Every day, nearly five million direct care workers support older adults and people with disabilities across the United States, and the critical need for this workforce is only increasing as the proportion of people over sixty-five continues to grow dramatically. Given an existing shortage of workers and a high turnover rate in the profession due to low pay, lack of training and poor management, the chances of meeting that need are low. Add in the unaffordability of these services and the difficulty many loved ones have navigating the system and it is a deeply troubling picture, according to our WorkforceRx guest Robert Espinoza, executive vice president for policy at PHI. “All of these barriers compound and create a system where it’s going quickly, I think, from crisis to catastrophe,” he tells Futuro Health CEO Van Ton-Quinlivan. But while the problems are many, so are the potential solutions. Espinoza sees particular promise in several state and local initiatives including wage pass-through laws to boost worker pay, stronger training requirements and tapping into the undocumented immigrant population, which he sees as a major part of the answer. Be sure to listen to the end to learn about an innovative training program in San Francisco on which Futuro Health and PHI are collaborating, and Espinoza’s ideas for leveraging the relationship between family caregivers and direct care workers.