PHI

03/12/2026

For more than 75 years, home care workers—predominantly women of color—were excluded from fundamental labor rights. While minimum wage and overtime protections were finally secured a decade ago, a new rule from the Department of Labor threatens to strip them away from over 3.2 million workers.

The need for care is rising faster than the labor market can match, and the solution to this growing care gap is to improve jobs, not eliminate worker protections. Growing demand for care is a reality that requires investment, respect, and recognition—not deregulation.

PHI strongly supports the Fair Wages for Home Care Workers Act, introduced today by Representative Alexandria Ocasio-Cortez (NY) and Senator Patty Murray (WA). Their legislation will codify these hard-won protections and ensure that the workers who care for older adults and individuals with disabilities can work with the labor protections afforded to nearly all other professions. Quality care requires quality jobs.

Learn more here:

Washington, D.C.–Today, Representative Alexandria Ocasio-Cortez (NY-14) and Senator Patty Murray (D-WA) introduced the Fair Wages for Home Care Workers Act, legislation that would amend the Fair Labor Standards Act of 1938 to guarantee minimum wage and overtime protections for over 3 million home ...

03/08/2026

Women lead the care economy — making up 85 percent of home care workers, 84 percent of residential care aides, and 91 percent of nursing assistants — despite low wages, policies, and systemic issues that have long undervalued their work. Critically, women represent more than 60 percent of family caregivers.

This , and throughout , PHI honors women's contributions to care. And at the same time, words are necessary, but they are insufficient. Women's labor sustains millions of people who depend on care to live full lives at home and in their communities. True recognition for their contributions requires that we provide direct care workers with quality jobs, fair compensation, and opportunities for career mobility within this sector.

03/06/2026

PHI is closely monitoring implications for the direct care workforce following the March 3, 2026, letter from the Centers for Medicare & Medicaid Services (CMS) to Governor Hochul. In the letter, CMS’s Dr. Mehmet Oz requested detailed information about New York’s Medicaid program, including its oversight of personal care and home health services, adult day care, and the Consumer Directed Personal Assistance Program (CDPAP).

In the spirit of the essential federal-state partnership that sustains Medicaid, our hope is that New York State and the federal Administration will work together to ensure New York’s Medicaid program is supported by strong program integrity tools, provider credentialing, and robust oversight mechanisms.

This effort must also recognize that a well-trained, fairly compensated, and properly credentialed direct care workforce is essential for quality care. By contrast, penalizing workers, creating unnecessary barriers to care, and destabilizing programs that support community living will only serve to shift costs—and suffering—elsewhere.

Read more here:

PHI is closely monitoring implications for the direct care workforce following the March 3, 2026, letter from the Centers for Medicare & Medicaid Services (CMS) to Governor Hochul. In the letter, CMS’s Dr. Mehmet Oz requested detailed information about New York’s Medicaid program, including its ...

02/27/2026

Dr. Stone’s pioneering research has profoundly shaped the landscape of long-term services and supports. PHI is especially grateful for her foundational work on the direct care workforce, which highlighted the undeniable link between job quality and the quality of care.

Thank you, Dr. Stone, for your unwavering commitment to improving the lives of older adults and the essential workers who support them. We look forward to your continued impact for this field in your advisory role!

Over her nearly three decades at LeadingAge, Dr. Robyn Stone has worked closely with our mission-driven members, observing, researching and helping to improve aging services practices on the ground. As LeadingAge’s senior vice president of research and co-director of the LeadingAge LTSS Center at UMass Boston, she’s helped strengthen the aging services workforce, support family caregiving, and enhance service-enriched housing.

Now, as she steps into an advisory role, she reflects on her time here: “There were always opportunities to do pretty cool things with our members. …It allowed us to always be looking for gaps in the literature and, in particular, to try to fill the gaps members were experiencing firsthand.”

Read more about her career, impact, and perspective on the future of aging services:
https://ldng.ag/4tVquoz

02/25/2026

New research from the National Bureau of Economic Research confirms what PHI has long advocated: immigrants are essential to the direct care workforce — and to the health and safety of older adults and people with disabilities across the country.

