Every state profile is built from a combination of national databases and state-specific sources. This page documents the Medicaid agency, labor department, legislative fiscal office, and key workforce organizations for each of the 50 states and D.C.
When multiple sources exist for the same metric, we apply a consistent hierarchy across all 51 jurisdictions. Higher-tier sources always take precedence.
Bureau of Labor Statistics (OES), CMS Medicaid data, state DHS/Medicaid agency reports, state legislative fiscal bureau analyses, and Federal Register publications. These are the most reliable, most frequently updated, and most consistently available sources. Public
PHI Direct Care Worker Index, MIT Living Wage Calculator, KFF State Medicaid Fact Sheets, Brown University LTCFocus, Mathematica/CMS LTSS reports. Peer-reviewed or methodologically transparent research with documented methodology. Public
Genworth/CareScout Cost of Care Survey, NELP state law maps, provider association surveys (LeadingAge, AHCA affiliates), union contract data (SEIU, AFSCME, 1199SEIU). Useful for metrics not available from Tier 1–2, but require cross-validation. Proxy
Calculated from public sources (living wage gaps, cost ratios, OT loss projections) or estimated from national proxies applied to state data. Always flagged with the calculation methodology. Derived Estimated
The primary source for HCBS enrollment, waiver programs, provider rates, and managed care data in each state.
| State | Medicaid / Health Agency | Key HCBS Programs | Managed Care | Expansion |
|---|---|---|---|---|
| Tier 1 — States with existing OT protections | ||||
| CA | DHCSdhcs.ca.gov | IHSS (In-Home Supportive Services) | Medi-Cal MCOs | Yes |
| CT | DSSportal.ct.gov/dss | CT Home Care Program, PCA waiver | HUSKY Health | Yes |
| HI | DHS Med-QUESTmedquest.hawaii.gov | QUEST Integration 1115 waiver | QUEST MCOs | Yes |
| IL | HFShfs.illinois.gov | Home Services Program, DoA CCP waiver | HealthChoice Illinois | Yes |
| MA | MassHealth / EOHHSmass.gov/masshealth | PCA Program, MFP, PACE | MCO + ACO | Yes |
| MD | MDH / Medicaidhealth.maryland.gov | CO waiver, Model waiver, TBI waiver | HealthChoice | Yes |
| MI | DHHSmichigan.gov/mdhhs | MI Choice waiver, PACE, HSW | Healthy Michigan | Yes |
| NJ | DHS / DMAHSnj.gov/humanservices | MLTSS, GO waiver, JACC | NJ FamilyCare MCOs | Yes |
| NV | DHCFPdhcfp.nv.gov | PCS waiver, HCBS waiver; SB 511 | MCO (urban) | Yes |
| NY | DOH / OHIPhealth.ny.gov | CDPAP, NHTD, TBI waivers | MLTC Plans | Yes |
| OR | OHA / ODHSoregon.gov/oha | K Plan, 1915(k) Community First Choice | CCOs | Yes |
| PA | DHSdhs.pa.gov | Aging waiver, COMMCARE, OBRA | CHC MCOs | Yes |
| VT | DVHA / AHSdvha.vermont.gov | Global Commitment 1115 waiver, Choices for Care | DVHA single-payer model | Yes |
| WA | HCA / DSHShca.wa.gov | COPES, New Freedom, DDA waivers | Apple Health MCOs | Yes |
| Tier 2 — States without OT protections beyond federal FLSA | ||||
| AL | Medicaid Agencymedicaid.alabama.gov | E&D waiver, SAIL waiver, ACT | Alabama Coordinated Health Network | No |
| AK | DHSS / Medicaidhealth.alaska.gov | 1915(k) PCS, ALI waiver | FFS | Yes |
| AZ | AHCCCSazahcccs.gov | ALTCS (Arizona Long-Term Care System) | ALTCS MCOs | Yes |
| AR | DHShumanservices.arkansas.gov | ARChoices, IndependentChoices | PASSE | Yes |
| CO | HCPFhcpf.colorado.gov | HCBS-EBD, HCBS-SLS, HCBS-DD waivers | ACC MCOs | Yes |
| DE | DHSS / DMMAdhss.delaware.gov | Diamond State Health Plan Plus (MLTSS) | DSHP MCOs | Yes |
| DC | DHCFdhcf.dc.gov | EPD waiver, IDD waiver | MCOs | Yes |
| FL | AHCAahca.myflorida.com | SMMC LTC waiver (48K+ waitlist) | SMMC MCOs | No |
| GA | DCHdch.georgia.gov | CCSP, NOW/COMP waivers, SOURCE | CMOs | No |
