PARAPROFESSIONAL HEALTHCARE INSTITUTE INC

: DRAWING ON MORE THAN THREE DECADES OF EXPERIENCE, PHI PROMOTES THE INTERVENTIONS NEEDED TO ENSURE THAT DIRECT CARE WORK IS QUALITY WORK SUCH AS IMPROVED TRAINING, FAMILY-SUSTAINING WAGES, AND MEANINGFUL CAREER PATHS. THROUGH POLICY DEVELOPMENT, ADVOCACY, RESEARCH AND EVALUATION, AND WORKFORCE INNOVATIONS, WE DRIVE SYSTEMIC CHANGE TO STRENGTHEN THE DIRECT CARE WORKFORCE AND THE LONG-TERM CARE SECTOR AS A WHOLE. DIRECT CARE WORKERS PROVIDE SKILLED, HANDS-ON SUPPORT TO OLDER ADULTS AND PEOPLE WITH DISABILITIES IN HOME, COMMUNITY-BASED, AND RESIDENTIAL SETTINGS. THEY ENSURE CLIENTS' WELL-BEING, PROVIDE SOCIAL AND EMOTIONAL SUPPORT, AND ASSIST WITH DAILY TASKS ESSENTIAL TO INDEPENDENT LIVING. HOWEVER, THESE WORKERS OFTEN STRUGGLE WITH POOR JOB QUALITY; CONSEQUENTLY, LONG-TERM CARE PROVIDERS FIND IT DIFFICULT TO RECRUIT AND RETAIN ENOUGH PROFESSIONALS TO MEET THE GROWING DEMAND FOR THESE SERVICES.PHI OFFERS PROVIDERS, PAYERS, AND POLICYMAKERS THE TOOLS TO TRANSFORM THE LONG-TERM CARE SYSTEM. OUR POLICY WORK IS INFORMED BY OUR ON-THE-GROUND TRAINING INITIATIVES AND VICE VERSA, ENABLING US TO ADVANCE EFFECTIVE SOLUTIONS THAT COMPREHENSIVELY IMPROVE THE QUALITY OF DIRECT CARE JOBS. TO ACHIEVE BROAD GEOGRAPHIC IMPACT, PHI MAINTAINS A NATIONAL HEADQUARTERS IN NEW YORK CITY AND DEPLOYS STAFF FROM ACROSS THE COUNTRY.UNIVERSAL DIRECT CARE WORKFORCE INITIATIVEPHI'S STRATEGIC INITIATIVES TEAM (1.5 FTE) WORKS TO DESIGN AND LEAD PHI'S MAJOR STRATEGIC INITIATIVES. WORKING COLLABORATIVELY WITH LEADERSHIP AND STAFF ACROSS THE ORGANIZATION, THE TEAM'S INITIAL PRIORITY IS TO DESIGN, ADVANCE, AND INFORM THE EVALUATION OF PHI'S UNIVERSAL DIRECT CARE WORKFORCE INITIATIVE AND TO CENTER THIS PROJECT, AS WELL AS OTHER KEY INITIATIVES, IN SUPPORT OF PHI'S MISSION.THE UNIVERSAL DIRECT CARE WORKER INITIATIVE PUBLICLY LAUNCHED ON JULY 10, 2025, A TRANSFORMATIVE STEP IN PHI'S COMMITMENT TO IMPROVING THE QUALITY OF DIRECT CARE JOBS. THE INITIATIVE SEEKS TO CREATE A FUTURE IN WHICH ALL DIRECT CARE WORKERS HAVE ACCESS TO STANDARDIZED TRAINING, PORTABLE CREDENTIALS, AND CLEAR CAREER PATHWAYS, ENABLING THEM TO MOVE SEAMLESSLY BETWEEN ROLES, SETTINGS, AND EVEN STATES WITHIN THIS SECTOR.THIS EFFORT DIRECTLY RESPONDS TO CRITICAL STAFFING SHORTAGES AND SYSTEMIC INEQUITIES PLAGUING THE LONG-TERM CARE SECTOR. THROUGH PILOT DEMONSTRATION PROJECTS IN NEW YORK AND WISCONSINAND POLICY ADVOCACY AND SYSTEMS CHANGE WORK IN THESE AND OTHER STATESPHI IS BUILDING A COMPREHENSIVE APPROACH INTENDED FOR NATIONWIDE ADOPTION. AS THE LONG-TERM CARE SECTOR FACES SUSTAINED THREATS, THE UNIVERSAL DIRECT CARE WORKER INITIATIVE PROVIDES AN ASPIRATIONAL SOLUTION THAT STATES CAN IMPLEMENT TO STRENGTHEN THE DIRECT CARE WORKFORCEAND IMPROVE THE QUALITY, EFFICIENCY, AND CONTINUITY OF CARE.TRAINING AND WORKFORCE DEVELOPMENT PROGRAMPHI CO-MANAGES A TRAINING AND WORKFORCE DEVELOPMENT PROGRAM IN NEW YORK CITY WITH COOPERATIVE HOME CARE ASSOCIATES (CHCA), A