At the National Domestic Workers Alliance (NDWA), we are committed to improving care services and supporting care workers in North Carolina. Our efforts focus on Home and Community-Based Services (HCBS) and early childhood education programs. These services are critical for ensuring families and communities get the support they need. Through legislative advocacy and grassroots organizing, we are fighting for fair wages, better working conditions, and stronger care systems that benefit both workers and families across the state.
Home and Community-Based Services (HCBS) Advocacy in North Carolina
In 2024, NDWA prioritized securing a wage pass-through for Personal Care Services (PCS) under HCBS. This would ensure that 80% of Medicaid reimbursement rates go directly to compensation for direct care workers, providing them with the fair wages they deserve. We sought to build off victories in 2021, when North Carolina had committed to raising all direct care workers to at least $15/hour and providers were asked to pass along 80% of its rate increases to worker wages and offered bonuses for direct care workers who provided care during COVID-19. While the 2024 legislative session faced challenges and delays, we made significant progress in holding providers accountable for how they use state funds.
Key Wins for HCBS
- For intellectual and developmental disability programs, we successfully pushed for a requirement that managed care organizations submit reports on how rate increases benefited workers’ wages. This additional oversight helps ensure that funds intended for wage increases are properly used.
- NDWA also worked with NC Medicaid to commission a rate study that will provide crucial data for future wage increases for direct care workers. Although this study may take time to complete, it is a critical step in preparing for the next budget cycle.
- NDWA partnered with the Child Care Services Association (CCSA) and the Budget & Tax Center to launch The Business Side of Child Care (BSCC) initiative. Funded by Durham County’s ARPA, this program provides business training and startup support to Family, Friend, and Neighbor (FFN) caregivers, helping them establish licensed Family Child Care Homes and expand access to quality child care.
Child Care Advocacy in North Carolina
In addition to HCBS, NDWA is fighting for better wages and job security for child care providers in North Carolina. The child care system is currently at risk as many centers face closures due to the expiration of federal stabilization grants. NDWA has partnered with other organizations to demand more funding to keep child care centers open and to continue paying fair wages to the workers who care for our youngest children.
Key Wins for Child Care
- In a last minute vote before the expiration of stabilization grant funding on June 30, the General Assembly passed $67.5 million to extend child care stabilization grant funding at 75% of previous levels. This emergency measure carries child care centers and family child care homes through Dec 2024, but more money is needed to reach the original, and fully fund programs at their original levels.
Key Actions for Child Care
- Statewide Mobilization: On May 16, 2024, NDWA led the Childcare for NC: United for Change rally. Child care centers and homes across the state shut down for the day to highlight the importance of child care services in North Carolina. This rally pushed for an additional $200 million in state funding to extend compensation grants, which have allowed child care centers to raise wages, provide benefits, and cover essential costs.
- Community Engagement: Ahead of legislators reconvening in Raleigh in November, the NC Chapter is continuing to engage providers, owners, teachers, families, and supporters to hold the General Assembly to their commitment to substantially fund stabilization grants. Chapter members and organizers have been collecting thousands of signatures on a statewide petition, held a community dinner on child care, and hosted a virtual town hall in late October. They will keep mobilizing advocates throughout the end of the year to win the funding early educators deserve.
Looking Ahead: 2025 Goals and Priorities in North Carolina
In 2025, NDWA will continue to build on the progress we’ve made in advocating for HCBS and child care programs in North Carolina. Our key goals include:
- Ensuring that a rate study commissioned by North Carolina Medicaid recommends wages of at least $20/hr for direct care workers in order to stabilize the workforce.
- Passing a data collection bill to ensure that providers are held accountable for how they spend Medicaid funds on wages.
- Engaging in the rulemaking process to revamp the Quality Rating and Improvement Systems (QRIS) for the benefit of child care providers
- Establishing a statewide floor for child care subsidy rates and ensuring that state funding for early childhood education covers the true cost of care, including adequately compensating and providing benefits to the early education workforce to create stable, well-paid jobs in the childcare sector.
Through collaboration with lawmakers, DHHS officials, and community organizations, NDWA is committed to transforming care in North Carolina and ensuring a better future for care workers and families alike.
Get Involved in the Fight for Better Care in North Carolina
At NDWA, we believe that improving both home and community-based services and child care in North Carolina is a shared responsibility. By coming together, we can ensure that direct care workers and child care providers receive the fair pay and respect they deserve, while strengthening the essential services families depend on. Together, we can create a brighter future for care in our state.
Take Action
Join us in advocating for dignity, respect, and fair compensation for North Carolina’s care workers and child care providers. Sign up below to stay informed about our work and learn how you can get involved in supporting care workers and improving care programs in your community.