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South Carolina Lawmakers Pause Debate on Bill to Raise Direct Care Worker Pay
Bill H.4464 could help strengthen the caregiving workforce by increasing wages for workers who support older adults and other vulnerable South Carolinians at home.
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South Carolina lawmakers this week paused debate on Bill 4464, a closely watched proposal that could help raise wages for direct care workers who support older adults and other people with care needs.
The bill, which has remained in committee since 2025, would create a Medicaid pass-through aimed at increasing pay for workers who provide in-home care and other essential support. At the center of the debate is a key question: How much of the Medicaid provider payment should go directly to workers?
Advocates and members of the direct care workforce are urging lawmakers to require that at least 70 percent of the proposed $25 hourly rate reach caregivers. They say that level is needed to make sure wage increases truly benefit workers, rather than being absorbed elsewhere in the system.
During the discussion, one longtime caregiver shared a powerful example of the challenges many workers face. She said that in 20 years of caregiving, the highest hourly wage she has earned is $11.50. Despite her deep commitment to the work, she described the personal cost of staying in the profession: losing her home, her vehicle and her own health. At times, she said, she has had to walk to work because she could not afford a car, insurance or gas.
The decision to adjourn debate highlights how complicated and sensitive the issue has become. Lawmakers are weighing the urgent need to strengthen a strained caregiving workforce against concerns about cost, oversight and implementation.
For direct care workers and the families who rely on them, the delay means more waiting. It also reflects a broader challenge facing many states: how to turn support for caregiving into policies that deliver meaningful, real-world results.
If enacted, Bill 4464 could play an important role in helping stabilize South Carolina’s care workforce and improving support for the people who make it possible for many older adults to live safely and independently at home.
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