Direct Care Careers: A Shared Solution with State-Specific Impact
The direct care workforce crisis has been called many things: a pipeline challenge, a training gap, a retention issue. But one truth stood out at the ADvancing States HCBS Conference in Baltimore (August 2025): no single program or employer can solve it alone. States need scalable tools that strengthen the workforce and reflect their unique policy and demographic realities.
That’s exactly where the Direct Care Careers (DCC) platform comes in.
Moderated by Ana Velasquez (ADvancing States) and Robert Breig (Altarum), this session featured three state leaders:
Claire Benitez, Texas Health and Human Services
Nancy Maier, North Dakota Department of Health and Human Services
Bonnie Silva, Colorado Office of Community Living
Together, they showed how a shared platform can deliver powerful, state-driven results.
What Is Direct Care Careers (DCC)?
DCC is a comprehensive workforce platform that serves states, providers, self-directing individuals, and direct care workers (DCWs). It’s not just a job board or training site. It combines:
Worker registry for access and transparency.
Learning management system (LMS) for training and credentialing.
Job-matching algorithm powered by worker profiles.
Resource library with 600+ state-posted resources.
Credentialing and data tools for workforce mobility.
Communication and campaign features to connect directly with workers.
Help desk and collaborative forums to support adoption.
Impact so far:
1,000+ agencies/providers engaged
2,000+ DCWs enrolled
138 self-directing individuals registered
599 job posts resulting in 139,000 job matches
57 training courses delivered
This shared-cost model allows states to tap federal matching funds while customizing features for their workforce priorities.
Why States Turned to DCC
Colorado (CO): Urgency and Customization
When the pandemic forced Colorado to deploy the National Guard into long-term care facilities, the scale of the workforce crisis became undeniable. Colorado turned to DCC to:
Directly connect workers and employers through a tailored platform.
Use campaign tools to reach workers with targeted messages.
Empower workers with portable training and credentials instead of relying solely on employers for development opportunities.
Quote-worthy theme: “Success was contingent on who the worker worked for. Now, we’re putting opportunities directly in the hands of DCWs.”
North Dakota (ND): From Spreadsheets to Strategy
Before DCC, North Dakota’s provider enrollment and registry processes were paper-based, slow, and error-prone. A state law required a registry, but the old system was unworkable. DCC gave them:
An online provider enrollment system integrated with a public-facing registry.
The ability to funnel state enrollment data directly into DCC.
Alignment between aging and ID/DD providers with shared HCBS core competencies.
A pathway to career mobility and latticing for workers through credentials.
Impact: ND now has real-time workforce data, expanded provider opportunities, and is preparing to roll out the LMS component.
Texas (TX): Data-Driven Workforce Planning
Texas framed its DCC adoption as a strategic solution and partnership with ADvancing States. Key benefits included:
Geo-matching and reporting tools to identify workforce deserts and surpluses.
Data to track wage trends, demographics, and workforce forecasting.
Tools to improve access for self-directing individuals hiring personal care attendants (PCAs).
Stakeholder feedback loops to strengthen worker recognition — such as “Spotlight Series” profiles and gratitude campaigns.
Big picture: Texas sees DCC as more than a registry — it’s a data engine to guide workforce strategy and policy.
Funding and Sustainability
The states were clear: DCC is affordable, sustainable, and fundable through multiple channels.
Colorado used pandemic funds and ARPA, then pursued enhanced federal match (up to 90%) for tech solutions.
North Dakota invested $5M through MFP capacity funds.
Texas combined ARPA funds with its Money Follows the Person taskforce efforts.
All emphasized that DCC has proven to be one of the most sustainable capacity-building investments out of pandemic-era funds.
How DCC Aligns with Broader State Goals
Colorado: Uses DCC campaigns to pull workers into state-led workforce strategies, ensuring real-time feedback validates policy assumptions.
North Dakota: Aligns registry, LMS, and credentialing with HCBS core competencies to build a cross-lifespan workforce.
Texas: Embeds workforce into every strategic plan, aligning DCC data and tools with broader health capacity-building efforts.
The takeaway: DCC is not a siloed solution. Each state linked it to broader goals around equity, transparency, and sustainability.
Panel Lessons: What Other States Should Know
Have an implementation plan. Success depends on outreach, onboarding, and communication — not just launching the tool.
Address provider fears. Some agencies feared losing control; states countered this with collaboration and transparency.
Invest in marketing. Government emails won’t cut it. Use campaigns, job fairs, high school outreach, and social media.
Balance customization with collective learning. States learn from each other while tailoring features to local needs.
Be patient. Early adoption takes time, but incremental success builds momentum.
Why This Session Mattered
The DCC session highlighted that while states face the same workforce crisis, no two solutions are identical. Colorado, North Dakota, and Texas each tailored the platform to their realities:
CO: Empowering workers with training and recognition.
ND: Modernizing systems and aligning competencies.
TX: Using data for strategic workforce planning.
Yet the shared platform model — affordable, customizable, and federally fundable — makes it possible to scale workforce solutions nationally without reinventing the wheel in every state.
My Reflection
I left this session struck by two things:
The workforce crisis is not just about numbers — it’s about infrastructure. Without modern registries, data systems, and training pipelines, states are flying blind.
Shared solutions work. For too long, each state has tackled workforce shortages in isolation. DCC demonstrates that states can pool resources while preserving customization — saving time, money, and frustration.
As the OBBB Act and Medicaid Access Rule push states toward workforce accountability, platforms like DCC will be essential. They don’t just help workers find jobs; they help states and providers build the data and infrastructure needed to sustain the system long term.