| ID | DHWhealthandwelfare.idaho.gov | A&D waiver, DD waiver | Idaho Medicaid MCO | Yes |
| IN | FSSA / OMPPin.gov/fssa | A&D waiver, BDDS waivers, Pathways | Hoosier Care Connect | Yes |
| IA | DHS / HHSdhs.iowa.gov | IA Health Link MLTSS waivers | IA Health Link MCOs | Yes |
| KS | KDADS / KDHEkdads.ks.gov | HCBS/FE, HCBS/PD, TA waivers | KanCare MCOs | Yes |
| KY | DMS / CHFSchfs.ky.gov | HCB, ABI, Michelle P waivers | MCOs | Yes |
| LA | LDHldh.la.gov | LT-PCS, OCDD waivers, CCW | Healthy Louisiana MCOs | Yes |
| ME | DHHS / OMSmaine.gov/dhhs | Section 19, Section 21 waivers | MaineCare (mostly FFS) | Yes |
| MN | DHSmn.gov/dhs | CADI, BI, DD, EW waivers, PCA Choice | MA/MSC+ MCOs | Yes |
| MS | DOMmedicaid.ms.gov | E&D waiver, IDD waiver, TBI waiver | MississippiCAN MCOs | No |
| MO | DSS / MHDdss.mo.gov | Aged & Disabled waiver, Missouri CDS | MO HealthNet MCOs | Yes |
| MT | DPHHSdphhs.mt.gov | Big Sky waiver, SDMI waiver | FFS | Yes |
| NE | DHHSdhhs.ne.gov | Aged & Disabled waiver, DD waivers | Heritage Health MCOs | Yes |
| NH | DHHSdhhs.nh.gov | Choices for Independence waiver | Granite Advantage MCOs | Yes |
| NM | HSD / MADhsd.state.nm.us | Mi Via, Centennial Care MLTSS | Centennial Care MCOs | Yes |
| NC | DHHS / DMHncdhhs.gov | CAP/DA, CAP/C, Innovations waivers | NC Medicaid Managed Care (2024) | Yes |
| ND | DHS / Medical Servicesnd.gov/dhs | HCBS waiver, SPED waiver | FFS | Yes |
| OH | ODMmedicaid.ohio.gov | PASSPORT, MyCare Ohio MLTSS | Managed Care MCOs | Yes |
| OK | OHCAoklahoma.gov/ohca | ADvantage waiver, SQ 802 expansion | SoonerSelect MCOs | Yes |
| RI | EOHHSeohhs.ri.gov | Rhody Health Options MLTSS | MCOs | Yes |
| SC | DHHSscdhhs.gov | CLTC waiver, HASCI waiver | Healthy Connections MCOs | No |
| SD | DSSdss.sd.gov | HOPE waiver, Choices waiver | FFS | No |
| TN | TennCare / DIDDtn.gov/tenncare | CHOICES (TennCare MLTSS) | TennCare MCOs | Yes |
| TX | HHSChhs.texas.gov | STAR+PLUS MLTSS, CLASS, DBMD waivers | STAR+PLUS MCOs | No |
| UT | DHHSdhhs.utah.gov | Aging waiver, New Choices waiver | ACOs | Partial |
| VA | DMASdmas.virginia.gov | CCC Plus MLTSS, DD waivers | CCC Plus MCOs | Yes |
| WV | DHHR / BMSdhhr.wv.gov | Aged & Disabled waiver, I/DD waiver | Mountain Health Trust MCOs | Yes |
| WI | DHSdhs.wisconsin.gov | Family Care, IRIS, Partnership | Family Care MCOs | Yes |
| WY | DOH / Medicaidhealth.wyo.gov | LT Care, Supports waivers | FFS | No |
State labor agencies provide occupational employment projections, vacancy surveys, and wage data that supplement federal BLS statistics.
| State | Labor / Employment Agency | Key Data Products | OES Partner | Vacancy Data |
|---|---|---|---|---|
| States with dedicated home care workforce data | ||||
| CA | EDDedd.ca.gov | Occupational employment projections, LMI data | Yes | Yes |
| MN | DEEDmn.gov/deed | Job Vacancy Survey (biennial), occupational projections | Yes | Yes |
| NY | DOLdol.ny.gov | Occupational outlook, wage data, home care employment | Yes | Partial |
| TX | TWCtwc.texas.gov | Occupational projections, LMCI data | Yes | Partial |
| WA | ESDesd.wa.gov | Occupational outlook, employment estimates | Yes | Yes |
| WI | DWDdwd.wisconsin.gov | Occupational projections, workforce surveys | Yes | Yes |
| All other states | ||||
| All 50 states participate in the BLS OES cooperative survey, providing state-level wage and employment data for SOC 31-1120 (Home Health and Personal Care Aides). State labor agencies are the local partners for this data. Vacancy-specific surveys are less common — most states rely on BLS JOLTS regional data or provider association surveys. States with dedicated vacancy reporting are highlighted above. | ||||
Legislative fiscal bureaus provide Medicaid budget analyses, program spending data, and rate assumptions used in cost projections.
