Sign Up to Receive PHI Alerts

PHI Releases New Federal Priorities Report on Direct Care Workforce

July 14, 2021

NEW YORK — The COVID-19 crisis has reinforced the essential value of direct care workers, and a new presidential administration offers a critical window of opportunity to improve jobs for this workforce, says a new report from PHI, the nation’s leading expert on the direct care workforce.

Federal Policy Priorities for the Direct Care Workforce offers 47 concrete recommendations for the White House, Congress, and key federal departments and agencies. The report’s recommendations span eight issue areas key to transforming jobs for this rapidly growing sector: financing, compensation, training, workforce interventions, data collection, direct care worker leadership, equity, and public narrative.

The attention on direct care workers—4.6 million home care workers, residential care aides, and nursing assistants in the U.S.—has increased significantly in the last 18 months, given their central role in supporting older adults and people with disabilities through the COVID-19 pandemic and President Biden’s introduction of the American Jobs Plan, which aims to boost wages for home care workers nationwide.

“Our country is at a historic moment with a new presidential administration that understands the enormous value of the direct care workforce and has a clear understanding from the COVID-19 pandemic about why we need to transform the direct care job to better support millions of older adults and people with disabilities,” said Jodi M. Sturgeon, president of PHI, a national research, advocacy, and workforce innovations organization based in the Bronx, New York.

“Our new report identifies the many ways that federal officials can invest in this workforce to enhance their financial wellbeing and ensure we can all live and age safely in the setting of our choice,” added Sturgeon.


The first series of recommendations in Federal Policy Priorities for the Direct Care Workforce addresses the financing and compensation needs of the long-term care sector and direct care workforce, respectively.

In addition to enacting President Biden’s recent infrastructure plan comprised of the American Jobs Plan and the American Families Plan, PHI recommends that Congress enact and fund bills that would create a federal social insurance program in long-term care and fund states to strengthen their HCBS infrastructure and further invest in the home care workforce, among other recommendations.

Regarding compensation, the report advocates for measures to create a national strategy for improving compensation for this workforce, boost financial support programs, address benefit cliffs and plateaus, and create state and regional public authorities that improve job quality in this workforce.

Federal Policy Priorities for the Direct Care Workforce also speaks to the training needs of this workforce and recommends developing a national competency-based training standard, creating federal training requirements for personal care aides, bolstering the training infrastructure and training-related research on this workforce, and incorporating direct care workforce quality measures into federally funded long-term services and supports programs and demonstrations.

In addition, the report offers an expansive slate of recommendations to develop stronger workforce interventions, including advancement opportunities, in direct care; improve data collection and monitoring in this job sector; create leadership opportunities for direct care workers to share their frontline expertise; rectify longstanding structural gender and racial inequalities that harm this largely female, people of color workforce; and promote a more constructive public narrative on this workforce.

As job openings in direct care grow exponentially in the years ahead—7.4 million between 2019 and 2029, according to recent research from PHI—these recommended policy measures will help meet this growing demand and ensure that millions of individuals receive high-quality services and supports.

“This country hasn’t had a more promising time in recent history to dramatically improve jobs for home care workers and nursing assistants throughout the country, and we hope this report begins making this much-needed goal a reality,” said PHI Vice President of Policy Robert Espinoza.

Read the full report here.


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.