s wins — and how the Pennsylvania home care workforce crisis can be stemmed.

Or, in Mia’s words: “Please don’t ever look at it as a loss… every year builds on the next.” If you’re a home care owner in Pennsylvania, that’s your north star for the next budget cycle—your agency at the table, your story tight, your data sticky, and your workforce front-and-center. That’s how you turn today’s headwinds into next year’s wins.

If you’re wondering where to start, think 30-/90-day sprints. In the next 30 days, schedule two district meetings, print a one-page “Home Care 101,” and assemble your three-point data spine (missed shifts, workforce gap, local client story). 

In 90 days, add five caregiver/client stories to your “Faces of Home Care” packet, track any commitments you made to staff (training hours, wage steps), and report back to your legislators—close the loop to build trust. 

Fold this into your culture: brief your office weekly, celebrate small wins, and coordinate through PHA. As Laura said, stay for “the whole meal.” As Mia reminded us, every cycle stacks—today’s story is tomorrow’s rate, grant, or regulatory relief.

Align with home care associations in Pennsylvania, document your home care staffing investments, and read up on how to advocate for better home care reimbursement so your case is specific and fundable. After all, home care policy reform in PA is a marathon, not a sprint.