What is advocacy?

Advocacy is the act of expressing support in favor of an issue, cause, policy, or an idea. Advocacy can include public education and grassroots organizing on a wide range of issues and in some cases actively contacting elected officials at the state, county, and city levels, and members of Congress in Washington, D.C. to provide information, resources, or personal stories about an issue that is important to you.


Direct Care Worker Wage Issue Brief Released by Iowa CareGivers

Candidates for Iowa’s Governor and Those You Will Send to Washington, D.C. Answered Questions About Direct Care Workers!

Check Out What They Had to Say and Remember to Vote on November 8!


Direct Care Worker (DCW) Registry and Education Survey Reveals Information Gaps

Education of DCWs About the Purpose of the DCW Registry and Steps to Remain Active on the DCW Registry is Needed                          

It is important to note that Certified Nurse Aides (CNAs) who work in nursing homes do not have a state-approved continuing education standard that is linked to their maintaining their eligibility to work by being on the active DCW Registry. Nursing home providers are required to provide 12 hours of in-service for staff, but those hours are not considered continuing education and therefore, do NOT keep CNAs active on the DCW Registry.  CNAs must work 8 hours in a 24-month period in state approved settings to retain their active status.  The settings that qualify were expanded to certified hospitals, ambulatory surgery centers, home health agencies, and hospices in 2017. Employers in these additional settings can submit employment verification to Department of Inspections and Appeals to keep DCWs active on the Registry. However, many employers do not report employment which can be problematic for DCWs who may be transitioning to a different job or move to a different location in the state.

Click here to view Combined Data from Active and No Employment Registry

Click here to view Only DCWs from Active Registry

Click here to view Only DCWs from the No Employment Registry


State Directors and Legislators Participate in Discussion About Modernization of Direct Care Worker Registry Hosted by Iowa CareGivers!

Modernization of the direct care worker registry and creation of a voluntary public portal of caregivers is something Iowa CareGivers has long advocated for. And now with American Rescue Plan Act funding, the work to establish the infrastructure needed to build and retain a strong direct care workforce can begin.

Watch the full video here:

Please contact us with any questions. 515-249-0138



Iowa CareGivers 2022 Issue Priorities — Committed to Collaboration

Click here to read the 2022 State and Federal Issue Priorities.

Click here to read the 10 Steps to Building a Strong Direct Care Workforce

Click here to read Step 1: Modernization of the Direct Care Worker Registry

Involuntary Nursing Home Discharges and Medicaid Eligibility: FREE webinar May 27

With the involuntary nursing home discharge moratorium expiring at the end of May 2021, Iowa Legal Aid will have a free webinar presentation for non-lawyer caretakes and service providers this Thursday 5/27 at 6PM.

Click here for more information and to join the presentation.


Advocates Vow to Keep Pushing for Direct Care Workforce Bill

Iowa caregivers not giving up on decadelong legislative effort
by James Lynch (Quad-City Times and Cedar Rapids Gazette - April 11, 2021)
Click here to read the article.


Care Workforce Crisis in Iowa Needs to be Addressed Now

Iowa needs to seize this historic moment. Take essential actions to enhance the jobs and lives of these essential workers.
by John and Terri Hale (Des Moines Register and Cedar Rapids Gazette-April 11, 2021)
Click here to read the article.



Advocacy — Having the Backs of Direct Care Workers (DCWs) is Central to Our Work

IMMEDIATE ACTION NEEDED TO FIX A BROKEN SYSTEM! Please take a few minutes to send one email to your State Representative to ask for support of House File (HF)692

It has never been more important for the voices of those giving and receiving care or support to be heard and understood by elected officials and others who make most of the decisions in our state. When direct care workers (DCWs) are faced with the extreme challenges and conditions of being on the front lines of a global pandemic, the furthest thing from their minds is to write an email to their elected official. That’s also why our advocacy and the support of all stakeholders is so important. Iowa CareGivers uses a number of ways to bring the faces and uncensored voices of those who work in direct care to elected officials, the general public, and media.  Many of you know we have worked for a number of years on legislation that would expand the state’s direct care worker registry and provide a public portal of caregivers. 

