Report: Advancing the Home Care Workforce

• Evaluation of advanced roles

Research

8. Survey of PCAs 9. Report on MCOs and their potential to incentivize advanced roles for home care workers with increased wages. 10. Report on opportunities for mergers and acquisitions across home care, home health, and home hospice agencies industries. How would the value proposition of advanced roles improve if there were better alignment?

7.1. Advocacy We propose two advocacy strategies that are upstream determinants of whether advanced roles can be widely adopted. The first recommendation is a bottom-up strategy to strengthen state-level coalitions of advocates and stakeholders with the aim of improving regulations, payment policies, and state sponsorship of training programs. The second is a top-down strategy of designing a public relations campaign to elevate the public’s and healthcare clinicians’ view of home care workers' value. 1. Invest in strengthening state coalitions to drive state programs and policies Rationale : Our review shows clearly that the state-sponsored programs and state policies have had the most impact and are the most sustainable over time. In addition, we have shown that where the best state programs and policies exist, there has been a strong coalition of advocates driving the process of change. Moreover, recent state and federal actions (and an elderly-care-friendly federal administration overall) have created opportunities for action and increased funding. It is likely that collective and strategic action will be needed to leverage these opportunities fully. Local Context : There are already organized networks of advocates in both New York and Michigan, and there has been interest on the part of both governments in welcoming multi- stakeholder recommendations. In Michigan, the State-Wide Direct Care Workforce Advisory Committee includes a cross- section of interest groups and advocacy leaders. As described in the prior section, they have already begun developing recommendations. In addition, IMPART Alliance has partnered with PHI to reach out to stakeholders across the state and organize a coalition (Kellogg Foundation funded). PHI produced an extraordinary roadmap for state-level changes needed to advance the direct care workforce in a document to lift workers out of poverty, improve

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