PHI

12/24/2025

As we mark the holiday season, we share warm wishes and gratitude with all who engage in PHI’s efforts to advance quality care through quality jobs.

While this past year has brought significant change—and cascading challenges—to the landscape around us, PHI’s guiding focus remains unchanged. We step into 2026 steadfast in our resolve to build a future where direct care workers hold jobs anchored in respect, recognition, and real opportunity. Only by investing in this workforce can we ensure that older adults, people with disabilities, and family caregivers benefit from high-quality care, rooted in principles of dignity and independence.

Note: Our office will be closed from Thursday, December 25, 2025, until Monday, January 5, 2026.

12/09/2025

Effective care delivery requires a stabilized, empowered workforce. With essential support from Margaret A. Cargill Philanthropies (MACP), PHI is advancing the Universal Direct Care Workforce™ (UW) Initiative, a comprehensive approach to direct care workforce training, credentialing, and employment that seeks to transform job quality at every level, in Wisconsin.

MACP has now released a new profile and video documenting the impact of PHI's efforts in rural Wisconsin. Through a story written by PHI's Grant Writer Tasha Beauchesne and a video produced by PHI with MACP and videographer Page Stephenson (and special thanks to GT Independence), we examine the Care Integration Senior Aide (CISA) role, a key component of PHI's UW model.

Drawing from a 2023-24 PHI evaluation, the footage demonstrates how the CISA role elevates direct care workforce contributions, while expanding quality of life for older adults living at home—as reflected in the experience of Tomahawk resident Gloria Walbeck.

Watch the video & read the full profile here:

For the past 15 years, Gloria has enjoyed the loyal companionship of her cat, Joey, whom she has raised since he was a kitten. “Joey’s been with me a long time, and he trusts me now,” says Gloria. “He trusts anyone who walks through that door.”

12/05/2025

"We can’t afford to look away from the challenges facing the direct care workforce—challenges that are both longstanding and compounded by current political trends."

In a new op-ed for Generations (American Society on Aging), PHI’s VP of Research & Evaluation, Kezia Scales, PhD, breaks down the realities exposed in our 20th Annual Key Facts Report. While the direct care workforce is expected to add more new jobs than any other occupation by 2034, we are facing an estimated 8.9 million job vacancies as workers leave the field due to persistently poor job quality.

With median annual earnings of just $26,000 and nearly half of this workforce relying on public assistance, the data makes one thing clear: fragile progress is not enough.

As demand for long-term care escalates, the workforce that powers it is facing unprecedented threats—from unprecedented cuts to Medicaid to challenges with the reliability of federal labor data.

Read Kezia's full insights on how we must protect our nation's caregiving infrastructure and safeguard access to essential services for older adults and people with disabilities:

Display text: ‘We can’t afford to look away from direct care workforce challenges that are both longstanding and compounded by current political trends.’

12/03/2025

Quality care is impossible without quality jobs.

In her latest column for The New York Times, Paula Span confronts the growing crisis in home care—a sector straining under surging demand and a critical workforce shortage. The piece highlights what PHI has long advocated: to solve this challenge, we must transform the quality of direct care jobs.

We were pleased to provide data for this reporting, which underscores the scale of the challenge. The column also spotlights innovative models creating real change, including the worker-owned cooperative movement strengthened by partners at Cooperative Home Care Associates (CHCA) and The ICA Group, as well as matching service registries like Carina: Connecting Families to Care, who are connecting clients with the care they need while empowering workers.

Read the full analysis on how we can build stronger home care infrastructure:

Paid home care is buckling under the surging demands of an aging population. But there are alternatives that could upgrade jobs and improve patient care.

12/02/2025

Across the country, 5.4 million direct care workers help older adults and people with disabilities live in their homes and communities. These essential workers make quality care possible—yet they face ongoing challenges to fair compensation, benefits, and basic labor protections.

This year, new policies have made their work even harder. Left unchecked, these changes will challenge the very availability of care for millions of Americans in every state.

PHI has worked since 1991 to advance quality care by improving direct care jobs. We offer workforce innovations, field-defining research, and proactive policy solutions to preserve and strengthen care.

Our work is only possible with donor support.

This , please choose to invest in the future of care. Make a donation of any amount to support the direct care workforce—and build a better future for all who rely on them.

For more than 30 years, PHI has combined policy, research, and workforce innovations to elevate the essential direct care workforce. Your contributions make our work possible. Support quality care through quality jobs today.

11/27/2025

During this season of gratitude, and always, PHI is thankful for our nation’s 5.4 million direct care workers. Each day, personal care aides, home health aides, nursing assistants, and others provide essential support for older adults and people with disabilities. Whether for ourselves or our loved ones, for our friends or our neighbors. For entire communities: This workforce is essential.

When direct care workers tell us what makes their work meaningful, they often mention the gratitude of their clients, alongside that of family members who know they can rely on skilled and trusted caregivers for support each day.

Join us in thanking and honoring these dedicated individuals—not just today, but every day.

11/24/2025

PHI’s VP of Research & Evaluation, Kezia Scales, will be a featured speaker at the Global Observatory of Long-Term Care’s celebration of the UN’s International Day of Care and Support this Friday, November 28.

This day-long global event is dedicated to "Changing the Narrative on Long-Term Care." By dispelling common myths and stigmas, we can build systems where older adults and people with disabilities live with meaning, and where care workers enjoy the decent working conditions they deserve.

Kezia will be speaking on the panel "Long-Term Care jobs are skilled (and cherished) jobs" alongside experts from the UK, Spain, Italy, and Canada.

