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Private Duty Source | Home and Community Based Services, Workforce

CMS Issues Guidance on Direct Care Worker Registries

December 13, 2023

On December 12, 2023, the Centers for Medicare and Medicaid Services (CMS) released an informational bulletin on the development of Direct Care Worker Registries. Although CMS’ guidance does not include any new policy, it reminds states of the ability to develop these registries and use them as tools to support workforce retention, recruitment, and credentialing. Some of the potential registry functions that CMS’ guidance proposes includes:

  • Worker recruitment;
  • Providing background checks;
  • Verifying worker qualifications and identifying special skills;
  • Facilitating access to health insurance;
  • Connecting workers to training and skills development.

Notably, CMS’ guidance stresses that these registries can be used both for connecting workers and participants with provider agencies and for supporting self-directed home and community-based services (HCBS). CMS also discusses the availability of increased federal match, potentially up to 90%, for the development of and installation of worker registries and 75 percent for ongoing maintenance and operations. States may also use any remaining unallocated American Rescue Plan Act (ARPA) HCBS funding to develop these systems.

The bulletin is available at: