Paraprofessional Healthcare Institute

Resource type: Grantee Story

Direct-care workers ensure quality elder care and disability services for millions of Americans, yet often do not have their own health coverage.


The Health Care for Health Care Workers (HCHCW) campaign is addressing this challenge. HCHCW raises awareness of the lack of coverage and its consequences, promotes policy solutions, and mobilises stakeholders – including direct-care workers – to advocate on their own behalf. HCHCW was launched in 2005 by PHI (formerly the Paraprofessional Healthcare Institute), a national nonprofit committed to improving services for elders and people with disabilities, by improving the jobs held by direct-care workers.


The campaign has focused on states with opportunities for reform, including Iowa, Maine, Montana, Michigan, New York, Pennsylvania and Vermont, and assisted numerous other states regarding coverage for direct-care workers.


During 2007 and 2008, PHI collaborated with the Iowa Caregivers Association, the largest organisation of its kind in the U.S., to advocate for the expansion of health coverage for workers in Iowa. They recruited caregivers to make their voices heard in legislative hearings, one-on-one meetings with legislators and other activities. Their efforts paid off.


In May 2008, Iowa Governor Chet Culver signed legislation to increase access to health care in the state. This new law established a pilot program that subsidises coverage for 250 direct-care workers to determine whether affordable coverage improves the stability of this workforce. Notably, this programme will also inform efforts to expand coverage to all Iowans, including thousands of direct-care workers, by mid-2010.


“Given the chance to advocate collectively, direct-care workers have been personally empowered to become very effective influencers of public policy,” said Carol Regan, PHI’s HCHCW and Government Affairs Director. “These workers, primarily women—many with chronic health conditions themselvesare—too often invisible to policymakers. Making their important, yet undervalued, work visible has been critical to winning affordable coverage and better wages—and ensuring quality care.”

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Paraprofessional Healthcare Institute, PHI