Biden-Harris Administration Partners with States and Releases Data Recommendations to Strengthen the Direct Care Workforce

As part of the Biden-Harris Administration's Care Workers Recognition Month activities and in support of President Biden's Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, the U.S. Department of Health and Human Services (HHS) announced today that 20 states have been selected to participate in two separate technical assistance programs that together will help participating states better recruit, train, and retain direct care workers, who provide home and community-based services (HCBS) for older adults and people with disabilities. Both programs are offered through the Administration for Community Living's Direct Care Workforce (DCW) Strategies Center. HHS also announced the first members of the advisory committee that will guide the center's work.

In addition, HHS and the U.S. Department of Labor (DOL) released key recommendations for building data infrastructure to support development of policies and initiatives to strengthen the HCBS direct care workforce. As directed by President Biden's care executive order, the recommendations are the culmination of a year-long partnership with DOL that was led by HHS' Office of the Assistant Secretary for Planning and Evaluation.

"Investing in care is an investment in the future of America's families, workforce, and economy," said HHS Secretary Xavier Becerra. "Better data infrastructure will ensure that these investments are made wisely, and our partnerships with states will accelerate the development and sharing of effective strategies for expanding the direct care workforce. These announcements reflect the Biden-Harris Administration's commitment to ensuring older adults and people with disabilities can get the care they need to live and thrive in their communities."

"The Biden-Harris Administration is committed to ensuring that workers across the country—including those who work in the crucial and growing care economy for older adults and people with disabilities—have access to good jobs," said Acting Secretary of Labor Julie Su. "Today, the Department of Labor is proud to release a joint report with the Department of Health and Human Services about gaps in data surrounding the home- and community-based workforce. We are also partnering with HHS to uplift the work of the Direct Care Workforce Strategies Center to improve job quality for this essential workforce. In order to better understand this critical sector and to improve job quality for these workers, we need the best possible data. Care workers show up every day to ensure people have the support they need. We need to show up for them to ensure these are quality jobs with family-sustaining wages, safety standards, and benefits."

"Urgent action is needed to address the shortage of direct care professionals – which is threatening to reverse decades of progress in community living," said Alison Barkoff, who leads the Administration for Community Living (ACL). "ACL's Direct Care Workforce Strategies Center was developed in partnership with DOL and agencies across HHS to catalyze that action and to improve recruitment, retention, and development of this critical workforce. The technical assistance announced today will help 20 states improve collaboration across state agencies, direct care professionals, people receiving services, and other stakeholders and accelerate progress toward this goal."

The DCW Strategies Center received applications from 20 states to participate in one of two programs to support them in addressing the workforce shortage in their state. After a rigorous review and scoring process, including interviews with state teams, the following six states were selected to participate in the first program, which offers intensive technical assistance:

• Alaska
• Colorado
• Delaware
• Indiana
• New Jersey
• New Mexico

Each will receive up to 250 hours of individualized technical assistance, have a coach, and have access to subject matter experts to support them in addressing their state's unique DCW challenges. Each team includes representatives from the state's Medicaid, aging, disability, and workforce development agencies, in addition to other stakeholders. Synopses of each state's areas of focus and goals for the program can be found here.

The remaining fourteen states will be offered an opportunity to participate in a second program offering learning collaboratives focused on sharing best practices, innovative strategies, and proven models for growing the direct care workforce. In addition, each participating state will receive up to 70 hours of individual technical assistance on a topic or issue important to the state.

To guide the work of the DCW Strategies Center, twenty-six stakeholders, primarily direct care professionals and people who receive HCBS, were selected to serve as members of the center's inaugural advisory council. A list of the members can be found here.

Making informed policy decisions to expand and strengthen the HCBS workforce can be difficult with the data currently available. Information is often unavailable or incomplete, and much of the data that is available cannot be broken out by state, making it difficult to understand the impact of Medicaid and other policies. That's why President Biden's Executive Order also charged HHS and DOL with identifying opportunities for government and non-government entities to build data infrastructure to inform federal and state policies that strengthen the HCBS workforce, which is disproportionately made up of women, persons of color, and immigrants with little or no formal education beyond high school.

A new issue brief released today by HHS and DOL presents recommendations to improve HCBS workforce data, informed by input from HCBS providers, workers, consumers, and researchers. HHS is taking steps to implement these recommendations, both through the recently finalized Ensuring Access to Medicaid Services rule that will enable greater transparency in rates paid to certain types of HCBS workers, and through the DCW Strategies Center's intensive technical assistance to selected states who have identified data collection, tracking and/or analysis as a key need.

"Implementing these recommendations will build the data infrastructure needed to answer key questions about the HCBS workforce and drive data-informed policy decisions to improve the quality of and access to HCBS for the millions of Americans who are receiving or need these services," said Miranda Lynch-Smith, who is performing the delegable duties of the Assistant Secretary for Planning and Evaluation.

The report is posted on the DCW Strategies Center website. It will be joined in the coming months by other resources developed through the HHS-DOL partnership.

On Tuesday, May 21, HHS and DOL, in collaboration with the DCW Strategies Center, will host a webinar to share highlights and recommendations from the issue brief. Advance registration