In a dramatically changing policy environment, direct care workforce-focused investments and innovations are more important than ever—to improve the quality and efficiency of care, bolster the U.S. economy, and build a better future for people and families in every state.
In this brief, we offer a direct account of both longstanding and current challenges and define an urgently needed path forward for state and federal policymakers. In Part One, we offer strategies to preserve our nation’s existing long-term care system and strengthen outcomes for all whose lives intersect with it. In Part Two, we offer proactive strategies to reimagine care and build a better future for direct care workers, older adults, people with disabilities, and all who rely on our nation’s care infrastructure.
Key Takeaways
Direct care workers already facing poor job quality and high turnover are now threatened by unprecedented Medicaid cuts, harsh immigration enforcement, and proposed rollbacks of basic labor protections like minimum wage and overtime.
Urgent priorities include restoring Medicaid funding, implementing nursing home staffing standards, protecting immigrant workers, sustaining Fair Labor Standards Act protections for home care workers, and rebuilding federal infrastructure that supports long-term care programs.
Beyond preserving long-term care, the system needs universal training and credentialing with portable credentials, fair compensation strategies, continued state-level workforce innovations, and reformed long-term care financing to sustainably support quality jobs and quality care.
