Showering daily, getting her hair braided for church and maintaining some independence are some of the basic human dignities that Linda Stokes worries she would lose if she had to move to a senior nursing facility. Instead, Stokes, who requires daily care due to complications from multiple strokes and other health problems, is able to stay in her North Side home with the help of her primary caretaker Angela Engram, who works full time under the state’s Participant Directed Services program.

State Rep. Jessica Benham, D-South Side, spent an afternoon with Stokes and Engram to learn more about the challenges faced by home health care workers and people who need home care.

State Rep. Jessica Benham, D-South Side, center, talks with Linda Stokes and her caretaker Angela Engram, of the Hill District, a home health care worker under the Participant Directed Services program, in Stokes’ North Side home during a visit to learn about the daily life of a home care worker, Friday, May 3, 2024.

Benham is cosponsoring a bill with Republican state Rep. Jason Ortitay, R-Cecil, who represents District 46, that aims to address a workforce shortage of home care workers that is due to low wages, no benefits, and long hours with no time off. Currently, there’s only one home care worker for every six people who need care, according to a memorandum announcing the bill.

The legislation will increase the minimum hourly wage for home care workers to $15 immediately with a path to $20 and mandate that home care agencies spend at least 80% of the total funding they receive on worker compensation. It will also mandate yearly reporting from the agencies on the use of taxpayer dollars and require re-analysis every three years to ensure pay continues to reflect inflation.

“There was a time when $13 an hour was a competitive wage, but now, when you can make $17 an hour working at a fast food place, it’s not competitive. And that’s our fault at the state level,” said Benham. “We’re looking at more and more folks growing old in Pennsylvania and not enough caregivers already,” she said.

Engram braids Stokes’ hair to prepare her for the Friday night church service they attend together.

Engram met Stokes through church, where they became like family. “I call her mother, and she considers me her daughter,” Engram said.

In 2020 Stokes’ husband became sick and died from lung cancer leaving her with no local family. That’s when Engram stepped in and soon became her full-time caregiver through the state’s Patient Directed Services program, which allows people in need of daily care to have a say in who provides it while allowing caretakers to be compensated for their work.

“If I didn’t have her, I would be lost,” said Stokes. “I wouldn’t trade her in for the world because she knows me. She takes care of me as if I were one of her own.”

During the visit Engram showed Benham some of many tasks she does for Stokes on a daily basis, including helping her put on compression socks, cleaning the catheter she uses overnight, making her bed, braiding her hair ahead of the Friday night church service they attend together, and preparing her medication two weeks in advance.

Engram said that at her current hourly wage of $13 she struggles to make ends meet. “[An additional] $5 an hour would do just so much for me. First of all, I probably wouldn’t have to go to a food bank to get food. A lot of us work without health care, so it would do so much just being able to provide care for myself,” she said.

“I could never repay her for what she does for me,” said Stokes, “so she’s got to get it from somewhere else.”

Alexandra is a photographer at the Pittsburgh Post-Gazette, but she's currently on strike.

Alexandra Wimley

Alexandra is a photographer at the Pittsburgh Post-Gazette, but she's currently on strike.