LICENSED HOME CARE AGENCY AND THE COUNTRY'S LARGEST WORKER-OWNED COOPERATIVE. PHI AND CHCA PROVIDE A FREE HOME HEALTH AIDE TRAINING PROGRAM, DISTINGUISHED BY ITS COMPREHENSIVE, ADULT LEARNER-CENTERED CURRICULUM; GUARANTEED JOB PLACEMENT; AND EXTENSIVE WRAPAROUND RETENTION SUPPORTS FOR PARTICIPANTSPRIMARILY WOMEN OF COLOR WHO FACE MULTIPLE BARRIERS TO EMPLOYMENT. THE PROGRAM IS OFFERED IN BOTH ENGLISH AND SPANISH AND EXCEEDS THE COMBINED 75 HOURS OF TRAINING REQUIRED BY FEDERAL AND STATE REGULATIONS. THESE ELEMENTS LEAD TO STRONG PROGRAM OUTCOMES; IN FISCAL YEAR 2025, PARTICIPANTS ACHIEVED A 92% GRADUATION RATE, A 78% JOB PLACEMENT RATE, AND AN 82% SIX-MONTH RETENTION RATE. WE HAVE TRAINED MORE THAN 14,000 NEW YORKERS TO DATE.PHI BUILDS FROM A MULTI-DECADE HISTORY OF PARTNERSHIP WITH CHCA TO BRING BEST PRACTICES IN RECRUITMENT, TRAINING, AND WORKFORCE DEVELOPMENT TO LONG-TERM CARE EMPLOYERS, EDUCATORS, AND HEALTH CARE SYSTEMS ACROSS THE COUNTRY, AND IN TURN, WE BRING EXPERTISE AND EXPERIENCE FROM OUR EFFORTS IN NEW YORK AND NATIONWIDE TO HELP CHCA TO DEEPEN ITS OWN IMPLEMENTATION OF DIRECT CARE WORKFORCE-CENTERED TRAINING AND EMPLOYMENT PRACTICES. WORKFORCE INNOVATIONSPHI'S WORKFORCE INNOVATIONS TEAM (6.5 FTE) COLLABORATES WITH LONG-TERM CARE PROVIDERS, TRAINING ENTITIES, STATE AGENCIES, AND ACADEMIC PARTNERS THROUGHOUT THE COUNTRY TO DEVELOP, IMPLEMENT, AND SUPPORT ENTRY-LEVEL TRAINING, UPSKILLING, AND ADVANCED ROLES IN DIRECT CARE. WE ALSO ENGAGE IN ORGANIZATIONAL DEVELOPMENT WITH PROVIDERS THROUGH PHI'S COACHING APPROACH PROGRAM, WHICH EMBEDS COMMUNICATION AND PROBLEM-SOLVING SKILLS ACROSS STAFF.AS ONE EXAMPLE OF THIS WORK, IN NORTH CAROLINA, PHI PARTNERS WITH WORKFORCE ENGAGEMENT WITH CARE WORKERS TO ASSIST, RECOGNIZE AND EDUCATE (WECARE) TO PILOT PARTNERING TO IMPROVE CARE, OUR HYBRID TRAINING MODEL AIMED AT ENHANCING THE RELATIONAL SKILLS OF DIRECT CARE WORKERS AND FAMILY CAREGIVERS TO STRENGTHEN THEIR COLLABORATION. THIS PAST YEAR, PHI WORKED WITH THE WECARE TEAM AND NATIONAL DOMESTIC WORKERS ALLIANCE FELLOWS TO PLAN OUR FIRST-EVER COMMUNITIES OF PRACTICEDESIGNED TO SUSTAIN LEARNING, FOSTER PEER CONNECTION, AND BUILD LEADERSHIP AMONG DIRECT CARE WORKERS.IN FISCAL YEAR 2025, PHI SUPPORTED THE MASSACHUSETTS EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES (EOHHS) IN THE DEVELOPMENT OF A CONSOLIDATED HOME HEALTH AIDE (HHA) AND CERTIFIED NURSING ASSISTANT (CNA) TRAINING CREDENTIAL, AS WELL AS A RELATED COMPETENCY-BASED CURRICULUM. THE CONSOLIDATED CREDENTIAL WILL ESTABLISH A MORE INTEGRATED AND FLEXIBLE WORKFORCE, ENABLING DIRECT CARE WORKERS TO WORK AS HHAS OR CNAS ACROSS MULTIPLE SETTINGS.FINALLY, THIS PAST FISCAL YEAR, PHI COMPLETED AN EVALUATION OF OUR CARE INTEGRATION SENIOR AIDE (CISA) ROLE, WHICH PROVIDES AIDES WITH A STRONGER ROLE IN IMPROVING CARE COORDINATION AND CLIENT SOCIAL DETERMINANTS OF HEALTH, WHILE OFFERING THEM MEANINGFUL CAREER ADVANCEMENT AND HIGHER COMPENSATION. SPECIFICALLY, AN EVALUATION IN WISCONSIN