WASHINGTON — The phones never seem to stop ringing at the offices of Granny Nannies, a company providing home care services across the country. 

“Services and service requests have definitely increased. We are very busy,” said Stephanie Valencia, an administrator for Granny Nannies in Sarasota, Fla. 

Valencia said her branch of Granny Nannies has lost 20 percent of its caregivers since the COVID-19 pandemic began, as the demand for in-home care has continued to grow

“The timely manner in which we are able to initiate services has definitely been the thing we’ve struggled with,” Valencia said.

“Our recruiting team is working harder than they ever have, trying to reach out to as many caregivers as possible,”she said.

Across the country, there’s an unprecedented shortage of in-home health workers, leaving older adults and people with disabilities without the caregivers they need.

Some caregivers have stopped working in the midst of the pandemic. Others have stopped working for clients receiving Medicaid, which many low-income people rely on for home care. Spectrum News independently verified rates from home care companies across five states. Medicaid reimbursements paid an average of $10 less an hour in comparison to those paying for care privately. For example, in Florida, Medicaid pays about $17 an hour for in-home care. However, the market rate for caregivers in the state has increased to an average of $28-$29 an hour.

“Our caregivers are getting paid more than they were prepandemic,” Valencia said. “They are expecting higher hourly rates, higher than national average rates to get caregivers into the homes.”

The reimbursement structure is part of the solution to ensuring long-term access to Medicaid home- and community-based services,” said Jack Rollins with the National Association of Medicaid Directors.

Rollins said other action needs to be taken to retain this workforce of caregivers.

“We think rates are part of the solution, but we also want to see the ability for states to have build-outs and career development pathways and training programs,” Rollins said. “To allow people who start to provide these services to get more specialized and perhaps see some more routine and predictable increases in their wages and benefit structures that attach to that increased specialization as they go up that training pathway.”

One part of President Joe Biden’s Build Back Better plan would increase reimbursements under Medicaid to open up care options within the home for more families, in addition to increasing wages and benefit opportunities for workers. Like most Republicans, Senator Marco Rubio, R-Fla., opposes Biden’s broader domestic agenda. However, he said he agrees Medicaid should pay more for home care. 

“To the extent that Medicaid reimbursements and its numbers are discouraging care, that is most definitely something I’m willing to look at and dealing with on a targeted basis. I think that is critically important,” Rubio told Spectrum News.

Across the country, at least 820,000 people are on wait lists for Medicaid waivers to help pay for home care, according to the Kaiser Family Foundation.

An update to the reimbursement system would go a long way to providing more people with the care they so desperately need, experts say. 

"If Medicaid could increase their rates to be competitive with our private pay clients and their rates so we can match the caregiver’s expectations, that would be beneficial,” Valencia said.