Ohio lawmakers unanimously advance plan to study caregiver shortage as aging population grows

COLUMBUS, Ohio — State lawmakers have advanced a proposal aimed at understanding and eventually remedying a growing shortage of at-home caregivers for older adults and people with disabilities.

House Bill 530 cleared the Workforce and Higher Education Committee on a 10–0 vote this week after six hearings.

Sponsored by Rep. Darnell Brewer, a Cleveland Democrat, and Republican Rep. Jodi Salvo of Bolivar, the bipartisan legislation would establish a commission tasked with examining Ohio’s direct care workforce shortage and recommending solutions to lawmakers. The initiative was fueled by an increase in demand for care as the state’s aging population grows and providers struggle to retain workers.

The same day as the unanimous vote, House Republicans backed away from a proposal that would have barred Medicaid from paying family members who serve as caregivers for relatives with disabilities or serious medical needs. The provision was removed from a Medicaid overhaul bill following immense pushback.

‘Grounded in lived experience, not bureaucracy’

Rather than creating new programs or funding, HB 530 aims to set up the Long-Term Care Workforce Study Commission to study:

• Current and future demand for direct care workers
• Statewide recruitment campaigns
• Career ladders and advancement opportunities
• Training needs
• Educational pathways
• Hiring barriers
• Job quality improvements
• Shared staffing models among providers
• Potential funding mechanisms and pilot programs
   
   

Supporters repeatedly emphasized that the commission would not simply consist of lawmakers studying the issue from afar. The group would include lawmakers from both parties, representatives of direct care workers, members of advocacy organizations and recipients as well as providers of long-term care. State officials from the departments of Aging, Developmental Disabilities and Veterans Services would serve as non-voting members.

“These perspectives are vital because they understand the daily realities of caregiving, the challenges caused by workforce shortages, and the support necessary to provide safe, consistent, high-quality care,” Brewer told lawmakers. “By ensuring that both providers and recipients of care have official seats at the table, this commission is grounded in lived experience, not bureaucracy.”

Per the most recent draft of the bill, the commission would be required to issue a report with recommendations to the General Assembly by Oct. 31, 2027.

Staying ahead of a growing need

It’s no coincidence that the bill was introduced as Ohio is entering a period of unprecedented demographic change.

Salvo told lawmakers Ohio’s fastest-growing age group is adults 85 and older — the population most likely to require long-term care, home-based services and ongoing support.

Citing data compiled by Miami University’s Scripps Gerontology Center, Bob Applebaum shared that Ohio is home to more than 2 million residents ages 65 and older as well as more than 230,000 residents ages 85 and older. The research institute also found that approximately 266,000 older Ohioans currently have a high need for long-term services and supports, a number expected to continue growing in the coming decades.

Area Agency on Aging Region 9’s Jud Love pointed to projections by the Ohio Department of Aging showing that the state’s population under 60 is expected to decline by 7.4% by 2030 while those over 60 are projected to increase by 33.4%.

“More people requiring assistance and fewer people to deliver the care,” he said. “The perfect storm.”

No longer a future problem

While much of the discussion centered on future workforce needs, many witnesses argued the consequences are already evident today.

Eli Faes of LeadingAge Ohio referred the committee to statistics from the Governor’s Office for Workforce Transformation showing that home health and personal care aides currently account for more than 16,000 job openings statewide. However, a study published by Innovation in Aging cited by Brewer noted that Ohio’s direct care workforce experienced a staggering 78% turnover rate in 2023.

“If Ohio does not act proactively, the growing demand for care will outpace workforce capacity,” Rep. Salvo warned legislators.

Direct care workers assist older adults and people with disabilities with essential daily activities such as bathing, dressing, preparing meals, taking medications and getting to appointments. Without that support, many individuals would be forced to leave their homes.

Katie Hunt Thomas, a disability rights attorney with The Ability Center, said that the organization got involved in the issue after hearing from people with special needs who could not find caregivers. She shared that many were forced to rely on friends and family, while some even went without care altogether or moved into nursing facilities despite wanting to remain independent.

Jennifer Kucera of the Ohio Olmstead Task Force stressed the urgency of the matter.

“Without these workers, many Ohioans would be institutionalized or worse,” she said.

Several advocates noted that workforce shortages affect not only people receiving care but also their families.

According to a 2023 report by the American Association of Retired Persons, 1.46 million Ohioans serve as family caregivers. Together, they provide an estimated 1.37 billion hours of unpaid care annually — work valued at approximately $21 billion.

Salvo said many families are already balancing jobs with caring for aging parents and relatives. When reliable care cannot be found, those caregivers often face difficult decisions about reducing work hours or leaving the workforce entirely.

The Ohio Chamber of Commerce echoed that concern, with representative Molly Mottram noting that workforce shortages in long-term care have ripple effects throughout the state’s economy because they remove workers from the labor force and place additional strain on employers.

Wages and beyond

Disability rights advocate Dr. Jules Patalita argued that more research is necessary because the issue does not stem from a single factor. He conducted a study last year on caregivers and home-care agencies in Northwest Ohio after Medicaid reimbursement rates for direct care services were increased in the state, finding that the average adjustment was $1.55 per hour — the first pay raise for 73% of participants.

“That’s barely enough to keep up with inflation, and many of the caregivers called it ‘not significant,’” he said. “Almost half of the participants had never even heard of the reimbursement increase until I brought it up.”

Several witnesses stated that higher wages alone will not solve the problem, and that the workforce crisis stems from multiple interconnected challenges.

Kucera brought attention to limited benefits, inadequate health insurance, a lack of career advancement opportunities, burdensome certification requirements and low public awareness of caregiving careers. Likewise, Kerstin Sjoberg of Disability Rights Ohio highlighted inadequate job advancement opportunities and inconsistencies across programs serving people with disabilities.

The bill received support from a wide range of organizations, including Ohio Association of Area Agencies on Aging, Stark County Board of Developmental Disabilities, Ohio Health Care Association, Ohio Association of People Supporting Employment First and The Arc of Ohio.

Across six hearings, there was no opposition to HB 530.