Funding Sources

This collection of resources contains information on the range of funding sources available to State Medicaid agencies and other agencies and stakeholders to support the development of a high quality direct service labor force.

Introduction

An important consideration for any project that attempts to address direct service workforce issues is the availability of funding to initiate and sustain it over the long term. Major funding for direct service workforce initiatives over the past five years has come primarily from federal grants, including several joint grants between federal agencies and private foundations. As interest in addressing the growing shortage of direct care workers grows, states have begun experimenting with different ways to fund initiatives, including legislative appropriations and the use of civil monetary penalties.

This Funding Sources resource collection provides information about how direct service workforce initiatives have been and are currently funded, and includes examples of sources and strategies for funding future initiatives (see Getting Started below). Past, current, and future CMS DSW grantees and TA recipients might use this information to sustain activities that have already begun or to stimulate financing for a new project. Funding opportunities for work of this kind are almost never permanent. For that reason, this resource has been compiled under the assumption that sometimes the best way to predict how future money will become available is to examine where it has come from in the past. As you will see, federal government, state government, and private funds have all contributed to workforce initiatives. The particular mix of financial resources available to a project will depend on timing, location, and subject matter, among other things. Therefore, those planning direct service workforce initiatives are encouraged to use this document not as a definitive list of funding sources, but as a source of strategies and ideas that will spark new and creative ways to fund their work.

Resources are organized into 5 sections:

Each page describes the types and sources of funding available. The menu on the left contains links to all sections and back to the DSW Resource Center homepage.

Getting Started...

This online tool breaks down funding sources into rough categories, but effective interventions often draw from more than one funding source, just as they often involve more than one stakeholder. Possible sources of funding for direct service workforce initiatives are many and varied, but actually finding and obtaining funding can be difficult and time-consuming. Listed below are several strategies that may not only improve your ability to secure funding, but your ability to carry out and sustain a successful initiative.

  • Know your state’s history and accomplishments in improving the direct service workforce, and use the accomplishments of other states as a source of ideas and examples. Knowing the landscape of direct service workforce projects in your state allows you to build on those accomplishments; it helps you make a case about the importance and effectiveness of these initiatives, and can provide new ideas about both types of programs and how to fund them. An overview of public and private initiatives, state by state, may be found on the Direct Care Clearinghouse.
  • Look at which funding streams you already have control of; can you rearrange them to fund a DSW intervention?
  • Evaluate the purpose of your project. Is it a demonstration project/research study or an ongoing activity? Agencies like ASPE may fund demonstration or informational studies, but grantees may need to look at other sources of funding like TANF or workforce development funds for long-term or continuation projects.
  • Think about your interventions both in terms of discrete activities related to the direct service workforce and of broader workforce activities that may be relevant to DSW issues. Different sources of funding might be available depending on how you define your project.
  • Partnering with other entities and initiatives can help leverage resources. Many funders favor, or even require, collaboration, and it can reduce duplication of effort and competition among entities with similar goals and interests.
  • Consider using grant opportunities to support or enhance existing initiatives instead of starting new programs that may be difficult to sustain.
  • Use a combination of funding sources and strategies to support your initiative; different segments of your program may be eligible for different types of funding.
  • Think about types of support you might request other than cash funding. For example, as part of their Better Jobs Better Care project, the Iowa Caregivers Association obtained in-kind matching contributions from the Deptartment of Inspections and Appeals toward enhancing the state’s nurse aid registry, and in-kind contributions to support training and peer mentoring projects from Iowa Community Colleges, along with a number of other in-kind contributions from other agencies, consumer advocacy groups, provider associations, and other state agencies.
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