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Recommendations for Congress, CMS, ACL, and States on Strengthening the Direct Care Workforce

A novel framework from the National MLTSS Health Plan Association (MLTSS Association) provides recommendations on how federal agencies and states with managed long-term services and supports (MLTSS) programs can leverage the role of MLTSS managed care organizations (MCOs) to bolster the DCW. Our recommendations span five key domains: Recruitment; Retention; Data Collection, Monitoring, and Evaluation; Workforce Alternatives; and Elevating the Social Value of DCW’s Impact, with considerations for informal caregivers, technology, and flexible funding models braided across all domains.


The MLTSS Association offers the following priority recommendations that Congress, CMS, ACL, and states can take to foster state and plan innovations to strengthen the DCW. We chose to highlight these actions because of their potential for lasting and widespread impact across the field and are feasible for CMS to rapidly implement. Read our framework for the full list of recommendations.


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