The numbers are stark. For every 1,000 additional immigrants, there are nearly 10 fewer deaths among older adults annually. Immigrants make up 40 percent of home health aides and 28 percent of personal care aides, workers who help older adults age in place with dignity and avoid nursing home care, according to the NBER paper.

As PHI's Kezia Scales told MarketWatch: "Workforce shortages existed before the changes to immigration policy. As you're driving immigrants out of this workforce, it creates unmet care needs, increased mortality, and further strain on the family caregiver network."

The evidence is clear. A stronger direct care workforce requires sound immigration policy. The lives of older adults, and the workers who care for them, depend on it.

Read the full article here: https://www.msn.com/en-us/news/us/relaxing-immigration-policies-in-america-may-actually-save-lives/ar-AA1WCw9V

02/21/2026

On , and every day, PHI honors and celebrates caregivers across the United States. Whether you are a PCA, home health aide, a CNA, residential care aide, or a family caregiver, know that your contributions to the lives of older adults and people with disabilities are seen. Know that they are valued. Know that they are recognized. Thank you for all that you support and all that you make possible.

02/10/2026

A workgroup led by the New Jersey Department of Human Services has released a comprehensive strategic plan to support the essential workers who provide daily care to older adults, people with disabilities, and individuals with behavioral health needs.

Developed through an intensive, PHI-facilitated interagency process, the plan outlines more than 40 strategies to address recruitment, retention, and job quality for direct care workers across the state. This initiative was heavily informed by collective input, including from the Essential Jobs, Essential Care New Jersey coalition, and serves as a blueprint for how the state can tackle the direct care workforce crisis as Governor Mikie Sherrill begins her term.

The plan acknowledges the scale of the challenge—noting that while home health and personal care aide employment grew 76.8 percent between 2019 and 2023, the median annual income remains just $27,889. To address this, the strategy focuses on gathering better workforce data, creating a universal training and certification system with stackable credentials, and improving compensation and benefits to create a sustainable workplace.

Read the full analysis by PHI Senior Policy Advocacy Specialist Jake McDonald here:

A workgroup led by the New Jersey Department of Human Services has released a comprehensive strategic plan to strengthen the state’s direct care workforce—the essential workers who provide daily support and care to older adults, people with disabilities, and individuals with behavioral health ne...

02/04/2026

The Centers for Medicare & Medicaid Services (CMS) has struck down the only federal policy to establish a baseline for nursing home staffing levels. This move effectively removes a critical lever for workforce improvements and puts nursing home residents at greater risk.

This week, PHI submitted formal comments strongly opposing this change.

A Misdiagnosis of the Crisis: CMS justifies this rollback by citing workforce shortages. However, this rationale fundamentally misinterprets the nature of the crisis. The challenge is not a shortage of workers but a recruitment and retention crisis driven by inadequate wages, unsustainable workloads, and poor job quality.

Risk for Residents: The standards CMS just repealed would have saved approximately 13,000 lives annually. Moving to repeal these protections without a replacement will result in the preventable deaths of thousands of nursing home residents every year.

Job Quality, Not Repeal: Eliminating minimum standards effectively guarantees that the cycle of understaffing, burnout, and attrition will continue unabated. Instead of abandoning worker protections, CMS should be leading a coordinated effort to improve job quality.

To erase minimum staffing standards without a viable alternative is to accept an unacceptable status quo.

Read our full comments to CMS here:

The Centers for Medicare & Medicaid Services (CMS) has struck down the only federal policy to establish a baseline for nursing home staffing levels, effectively removing a critical lever for workforce improvements, compounding the challenges already facing the direct care workforce, and putting nurs...

01/31/2026

With demand projected to add 681,000 home care jobs in the next decade, we need to invest in this workforce—not dismantle their labor protections. Quality care depends on quality jobs.

"They should not carry this affordability problem on their own backs."

The Labor Department has proposed rescinding an Obama-era rule that gave home care workers the right to overtime pay and other wage protections. The administration says the rule made care too costly.

