Special Projects Fund

Project Title

Reshaping New York’s Direct Care Workforce Model

Grant Amount


Priority Area

Special Projects Fund

Date Awarded

December 13, 2021





In Progress



Direct care workers—personal care aides, home health aides, and nursing assistants—provide in-home care and personal assistance to older adults and to those living with disabilities or other chronic conditions.

The long-term care sector is expected to add 1.3 million of these direct care jobs over the next decade. In New York State alone, the growing need for home care workers is projected to generate more than 190,000 home care jobs. While demand for direct care workers is booming, New York and other states struggle to fill vacancies as a result of workforce shortages and high turnover rates. Recruiting and retaining direct care workers remains an uphill battle because of inadequate compensation with unstable, low hourly wages; minimal support and training, leading to burnout and job dissatisfaction; poor prospects for career mobility; and a disconnect from the larger health care system. In 2021, NYHealth awarded Manatt Phelps & Philipps, LLP, in partnership with 1199SEIU Training and Employment Funds (TEF), a grant to form a consortium of health plans, providers, labor unions, and other community-based organizations to develop and implement a new employment model for direct care workers in New York State.

Under this grant, Manatt and TEF will lead the consortium to develop and test a new direct care workforce employment model. The consortium will research and identify national best practices and will facilitate stakeholder interviews and focus groups with providers and patients. Using this information, it will develop a new direct care worker compensation and training model. The consortium will also develop a detailed implementation blueprint to test the model, including formalized employee training structures and curricula to support increased skill levels. Finally, three Medicaid managed care plans in the consortium will select at least one direct care service provider to test the new model for one year. The health plans will work with their selected provider to operationalize the training model, new compensation approach, and peer support functions. The consortium will conduct interviews and administer monthly surveys to identify problem areas. Manatt will coordinate with an external evaluator to fully assess the outcomes. The findings will inform the creation of a final blueprint, which will be used to advocate with New York State to secure the financing needed to scale the model.