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the question of how to provide necessary health care and personal services to a growing population over age 65 is an urgent policy problem facing new Hampshire and the nation. With the aging baby boom generation, the new Hampshire population over the age of 65 is growing twice as fast as the total population,1 and today 13 percent of the state’s population is age 65 or older, up from 11 percent in 1990.2 research shows that the population over 65 in new Hampshire prefers to remain in their own homes and receive home-based care rather than reside in a nursing home or an assisted living facility.3 There is evidence suggesting that home-based care may be more cost effective than institutional care, as states with established home and community-based services (HCBs) experienced cost savings in Medicaid spending over time.4 In response to the preference for home-based care among older adults and people with disabilities and the potential for cost savings, the state of new Hampshire has supported the expansion of the HCBs system and increased Medicaid funding for homebased services.5 The growing older population and their desire to remain in their homes coupled with increased funding for homebased services translates into increased demand for the services the home care workforce provide. In fact, the new Hampshire Department of employment security projects that between 2006 and 2016, “home health aide” will be the fastest growing occupation, highlighting the demand and preference for home-based care.6 yet, despite the growth of the home care workforce in new Hampshire, the demand for home care workers outpaces the supply. new Hampshire is just not keeping up with the rising demand. High turnover rates are common among the home care workforce. The majority of direct care employers in new Hampshire agree that turnover is a problem and state that they need to hire one or more home care workers to meet current service demands. High turnover in this workforce contributes to lower-quality care. Furthermore, research Key Findings:

Home care workers: keeping Granite Staters in their homes as they age