Direct care workers provide hands-on support to older adults and people with disabilities. For years, there has been a national shortage. Low wages, long hours, few benefits, and the demanding nature of the work has led to high turnover rates and this shortage. A recent report done by the Center for Health Care Strategies drew four key recommendations. 

1.. Focus and organize state-level and advocacy efforts related to the direct care workforce shortage- The commitment of state leaders to a common goal is very important for making progress in the workforce shortage.  

2. Use federal funding and flexibilities- the Build Back Better Act has potential, but is uncertain. There are other ways to access federal funding and flexibilities to support the workforce. 

3. Prioritize DCW-related goals in Medicaid managed care contracts- Many states use managed care contracts for Medicaid services.  States could use their contracts to expand and strengthen their workforce. 

4. Recognize the deep value and importance of the profession-  From the start, caregiving isn't consistently valued. States could promote the value and importance of the profession. 

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