All 50 states have a legislative fiscal office or equivalent that produces Medicaid budget analyses. These offices are primary sources for state-level Medicaid spending data, FMAP calculations, and program cost projections. Key offices include Wisconsin’s Legislative Fiscal Bureau (docs.legis.wisconsin.gov), Minnesota’s House Research (house.mn.gov/hrd), California’s LAO (lao.ca.gov), New York’s Division of the Budget (budget.ny.gov), and Texas’s LBB (lbb.texas.gov).
Home care worker unions and disability coalitions provide contract data, workforce surveys, and policy impact data not available from government sources.
| Organization | States Covered | Data Available | Access |
|---|---|---|---|
| Home care worker unions | |||
| SEIU 2015 | California | IHSS contract terms, wage scales, workforce demographics, turnover data | Free |
| SEIU 775 | Washington | Contract wages, training fund (BTC), retention data, IP workforce surveys | Free |
| 1199SEIU | NY, MA, RI, CT, MD, NJ, FL | Contract terms, home care wage scales, workforce stabilization data | Free |
| SEIU Healthcare | MN, IL, IN, MO, KS | PCA contract terms, EVV impacts, wage data | Free |
| AFSCME | OR, IL, OH, PA, WI | Home care worker contract terms, public-sector bargaining data | Free |
| SEIU 32BJ | DC, MD, VA, NJ, NY | Contract terms, home care workforce data in Mid-Atlantic | Free |
| Disability and caregiver coalitions | |||
| Survival Coalition | Wisconsin | Caregiver workforce surveys, disability impacts, policy analysis | Free |
| ADAPT | National (all states) | Community integration advocacy, HCBS access data, Olmstead compliance | Free |
| State DD Councils | All 50 states + DC | DD waiver data, self-directed program enrollment, provider network capacity | Free |
| National Domestic Workers Alliance | National (12 state affiliates) | DWBoR status, policy campaigns, worker survey data | Free |
| Provider associations | |||
| LeadingAge (state affiliates) | All 50 states | Vacancy rates, turnover data, provider capacity surveys | Free/Request |
| AHCA/NCAL (state affiliates) | All 50 states | Nursing home and home care provider workforce surveys, staffing data | Free/Request |
| HCAOA | National | Home care industry benchmarking, turnover rates, revenue data | Members |
Every metric on every state profile carries a status indicator showing the source quality and confidence level. These 10 statuses are applied consistently across all 51 jurisdictions.
| Badge | Status | Meaning |
|---|---|---|
| Public | Directly available | Verified against a Tier 1 or Tier 2 primary source (BLS, CMS, state agency, PHI, KFF). Highest confidence. |
| Derived | Calculated | Computed from two or more public sources using documented methodology (e.g., living wage gap = MIT living wage − BLS median). |
| Estimated | Best estimate | From secondary sources or reasonable inference. Needs verification against primary source. Flagged for future FOIA or data update. |
| Proxy | Imprecise | National average or regional proxy applied to a state where state-specific data is unavailable. Common for turnover rates and demographic breakdowns. |
| Partial | Partially available | Some dimensions of the metric are documented; others remain gaps. Common for geographic data where urban counties are documented but rural are not. |
| FOIA | Requires records request | Data exists but is not publicly published. A pre-drafted FOIA request is available in the FOIA Tracker. |
| Gap | Not available | Data does not appear to be collected or published by any source. Highest priority for future research. |
| Pending | Awaiting determination | Source has been identified but data has not yet been retrieved or verified. |
| Analysis | Requires interpretation | Raw data exists but requires analysis, calculation, or expert interpretation to produce a usable metric. |
| Monitor | Status monitoring | Active regulatory, legislative, or legal process where the value may change. Checked regularly for updates. |
We document what we know, what we don’t know, and what we’re working to find out. Every Gap and FOIA badge is an invitation — if you have access to data we’re missing, we want to hear from you. The FOIA Tracker contains 490 pre-drafted public records requests across 49 states targeting the most critical data gaps.
The 20 core national databases, surveys, and government reports used across all state profiles.
→ Source registryPre-drafted public records requests targeting data gaps across 49 states.
→ FOIA trackerMetrics requiring FOIA, independent analysis, or county-level research.
→ Known gapsModel legislation, talking points, FOIA templates, and more.
→ Action Toolkit