My career is as a physician in post acute care settings. From my experience one of the biggest, if not the biggest, issue regarding home care for seniors is the cost. The agencies near us are rather expensive for most seniors. It&#x27;s covered by Medicaid for those who have it and some insurances provide benefits, but otherwise if you are a senior who needs care for several hours to 24 hours a day, you are typically paying about $20 an hour or $200 a day. Medicare does not cover it, and a lot of people cannot afford it. Which is why when we discharge people and make the recommendation for home care, and connect them with an agency, many patients and families do not follow through with it, beyond what their insurance may cover for a short period of time. 
Mind you I realize this doesn&#x27;t mean the caregiver gets paid anywhere near $20 an hour or $200 a day, so I applaud Honors intentions of making them full time workers with, I hope, benefits. 
But the bigger issue is how do seniors pay for these services? It will probably require a change at the level of CMMS.