Direct Care Workforce Briefs

Time to read: 2 minutes.

Nearly half of all individuals dually eligible for Medicare and Medicaid receive help with personal care, such as bathing and dressing, managing medications, and other long-term services and supports (LTSS).[1] Given the intimate nature of these services and caregiver-client interactions, cultural competence – the ability to work effectively in cross-cultural situations –is a key part of establishing trust and respect between direct care workers and their clients. As the population of individuals using LTSS grows increasingly diverse in race and ethnicity,[2] the ability of direct care workers to provide culturally competent care is increasingly vital. We invite you to explore each of the briefs linked below to learn more:


 Organizational Cultural Competence

This brief highlights strategies for developing cultural competence within LTSS provider organizations to support a culturally competent direct care workforce. The brief provides strategies for assessing organizational cultural competence, supporting diversity across all levels of an organization, addressing linguistic competence, and engaging community partners.


 Training Culturally Competent Direct Care Workers

This brief focuses on strategies for training direct care workers in cultural competence. Highlighted strategies include establishing and building on organizational policies to support cultural competence, using adult learner-centered training methods, and identifying setting- and community-appropriate training programs for direct care workers.


 Recruiting and Retaining a Diverse Direct Care Workforce

This brief focuses on strategies for recruiting and retaining a diverse direct care workforce. This brief includes approaches for inclusive hiring practices, supporting staff through an inclusive environment, and proving comprehensive training for direct care workers, supervisors, and administrators.


[1] Centers for Medicare and Medicaid Services (2019). Fact Sheet: People Dually Eligible for Medicare and Medicaid. Retrieved from

[2] Reaves, E.L. & Musumeci, M. (2015). Medicaid and Long-Term Services and Supports: A Primer. Kaiser Family Foundation. Retrieved from


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