FOUND THAT THE ROLE CREATES COMPELLING PROFESSIONAL ADVANCEMENT OPPORTUNITIES THAT KEEP SKILLED WORKERS IN THE FIELD WHILE IMPROVING JOB SATISFACTION FOR THE BROADER WORKFORCE. THE EVALUATION ALSO FOUND THAT CISAS PLAYED A CRUCIAL ROLE IN MITIGATING SOCIAL ISOLATION AND ENHANCING CARE COORDINATION BY PARTICIPATING IN HOSPITAL DISCHARGE PLANNING AND IMPROVING COMMUNICATION AMONG CARE TEAM MEMBERS.RESEARCH AND EVALUATION PHI'S RESEARCH & EVALUATION TEAM (4 FTE) BUILDS THE EVIDENCE BASE ON STATE AND NATIONAL POLICIES AND WORKFORCE INTERVENTIONS THAT IMPROVE DIRECT CARE JOBS AND STRENGTHEN LONG-TERM CARE. WE CONDUCT ORIGINAL RESEARCH, REGULARLY ANALYZE WORKFORCE AND CONSUMER DATA, RELEASE POLICY PUBLICATIONS, AND EVALUATE PHI'S OWN FIELD-LEARNING INTERVENTIONS. THE TEAM MAINTAINS PHI'S ONLINE WORKFORCE DATA CENTER, WHICH PROVIDES THE LATEST STATE AND NATIONAL DATA ON THE DIRECT CARE WORKFORCEFROM EMPLOYMENT STATISTICS AND PROJECTIONS TO EARNINGS AND DEMOGRAPHICS. WE ALSO MAINTAIN PHI'S DIRECT CARE WORKFORCE STATE INDEX, AN INTERACTIVE ONLINE TOOL FEATURING ALL 50 U.S. STATES AND WASHINGTON, DC, WHICH ENABLES USERS TO RANK AND COMPARE STATES BASED ON THE ECONOMIC STATUS OF DIRECT CARE WORKERS AND THE RANGE OF POLICIES THAT STATES HAVE ENACTED TO SUPPORT THEM.ANNUALLY, PHI PRODUCES THE REPORT, DIRECT CARE WORKERS IN THE UNITED STATES: KEY FACTS, WHICH PROVIDES EXTENSIVE DIRECT CARE WORKFORCE DATA, INCLUDING ITS DEMOGRAPHICS, OCCUPATIONAL ROLES, JOB QUALITY CHALLENGES, AND PROJECTED JOB OPENINGS; OUR MOST RECENT REPORT WAS RELEASED ON SEPTEMBER 15, 2025. IN AUGUST 2025, WE RELEASED A REPORT, "TIPPING POINT: EXPLORING THE RISK OF BENEFITS CLIFFS AMONG DIRECT CARE WORKERS IN VIRGINIA," WHICH PRESENTS THE FINDINGS OF A MIXED-METHODS STUDY THAT MODELED THE IMPACT OF HYPOTHETICAL INCREMENTAL WAGE INCREASES FOR DIRECT CARE WORKERS, EXPLORED WORKERS' LIVED EXPERIENCES NAVIGATING CHANGES IN INCOME AND PUBLIC BENEFITS, AND OFFERED POLICY RECOMMENDATIONS FOR VIRGINIA.POLICY PHI'S POLICY TEAM (2 FTE) SUPPORTS POLICYMAKERS AND ADVOCATES IN CRAFTING EVIDENCE-BASED POLICIES TO ADVANCE QUALITY CARE AND QUALITY JOBS. OUR CAPACITY INCLUDES POLICY AND LABOR MARKET ANALYSIS AND STATE AND NATIONAL POLICY EXPERTISE. THIS EXPERTISE, AND OUR RELATED PUBLIC EDUCATION CAMPAIGNS, HAVE ESTABLISHED PHI AS THE NATION'S PRIMARY SOURCE OF INFORMATION AND ANALYSIS ON DIRECT CARE, ANCHORED AT WWW.PHINATIONAL.ORG AND @PHINATIONAL.OVER THE PAST FISCAL YEAR, WE ADVANCED THE TOGETHER IN CARE INITIATIVE, WHICH STRENGTHENS THE VITAL RELATIONSHIP BETWEEN DIRECT CARE WORKERS AND FAMILY CAREGIVERS TO REDUCE CAREGIVER STRESS AND IMPROVE THE OUTCOMES OF THOSE WHO RELY ON THEIR CARE. IN AUGUST 2024, WE HELD A TOGETHER IN CARE WEBINAR TO PROMOTE OUR POLICY BRIEF, WHICH OUTLINES A RANGE OF RECOMMENDATIONSSUCH AS MATCHING SERVICE REGISTRIES, CARE TEAM INTEGRATION, RESEARCH, AND WORKFORCE INTERVENTIONSTHAT CAN ELEVATE THE RELATIONSHIP BETWEEN THESE CAREGIVERS TO CREATE A MORE SUS