Home Health Care Workers in Hawaii

Hawaii

Home health and personal care aides enable older adults to remain in their homes as they age — a preferred care option for many. These aides provide short-term skilled nursing services, such as aiding in recovery from surgery, as well as long-term care for those with disabilities, functional decline or chronic illness. 

The number of adults age 65 and older is projected to increase from 56 million to 73 million by 2030. The need for home health and personal care aides is therefore projected to grow much faster than the national average for all occupations, with a predicted 804,600 job openings added between 2022 and 2032.

Home- and community-based services are less expensive care options than institutional care facilities like nursing homes. The average annual cost for nursing home care was $94,900-$108,405 in 2021, compared with approximately $60,000 for home health care services. Using home- and community-based services may lead to cost savings in the long-term care sector.

Adults age 65 and older make up the majority of patients who use home health care services. The use of home health care services is higher among:

• Adults ages 75-84 compared with those ages 65-74 and those age 85 and older.
• Women compared with men. 
• Older non-Hispanic white adults compared with adults of all other racial groups.
• Older adults in metropolitan areas compared with those living in non-metropolitan areas. 
• Adults who live with their family members compared with those who live alone or with non-family members. 
• Adults who are unmarried compared with those who are married.

While Medicare covers many part-time or temporary home health care services, it does not cover ongoing supportive care. The Affordable Care Act allows states expanded options to pay for home- and community-based services through state Medicaid benefits and provides new funding opportunities through the Balancing Incentive Program. Programs of All-Inclusive Care for the Elderly, a Medicare and Medicaid initiative, is a program for older adults who need nursing home-level care and are seeking assistance paying for home health care.

Addressing the home health workforce shortage can help bring services to more rural areas and contain rising health care costs. Strategies include increasing reimbursement rates for community health workers and incentivizing family members to care for their elderly relatives. The 2022 National Strategy to Support Family Caregivers report offers additional ways for state and federal governments to support family caregivers. 

County Health Rankings & Roadmaps offers several evidence-based strategies for increasing the quality of home health care services and decreasing negative health outcomes for older adults. These strategies include an integrated long-term care model to address the needs of older adults who reside in the community and a case management model to coordinate care across a team.

The Department of Health and Human Services’ Eldercare Locator can help you find home health care services for older adults in your area.

“2022 National Strategy to Support Family Caregivers.” Administration for Community Living, September 21, 2022. https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf.

Hostetter, Martha, and Sarah Klein. “Helping Older Adults Age Well in Rural America.” Feature article. The Commonwealth Fund, November 9, 2023. https://doi.org/10.26099/411v-9255.

Kaye, H. Stephen, Mitchell P. LaPlante, and Charlene Harrington. “Do Noninstitutional Long-Term Care Services Reduce Medicaid Spending?” Health Affairs 28, no. 1 (February 2009): 262–72. https://doi.org/10.1377/hlthaff.28.1.262.

“Long-Term Care in America: Americans Want to Age at Home.” Issue Brief. The AP-NORC Center for Public Affairs Research, May 2021. https://www.longtermcarepoll.org/wp-content/uploads/2021/04/LTC_Report_AgingatHome_final.pdf.

Mitzner, Tracy L., Jenay M. Beer, Sara E. McBride, Wendy A. Rogers, and Arthur D. Fisk. “Older Adults’ Needs for Home Health Care and the Potential for Human Factors Interventions.” Proceedings of the Human Factors and Ergonomics Society Annual Meeting 53, no. 11 (October 2009): 718–22. https://doi.org/10.1177/154193120905301118.

Quigley, Denise D., Ashley M. Chastain, Jung A. Kang, David Bronstein, Andrew W. Dick, Patricia W. Stone, and Jingjing Shang. “Systematic Review of Rural and Urban Differences in Care Provided by Home Health Agencies in the United States.” Journal of the American Medical Directors Association 23, no. 10 (October 2022): 1653.e1-1653.e13. https://doi.org/10.1016/j.jamda.2022.08.011.

Sengupta, Manisha, Jessica Penn Lendon, Christine Caffrey, Amanuel Melekin, and Priyanka Singh. “Post-Acute and Long-Term Care Providers and Services Users in the United States, 2017–2018.” National Center for Health Statistics (U.S.), May 9, 2022. https://doi.org/10.15620/cdc:115346.