Webinar on Addressing Wages of the Direct Care Workforce through Medicaid Policies

This webinar, held November 10, 2022, discusses the NGA publication “Addressing Wages of the Direct Care Workforce through Medicaid Policies”.

Recruiting and retaining direct care workers, including certified nursing assistants (CNAs), home health aides, direct support professionals, personal care aides and other non-licensed personnel, has represented a longstanding challenge in the United States due to low wages and the intense demands of these occupations. The COVID-19 pandemic exacerbated these issues by increasing health risks to direct care workers. As states have grappled with staffing concerns in both facility and home and community-based (HCBS) settings, they are seeking long-term solutions to recruit and retain workers, an objective that also has significant equity implications because most direct care workers are women and people of color.

The National Governors Association publication, “Addressing Wages Of The Direct Care Workforce Through Medicaid Policies”, provides a summary of state approaches to increase direct care worker wages through Medicaid policy vehicles, with a focus on those that have reporting requirements, enforcement vehicles or other mechanisms to help ensure funds go to intended recipients working in facility and HCBS settings. Medicaid is the largest payer for facility-based and HCBS care, paying for 42.1 percent of all long-term services and supports in 2020. NGA is pleased to have hosted this webinar to facilitate discussion of this important topic.



  • Dr. Shelby Hockenberry, Healthcare Delivery Program Director, NGA Center

Setting the Context

  • Lauren Block, Aurrera Health Group


  • Dr. Hannah Maxey, Veritas Health Solutions

Panel Discussion and Q&A

  • Hayley Gleason, Strategic Outcomes Division Director, Office of Community Living, Colorado Department of Health Care Policy & Financing
  • Dawn Lambert,Co-leader, Community Options Unit, Division of Health Services, Connecticut Department of Social Services
  • Nicole Godburn, Fiscal Manager, Connecticut Department of Social Services
  • Katie Moss, Chief of LTSS, Tennessee Division of TennCare