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PHI

@phinational.bsky.social
19 followers 24 following 55 posts

35+ years of strengthening the direct care workforce nationwide through research, advocacy, and workforce innovation. Quality care through quality jobs.

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PHI @phinational.bsky.social · 02/10/2026
PHI is proud to endorse the Direct CARE Opportunity Act, and to see our research inform it. As Medicaid cuts threaten job stability, this bill from Reps. Scott, Grijalva & Lee invests in better jobs for direct care workers and better care for older adults and people with disabilities. bit.ly/46WwYcG
democrats-edworkforce.house.gov
Scott, Grijalva, Lee Introduce Bill to Invest in Direct Care Workers | Education & Workforce Committee Democrats
Education & Workforce Committee Democrats
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PHI @phinational.bsky.social · 01/10/2026
As of today, new federal rules strip Medicaid eligibility from many lawfully present immigrants. Nearly 1 in 3 direct care workers rely on Medicaid for their own coverage. These cuts deepen economic insecurity for workers and put access to care at risk. Read more: www.phinational.org/resource/phi...
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PHI @phinational.bsky.social · 23/09/2026
Nursing home capacity is shrinking, and the workforce is central to why. Drawing on PHI data @nytimes.com reports aides earned a median $20.67/h last year and 40% rely on public assistance. Quality jobs are the foundation for quality care. Policymakers must invest in direct care jobs. bit.ly/4cWHEeO
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PHI @phinational.bsky.social · 22/09/2026
Direct care workers are now the largest occupation in the U.S., and the data show real progress on wages and staffing. Those gains are at risk. Join PHI experts Kezia Scales, Stephen McCall, and Sarah Angell on Oct 15 at 2 PM ET to unpack Key Facts 2026. Register: bit.ly/4hfICDZ
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PHI @phinational.bsky.social · 18/09/2026
As of today, DHS's new public charge rule is in effect. Immigrants can now be penalized for using programs they're lawfully eligible for, like Medicaid and SNAP. Immigrants are at least 29% of the direct care workforce. Policymakers must strengthen, not undermine, these workers. bit.ly/4hdBckS
phinational.org
Public Charge Rule Will Undermine the Direct Care Workforce
DHS's final public charge rule puts immigrant direct care workers at risk, threatening care for older adults and people with disabilities. Read PHI's statement.
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PHI @phinational.bsky.social · 15/09/2026
NEW: The direct care workforce has grown to nearly 5.8 million, the largest occupation in the U.S. The sector will need to fill 9.6 million direct care jobs by 2035, yet workers still earn a median of $17.99/hour. Read our full 2026 Key Facts report: www.phinational.org/resource/dir...
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PHI @phinational.bsky.social · 08/09/2026
Immigrants make up over 25% of U.S. direct care workers, supporting older adults and people with disabilities. Terminating statuses like TPS devastates care access for everyone. Read the full BBC feature PHI contributed to: www.bbc.com/news/article...
bbc.com
Families lose 'lifeline' after Haitian caregivers let go as TPS status ends
Haitian immigrants make up a large portion of the already overburdened home-care workforce.
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PHI @phinational.bsky.social · 07/09/2026
This #LaborDay, we honor the 5.4M direct care workers supporting older adults & people with disabilities. Yet, their basic labor protections—like minimum wage & overtime—are being eroded. Quality care depends on the quality of their jobs. Read our policy brief: www.phinational.org/resource/phi...
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PHI @phinational.bsky.social · 02/09/2026
"The home care crisis isn't a mystery—it’s a job quality problem." Earlier this year, PHI experts Jake McDonald & Jenna Kellerman joined CAHSAH’s At the Table podcast to discuss the challenges facing home-based care and the solutions within reach. Catch up here: www.phinational.org/at-the-table...
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PHI @phinational.bsky.social · 01/09/2026
Federal rollbacks are stripping basic workplace protections from 5.4M direct care workers. Our final policy brief, "Defend Labor Rights," outlines how recent DOL and CMS actions threaten wages, worker classification, and vital staffing standards. Read the McKnight's coverage here: bit.ly/4qQjB6L
mcknightsseniorliving.com
Federal rollbacks strip protections from direct care workers, PHI brief says
Federal policy changes are stripping away basic workplace protections for the nation’s 5.4 million direct care workers, and it’s imperative that Congress and the states act to reverse the damage, acco...
