About the Initiative
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PHI’s Universal Direct Care Workforce Initiative™ is a national, multi-year effort to build a stronger, more connected care system for direct care workers and the millions of individuals and families who rely on them for care and support.
The PHI Universal Direct Care Workforce Model allows workers to build careers across care settings and state lines, and allows employers, payers, and states to sustain a stronger care workforce over time.
The Model leverages four key elements
1
Universal Entry-Level Competencies
Before workers can thrive, they need a common foundation. Standardized core competencies equip all direct care workers with essential skills while enabling seamless mobility across homes, residential care settings, and nursing facilities. Shared competencies reduce duplication, improve quality, and ensure that skills carry from one setting to another.
2
Stackable, Portable Credentials
Competencies alone aren’t enough, without portability and stackability. A structured framework of credentials—recognized across employers and state lines, and tied to transparent wage progression—allows workers to be recognized for their expertise and to build their skills over time. Portable credentials reduce retraining, reward skill development, and support economic mobility.
3
Integrated Career Pathways
Workers should see a future in the work they already do. Accessible entry points can launch careers, if complemented by meaningful specialization and leadership roles, including advanced positions in care coordination, peer support, and more. Career pathways connect frontline experience to higher responsibility and higher wages, creating real opportunity within the sector.
4
Accessible Training Infrastructure
Training should meet workers where they are. Evidence-informed training is delivered through flexible, language-accessible formats — virtual and in-person—designed for adult learners. Accessible infrastructure ensures equitable participation and expands opportunity across diverse worker populations.
How the Model Works
The elements of the PHI Universal Direct Care Workforce Model™ are designed to reinforce one another:
Standardized competencies anchor portable credentials.
Credentials unlock mobility and advancement, higher-paying jobs, and wage progression.
Stronger jobs improve economic stability and retention.
Retention strengthens care quality and long-term sustainability.Workforce contributions generate meaningful cost savings to the system.
Public and private financing structures reward workforce stability instead of driving workforce churn.Together, these elements replace a fragmented, uncertain universe with a constellation of opportunity.
Aligning the SYSTem
Durable workforce reform requires coordinated action across policy, practice, and financing: Federal leaders establish baseline standards, informed by leading direct care workforce experts.
States standardize competencies and align reimbursement with workforce advancement. Training providers issue portable, stackable credentials.
Employers recognize universal credentials and tie specialization and advancement to wage improvements.
Public financing systems and private payers reimburse in ways that reward and sustain career pathways, higher retention, and workforce stability.
Improved financing from public and private payers sustains workforce investments, with cost realities met head-on.
When these incentives move together, the system shifts.
Get CONNECTED
Connect with PHI to learn more about the Universal Direct Care Workforce Initiative. Together, we can solve today’s care challenges—and build a sustainable care system.