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Policy Reform for New York’s Workers & Consumers

As New York’s long-term care system evolves, we continue to lend our extensive experience to policy leaders statewide.

For more than two decades, PHI has driven crucial policy victories for the direct care workforce.

Our New York City home care system, which includes Cooperative Home Care Associates and Independence Care System, has piloted interventions in direct care worker training and workforce supports, spurring lessons that have improved direct care in New York and across the country. And our research, policy analysis, and advocacy have provided reliable data and sound advice to policymakers at the city and state levels.

Direct care workers in New York State are expected to grow 33 percent between 2014 and 2024—from more than 437,000 workers to about 580,000 workers. Unfortunately, due to low wages and inconsistent hours, many of them struggle to make ends meet—43 percent of direct care workers in New York fall below 200 percent of the federal poverty line, and nearly half rely on public assistance. Turnover remains high in this workforce, and providers increasingly report a growing workforce shortage, particularly in rural areas. Yet demand for home care is growing rapidly as the number of older adults who require long-term care increases.

This situation is compelling New York policymakers to devise effective ways to support this workforce and transform long-term care. PHI’s policy experts and researchers work closely with state officials to achieve this vision.


New York should increase recruitment and retention funding and compel managed care plans to better support workers.
New York should establish a rate floor for home care providers to ensure compliance with new federal and state laws.
New York should establish a state ombudsman for home care workers and increase funding to pilot workforce interventions.
New York should commission a landscape study and create a data system on the state’s direct care workforce.
Ensure Medicaid rates adequately support workforce costs, including high-need clients and unique geographic areas.
New York should apply a geographic adjustment to managed long-term care rates so home care reaches rural New Yorkers.

Caring for the Future

Our new policy report takes an extensive look at today's direct care workforce—in five installments.

Workforce Data Center

From wages to employment statistics, find the latest data on the direct care workforce.