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PHI @phinational.bsky.social · 31/08/2026
New reporting from Forbes: the end of TPS for Haitian immigrants is pulling experienced direct care workers out of the field. Tens of thousands are losing the work permits their jobs depend on, leaving fewer people to care for older adults and those with disabilities. www.forbes.com/sites/howard...
forbes.com
What Deporting Haitian Immigrants Means For Older Adults And Caregivers
Trump’s decision to revoke Temporary Protective Status for immigrants will damage long-term care in the US. One facility had to fire 19 Haitian staffers.
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PHI @phinational.bsky.social · 27/08/2026
"Investing in this workforce must be a national priority." In Health Affairs Forefront, Bianca Frogner examines how recent federal policies are destabilizing the immigrant direct care workforce, and the concrete steps states can take to support these workers: www.healthaffairs.org/content/fore...
healthaffairs.org
Recent Immigration Policies Threaten The Sustainability Of The LTSS Workforce | Health Affairs Forefront
To make sure that long-term services and supports remain available as the older population grows, it is essential that states partner with policy makers at the federal and local levels, along with lea...
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PHI @phinational.bsky.social · 26/08/2026
Gender equality in America runs directly through the care economy. Women are 85% of the direct care workforce: 5.4M workers earning a median $17.36/hr and under $26K a year. This #WomensEqualityDay honor this workforce with structural change, not just recognition. Read more: bit.ly/3UF8cux
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PHI @phinational.bsky.social · 24/08/2026
This summer, the DOJ signaled it will step back from enforcing the Olmstead integration mandate, shifting the burden onto people with disabilities. Realizing the right to community living requires sustained investment in the direct care workforce. Read more: www.phinational.org/fulfill-the-...
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PHI @phinational.bsky.social · 21/08/2026
PHI is at #HCBS26 next week! Find us at our booth to learn how the Universal Direct Care Workforce Initiative™ is helping states, employers, and payers strengthen the direct care workforce. And catch our sessions to learn more about the strategies helping states build workforce momentum.
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PHI @phinational.bsky.social · 20/08/2026
Our latest report offers seven considerations for building matching service and respite registries that promote autonomy and access for consumers while ensuring stable, high-quality jobs for direct care workers. Developed in collaboration with the Respite Care Association of Wisconsin bit.ly/45FMzN3
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PHI @phinational.bsky.social · 18/08/2026
More than 710,000 people were on HCBS waiting lists in 2024. McKnight's Senior Living looks at how the reintroduced HCBS Access Act would expand access and strengthen the direct care workforce. www.mcknightsseniorliving.com/news/how-the...
mcknightsseniorliving.com
How the HCBS Access Act would reshape assisted living demand and workforce
Legislation that would make home- and community-based services a mandatory Medicaid benefit has been reintroduced in the Senate, with potential benefits for assisted living providers and the older adu...
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PHI @phinational.bsky.social · 17/08/2026
New in @wsj.com, drawing on PHI analysis: ending TPS for Haitian immigrants is straining Florida's direct care workforce. Immigrants are a cornerstone of care, and Congress should reinstate TPS protections and create pathways that keep workers on the job. www.wsj.com/us-news/revo...
wsj.com
Revoking Protected Status for Haitian Workers Triggers Labor Crunch in Florida
The Trump administration move leaves home-care agencies, restaurants and other employers racing to fill vacancies.
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PHI @phinational.bsky.social · 11/08/2026
Immigrants make up 28% of the U.S. direct care workforce. As @fortune.com reports, the termination of Temporary Protected Status (TPS) is actively shrinking this critical sector. Every worker lost means more unpaid care shifting directly onto families. fortune.com/2026/08/07/d...
fortune.com
The deportation economy is backfiring on American workers, top economist warns | Fortune
Diane Swonk says July’s bizarre jobs report is the first data from the deportation economy: shrinking payrolls and a shrinking workforce.
