By Emily Eisner, Ph.D.
March 2023

Key Findings

  • Over 6 million New Yorkers will be over age 65 by 2035 — an increase of 29% in the next decade
  • Nearly 1 million New Yorkers will require home care by 20351
  • With no wage increase, the home care worker shortage will hit 47 million workers by 2035
  • Home care workers make approximately 40% less than workers in nursing care facilities


New York State has been reported to be one of the states most at risk of incurring a shortage of healthcare workers over the next decade (Stevenson, 2019). With a quickly growing population of adults over the age of 65 (“older adults”) and a movement towards “aging in place,” the demand for home care workers will rise dramatically over the next decade. As of 2016, the healthcare workforce accounted for over 11 percent of all wages paid in the state and was growing faster than any other sector (New York Department of Labor, 2016). The healthcare sector accounts for an even larger share of work for women, immigrants and people of color and the healthcare industry is expected to see more growth than almost any other industry over the coming decades. However, compensation in care work and home care in particular are some of the lowest of any industry, often just above the minimum wage with little to no additional benefits. These jobs are precarious, and undercompensated relative to other similar jobs. Low wages paired with challenging day-to-day tasks on the job creates a labor market with shortages and high turn-over, resulting in a constant need for recruitment and unmet needs of older adults and people with disabilities.

1 Exact figure: 932,000

The Home Care Association of New York State (HCA) reported in 2019 that 87 percent of home care and personal care services were covered by the New York Medicaid system (HCA, 2019). The striking number of home care workers being paid out of state Medicaid funds make understanding this labor market of key importance to state policy-makers. Not only is this market of large consequence to the state budget — much of which goes to Medicaid services — but additionally, the large and increasing needs of the New York aging population demands urgent attention as individuals find it difficult to attain services. Due to the fact that a vast majority of home care needs are being met via the state’s Medicaid services, it is of crucial importance for state policy-makers to account for the large and rising demand.

This report documents ongoing research, develops evidence for the increasing shortage of home care workers in New York State, and provides an economic model demonstrating that increasing the wage paid to home care workers will lessen the crisis of home care shortages for New York’s aging and disabled population.