The DCW Strategies Center delivers training and technical assistance (TA) to build capacity and drive systems change in the recruitment, training, and retention of the direct care workforce. This TA is intended for state agencies, employers, educational institutions, advocacy groups, and program administrators.
The six selected states will receive up to 250 hours of individualized technical assistance, have a coach, and have access to subject matter experts to support them in addressing their state’s unique direct care workforce (DCW) challenges. Each team includes representatives from the state’s Medicaid, aging, disability, and workforce development agencies, in addition to other stakeholders. The state teams will complete individualized systems-change TA plans aimed at improving direct care workforce development and retention through reforms in policy, practice, programming, payment, and performance. The Intensive Technical Assistance will build upon state’s previous and current workforce efforts, including those undertaken using American Rescue Plan Act (ARPA) Section 9817 funding.
The first cohort of the Direct Care Workforce Intensive Technical Assistance to States runs through December 31, 2024. The technical assistance will be facilitated by the DCW Strategies Center partners ADvancing States, National Association of State Directors of Developmental Disability Services, and the National Association of State Medicaid Directors.
- Alaska
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Proposed Technical Assistance Activities
Alaska will focus on strategies for braiding funding across state agencies (including education, workforce development, vocational rehabilitation, Medicaid, aging, and disabilities systems) to support recruitment, training and professional development, career pathway and pipeline development, and retention strategies. The state will evaluate recent steps it has taken to allow legally responsible individuals to be reimbursed for providing HCBS services. Alaska also will solicit ideas for linking certification levels to reimbursement rates and wage increases, as well as on designing a system for collecting and tracking data on the impact of rate increases on participant-directed services. Finally, the state intends to collaborate with its stakeholders to establish a statewide advocacy board to advise on rate and wage increases, as well as workforce recruitment and retention (particularly to address workforce shortages in rural and remote areas).About the Team
The state’s Division of Senior and Disabilities Services will lead a cross-agency partnership to include, at a minimum, Alaska’s Medical Assistance Health Enterprise, and University of Alaska Anchorage’s Center for Human Development. These entities will also engage and forge stronger linkages with the State’s education and workforce systems as part of the TA initiative. - Colorado
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Proposed Technical Assistance Activities
The technical assistance provided through the DCW Strategies Center will support Colorado's implementation of key recommendations presented in a research project on workforce compensation initiated in 2022. The state aims to develop an adaptable direct care worker peer mentoring program that can be utilized across various work environments and with different populations. Additionally, Colorado will determine how to help both workers and employers who need access to benefits and services to best navigate them.About the Team
Led by the Colorado Department of Health Care Policy & Financing, the state’s team also includes the Colorado Department of Labor and Employment and the Colorado Department of Public Health & Environment. The state will also engage its Direct Care Workforce Collaborative. - Delaware
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Delaware will utilize the intensive TA to draft a multi-disciplinary DCW workforce development strategy with goals to improve information sharing across diverse sectors, identify workforce priorities, outcomes, and performance metrics, and eliminate duplication of effort across state agencies. Other planned outcomes include establishing a shared data tracking strategy to understand current and future workforce needs, expanding partnerships to include a broader range of stakeholders and increase interconnectedness across the HCBS programs and workforce development system, and launching cutting-edge training programs and career advancement opportunities that allow for seamless movement of DCW workers across HCBS programs. In addition, Delaware also hopes to expand efforts to support the DCW workforce better by ensuring access to financial and benefits coaching and counseling for workforce, enabling access to mental health resources for DCWs, and providing support for ongoing education and learning across the HCBS system.
About the Team
Led by the State’s Division of Developmental Disabilities Services, Delaware’s integrated team includes the state Divisions of Medicaid and Medical Assistance and Division of Services for Aging Adults with Physical Disabilities, as well as the State Departments of Labor and Education. - Indiana
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Indiana plans to use intensive TA to help develop the next level of training for DCWs to explore career development opportunities, initiate and widely distribute a career development survey for DCWs, explore ways to address the impact of a possible benefits cliff among DSWs, and launch the state’s first Health Care Support Program (HCSP) through collaboration with the Indiana Association of Home and Hospice Care (IAHHC) and the Family & Social Services Administration FSSA’s managed care entities (MCEs) partners. The HCSP will focus on offering coaching and peer support programming to DCWs and supporting providers to better connect to and support DCWs. A special focus will be placed on recruiting and supporting both immigrants who were trained in various health and human service professions and people with disabilities who offer lived expertise. Indiana is seeking TA and subject matter expertise to understand the best use of the state’s Employer Resource Network, and HCSP marketing program as well as the benefits of an Employee Assistance Program (EAP). TA and subject matter expertise is also needed in utilizing data and evidence-based supports that affect loyalty to the profession, creating DCW learning cohorts and peer-mentoring programs, and building strategies to assist providers with retaining DCWs.
About the Team
Indiana’s TA initiative will be led by its Family and Social Services Administration (FSSA), including FSSA’s Division of Disabilities and Rehabilitative Services and Office of Medicaid Policy and Planning. Other partners include the Indiana Department of Workforce Development, Indiana Commission for Higher Education, and the Arc of Indiana. - New Jersey
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New Jersey plans to leverage technical assistance to help create and implement a comprehensive strategy that focuses on providing training and career development for DCWs by partnering with existing programs across the state. New Jersey will also better integrate its DCW enhancement strategies across agencies into a set of objectives that it can managed collaboratively, using each agency’s unique strengths and capacities. The state will also conduct a formal needs assessment and strategic planning process to ensure that all available resources and expertise are being used to address the ongoing direct care workforce crisis.
About the Team
New Jersey’s Department of Human Services (including the Division of Developmental Disabilities, Division of Medical Assistance and Health Services, Division of Aging Services, and the Division of Mental Health and Addiction Services) will serve as the primary lead agency. DHS will be joined by the Office of the Secretary of Higher Education and the Department of Labor and Workforce Development. - New Mexico
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New Mexico will utilize the DCW Strategies Center’s intensive TA initiative to identify and better understand the diverse caregiver role and compensation structure across its HCBS systems, with the goal of developing a foundation for a cohesive state caregiver workforce training, recruitment, and retention strategy. Activities may include action steps to implement training equivalencies across programs, identification, and mapping of a career path for caregivers across programs and in association with existing hospital and health programs, exploration of a universal collection tool for caregiver specific data across programs to identify workforce trends, and exploration of a state reimbursement baseline for caregivers across programs.
About the Team
New Mexico Department of Aging and Long-Term Services will lead the state’s team during the intensive TA cohort, and will partner with the state’s Human Services Department, Department of Workforce Solutions, and New Mexico Caregivers Coalition.