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PHI @phinational.bsky.social · 10/08/2026
PHI welcomes Rep. Debbie Dingell's introduction of the Medicare at Home Act, establishing a home care benefit of up to 20 hrs/week. We're encouraged it points toward a wage floor for workers. Congress should pair this with benefits and job-quality standards for good home care jobs. bit.ly/4gmDuyC
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PHI @phinational.bsky.social · 07/08/2026
600,000+ people are waiting for home and community-based services. Behind every one of those waits is a job someone couldn't afford to keep. PHI endorses the HCBS Access Act, reintroduced today by Senator Lujan and the bill's sponsors. Read our full statement: www.phinational.org/phi-endorses...
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PHI @phinational.bsky.social · 05/08/2026
"Immigration policy is long-term care policy." PHI's Kezia Scales, VP of Policy, Research, and Evaluation, talks with McKnight's Senior Living about our new Support Immigrants brief and what providers can do to protect the workers older adults count on: www.mcknightsseniorliving.com/news/phi-mid...
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PHI @phinational.bsky.social · 04/08/2026
DHS's new public charge rule puts immigrant direct care workers at risk. Immigrants make up at least 28% of this crucial workforce, and nearly half rely on benefits like Medicaid and SNAP. PHI condemns this rule. Read our statement: www.phinational.org/public-charg...
phinational.org
Public Charge Rule Will Undermine the Direct Care Workforce
DHS's final public charge rule puts immigrant direct care workers at risk, threatening care for older adults and people with disabilities. Read PHI's statement.
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PHI @phinational.bsky.social · 03/08/2026
1 in 3 direct care workers rely on Medicaid for their own health coverage. New federal work requirements put that coverage at risk, even for workers who meet the requirements but struggle to document their compliance. PHI is urging CMS to revise its rule and states to act now: bit.ly/3TyC2k4
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PHI @phinational.bsky.social · 30/07/2026
This week, hundreds of thousands of people, primarily Haitians, lost Temporary Protected Status (TPS). Immigrants are a cornerstone of the direct care workforce. Losing them deepens care shortages. Read our full statement: www.phinational.org/tps-protecti...
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PHI @phinational.bsky.social · 29/07/2026
At a time when the need has never been greater, Congress and states should invest in aging services and the direct care workforce, not move backward. PHI urges New York to withdraw its proposed CNA training rollback and the House to pass the Older Americans Act reauthorization. bit.ly/4hB1cZ1
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PHI @phinational.bsky.social · 26/07/2026
Exactly 36 years ago today, the #ADA was signed into law. Its promise depends on a stable, respected workforce. When poor job quality drives workers away, the consequences fall on people with disabilities. Honoring the ADA means investing in the people who bring it to life. Read more: bit.ly/4pFSr1K
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PHI @phinational.bsky.social · 22/07/2026
Medicaid cuts, restrictive immigration policies, and dismantled labor protections are converging to destabilize 5.4M direct care workers. Read PHI’s new midterm policy series—Restore Medicaid, Support Immigrants, and Defend Labor Rights—for a strategy forward: www.phinational.org/restore-supp...
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PHI @phinational.bsky.social · 21/07/2026
Immigrants make up more than a quarter of the direct care workforce. The Careworker Visa Act, introduced last month by Rep. Gabe Vasquez (NM-02), opens a pathway into these jobs while strengthening wage standards and protections against exploitation. PHI is proud to support it.
santafenewmexican.com
New Mexico Wellness Wire: Vasquez introduces Careworker Visa Act
Vasquez described the careworker visa bill as both an economic development initiative and an immigration reform measure.
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PHI @phinational.bsky.social · 17/07/2026
Immigrant care workers are vital to the direct care workforce. A recent Salon article shows how tightening immigration policies put immense pressure on our strained system, threatening care for older adults and people with disabilities. www.yahoo.com/news/politic...
yahoo.com
Immigration crackdown cripples America’s caregiving industry
Leaked plans to declare migrants dead and a SCOTUS ruling are hollowing out elder care
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PHI @phinational.bsky.social · 16/07/2026
PHI applauds the Senate's passage of the Older Americans Act Reauthorization Act, which would renew and strengthen the essential nutrition, health, caregiver, and community-based services that help millions of older adults. The House must now act to ensure that OAA’s supports are renewed to 2030.
