Essential but Excluded: Building Disaster Preparedness Capacity for Home Health Care Workers and Home Care Agencies

Emily Franzosa, Tamar Wyte-Lake, Emma K. Tsui, Jennifer M. Reckrey, Madeline R. Sterling

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


COVID-19 has demonstrated the essential role of home care services in supporting community-dwelling older and disabled individuals through a public health emergency. As the pandemic overwhelmed hospitals and nursing homes, home care helped individuals remain in the community and recover from COVID-19 at home. Yet unlike many institutional providers, home care agencies were often disconnected from broader public health disaster planning efforts and struggled to access basic resources, jeopardizing the workers who provide this care and the medically complex and often marginalized patients they support. The exclusion of home care from the broader COVID-19 emergency response underscores how the home care industry operates apart from the traditional health care infrastructure, even as its workers provide essential long-term care services. This special article (1) describes the experiences of home health care workers and their agencies during COVID-19 by summarizing existing empiric research; (2) reflects on how these experiences were shaped and exacerbated by longstanding challenges in the home care industry; and (3) identifies implications for future disaster preparedness policies and practice to better serve this workforce, the home care industry, and those for whom they care.

Original languageEnglish
Pages (from-to)1990-1996
Number of pages7
JournalJournal of the American Medical Directors Association
Issue number12
StatePublished - Dec 2022


  • COVID-19
  • Home health
  • disaster preparedness
  • home care
  • home care agencies
  • home healthcare workers
  • older adults


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