How many times have you heard “the system is broken”?   Then let’s fix it.  This bill will go a long way toward fixing some of what is broken.  We are calling upon DCWs, people with disabilities, older Iowans, family caregivers, the business community and health and long-term services and supports (LTSS) employers, and educators to join forces in supporting a long overdue bill that contains benefits for all stakeholders.   Please help us get this bill over the finish line!  Thank You.  Di Findley


Who Benefits:

  • direct care workers by providing a place for the permanent keeping and portability of their various trainings or certifications, whatever those may be, so they don’t have to take the same training over and over again.
  • people with disabilities, older Iowans, and family caregivers who are placed in dire circumstances when they can’t find caregivers with the needed skills and experience will have access to a public portal of caregivers who opt in, to enhance access to care/support and perhaps prevent premature institutional care (details will need to be worked out with the state, of course).
  • health and long-term services and supports (LTSS) employers, experiencing serious worker shortages and sometimes high turnover, by enhancing the hiring and onboarding of new staff, and by also having access to a pool of workers to fill gaps.
  • State of Iowa by having more accurate and reliable direct care workforce data to help inform state plans on how to meet the growing demand for the health and LTSS workforce and be better equipped to respond to state emergencies such as COVID-19 and any future disasters.

Click here for other stakeholder testimonials.

If you are a DCW or Support DCWs and the Iowans who depend on this essential workforce, you can help by emailing your house representative. And please let us know if you contact your representative and if so what kind of response you receive.  If you need help email

Find your house representative 


Sample Message:

Dear Representative _________________

My name is _________________  and I am pleased that HF692 passed unanimously with bipartisan support and is now eligible for debate in the House.  The bill is important to me because    (share your personal story and reference any of the benefits listed above or other benefits).


Will you please ask the house leadership to place HF692 on the debate calendar, support the bill, and ask your fellow representatives to do the same?

Thank you very much for your consideration.

Sincerely, (your name, town)

Encourage House Leadership To Place House File HF692 On The House Debate Calendar and Support Passage of the Bill!

Click here to read the HF692 bill.

Click here to listen to WHO Radio’s Sue Danielson Interview Di Findley Regarding HF692

Click here to learn how the bill can benefit direct care workers, people with disabilities, older Iowans, employers, and the State of Iowa.

Click here to view the Impact of the direct care workforce.

Click here to view the press release.

Please send one short email to your state representative to ask for their support of House File 692.  Do it for those on the front lines of care, people with disabilities, older Iowans, and their families, and health and long-term services and supports employers. Click here to find your state representative. 

Additional questions? Call Iowa Caregivers at 515-223-2805.



Click here to read the Iowa Capital Dispatch article by Clark Kauffman  Lawmakers Consider Expanding State Registry of Health Care Workers



COVID19 Casts Bright Light On Direct Care Workforce Issues

An ESSENTIAL Workforce That Can No Longer Be Ignored   
Direct Care Workforce Making News! 

Caregiver Crisis and COVID19 Podcast with Di Findley

Insight on Business, The News Hour welcomes back Di Findley, Executive Director of Iowa CareGivers for this in depth conversation about direct caregivers and three issues they are facing here and in every state in the nation. We'll be talking about issues such as COVID19 TestingChild Care Issues & Concerns and Personal Protective Equipment. In April, Iowa CareGivers conducted surveys on those three issues and the answers highlight the massive problems Iowa has with our direct caregiving efforts. For reference here is the official State of Iowa COVID10 Website.

The award winning Insight on Business the News Hour with Michael Libbie is the only weekday business podcast in the Midwest. The national, regional and local business news along with long-form business interviews can be heard Monday - Friday. You can subscribe on Google PlayPlayerFMPodbeaniTunesSpotifyStitcher or TuneIn Radio. And you can catch The Business News Hour Week in Review each Sunday Noon on News/Talk 1540 KXEL. The Business News Hour is a production of Insight Advertising, Marketing & Communications.

Click here to listen to the full podcast.


Iowa Press Episode Touches on Direct Care Worker Wages, COVID-19 Testing, and PPE

The need to raise wages for direct care workers and ensure that workers have adequate testing and personal protective equipment (PPE) was raised by Brad Anderson, AARP Iowa State Director on a recent episode of Iowa Press.

Click here to watch the full episode.


Iowa needs to do more to save lives in long-term care facilities

An opinion piece in the Des Moines Register on May 24, 2020 by Jane Hudson, Executive Director, Disability Rights Iowa advocates for hazard pay and child care for direct care workers as well as a centralized direct care worker data base system, something Iowa CareGivers and partners have long advocated for.

Click here to read the full article.




Nursing Assistants/Home Care/Hospice Aides, Direct Support Professionals, and Other Direct Care Workers (DCWs) Are Among Those Who Are the Best Defense in Fighting the Spread of COVID-19.