Date: Friday, Nov 28 Time: 11:00 AM ET / 16:00 GMT Register here: https://goltc.org/save-the-date-changing-the-narrative-on-long-term-care-a-celebration-of-the-uns-international-day-of-care-and-support/

Join us in recognizing the skill, value, and necessity of the direct care workforce.

Join us on the 28 November for the Global Observatory of Long-Term Care’s contribution to celebrating the UN’s International Day of Care and Support.

11/19/2025

Strong frontline supervision is more crucial than ever. For direct care workers entering the field, it can be the difference between excelling in their roles and costly turnover.⁣
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Join PHI facilitators and a group of your peers for the 𝐏𝐇𝐈 𝐂𝐨𝐚𝐜𝐡𝐢𝐧𝐠 𝐀𝐩𝐩𝐫𝐨𝐚𝐜𝐡® 𝐭𝐨 𝐒𝐮𝐩𝐞𝐫𝐯𝐢𝐬𝐢𝐨𝐧—a proven program that strengthens communication skills and equips supervisors with practical tools to support, motivate, and retain staff.⁣
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Focused on real-world challenges in long-term care, this training helps providers break the costly cycle of turnover and build a more stable, satisfied workforce—ultimately improving the quality, efficiency, and continuity of care.⁣
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𝐀𝐯𝐚𝐢𝐥𝐚𝐛𝐥𝐞 𝐒𝐞𝐬𝐬𝐢𝐨𝐧:⁣
January 13-14, 2026 | 9 a.m. - 4 p.m. ET | Online Format | $500⁣

Space is limited and available on a first-come, first-served basis.⁣
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Learn more and register today:

PHI Coaching Approach® to Supervision training is designed to enhance core communication skills for effective supervision of direct care workers in home and residential settings. Break the cycle of direct care workforce turnover and improve the quality and continuity of care.

11/18/2025

How can states leverage data to forecast demand, guide smarter investments, and strengthen the direct care workforce?

Join the Direct Care Workforce Strategies Center (Administration for Community Living) tomorrow, November 19, at 3:00 PM EST for a webinar, From Numbers to Action: Using Data to Strengthen the HCBS Direct Care Workforce.

We are thrilled to highlight that PHI’s Vice President of Research & Evaluation, Kezia Scales, will share insights on how data can drive evidence-based decision-making and help measure the impact of workforce investments in home and community-based services.

She will be joined by a panel of experts, including Dr. Julie Bershadsky (University of Minnesota), Mary Kaschak (National MLTSS Health Plan Association), and state leaders from New Jersey and Tennessee.

Don't miss this opportunity to learn how to connect datasets across systems to drive policy change.

Register here: 2ed5f1fd-0239-4f48-b84f-6514a191b4f5@64430c8a-03ad-4ddb-8eae-39389e00a4a3" rel="ugc" target="_blank">https://events.teams.microsoft.com/event/2ed5f1fd-0239-4f48-b84f-6514a191b4f5@64430c8a-03ad-4ddb-8eae-39389e00a4a3

11/17/2025

Tomorrow at 1:00 PM ET, PHI Vice President of Research and Evaluation Kezia Scales joins the National Skills Coalition to address a critical question: how can workforce leaders shake loose long-held assumptions to meet the urgent need for better care jobs?

In this webinar, "Tackling the Care Workforce Challenge," Kezia and a panel of experts (San Antonio College and National Council on Aging) will discuss practical opportunities for workforce development leaders to tackle the complex challenges of low pay and difficult working conditions in the care sector.

Tune in to learn actionable steps to improve direct care jobs and strengthen the workforce pipeline.

Join the conversation: https://us06web.zoom.us/webinar/register/WN_0UcCwnaaTni9uZP7RizNug #/registration

11/14/2025

This week, Congress resolved the stalemate over the longest government shutdown in U.S. history. Even as funding temporarily returns to most government agencies and services resume, work on the FY26 federal budget remains unfinished. As a result of the extended budget process, critical attention and resources are being drawn away from issues with significant long-term consequences – including challenges that will have a damaging impact on our nation’s paid caregiving workforce. Read our full statement here.

This week, Congress resolved the stalemate over the longest government shutdown in U.S. history. Even as funding temporarily returns to most government agencies and services resume, work on the FY26 federal budget remains unfinished. As a result of the extended budget process, critical attention and...

11/14/2025

As Home Care Week comes to a close, PHI continues to celebrate National Care at Home Month—celebrating nearly 3.2 million essential home care workers across the United States.

Home care workers provide critical personal assistance and support that enables millions of Americans to age in place and maintain their independence. Their work requires skill, compassion, and dedication—yet they face persistent challenges that threaten both their livelihoods and the sustainability of care.

Despite their critical role, home care workers earn a median hourly wage of just $16.77, with median annual earnings under $22,500. Many work part-time without benefits, 41% live in low-income households, and more than half rely on public assistance. Demand is projected for more than 681,400 new home care jobs over the next decade—making this occupation the fastest growing by volume in the U.S.

To honor direct care workers, we need to ensure they work in quality jobs. We cannot afford to maintain the status quo.

Today and every day, we call for our nation to:

✅ Invest in fair wages and benefits that reflect the skill and value of home care work

✅ Support training and career pathways that create advancement opportunities

✅ Strengthen workforce protections, including overtime pay and workplace safety standards

✅ Ensure adequate Medicaid funding to support sustainable compensation and quality care