Direct Care Workforce

States are often exploring ways to effectively support direct care workers, who are often times women, people of color, and living at or near the poverty level. This blog post explores four key recommendations for states to strengthen their direct care workforce, with an emphasis on state Medicaid agencies. The post draws from a CHCS report which focused on strategies used in the state of Michigan.

This scan highlights examples of strategies in 11 states, including Colorado, Iowa, Illinois, Indiana, Massachusetts, Minnesota, Nevada, New Jersey, Tennessee, Washington State, and Wisconsin, that have been aimed at strengthening the direct care workforce through legislation, American Rescue Plan Act funding and training.

This PHI report provides a new annual snapshot on the direct care workforce, including its demographics, occupational roles, job quality challenges, and projected job openings. The report includes detailed overviews of home care workers, residential care aides, and nursing assistants in nursing homes, as well as analyzes how the pandemic has affected the workforce.

The AARP Public Policy Institute recently launched a three-year initiative which aims to transform long term care in the United States. LTSS Choices will be a series of reports, blogs, videos, podcasts, and virtual convenings that seek to catalyze reform and spark ideas to modernize LTSS, long term services and supports. The goal is a long-term care system that provides a wide range of choices to meet the dynamic needs and preferences of consumers and their families.

Like many states, Michigan is facing a looming workforce shortage as their aging population grows. This policy brief from the Michigan Aging & Adult Services Agency highlights the challenges and opportunities in addressing the state's direct care workforce (DCW) issues. Challenges that have led to this shortage include low wage levels, lack of affordable comprehensive training, and low job appreciation and respect. This paper identifies various strategies for overcoming these issues.

The report provides an overview of the expected increased need for direct care workers and a breakdown of the current direct care workforce. In each description of barriers facing the direct care workforce, PHI includes program and policy recommendations. Challenges and recommendations in this report include areas regarding: wages and benefits, training, advanced roles, supervision, recruitment and retention, data collection, decision-making, family caregivers, and matching service registries.

This report is the third in a series of publications from the MLTSS Institute. The report identifies the challenges and promising practices in addressing the mismatch between supply and demand for direct care workers in long term services and supports programs, all viewed through the lens of MLTSS programs. This report is co-authored by ADvancing States and Sage Squirrel Consulting, LLC.