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PHI @phinational.bsky.social · 13/07/2026
U.S. Senator Tim Kaine (D-VA)reintroduced the Supporting Our Direct Care Workforce and Family Caregivers Act (S. 4889). PHI enthusiastically endorses this legislation, which reflects policy priorities we have long championed across successive Congresses. www.phinational.org/phi-endorses...
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PHI @phinational.bsky.social · 09/07/2026
Direct care jobs have been driving U.S. employment growth — and Medicaid cuts put that at risk. PHI's Kezia Scales tells Barron's that when HCBS is cut, workers and families bear the cost. www.msn.com/en-us/money/...
msn.com
MSN
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PHI @phinational.bsky.social · 04/07/2026
America marks 250 years this Fourth of July—a moment to reflect on the ideals we've declared and the work ahead. Direct care workers are essential to millions, yet too many go underpaid and unrecognized. Fulfilling those founding ideals means valuing care workers too. Happy Fourth from PHI.
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PHI @phinational.bsky.social · 01/07/2026
Recent federal actions threaten to strip basic workplace protections from the 5.4 million direct care workers who support older adults and people with disabilities. Our new policy brief, Defend Labor Rights, breaks down the rollback—and what Congress and the states must do. Read here: bit.ly/4fc5vse
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PHI @phinational.bsky.social · 25/06/2026
The OMB has proposed the most significant revision to federal grant rules in a decade. PHI is concerned this could compromise critical funding for direct care workforce research and services. Public comments are due 7/13 at regulations.gov, docket OMB-2026-0034. Read our statement: bit.ly/4vr4amZ
bit.ly
PHI Statement on OMB's Proposed Overhaul of Federal Grant Rules
On May 29, 2026, the Office of Management and Budget (OMB) proposed the most significant revision to the rules governing federal grants in more than a decade. The proposed rule would change how nearly...
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PHI @phinational.bsky.social · 24/06/2026
Immigrants are a cornerstone of the direct care workforce — over 1 in 4 workers nationwide, and 50%+ in some states. Federal immigration policy is pushing them out of the field, shrinking the pipeline just as care demand grows. PHI's latest policy brief lays out what must change: bit.ly/3R0jYy8
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PHI @phinational.bsky.social · 23/06/2026
Language access is a workforce strategy. PHI analysis from Jake McDonald finds at least 27% of direct care workers are immigrants — up from 21% in 2011. Investing in multilingual supports helps states recruit and retain the workforce communities depend on: www.ltcnews.com/articles/los...
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PHI @phinational.bsky.social · 22/06/2026
New from PHI: Inflation has cut real wages for WA State's 60,000 individual providers by 11% since 2020, weakening the case for caregiving over other low-wage work. The workforce is growing—but most new providers leave within a year. Read Falling Behind: www.phinational.org/resource/fal...
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PHI @phinational.bsky.social · 19/06/2026
It took over 75 years for home care workers to win basic labor rights—protections secured in 2015 that now face real risk again. This Juneteenth, PHI recognizes Black direct care workers and the accountability the day demands. Read our full statement: www.phinational.org/juneteenth-a...
phinational.org
Juneteenth and Our Nation's Unfinished Work of Valuing Care and Care Workers
This Juneteenth marks 161 years since the last enslaved people in Galveston, Texas, learned of their freedom, more than two years after the Emancipation Proclamation had been signed. The day has alway...
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PHI @phinational.bsky.social · 17/06/2026
New Policy Brief: Restore Medicaid, the first in a 3-part series on how federal policy is reshaping long-term care. Medicaid is the primary payer of long-term care in the US—and nearly a third of direct care workers rely on it themselves. Read our full brief: www.phinational.org/resource/phi...
