Workforce, Direct Care Workers

This study explores duties and activities that distinguish the DSP occupation from other direct care workforce occupations to inform the consideration of a DSP SOC code and other workforce data collection efforts. This study also identifies information beyond what is needed to create a DSP SOC code that states need on the DSP workforce to address policy and workforce planning activities.

Over one million Americans rely on nursing homes for care, yet nursing homes face challenges in recruiting and retaining staff. Nursing homes rely on registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistants (NAs) to provide care, but staff shortages that increased during the COVID-19 pandemic have persisted.

Direct care workers (DCWs) such as nursing assistants, home health aides, and personal care assistants play an essential role in the health and well-being of over 20 million Americans. Yet DCW wages are not enough to make jobs competitive with entry level positions in other industries with similar job requirements which exacerbates the challenges in recruitment and retention of these workers.

This report outlines the major issues faced by the U.S. health care workforce. It addresses medical, dental and behavioral health components of the workforce as well as direct care workers. The report also describes opportunities for progress to address these issues and existing activities supported by the Department to address these issues.

On April 25, 2024, HHS and DoL released recommendations, in the form of an Issue Brief, to improve data infrastructure on the workforce delivering home and community-based services (HCBS) in response to President Biden’s

Due to the increasing demand for homecare workers and the high rate of occupational injuries among these workers, addressing homecare worker safety is critically important. High injury rates among homecare workers contribute to turnover and absenteeism, and lead to high costs of workers’ compensation insurance for employers.