Click here to read Iowa CareGivers’ Response to COVID-19.

Due to Workforce Shortages…The Toughest Job You’ll Ever Love Is Getting Tougher! 


The Fight for a Centralized Direct Care Worker Data Base System Continues: HF 2117/SF 2017 

A System To Serve Needs of Direct Care Workforce, Employers, Consumers, and Family Caregivers!

Click here to read HF 2117

Click here to read SF 2017  

Neither House File (HF) 2117 nor Senate File (SF) 2017 made it out of committee before the first funnel, a deadline date for all bills to pass out of committee in order to remain eligible for debate. However, just because a bill doesn’t make it out of committee doesn’t mean it’s over. There are other options for moving these two pieces of legislation forward and it NEEDS TO BE MOVED FORWARD. If passed, this legislation will go a long way toward direct care workers (DCWs) having a central place for permanent keeping of their credentials, certifications, and various trainings. We also hope the effort will become a resource to family caregivers and consumers. HF2117 passed out of the subcommittee unanimously by Representatives Bergan, Salmon, and Matson. I would urge you to continue to contact your state senator and state representative and ask them to support legislation for a centralized direct care worker data base system. Let them know that we need a system that will work for workers, employers, consumers, and family caregivers!

Click here for Step 1: Building a Strong Direct Care Workforce

Click here for 10 Steps to Building a Strong Direct Care Workforce  

For more information contact Di Findley


Presidential Candidates Respond to Questions About Direct Care Workforce

Click here to view their responses and be an Informed Caucus-Goer and Voter

Iowa CareGivers Announces 2020 Issue Priorities

Join us in advocating for policies that place a VALUE on the importance of Direct Care and Support to Iowans!
Mark Your Calendar – March 12, 2020 Day at the State Capitol

Click here to view the 2020 Issue Priorities.

Congresswoman Axne Responds to Question About the Direct Care Workforce

Congresswoman Axne recently responded to a listener’s question about the Direct Care Workforce on Iowa Public Radio’s River to River.


Please comment on direct caregivers: nurse aids, home health aids and others. In Iowa and across the country, caregivers are underpaid and often under-trained. The result is often massive turnover, when the need for them is huge. In Iowa, caregivers are the largest paid workforce sector. Why don’t you and other democrats champion them?


Well, that is a great question and thank you for recognizing that.

As we continue to see an aging population, more baby boomers retiring and certainly in Iowa we’ve got an older population here, we are in a crisis, where we don’t have enough caregivers within skilled nursing centers certainly, within people’s homes.

I couldn’t agree with you more, we have too many parts of our population, the most vulnerable in our population, whether its older Americans or children, who are taken care of by people who are paid so low. And we absolutely need to raise the wages not just for caretakers in this country, but for everybody, but certainly by our caretakers.
Never should we be putting our older Americans in harm’s way because they don’t have appropriate care or maybe we don’t have the best people in place to support them.

I know that our caretakers want to do the best that they can and do the job that they fully believe in and we’ve got to increase their pay, so I appreciate you bringing that up.

We are working on some issues in the House to address that issue, I’m on the healthcare task force within the New Dems Coalition. We are a very pragmatic solutions-oriented group; we do understand that this is an issue. I’d like to be able to keep as many seniors in their homes as possible, if they would like to, and we need to make sure that external caretakers or internal caretakers have the resources that they need to support that population. So thank you.

70 thought-leaders from around the state convened to focus on solutions to: Building a Strong Direct Care Workforce

Iowa CareGivers along with co-sponsors, Central Iowa Works and Des Moines Area Community College, hosted a day-long forum with various stakeholders that included direct care workers from various settings; health and long term service and support (LTSS) employers/providers; disability, consumer, and worker advocates; community colleges; state agencies; job corps instructor and students; and others to discuss two key topics:


Panelists Shared Views on Each Topic

Participant’s Weigh By Speaking Up and a Process of Ballot Voting

Ballot 1: Wages, Building a Strong Direct Care Workforce

Ballot 2: Central DCW Database and Portability of Credentials, Building a Strong Direct Care Workforce

“I’ve worked in direct care for more than 40 years. So direct care is a career choice for me. Sadly, I’m still viewed as an entry level worker by the public and I don’t think that is right.”