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PHI @phinational.bsky.social · 15/06/2026
PHI proudly recognizes the LGBTQ+ community and recommits to championing the conditions that allow every person to live, work, and age with dignity. Across long-term care, this shared commitment is vital. Fostering equitable workplaces is inseparable from delivering quality care. bit.ly/4eny1FP
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PHI @phinational.bsky.social · 05/06/2026
High-quality care depends on a stable, well-supported workforce. PHI applauds Sen. Wyden and colleagues for launching an effort to reimagine long-term care—and for centering the direct care workers who make it possible. www.finance.senate.gov/ranking-memb...
finance.senate.gov
Wyden, Senate Democrats Unveil Plans to Improve Long-Term Care Amid Republican Attacks | The United States Senate Committee on Finance
Wyden, Senate Democrats Unveil Plans to Improve Long-Term Care Amid Republican Attacks
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PHI @phinational.bsky.social · 20/05/2026
CMS deferring $1.3B in Medicaid funds to CA threatens the stability of the direct care workforce. The most effective way to ensure care is delivered is to invest in this workforce—through better training and livable wages—not impose broad financial penalties. www.phinational.org/phi-statemen...
phinational.org
PHI Statement on CMS’s Deferral of Medicaid Payments to California
The Centers for Medicare & Medicaid Services has deferred $1.3 billion in Medicaid reimbursement payments to California, while issuing a six-month national moratorium on new Medicare enrollments for h...
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PHI @phinational.bsky.social · 18/05/2026
Direct care workers deserve a system they can navigate. Where training counts, credentials travel, and careers can grow. In ASA's Generations Journal, we introduce our Universal Workforce Model to build clear career pathways & a thriving care ecosystem. generations.asaging.org/putting-the-...
generations.asaging.org
Putting the Pieces Together: A Transformative Vision for the Direct Care Workforce - ASA Generations
A transformative vision for the direct care workforce.
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PHI @phinational.bsky.social · 14/05/2026
The DOL now proposes to strip home care workers of the right to minimum wage and overtime pay, devaluing their labor and demeaning their skilled contributions to families, communities, and the economy. The solution to the growing care gap is to improve jobs, not eliminate protections. bit.ly/4wkrrIa
bit.ly
It Took Over 75 Years for Home Care Workers to Win Basic Rights. A New Rule Would Strip Them Away.
A critical challenge facing home care in the United States dates back to 1938, when Congress passed the Fair Labor Standards Act. The law granted minimum wage and overtime protections to most American...
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PHI @phinational.bsky.social · 07/05/2026
All Medicaid expansion states must soon impose work requirements as a condition of coverage. One-third of the nation's 5.4 million direct care workers rely on Medicaid for their own health coverage—and many will face heightened barriers to comply. New PHI brief for state leaders: bit.ly/4nfggwl
bit.ly
Medicaid Work Requirements: State Options and Implications for the Direct Care Workforce
The budget reconciliation act of 2025 (HR 1) mandated that all states which have expanded Medicaid impose community engagement requirements—more commonly known as work requirements—as a condition of M...
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PHI @phinational.bsky.social · 05/05/2026
Congrats to Adria Powell, CEO of CHCA — the nation's largest worker-owned home care co-op — and PHI Board member, on being named to Crain's NY Business 2026 Women of Influence. "Adria's leadership exemplifies the connection between quality jobs and quality care." Jodi Sturgeon, PHI bit.ly/42SPtMM
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PHI @phinational.bsky.social · 04/05/2026
Wisconsin has emerged as a national leader in strengthening its direct care workforce. PHI's latest report examines the state's training, employment, and career development landscape — with a focus on PCAs and the Certified Direct Care Professional (CDCP) program. Learn more: bit.ly/3P336pp
bit.ly
Building Skills, Building Careers in Care: Wisconsin’s Direct Care Workforce Training, Employment, and Career Development Landscape
More than 107,000 direct care workers in Wisconsin provide essential assistance to older adults and people with disabilities in home- and communitybased services (HCBS), residential care communities, ...
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PHI @phinational.bsky.social · 30/04/2026
Today @debbiedingell.house.gov reintroduced two landmark bills to systematically address the direct care workforce crisis: the Long-Term Care Workforce Support Act and HCBS Access Act. PHI strongly endorses both and joined Rep Dingell and partners across the field for the announcement bit.ly/4n0P8RG
phinational.org
PHI Endorses Reintroduction of the Long-Term Care Workforce Support Act and the HCBS Access Act
Today in Congress, Representative Debbie Dingell (D-MI) reintroduced two landmark bills to systematically address the direct care workforce crisis: the Long-Term Care Workforce Support Act and the Hom...
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