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5 Reasons We Need the Direct CARE Opportunity Act

By Robert Espinoza | October 7, 2019

On September 19, House and Senate leaders introduced the Direct Creation, Advancement, and Retention of Employment (CARE) Opportunity Act, a federal bill that aims to strengthen the direct care workforce by funding a variety of projects nationwide related to recruitment, retention, and advancement. The bill is being led by Committee on Education and Labor Chairman Bobby Scott (VA-03), Representative Susie Lee (NV-03), Senator Tim Kaine (D-VA), and Senator Maggie Hassan (D-NH).

Direct care workers provide critical support to millions of older people and people with disabilities, yet their jobs are too often characterized by low compensation, minimal training, and limited career paths, among other barriers. In turn, states in all regions of the country are experiencing a crisis in recruitment and retention among this workforce.

The need for a federal investment in this workforce has never been greater, as Committee on Education and Labor Chairman Bobby Scott emphasized in the official announcement of this proposed legislation: “As one of the fastest growing occupational sectors in the country, we must make meaningful investments to ensure that this field attracts talented professionals and provides advancement opportunities for those dedicated to the profession.”

“The Direct CARE Opportunity Act will achieve this by funding and promoting innovative strategies to recruit, retain, and support our nation’s direct care workers. This bill will also ensure that seniors and individuals with disabilities have access to the care they need to age in place with dignity,” added Scott.

Here are five reasons this country needs the Direct CARE Opportunity Act.

The Direct CARE Opportunity Act responds to a growing crisis: the inability of long-term care employers and families to attract and retain quality direct care workers.

Turnover among direct care workers hovers around 60 percent or higher, and it’s estimated that the long-term care sector will need to fill 7.8 million job openings in direct care by 2026—a need spurred by growing demand, workers who exit the labor workforce, and workers who leave direct care for other industries, largely because of poor-quality jobs. Without sufficient and stable care, the health and well-being of older people and people with disabilities will be compromised.

The Direct CARE Opportunity Act prioritizes recruitment, retention, and advancement among direct care workers—three top concerns for this sector.

Recruitment and retention among this workforce will best be addressed by improving the quality of direct care jobs across the board: raising wages, offering full-time work, strengthening training standards and the direct care training infrastructure, and proving opportunities for advancement, among other measures. Moreover, long-term care employers are currently designing approaches that could make it easier in the short term to find and keep workers, from transportation benefits to childcare assistance, and much more—and this bill seeks to support those measures.

The Direct CARE Opportunity Act acknowledges the wisdom of leaders in different parts of the country and the need for context-specific workforce solutions.

In Wisconsin, long-term care leaders are creating a stronger pipeline of nursing assistants through a new training and employment program. In Minnesota, a senior living facility contracted with a digital media firm to successfully boost recruitment for nursing assistants through social media. And in New Mexico, a nonprofit developed a culturally and linguistically competent home care training program for Spanish-speaking immigrants. These are just a few examples of localized interventions that this bill could support.

The Direct CARE Opportunity Act seeks to fund large-scale, multi-year interventions, recognizing that improving jobs will take time and effort.

Well-designed training and advanced role interventions take years to fully implement and evaluate. At the state level, it can take several years to transform the training landscape for direct care workers. By limiting funding to projects that are at least three years long, this bill recognizes that effective programs rely on proper planning, implementation, and evaluation—all of which take time and resources.

The Direct CARE Opportunity Act represents one essential piece of the much larger puzzle of strengthening caregiving in this country.

This proposed legislation elevates the value of direct care workers in the federal policy discussion and, if successful, will bolster a variety of important interventions nationwide, building the knowledge on this workforce. However, the direct care workforce will need a much larger, long-term investment at the federal and state level, including a healthier, worker-centered financing system and policies that improve data collection, enhance supervision, and optimize the relationship between direct care workers and family caregivers, among other policy reforms (including the job-quality improvements described earlier in this article).

The Direct CARE Opportunity Act has rightfully placed federal attention on direct care workers. But this bill—like the workforce itself—will now need monumental support.

Read the official fact sheet on the Direct CARE Opportunity Act.

Read the bill text.

Robert Espinoza
About The Author

Robert Espinoza

Vice President of Policy
Robert Espinoza oversees PHI's national policy, research, and communications division. He has been a national policy expert, communications strategist, and writer for 20 years.
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