– Donna Cheers

‘I’ve worked in the field for over 30 years. “I gave up a career in accounting for what I feel is more meaningful work... Our work, in general, is stigmatized as not being very important and then men in caregiving deal with the stigma of “doing women’s work”. And that’s also a put down to the many strong women who work in this field. Minorities and immigrants in the field also face various challenges.”

– Tony Wells

“Altruism isn’t a skill that is valued or rewarded monetarily in the labor market. In my opinion, I think being altruistic actually hurts you in the labor market, by decreasing your compensation negotiation thresholds.” Ryan Murphy, Iowa Workforce Development

– Ryan Murphy

“The system is broken”….Tray Wade, CEO, EveryStep. As a panelist, Tray discussed the benefits and challenges related to their decision to raise their minimum wage to $15.00 an hour. … with a Central Direct Care Worker Data Base… “Direct Care Workers’ training at one agency/facility can be portable regardless of care setting/employer and also encourages quicker onboarding time.” Elanna Fultz, Director of Clinical Quality, WesleyLife Community Services, when asked how a central direct care workforce data base might help direct care workers and employers.

– Tray Wade


Supported solutions included raising caps on Medicaid and Medicare reimbursement rates; establishing a central direct care workforce data base system; and eliminating the wage threshold in the Governor’s Future Ready Iowa Initiative OR urge the Governor to place a higher priority on direct care and child care workers by including them in the Future Ready Iowa Initiative or creating a NEW workforce innovation fund that focuses on high demand, low income occupations.


Thanks to Julie McMahon and Cindy Ramer for their Facebook Live Interview.
Click here to watch!

View the photo gallery!


Join Us For Day at the Capitol on March 12, 2020 – First Floor Rotunda from 7:30 – noon
(Training Day For Day at the Capitol is March 11, 2020)


If You Want to Help Us Build A Stable Direct Care Workforce Please Contact Di Findley at


Building a Stable Direct Care Workforce Was Made Possible by the Generosity of the Following:



Direct Care Workforce Impact Was Focus of Discussion With State Legislators at the Capitol

Direct Care Workforce Impact

Iowa CareGivers Impact

Click here to see the full photo gallery!


Major Step Taken By EveryStep and We Applaud Them!! 

Large health care services provider boosts minimum wage to $15 (Reported by Business Record 3/1/19)

Des Moines-based EveryStep, a nonprofit health care services organization with operations in 47 Iowa counties, announced that it will implement a $15 hourly wage for its employees, effective immediately. The change will increase wages as much as nearly $4 per hour for some employees, and benefit 14 types of roles within the organization. In all, 44 employees will immediately benefit from the increase; more than half of those employees work as hospice and home care aides, the organization said. "We are constantly looking for ways to improve the lives of our employees, and we recognize that the first step to providing excellent care to our clients and patients is to make sure our employees are taken care of as well," said Tray Wade, EveryStep president and CEO. According to the advocacy group Iowa CareGivers, in 2016 the average wage for entry-level to experienced direct care positions ranged from $9.01 to $13.22 per hour. EveryStep, formerly known as HCI Care Services & Visiting Nurse Services of Iowa, provides care programs to more than 63,000 Iowans.

Sally Chapman and Donna Cheers, EveryStep Hospice Aides, meet Congresswoman Cindy Axne.

Sally and Donna are 2017 recipients of Iowa CareGivers Leadership Award. 

Direct Care Workforce Among Top 5 Issues of Gazette’s Iowa Ideas Conference

Click here to read the full article.

Iowa CareGivers Releases 2019 Issue Priorities

Join Us In Standing Up For A Strong and Prepared Direct Care Workforce and Family Caregivers!

Click here to view the 2019 Issue Priorities.

  • Click here to view issue paper on the Need for a Central Direct Care Workforce Database System
  • Click here to view the detailed report on the Need for Direct Care Workforce Data and Database
  • Standardized, competency-based, and portable certifications/credentials.
  • Better wages/compensation.

Call Di Findley at 515-249-0138 for information.



Lives of all Iowans impacted by direct care workforce

Click here to learn more and read the full Des Moines Register article.

Who Deserves Your Vote For Governor?

Two Leading Candidates For Iowa’s Governor Tell Us Why Those in Direct Care/Service Jobs and Family Caregivers Should Vote For Them.

Click here to read the full Q and A.

