State-Based Initiatives to Improve the Recruitment and Retention of the Paraprofessional Long-Term Care Workforce


The Department of Health and Human Services awarded a contract to launch a national initiative designed to improve recruitment and retention of direct care workers in the long-term care field. As part of this initiative, the Institute for the Future of Aging Services and the Paraprofessional Healthcare Institute have identified a range of workforce improvement initiatives at the state and sub-state level to reduce high vacancy and turnover rates among direct care workers, and improve the quality of their jobs. This report summarizes the experiences of five states — California, Massachusetts, North Carolina, Pennsylvania and Wisconsin — that have pursued several strategies to address this issue to inform policymakers, long-term care providers, organized labor and other worker groups, and consumers across the country grappling with serious shortages of direct care workers. [42 PDF pages]

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