Katherine Mitchell in wheelchair is joined by her mom, Michelle Mitchell (Left) and BAYADA staffers as they prepare to visit lawmakers to advocate for better pay for caregivers. (photo: Greg Childress)
Melissa Mitchell and her daughter Katherine Mitchell were among dozens of home health care advocates who came to Raleigh on Wednesday to ask lawmakers to invest more in home health aide services.
The advocates say an appropriation of an additional $120 million is needed so that home health employers can keep pace with Amazon, McDonald’s and other corporations that pay employees more than the $14-$16 per hour caregivers earn in North Carolina. Medicaid and other federal reimbursement programs don’t allow them to pay more, they said.
Meanwhile, hourly pay at Amazon starts at $22 per hour, advocates said.
“I think caregivers should make more than Amazon employees or McDonald’s employees,” said Melissa Mitchell, a paid family caregiver for daughter Katherine who has Muscular Dystrophy.
Melissa Mitchell, a BAYADA Home Health Care employee from Greensboro, doesn’t begrudge anyone their Amazon purchases or Big Macs, but believes people who care for the elderly and people with disabilities should be fairly compensated for the difficult work they do.
“It’s a very intimately driven job … and you need to have an extremely large heart,” Melissa Mitchell said. “There’s no value that you can place on this.”
Katherine Mitchell said it’s beneficial to have her mom as caregiver because she “knows me best and knows how to care for me.”
Katherine Mitchell, an artist, said she planned to share tidbits about her life with lawmakers. At home, Katherine Mitchell said, she is surrounded by people who know her and love her.
“I wouldn’t be able to thrive as I am if I wasn’t able to be cared for at home,” Katherine Mitchell said.
Wednesday’s advocacy day event was organized by Hearts for Home Care (H4HC) in conjunction with the Association for Home & Hospice Care of North Carolina (AHHC) and SembraCare. More than 150 people were expected to meet with lawmakers throughout the day to urge them to increase funding for health aide services.
The organizers contend that 51,000 seniors and people living with disabilities are in danger of losing access to care due to staffing shortages. Aides, they said, are being forced to leave the home health care industry to find better paying jobs.
In February 2024, a North Carolina Health Talent Alliance workforce demand survey found that the turnover rate for in-home caregivers was 80%.
“Caregivers will come in and they’re disappointed in the wage, and they’ll start with us but if an agency down the road will pay them 25 cents [an hour] more or McDonald’s will pay them 25 cents [an hour] more, then they leave us,” said Felicia Cunningham, division director at BAYADA. “There’s not a lot of commitment to this work because they’re trying to make ends meet.”
Cunningham and others said an increase to $25 per hour would make a huge difference in recruitment and retention.
“Twenty-five dollars an hour would make an amazing difference because we could compete with caregivers in nursing homes, caregivers at hospitals and the fast-food industry,” Cunningham said.
Rep. Donna McDowell White (Photo: NCGA)Rep. Donna McDowell White (R-Johnston) noted in an interview with reporters the cyclical nature of the issues that tend to capture the attention of lawmakers. White said that could mean there’s little-to-no appetite this year for additional funding for home health caregivers after recent increases funded by federal COVID dollars.
“Folks that tend to be at the Fulcher level [a reference to a legislative budgeting term] see things in a cyclic pattern and they might really focus on health care one year, then they’ll focus on another issue another year,” White said. “I’ve just seen that as a pattern. I think this year, it’s not only keeping with that pattern, but it’s also the fact that we just don’t have the resources that we’ve had with all over the extra federal money that we’ve had.”
On the Senate side, Sen. Gale Adcock (D-Wake) said most health care legislation thus far in 2025 has consisted of bills to alter policies and not “money bills.”
Adcock said home health care providers are small businesses and there needs to be a way to help them to succeed.
“I think their [lawmakers] hearts are there, it’s finding the money because there’s never enough money to do everything you want to do,” Adcock said.
Monica McKenney, CEO of Carolina Home Care, LLC, said one of the toughest parts of her job is telling a new hire how much they will be paid.
“When I have to tell her $14 or $15 an hour, it’s like crickets, everything gets quiet,” McKenney said.
New hires say they can’t work for that amount because they can’t pay bills or put food on the table, McKenney said. McKenney said new hires also tell her that $14 or $15 an hour will only pay for gas to travel to take care of the client.
“It’s frustrating to me and honestly, it’s a little embarrassing,” McKenney said.
Shannon McCarson, regional director of the Southeast and Midwest for BAYADA, echoed those concerns, and said hiring and retaining staff has been a big challenge. McCarson said the home health care industry is losing employees to Amazon and fast-food restaurants at a time when the number of caregivers is declining and the need for their services is growing.
The $120 million request from the state would go a long way toward helping to improve pay for caregivers, he said.
Toynia Edmond-Moore (Photo: Greg Childress)“It just puts us in a more competitive wage range, and it creates more of a living wage for those caregivers so that they can do the work they love to do,” McCarson said. It becomes a win for everybody.”
Toynia Edmond-Moore traveled from Charlotte to share photos of her brother Derrick Hasan Allen who died in October at age 23. Allen had developmental disabilities and received home care 10 hours per day, Monday through Friday, Edmond-Moore said.
“We would not have had my brother for as long as we did without home health,” said Edmond-Moore.
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