direct care workers walking down the hall
(Credit: John Fedele / Getty Images)

A public education campaign would improve the public’s understanding of the direct care workforce, help recruit more workers, empower those workers to tell their own stories and publicly recognize this workforce, according to the author of a new report from PHI.

In “State policy strategies for strengthening the direct care workforce,” PHI compiled 24 specific policy strategies for improving direct care job quality and stabilizing the workforce. The report author noted that state leaders can help resolve the direct care workforce crisis by implementing a tailored combination of those strategies.

The solutions fall within eight categories: long-term care financing, compensation, training standards and delivery systems, workforce interventions, data collection and monitoring, leadership, inequalities and the public narrative.

“The (state)  funding of a public education campaign is about bringing more attention to this workforce and their unique contributions, so the public and policymakers better understand their value, and job seekers are encouraged to consider direct care jobs,” Scales said. “This absolutely could and should cross industry lines so that they are working collectively to bring new people into the field and jobs across the LTSS setting.”

All types of providers, experts and stakeholders from across the long-term care continuum need to identify common ground and strategies to identify workforce challenges and solutions, and advocate for the changes recommended in the PHI report, she said.

“We’ve operated for too long in silos of care, where we’re really trying to strengthen the home care workforce or adjust the workforce in nursing homes,” Scales said. “The workforce crisis is across the board, and we need more comprehensive solutions.”

Establishing a cross-sectional approach to workforce challenges is the only way to identify common solutions to resolving direct care workforce issues in long-term care, she said.

A spokeswoman for the American Health Care Association / National Center for Assisted Living noted the long-term care sector has lost more than 400,000 workers since the beginning of the pandemic.

“The crisis has never been more dire, and we need public health officials to invest in our chronically underfunded healthcare sector,” the spokeswoman said, adding that AHCA / NCAL proposed reforms last year to address these challenges. “We continue to advocate for these meaningful solutions and actions that will help recruit and retain more caregivers to serve our nation’s seniors and individuals with disabilities.”

The new report stems from a 2020 PHI multi-state initiative, Essential Jobs, Essential Care, to drive a unique policy agenda in each state to focus on increasing compensation for direct care workers, boosting investment in recruitment and retention, and improving workforce data and research. 

3 recommendations could affect long-term care workforce

Scales said the recommendations related to strengthening training, developing state-sponsored curricula, and clear training opportunities and pathways could affect direct care workers seeking jobs in assisted living as well as other long-term care settings.

According to the report, inconsistent and insufficient requirements, fragmented delivery systems and a lack of portability across settings, roles and regions affect training for direct care workers. 

By modernizing training standards and systems, states can better prepare workers to meet the needs of users of long-term services and supports, according to the report. Recommendations include funding training efforts, establishing portable and stackable credentials, and designing a model training curricula.