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Reforming Direct Care

By Jessica Cutcliffe


The Direct Care Job Quality Improvement Act introduced by Senator Robert Casey, Jr. (D-PA) and Congresswoman Linda Sanchez (D - CA) is aimed at giving home health care the esteem it deserves.  In-home care is a growing trend that relies on the services of direct care workers who are entrusted with the wellbeing of individuals served.  Today, there are more than 13 million Americans calling upon the services of the direct care workforce and it is projected that this number will continue to grow in the years ahead. 

The demand for reform ascends into the public arena as the unmet care gap becomes more than a mounting number.  The need for long-term care for seniors and persons with disabilities is a pervading reality for families all across America.  There is an immediate need to recruit direct care workers and minimize the high rate of turnover which compromises this field.  Sanchez, herself, is cognizant of the pressing need to create a stable workforce as she relies on direct care staff to provide assistance to her own father who has Alzheimer’s disease.  In speaking about her father at a legislative briefing on Capitol Hill and in describing the care that he receives she aired a sentiment of respect for direct care workers, “If it weren’t for this workforce taking care of him it would be incredibly difficult for my family to manage it” 

As the labor law stands, nearly two million home care workers are exempt from federal minimum wage and overtime protections.  In failing to provide home care workers with these basic entitlements we undermine the caregivers, the care recipients, and the care service itself.  Senator Casey is confident that the proposed legislation “… will correct these shortcomings and lay the foundation for a stable direct care workforce to help Americans age at home in health and dignity" 

The Direct Care Job Quality Improvement Act outlines provisions that improve data collection and workforce monitoring.  State grants are provided to improve compensation, advance worker training, and promote opportunities for career advancement.  Professionalizing home health care services can help attract direct care workers and improve the quality of care delivered.  Seniors and individuals with disabilities deserve a choice in where support services are provided and they have a right to demand that direct care workers are not only compassionate but competent.  This right should not be forfeited as a result of a care system in need of reform. 


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