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Federal grantee network and states press for a new 'Goal 6' to shore up the direct care workforce
Summary
Speakers at the ACL joint RAISE/SGRG meeting endorsed adding a proposed Goal 6 to the National Strategy focused on a well-prepared, adequately compensated direct care workforce; the Direct Care Workforce Strategies Center described state technical assistance and examples from New Jersey, Nevada, Idaho and New Mexico.
Members of the RAISE and SGRG Councils and federal grantees urged that the National Strategy to Support Family Caregivers include a new Goal 6 focused on strengthening the paid direct care workforce — a measure they said is essential to sustaining family caregiving.
Jonathan Cottor, one of the RAISE co-chairs, presented draft language proposing that family caregivers be supported "by a well-prepared, adequately compensated, quality-focused, direct care workforce, as well as volunteers" and outlined how a stand-alone workforce goal would expand actions across federal, state and private sectors.
Federal and national partners described a practical template for that work. Caroline Ryan of ACL said the agency and interagency partners created the Direct Care Workforce Strategies Center to provide technical assistance, peer learning and tools to state teams. Nicole Howell, director of the Strategies Center, said the Center has supported multiple cross-agency state teams (28 teams across two years) with tailored technical assistance and peer learning targeted at three worker-journey areas: joining the workforce, well-being at work, and career progression.
Several state examples were cited as early results: New Jersey developed a cross-agency strategic plan that lists 40-plus recruitment and retention strategies and a public "Jobs That Care" campaign; Nevada is building a statewide career-pathway framework for personal care attendants; Idaho is working with managed-care partners and rural stakeholders to ensure access in frontier areas; New Mexico is framing direct care work as a broader economic issue to support statewide planning. The Strategies Center said it will expand on-demand, short-term assistance and publish briefs and webinars for broader adoption.
Data underpinned the case. Kezia Scales of PHI flagged recent workforce projections showing nearly 800,000 new jobs are needed by 2034 to meet demand and an estimated 8.9 million total job openings from 2024–2034 when separations are included. Scales urged that Goal 6 be comprehensive — covering recruitment, pay and benefits, training and career ladders — and said states must coordinate across Medicaid, workforce agencies and aging/disability partners to sustain progress after pandemic-era funds expire.
Why this matters: Council members and grantees argued that without a better-funded, better-trained direct care workforce, family caregivers will absorb more complex responsibilities, and access to home- and community-based services will erode. The meeting closed with commitments to continue Council deliberations and to align the Strategies Center’s state-level lessons into the National Strategy update process.
Next steps: The Strategies Center will continue technical assistance cycles, offer on-demand short-term TA, publish toolkits and convene webinars; ACL staff said a Strategy update draft will be circulated for comment later in 2026.
