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We Can Do Better: How Our Broken Long-Term Care System Undermines Care (Section 2)

This report examines the long-term care system across settings and service delivery models, highlighting key trends in the industry and financing landscape.

Today’s long-term care system remains fractured and scattered, routinely failing to improve direct care jobs—a reality that has become even more pronounced during the COVID-19 crisis.

We Can Do Better: How Our Broken Long-Term Care System Undermines Care describes the shortfalls in long-term care financing; the seismic shifts in the long-term care landscape; and the many, dispersed stakeholders that comprise long-term care, including employers, federal and state governments, managed care plans, and and many others. This report aims to directly inform the discussion on the long-term care response to COVID-19.

This report is the second installment in a year-long series of reports examining the importance and impact of the direct care workforce. The final, comprehensive report—Caring for the Future—will be released in January 2021. This report series was made possible through generous support from the W. K. Kellogg Foundation and the Woodcock Foundation.


To inform the dialogue on direct care jobs, PHI spoke with workers in different parts of the country to hear their stories and ideas.

"“Caring for somebody feels amazing, and helping people really is the best way of giving back.” "
"“We work too hard….and we're not getting paid for how hard we work. That's the problem.”"
"“There's too much work to get done and not enough people doing the work. And I know that a lot of that has to do with pay.”"

Key Takeaways

Our long-term services and supports system does not adequately meet consumer needs or invest in direct care jobs.
As the long-term care system grows rapidly, workforce development remains virtually unaddressed in public policy.
Long-term care should be better financed, organized, and regulated to strengthen the direct care workforce.

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.