New Freedom Initiative -- Preliminary Report: Personal Assistance, Direct Care Services and Community Workers <TITLE>New Freedom Initiative -- PageTitleGoesHere

U.S. Department of Health & Human Services

Initiative ~ Executive Order ~ HHS Role ~ News & Additional Resources

Delivering on the Promise: Preliminary Report

Federal Agency Actions to Eliminate Barriers and Promote Community Integration

Personal Assistance, Direct Care Services
and Community Workers

As the President's Executive Order is implemented and more people with significant disabilities live in home and community-based settings and enter the workforce, the already critical need for personal care assistants and other direct care staff and community service workers will become even more pronounced. A chronic inability to attract and retain dedicated people in these fields can be traced to the fact that traditionally, across the country, these workers earn very low pay, work long hours, and often receive no benefits. There is an urgent need to address the areas of recruiting, training, retaining, promoting, and improving the earnings/benefits of personal assistants and other community service workers. The following activities are planned to address these barriers.

Department of Labor

DOL's Office of Disability Employment Policy (ODEP) will work to identify and propose options for increasing the availability of personal assistants for people with disabilities and providing some path of career progression for personal assistants and other direct care staff. ODEP expects to consult with DOL agencies and with other Federal agencies including the Department of Education, HHS' Assistant Secretary for Planning and Evaluation's Office for Disability, Aging and Long Term Care; and others. The overarching goal is to develop a cross-agency/cross-department plan to increase the availability and quality of personal assistants, and to identify options for the education, training, and career advancement for personal assistants and other direct care staff and community service workers.
ODEP and ETA will explore increased access to personal assistance supports through the One-Stop Center system.
ODEP will establish an online registry, similar to America's Job Bank, on DisAbilityDirect.gov where local or community-based organizations that help locate personal assistance can be identified.
ODEP will work with ESA's Wage and Hour Division to assess the impact, if any, of the Fair Labor Standards Act's minimum wage and overtime exemptions for companionship services and live-in help services on the availability of personal assistance services.

Department of Education

ED's Rehabilitation Services Administration (RSA) will seek collaboration and partnerships with appropriate federal agencies in order to explore how funds for attendant services can be more "consumer driven." RSA will also work with other Federal agencies to assess training opportunities for personal assistance service providers, consumers, family members, and consumer representatives in skill areas such as recruiting, hiring and supervision of personal assistance service providers.

Department of Health and Human Services

HHS will, together with a limited number of volunteer states, initiate a national demonstration designed to address workforce shortages of community service direct care workers. The demonstration will test the extent to which workforce shortages and instabilities might be addressed through (a) better coordination with the Temporary Assistance for Needy Families (TANF) program; and (b) the availability of vouchers for worker health insurance or for tuition or day care credits. Participating states would be expected to develop options for workers to purchase affordable group health coverage through the state health insurance system or similar organized insurance group.
HHS components will collaborate on a joint initiative to: (a) mobilize and make available to states a coherent body of information about methods to address worker shortage issues; (b) research significant issues; and (c) partner with foundations, other private sector organizations, the Department of Labor, and other agencies to formulate a comprehensive approach to the worker issue.
HHS will work with other federal agencies to devise and implement additional strategies on workforce issues as part of the activities of the Interagency Council on Community Living.

Last revised: April 9, 2002