Direct Care Workforce

This report summarizes findings from research involving stakeholder organizations working with family caregivers in the private and public sectors. The report includes insights into best practice models and action steps that can be included in the national strategy to meet the RAISE goals. Additional stakeholder groups such as the direct care workforce, county health care providers, employers, aging and disability organizations, faith-based groups, respite care providers, and others participated in a series of individual interviews and group listening sessions.

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 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.

This report looks at the changes states implemented to their Medicaid or other publicly-funded consumer directed home care programs in order to comply with the 2013 FLSA Home Care Rule. The report includes perspectives from various stakeholders and describes issues raised in interviews. It provides an overview of early implementation efforts, an environmental scan of state policies and procedures, and a case study examination of states with well-documented hardship exceptions.

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.

This brief focuses on how providers can recruit and retain a direct care workforce. Considerations include inclusive hiring practices, cultivating an organizational environment of inclusivity, and providing appropriate training. Companion briefs in this series discuss direct care worker training and organizational cultural competence.

This brief highlights how providers can train their workforce in cultural competency. Key recommendations include establishing formal policies, focusing on the elements most relevant for LTSS, using adult learner-centered methods of training, and identifying which programs work best for your organization's setting. Additional briefs in this series focus on organizational cultural competence and recruiting and retaining a diverse direct care workforce.

This brief describes how LTSS providers can build cultural competence within their organization. It covers key considerations including identifying areas for improvement, supporting diversity across the organization, addressing linguistic competence, and engaging community partners. Other briefs in this series provide specific considerations for training, recruitment, and retention of direct care workers.

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.