New Findings on Direct Care Worker State Task Forces

Tomi Ayeni

As states grapple with how to address the growing need for direct care workers and urgent job quality challenges, many have formed direct care workforce task forces. Although diverse in their composition and scope, these task forces share the goal of better understanding the challenges facing the direct care workforce and outlining recommendations for action.

This summer, PHI was fortunate to work with Brown University Careers in the Common Good Summer Policy Research Intern, Tomi Ayeni, who researched state direct care workforce task forces. PHI’s Director of Research, Dr. LS Stepick, recently spoke with Tomi about his internship experience and what he learned.

Lina Stepick (LS): How did you go about researching direct care workforce state task forces?

Tomi Ayeni (TA): I first compiled a list of state task forces and found that nine states have had direct care workforce task forces at one point in time. These states—listed in order from the most recently formed—include Colorado, West Virginia, Ohio, Indiana, Wisconsin, Maine, New Mexico, Minnesota, and Iowa. In addition, I found three other states—Alaska, Kansas, and Kentucky—that have formed task forces that are focused on the broader health care system and mention direct care workers but do not focus on them.

Once I identified the list of nine relevant state task forces, I read the reports these groups issued, drafted summary abstracts, analyzed similarities and points of variation, and conducted interviews with task force leaders from Wisconsin and Colorado. Overall, my impression was that these task forces are important for bringing awareness to state legislatures and the public about direct care workforce issues, while their effectiveness in shaping state policies related to direct care workers is understandably mixed.

LS: What kinds of variation did you observe in your research on these state task forces?

TA: I found variation in the dates of formation (from 2003 to 2020), the composition of members, what branch of government (executive versus legislative) convened them, and their recommendations. Some more specific examples of variation included the fact that three of the nine states (Wisconsin, New Mexico, and Maine) discussed connections to family caregivers and produced related recommendations. Also, I noted that six of the eight states mention both direct care wages and rate setting in their recommendations, with four of these states (Wisconsin, Maine, New Mexico, and Minnesota) clearly outlining how an increase in rates would result in an increase in wages for direct care workers.

LS: From your review, what advice would you offer other states that are considering developing  direct care workforce task forces?

TA: If a state were to decide to create a DCW task force, this is what I would suggest: First, the task force organizers should foster executive and legislative engagement from the group’s inception to support convening, dissemination of findings, and implementation of recommendations. Second, organizers should be sure to include many more direct care workers should participate in these task forces, which requires investing in stipends for workers to participate and creative thinking about scheduling. Third, ideally, include implementation guidance along with recommendations for action. Most state task forces simply list their recommendations, though some include an explanation on how the state legislature could adopt each recommendation and/or potential funding sources that the state could leverage. Finally, I noted that, while three of the eight states mentioned connections between direct care workers and family caregivers, this is an area that could benefit from more attention. I think task force conveners could benefit from following recommendations from the PHI and National Alliance for Caregiving initiative, Together in Care, which has identified the overlapping challenges that the two groups face.

LS: Finally, we’d love to hear more about your internship experience. Specifically, what are your top three tips for a future PHI intern?

TA: One of my tips would be to connect with as many PHI staff as possible. Everyone at PHI was incredibly kind and has a different story to tell, so definitely take advantage of learning about the different types of work that PHI staff are doing. Another one of my tips would be to set a realistic schedule for yourself. Because of the remote nature of the work, it’s really on the individual to ensure they’re doing what they’re supposed to be doing on a daily/weekly basis. Finally, my last tip would be to ask questions of PHI staff whenever they come to your mind. There is so much to learn about the direct care space and everyone at PHI is super receptive to hearing whatever questions you may have, so never be afraid to reach out!

The findings from Tomi Ayeni’s research will help shape PHI’s state policy advocacy efforts. Please contact Jake McDonald at jmcdonald@PHInational.org if you are interested in learning more.