Direct Service Workforce

Partner: Indiana Family and Social Services Administration (FSSA)
Time Frame: January – December 2022

Supply, Demand, & Distribution


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Policy Research & Tracking

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Occupational Regulation

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Special Issues

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Data Collection & Information Management



The State of Indiana is currently in the process of reforming its long-term services and support (LTSS) delivery system. Current reform initiatives are focused on expansion of home and community-based services (HCBS). The LTSS workforce is foundational to this delivery system. Unfortunately, workforce shortages and other challenges have historically been reported to plague the LTSS sector, and such conductions have worsened since the onset of the COVID-19 pandemic.  

This is especially the case with direct service workers (DSWs). DSWs are paid frontline workers who provide hands-on care, services, and support to the elderly and individuals with disabilities across the long-term services and supports continuum, from home and community-based settings to skilled nursing facilities.  In general, there are minimal barriers to entry for these roles as compared to other occupations in the health and human services sector; however, these roles typically have high physical demands and relatively low wage. Recruiting, training, and retaining DSWs is a strategic priority for the LTSS sector, and necessary for successful delivery of services.  

As part of current reform initiatives, Indiana is seeking to develop an LTSS DSW Plan for the purpose of informing and aligning related policies and investments in a manner that encourages workforce recruitment and retention, ensures quality and safety of LTSS services, and supports the well-being of the workforce and the individuals they serve. Indiana is the first state in the nation to embark on a state-level Direct Service Workforce Strategic Plan, and the Bowen Center is honored to be partnering with the Family and Social Services Administration on this endeavor.