PHI

Today, marks 161 years since the last enslaved people in Galveston, Texas, learned of their freedom, more than two years after the Emancipation Proclamation had been signed. The day has always carried a dual meaning: a celebration of liberation, and an accounting of how long this country made freedom wait. For PHI, it is also a day to reflect on how that history lives on in the direct care workforce.

Nearly one in three direct care workers in this country is Black. That representation is not incidental. After emancipation, domestic and care work was among the few occupations open to Black women, and that labor was systematically devalued from the start. When Congress established the nation's foundational labor protections in the 1930s, domestic workers (a workforce composed largely of Black women) were deliberately excluded from minimum wage, overtime, and collective bargaining rights. It took over 75 years for home care workers to win basic rights—and today, those protections face significant risk of being lost again.

Juneteenth asks us to hold both celebration and accountability. PHI celebrates the skill, expertise, and leadership of Black direct care workers. And we dedicate our work to what that sense of accountability demands: producing research documenting disparities in this workforce, advancing policies that raise compensation and strengthen protections, and elevating the voices of direct care workers in shaping the future of this sector. Honoring the day means building a long-term care system where the people who provide care are compensated, protected, and recognized in full measure of their worth.

Read our full statement here:

Juneteenth and Our Nation's Unfinished Work of Valuing Care and Care Workers This Juneteenth marks 161 years since the last enslaved people in Galveston, Texas, learned of their freedom, more than two years after the Emancipation Proclamation had been signed. The day has always carried a dual meaning: a celebration of liberation, and an accounting of how long this country ma...

Last week, the Centers for Medicare & Medicaid Services (CMS) deferred $1.3 billion in Medicaid reimbursement payments to California and issued warning letters to all 50 states.

Strong program integrity is critical to Medicaid, but withholding funding from a state Medicaid program is a blunt instrument that puts care itself at great risk.

At PHI, we are concerned by narratives that conflate the necessary expansion of the home care sector with systemic abuse. The rapid growth of the direct care workforce across the country is driven by surging demographic demand. Our growing population of older adults and people with disabilities increasingly requires paid care, and the majority of people prefer to receive services at home.

Read PHI’s full statement here.

PHI Statement on CMS’s Deferral of Medicaid Payments to California The Centers for Medicare & Medicaid Services has deferred $1.3 billion in Medicaid reimbursement payments to California, while issuing a six-month national moratorium on new Medicare enrollments for home health and hospice agencies and sending warning letters to all 50 states. These measures represe...

In 1938, the Fair Labor Standards Act granted minimum wage and overtime protections to most American workers, but deliberately excluded domestic workers—predominantly Black women. It was a choice grounded in both racism and sexism, and home care workers lived with the consequences for 75 years.

It took until 2015 for the home care workforce to finally gain the same basic labor protections that most American workers take for granted.

Yet the Department of Labor now proposes to strip home care workers of the right to minimum wage and overtime pay, devaluing their labor and demeaning their skilled contributions to families, communities, and the economy.

As PHI's Jodi M. Sturgeon writes in her latest opinion piece, this rule risks "devaluing their labor and demeaning their skilled contributions to families, communities, and the economy."

"The solution to the growing care gap is to improve jobs, not eliminate worker protections. This is not a debate about labor regulations. It is a debate about what we owe the people who need support and the people who provide it."

Read the full piece on why we must protect these hard-won rights:

It Took Over 75 Years for Home Care Workers to Win Basic Rights. A New Rule Would Strip Them Away. A critical challenge facing home care in the United States dates back to 1938, when Congress passed the Fair Labor Standards Act. The law granted minimum wage and overtime protections to most American workers, but deliberately excluded domestic workers—predominantly Black women. It was a choice gr...