Policy Priorities

Care for caregivers

DC must step to the forefront of national efforts to mitigate the long term care crisis plaguing our healthcare workers, aging population, and local families. To address this crisis and create a safer DC for all, we urge Mayor Bowser and the DC Council to fully implement and fund the Certified Nurse Aide Amendment Act of 2024.

Funding

Mayor Bowser and the DC Council should fully fund the Certified Nurse Aide Amendment Act. Our Coalition recognizes the current budget pressures facing DC, including the slow recovery of downtown and evolving post-pandemic work patterns. Still, the long-term care workforce is in crisis. We believe essential workers deserve a living wage, and without this wage rate, DC will fall short in creating policies that ensure all residents—especially those with the greatest needs—have access to quality care.

Investing in Long-Term Care Workers and Residents

In the Fiscal Year 2026 budget, long-term care programs will receive $8.7 million in local tax dollars and $20.8 million in federal reimbursements to support some of DC’s most vulnerable residents.

The Coalition believes that the workers who provide essential care deserve to earn a living wage of $21 per hour. Our analysis shows that achieving this goal would require an additional investment of $89 million—with $26.7 million from local funds and $62.3 million from federal sources.

FY 26: $29 Million

Financial Plan: $89M

Our priorities

In addition to the progress that has been accomplished, and despite the setbacks that have been imposed, the Coalition continues to pursue old challenges and new goals. We will continue to work hard on these issues in 2025:

Combining Certified Nurse Aids (CNA) and Home Health Aides (HHA) into one professional certification, permitted to practice in both home and facility settings.
Expediting the process for nurse aides from Maryland and Virginia to practice in DC.
Establishing a minimum wage or living wage, equating to $21 per hour at this time.

Creating an Advisory Committee on Certified Nurse Aides and Nursing Assistive Personnel to advise the Board of Nursing on certification guidelines, standards for professionals, and improvements to training programs.
Reducing barriers to CNA certification to ensure equitable access for all who wish to enter the caregiving profession.
Advocating for a more coherent and robust post-secondary training system in DC. Currently, there are few options for residents to get workforce development training of any kind and especially in long term care.

Workforce Committee

Get Involved in Advocacy

If you’re interested in advocating for long-term care priorities, consider joining our Workforce Subcommittee or using our policy priorities in your own advocacy efforts. We encourage you to share feedback if you do—email us at ltccoalition@homecarepartners.org to let us know how our resources are being used and how we can better support your work.

The DC Coalition brings together consumers, advocates, and health care providers to work with the District government on long-term care issues. Among the most pressing challenges in the long term care sector is paying fair wages and making all the jobs associated with health care a good job that includes benefits.

Beyond wages and benefits a constellation of issues affect the long term care workforce including;

Lack of qualified workers and training capacity. Each year, the Coalition surveys members and in our most recent survey we find providers are struggling to hire and retain direct care workers. As baby boomers retire, more and more residents need the services of long term care workers. Data from the Board of Nursing in 2023 show that we are not keeping up with increasing demand.

Making matters worse, the District has lost capacity to train workers. Without an independent and comprehensive community college or career and technical institute in the city, most workers are trained and live in surrounding jurisdictions including especially Maryland.

Other states around the country have coherent education pathways for workers to progress into increasing better paying jobs. The District does not have a post-secondary training system.

For example, rules establishing the MA-C (Certified Medication Aide) were finalized in 2019. This credential allows Certified Nursing Assistants who have completed training and certification to administer medications. The city has still not set up a training and credentialing program. Besides creating an opportunity for workers to earn better pay and reduce the staffing strain in hospitals and other care settings, this credential could be a stepping stone for workers to advance their healthcare careers.

The Coalition’s workforce development subcommittee meets monthly and more frequently when necessary.

For more information or join the subcommittee please contact the Chair of the Subcommittee on Long Term Care, Kristin Ewing at kewing@dcappleseed.org or Neil Richardson, Coordinator for the DC Coalition on Long Term Care at ltccoalition@homecarepartners.org