Action Toolkit

For Journalists

Citable data points, source documentation, story leads, and expert contacts for reporters covering the home care workforce crisis, Medicaid policy, or the FLSA companionship exemption.

Key data points

Citable statistics with sources

All figures below are sourced from federal databases and peer-reviewed research. Each links to its primary source. All content on this site is licensed CC BY 4.0 — cite freely.

3.7M
Home care workers nationally (BLS Occupational Employment and Wage Statistics, SOC 31-1120)
$14.98/hr
National median wage for home care aides (BLS OES May 2024)
$48K vs $128K
Annual per-person cost: home-based care vs. nursing home (Wisconsin Medicaid data)
$911B
Federal Medicaid cuts over 10 years in the 2025 reconciliation law — HCBS bears disproportionate risk

Additional citable figures: 85% female and 67% people of color workforce; 27.8% vacancy rate (Wisconsin); 14 states with OT protections beyond federal FLSA; 50–78% of paid caregivers in self-directed programs are family members of the care recipient.

Story angles

Three data-driven story frameworks

Each framework below is built on publicly available data with specific source citations. They can stand alone as feature stories or serve as analytical frames for broader coverage of Medicaid, labor, or aging policy.

Story 1: The familial caregiver paradox

In the nation's largest self-directed care programs — Wisconsin's IRIS and Minnesota's PCA — 50–78% of paid caregivers are family members of the care recipient. The FLSA companionship exemption doesn't transfer savings from workers to families. It transfers income from low-income family caregivers to government budgets. The family neither saves money nor receives better care; it simply has less household income. Source: Wisconsin DHS IRIS enrollment data; Minnesota DHS PCA program reports.

Story 2: The fiscal arithmetic

The companionship exemption saves an estimated $500–700 million annually — roughly 0.2% of the $313 billion HCBS system. Meanwhile, cutting HCBS generates massive institutional cost blowback: a 30% HCBS reduction would add $943 million in nursing home costs. Every dollar not spent on a $48,000 HCBS participant risks generating a $128,000 nursing home resident. People without access to HCBS are 5× more likely to enter a nursing home. Source: CMS HCBS expenditure reports; Medicaid nursing facility cost data; state waiver program analyses.

Story 3: The Nevada experiment

In 2023, Nevada passed SB 511, raising Medicaid home care reimbursement to $25/hr. The result: workforce turnover dropped from ~50% to 4%. This is a natural experiment in what happens when you invest in the home care workforce — and the data is now available for comparison with states that haven't acted. Source: Nevada DHCFP rate data; provider workforce reports. See Nevada state profile →

State data

16 state profiles with 89 metrics each

We publish comprehensive state profiles covering wages, workforce demographics, Medicaid HCBS programs, cost comparisons, and policy status. Each metric is tagged with its data source and quality status (public, derived, estimated, or gap). Profiles are designed to be cited directly in reporting.

Fully validated

Wisconsin

27.8% vacancy rate. $48K vs $128K cost comparison. IRIS self-directed program with 50%+ familial caregiver rate. The site's primary validation state.

→ State profile
Fully validated

Minnesota

72% Medicaid wage pass-through requirement. PCA program data. Strong union infrastructure. Second validation state.

→ State profile
Largest workforce

California

Nation's first Domestic Worker Bill of Rights (2013). Largest home care workforce. IHSS self-directed program covers 700K+ recipients.

→ State profile
Highest density

New York

623,000 home care workers — 171 aides per 1,000 elderly residents, the highest density nationally. Statutory wage parity requirements.

→ State profile

View all 16 state profiles →

Resources

Source documentation and downloads

Data

State Research Spreadsheet

Full 90+ metric template pre-populated with WI and MN validated data. Includes data sources registry and FOIA tracker tabs. Add any state's data to the blank column.

↓ Download .xlsx
Data

State Research Guide

Comprehensive 355-line research methodology covering all 6 data categories, WI–MN validation data, template instructions per metric, and data availability analysis.

↓ Download .md
Methodology

Source Hierarchy & Validation

How we prioritize and validate data sources. Primary government databases, academic research, provider surveys, and FOIA responses — ranked by reliability and recency.

→ Methodology
Toolkit

Full Action Toolkit

Model legislation, talking points, FOIA templates, embeddable widgets, and public comment templates. All free to use and adapt under CC BY 4.0.

→ Action Toolkit
Transparency

Data gaps we're working to fill

What we don't know yet

We currently have 41.5% of targeted metrics populated across 14 Tier 1 states (those with existing OT protections beyond federal FLSA). Key gaps we're actively working to fill include: Genworth/CareScout cost-of-care data by state, HCBS waiting lists and enrollment by state, county-level HCBS vs. nursing facility spending breakdowns, and Managed Care Organization contract provisions for home care workers.

Every metric on every state page is flagged with its data quality status. Where data is missing, we say so. We provide FOIA request templates for obtaining data that requires public records requests. If you're a reporter who obtains data we're missing, we'd welcome the opportunity to incorporate it — with full attribution.