01/29/2026

The Department of Labor has proposed rolling back wage protections that home care workers have held for nearly a decade. PHI’s Vice President of Research and Evaluation, Kezia Scales, PhD, spoke with NPR's Morning Edition about what this would mean:

"We are talking about stripping back hard-won employment rights from our country's largest workforce and one that is providing arguably some of the most essential services for ourselves and our loved ones."

The data is clear: since a rule extending these protections to home care workers took effect in 2015, home care agencies have paid workers nearly $158 million in back wages, with countless more benefiting from employers' proactive compliance. In short: These protections work.

Quality care depends on quality jobs. With demand for home care projected to add 681,000 jobs in the next decade, we need more investment in this workforce—not less. As Kezia told NPR: "Further marginalizing and devaluing the workforce that provides the services—that is simply not the answer. They should not carry this affordability problem on their own backs."

Listen to the full story: https://www.npr.org/2026/01/29/nx-s1-5626767/home-care-seniors-trump-labor-overtime

01/21/2026

The direct care workforce is the backbone of Maine’s healthcare system. Yet, echoing a nationwide crisis, this workforce faces daunting systemic challenges—including low pay, poor job quality, and outdated training—that have created a staggeringly large care gap.

In response, Maine’s Essential Care & Support Workforce Partnership brought experts together to develop targeted recommendations. These recommendations have informed the Maine Essential Care & Support Workforce Enhancement Act, an omnibus bill championed by Speaker Ryan Fecteau that is being taken up in Maine's legislative session.

If enacted, this bill would take significant steps toward closing Maine’s care gap by budgeting for all care needs, raising wages, developing a universal training and credentialing system, and creating a plan to harness technological advancements to support direct care workers and improve service delivery.

As federal shifts threaten the stability of the direct care workforce nationwide, this bill offers a clear framework for recruiting and retaining the workforce Maine’s people and economy desperately need.

Read a full analysis by PHI's Senior Policy Advocacy Specialist, Jake McDonald, here:

The direct care workforce is the backbone of Maine’s healthcare and support system, providing essential services to older adults, people with disabilities, and individuals with behavioral health challenges across the state. Yet, this workforce faces daunting systemic challenges, including low pay,...

01/19/2026

On this day, as we honor the life and legacy of Dr. Martin Luther King Jr., we reflect on what he called “the most persistent and urgent question”: What are you doing for others?

Every day, 5.4 million direct care workers answer that question. They support older adults and people with disabilities, strengthening families and economies in every U.S. state.

We observe this MLK Day amid a surge in harmful rhetoric that questions the belonging of immigrants and seeks to divide communities based on origin and background. But this rhetoric, which deals in abstractions and fear, ignores the reality of care in this country.

The real experience inside American homes is one of trust and connection. Every day, families across the political spectrum entrust their loved ones to direct care workers from different backgrounds, cultures, and countries of origin. In these intimate moments, our shared humanity outweighs our differences.

Dr. King understood that economic justice and civil rights are inseparable. Yet, direct care workers continue to face systemic barriers rooted in the same racism and sexism he spent his life confronting.

𝗧𝗼𝗱𝗮𝘆, 𝗣𝗛𝗜 𝗰𝗮𝗹𝗹𝘀 𝗳𝗼𝗿 𝗮𝗰𝘁𝗶𝗼𝗻:

𝗣𝗼𝗹𝗶𝗰𝘆𝗺𝗮𝗸𝗲𝗿𝘀: Safeguard and strengthen labor protections for direct care workers.

𝗘𝗺𝗽𝗹𝗼𝘆𝗲𝗿𝘀: Invest in wages, training, and career pathways.

𝗔𝗹𝗹 𝗔𝗺𝗲𝗿𝗶𝗰𝗮𝗻𝘀: Recognize the contributions of the workforce that makes all other work possible.

We cannot build a strong care economy by alienating the very workers who sustain it.

Read our full statement here:

On this day, as we honor the life and legacy of Dr. Martin Luther King Jr., we reflect on what he called “the most persistent and urgent question”: What are you doing for others? Across the nation, nearly 5.4 million direct care workers answer that question every day. They are home care workers ...