This November, as we honor National Family Caregivers Month, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Labor also recognize the paid workforce that provides essential services in home and community for millions of older adults and people with disabilities. Without access to these critical workers, who are predominantly women and disproportionately women of color, family caregivers have no choice but to take on more caregiving. These direct care workers include personal care and home health aides, direct support professionals, and others who help with personal care and other daily tasks. Their work supports people’s ability to work and live in their communities, rather than in institutions.
People can need care at any time in their lives. Providing care and services to older adults and people with disabilities is important and often deeply personal work. This assistance can enable people who need it to live, work and be fully integrated into all aspects of community life. As policymakers, people with disabilities, older adults, and families continue to push for care in the community, the need for these workers is expected to increase. more than any other occupational group.
But despite growing demand and prolonged labor shortages, direct care jobs often include part-time work hours, Lower salaries than other entry-level jobs, few benefits, little access to training and physically demanding work. As a result, job turnover is high, recruiting and retention is difficult, and many people are unable to get the care they need.
President Biden recognized the critical role of home and community-based service providers when he signed the Executive Order on Increasing Access to High-Quality Care and Caregiver Support in April 2023. The Executive Order recognized the need for better data on this workforce to improve the quality of their employment and help inform policies and practices, and tasked HHS and the Department of Labor to analyze existing data and identify opportunities to improve data and knowledge about the workforce. .
Many of the questions relevant to improving direct care jobs and making informed policy decisions are difficult to answer with currently available data. Information is often unavailable or incomplete, and much of the data we have cannot be disaggregated by state, making it difficult to understand the impact of Medicaid and other state policies.
Over the past six months, we have established a working group to identify key priorities, review existing data sources, and recommend ways to fill critical knowledge gaps. This effort has been driven by a focus on policy—what data we need to support the workforce, meet growing demand, and improve access to high-quality services—and how we track the impacts of policy changes over the course of the year. time. Stakeholder input is essential, and we continue to turn to consumers and their families, direct care workers, including those providing self-directed care, unions, advocacy organizations and providers, state leaders, and other stakeholders to inform our work. The new solutions emerging are bold, along with opportunities to expand and maximize existing data.
The task force, which is made up of experts from the Department of Labor’s Women’s Bureau, the Office of Disability Employment Policy and the Office of the Under Secretary for Policy, and experts from the HHS Office of the Under Secretary for Planning and Evaluation , the Administration for Community Living, the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, the National Center for Health Statistics, and the National Institute on Aging will publish their recommendations in spring 2024, but that will only be the first step. Investing in care is an investment in the future of America’s families, workforce, and economy. To do this smartly, better data is needed to improve the quality of employment for home and community-based service providers and expand equitable access to services for millions of people with disabilities and older adults.
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