CMS Suggests Approaches for Strengthening Home Care Workforce

The Centers for Medicare and Medicaid Services (CMS) has issued an Informational Bulletin (IB) that “highlights steps available to states, providers, and others to strengthen the home care workforce.” Suggested actions include building workforce identity, strengthening provider qualifications and basic training, and wage analyses. CMS uses the term home care workforce in this document “to encompass individuals furnishing HCBS [Home and Community-Based Services], consistent with advancing goals of beneficiary autonomy and self-direction of needed services.”

 The agency points out that “because home care workers often deliver care on site in the homes of beneficiaries receiving services, and travel from home to home independently, home care workers may interact with their professional peers infrequently, which can promote isolation and disengagement, and make professional development challenging.” To combat this, the IB recommends “establishing an open registry of workers for public use,” which “can help strengthen the identity of the workforce.” CMS also suggests that “professional associations or unions can also help support home care worker training and development.” In the IB, CMS also “encourages states and providers to be mindful of the relationship between wage sufficiency, workforce health, and access to care.” When developing payment rates for home care services, CMS says, “states should also consider business costs incurred by a provider…associated with the recruitment, skills training, and retention of qualified workers.”