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PHI Testifies Before National LTC Commission

July 24, 2013

PHI Government Affairs Director Carol Regan spoke about the need for Congress to address direct-care workforce issues during her testimony before the National Commission on Long-Term Care on July 17 in Washington, DC.

There is a “glaring absence of coordinated federal policy leadership directed at augmenting and improving the nation’s direct-care workforce, despite the ever-escalating demand for long-term care services and supports,” Regan told the 15-member commission.

To correct that absence of leadership, Regan urged the commission to consider four key workforce domains:

  • Payment and procurement
  • Training
  • New models of coordinated care, and
  • Infrastructure to support independent living.

Regan then made recommendations pertaining to each domain, including:

  • Minimum training standards for personal care aides;
  • Enhanced training standards for home health aides and certified nursing assistants;
  • The creation of demonstration projects within the Centers for Medicare & Medicaid Services (CMS) to develop infrastructure that will support self-directed services, including matching service registries;
  • Improved workforce-monitoring standards within both CMS and the Department of Labor; and
  • The appointment of a home care workforce advisory panel to guide policymakers on the issues of wages, benefits, and staffing levels for the home care workforce.

Regan’s full testimony is available online (pdf).

Other Experts Offer Testimony

Regan was one of several experts offering testimony about ways to improve long-term services delivery in the U.S.

Joanne Lynn, director of the Altarum Institute‘s Center for Elder Care and Advanced Illness, highlighted direct-care workers in her testimony. 

Direct-care workers “should be given a fair deal on income, access to their own health care services, solid baseline training, and ongoing opportunities for further education and expansion of skills,” she said.

Lynn also highlighted the need to extend minimum-wage and overtime protections to home care workers through the Fair Labor Standards Act.

H. Stephen Kaye, a professor of health and aging at the University of California, San Francisco, spoke about the need for states to rebalance their eldercare systems to favor home- and community-based settings.

Robyn Stone of LeadingAge also spoke about older adults, highlighting the increasing numbers of minorities that will be in need of long-term care in the coming years.

“We need to be thinking about those minority, non-white populations, not just because they’re more likely to be lower income, but because there’s going to be substantial cultural competence questions” that will need to be answered in order to deliver the best possible care to them, Stone said.

More on the Commission

The National Commission on Long-Term Care was established in January 2013 by the American Tax Relief Act, tasked with developing “a plan for the establishment, implementation, and financing of a comprehensive, coordinated, and high-quality” long-term services and supports system.

The July 17 meeting — which is available to watch online — was the commission’s second meeting overall. The next will be held on August 19.

The commission is seeking input from long-term care providers before it makes its final recommendations to Congress in September. 

Providers are encourage to submit comments by sending an email to

— by Matthew Ozga

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