“It’s Allowed Me A Platform for Advocacy,” Anthony C. Wells Certified Nursing Assistant, and Iowa CareGivers Leadership Council — Anthony Wells, CNA, CHPNA

The Issues:

The ISSUES that the Iowa CareGivers focuses on are those that address your needs and the needs of those you serve. We will support:

  • Promotion and expansion of the State’s Prepare to Care program; educational standards, and opportunities to grow professionally within the field of direct care
  • Strategies to enhance compensation for those in direct care
  • Efforts to build relationships between those in direct care and family caregivers
  • Establishment of partnerships with community colleges, employers, family caregiver and veteran groups, consumer advocates, government, business community, and other stakeholders to work on policies that will ensure a stable health workforce and access to quality services and care for all Iowans

Each year before the Iowa Legislature begins its work at the State Capitol in Des Moines, the Iowa CareGivers’ Board of Directors and the Leadership Council, which is made up of those who work in direct care from across the state, decide what issues to focus on during the legislative session.  

For more information, please click on the links below.

Care Gap
Action Gap
Solutions: Direct Care Workforce 2020 

To discuss these issues or learn how you can become more involved, please contact Di Findley at or 515 249 0138.


Summit Hosted by Iowa Department of Public Health on Direct Care Workforce Sheds Light on Challenges and Solutions

About 30 stakeholders participated in a discussion led by Director Gerd Claybaugh, on key challenges related to the recruitment and retention of the direct care workforce.  Panelists included Fran Mancl, Certified Nursing Assistant who said, “I had to work a second job to supplement my income so I could afford to work in the direct care job that I love.”; Michael Wolnerman, Pharmacist and family caregiver, who stated, “Our family had 50 different home care aides and nurses in one year’s time assigned to help my mother before she passed”; read more here and Michele Meadors Omaha, who, following a car accident was left quadriplegic said, “I thought my worst nightmare, upon moving to Des Moines, would be transportation and housing, and they were.  But my biggest nightmare was finding people to come into my home to assist me.”   Other panelists included: Gene Leutzinger, Hawkeye Community College; Dr. Brad Richardson, University of Iowa, NRCFCP; Courtney Greene, Iowa Workforce Development, who commented on a recent report indicating a high number of direct care job vacancies that health and long term care providers are having difficulty filling; and Joyce McDanel, Unity Point in Des Moines; who further commented on the difficulty in finding and keeping both direct care workers and licensed nurses, and Di Findley, Iowa CareGivers, who stressed the need for policies and infrastructure to maintain the training credentials and supply and demand of the direct care workforce and to identify and implement strategies to enhance compensation.

Panel presentations were followed by a discussions involving all participants, some of the leading recommended priorities that surfaced included, wages and compensation and to build upon the work that the Department is already doing.

Help Wanted!  Day at the State Capitol
Join us on March 2, 2017

Check back for more details! 

A "Point in Time" survey conducted by Iowa Workforce Development for Iowa CareGivers revealed

  • 287 of 319 Health and Long-Term Care/Service Employers reported a total of  1,826 vacancies for direct care positions.
  • 539 expected direct care position retirements in the next year.
  • Total of nearly 50,000 working in the occupational titles: certified nursing assistant, personal care aide, and home health aide.

(A Direct Care Workforce Initiative committee  of Iowa Departments of Workforce Development, Inspections and Appeals, Human Services, Public Health, Education, and Aging, and Iowa CareGivers, and others  estimated another 20,000-25,000 working under other titles or titles not yet recognized by Department of Labor such as consumer directed attendant care workers, private duty, psychiatric aides, and others serving individuals with disabilities)

Average Wages for Entry Level to Experienced Direct Care Positions:

  • Certified Nursing Assistants:     $10.00-$13.22/HR
  • Home Health Aides                   $9.23-$11.74/HR
  • Personal Care Aides                 $9.01-11.63/HR

Click here to read a brief summary.
Click here for the full report.
Click here for news release.

Last Year - First Time Visit For Many! 

Click here to view the photo gallery (January 2016).

January 27, 2016 was actually my first time ever being at the Capitol. But this day I was able to experience it with my son Christopher. Christopher is a senior and was able to come with me because he is in SCHOOL to CAREERS.

We went to the Capitol to learn more and we were so pleasantly surprised with all the people we were able to meet and the topics that I had no idea were affecting me!  

I was also able to talk to my Senator and Representative.  Senator Segebart really listened to me and understands the issues facing health care workers.  He really gave me his attention, but I think I learned more from him!!

As an in home non-medical provider, I want so much to be more involved. The care that we give to our clients is truly important to me!  – Julie Kitt

If your life or the life of a loved one has been touched by workforce shortages, please share your story at