Paraprofessional Healthcare Institute (PHI) is a left-of-center healthcare worker training and research nonprofit. Located in Bronx, New York, this group advocates for increased training and pay for “direct care” workers who perform in-home services as an alternative to nursing homes or live-in patient care facilities. PHI also has a research and policy advocacy wing, the Equity Institute, through which it develops research papers and collaborates with minority- and LGBT-interest groups. ¹

It is a recipient of funds from the pool of grant money pledged by MacKenzie Scott. PHI is also a member of New York Caring Majority, a coalition of health worker advocacy groups. ²

Racial Justice

PHI regularly advocates for an increase in the number of minority direct-care workers. Following the 2020 COVID-19 pandemic, PHI ran a study tracking the displacement of healthcare workers. The study showed that some groups of minority healthcare workers were slightly more likely to have been displaced during the pandemic, ranging from 6 percent (Latinos) to 9 percent (Asian/Pacific Islanders). The study also showed that Black and Asian/Pacific Islander workers were less likely to return to the healthcare field, a phenomenon PHI attributed to “occupational segregation and employment discrimination.” To combat this trend, PHI recommended that “race-explicit strategies could help recruit and retain displaced workers of color in the direct care workforce.” ³

PHI advocated for similar policies before COVID-19. In 2018, PHI spokesman and vice president of policy Robert Espinoza suggested that the shortage of healthcare workers could be solved by supporting “racial justice,” and called for “race-explicit hiring and retention goals.” ⁴ In its 2018 report on racial disparities in the workforce, PHI also highlighted the $15,000 pay gap that existed between Black healthcare workers and their white and African-immigrant counterparts, again citing racial discrimination as the cause. ⁵  

CDPAP Rule Change and Legislation

The Consumer-Directed Personal Assistance Program (CDPAP) is a system that allows the elderly or disabled to contract in-home care with healthcare workers, who are then compensated through “financial intermediary” organizations, with payment usually coming from Medicaid.  In 2019, then-governor Andrew Cuomo (D) proposed a series of budget cuts and program reforms to this system, which was seen as one of the major areas of spending for the Medicaid program. The changes included both a flat 17 percent cut to funding, and a reduction in the number of eligible financial intermediaries from 450 to 70. Opponents of this change pointed out that this would affect up to 60,000 of the 70,000 program participants and could result in three-month payment delays for workers. PHI opposed these changes, with New York policy manager Allison Cook expressing concern about the lack of home healthcare workers in that state, and fear that some of the CDPAP support system would “outright disappear.” ⁶

In March 2022, a bill was introduced in the New York State Senate to halt any changes to the CDPAP program until December 31, 2024, during which time a study would be conducted to streamline and refine any proposed alterations. ⁷

People

Jodi M. Sturgeon is president and CEO of PHI. She is also board treasurer for Cooperative Home Care Associates in New York, and the Philadelphia, Pennsylvania-based Home Care Associates. Prior to her work at PHI (where she formerly worked as vice president, CFO, and COO) she was vice president of the New Hampshire Community Loan Fund. She is also a member of Chief, an organization that advocates for greater representation of women in executive leadership roles in business. ⁸

Robert Espinoza is executive vice president of policy and a frequent spokesperson for PHI. He is also the former senior director of public policy and communications for LGBT elder advocacy group SAGE (Services & Advocacy for GLBT Elders), and director of research and communications for Funders for LGBTQ Issues. ⁹

1. “Equity Institute.” PHI. Accessed August 15, 2022.  http://www.phinational.org/equity-institute/
2. “About.” New York Caring Majority. Accessed August 15, 2022. https://www.nycaringmajority.org/about-coalition
3. McCall, Stephen. “Recruiting Covid-Displaced Workers to Build the Direct Care Workforce.” Generations. October 28, 2021. Accessed August 15, 2022. https://generations.asaging.org/rebuilding-direct-care-workforce-post-covid
4. Espinoza, Robert. “Worried About Care for Your Aging Parents? Support Racial Justice.” Diverse Elders. February 20, 2018. Accessed August 15, 2022. https://diverseelders.org/2018/02/20/worried-about-care-for-your-aging-parents-support-racial-justice/
5. “PHI Releases Research Series on Racial Disparities in Direct Care.” PHI. February 6, 2018. Accessed August 15, 2022. https://www.phinational.org/news/phi-releases-research-series-racial-disparities-direct-care/
6. Abraham, Roshan. “Alarm Over Proposed Cuts to State Program Overseeing Home-Health Aides.” March 11, 2019 Accessed August 15, 2022. https://citylimits.org/2019/03/11/cuomo-cut-cdpap-home-aides-medicaid/
7. “Senate Bill S8586.” NY Senate.gov. Accessed August 15, 2022. https://www.nysenate.gov/legislation/bills/2021/S8586
8. “Jodi Sturgeon.” Linkedin. Accessed August 15, 2022. https://www.linkedin.com/in/jodi-sturgeon-707262a/
9.  “Robert Espinoza.” Linkedin. Accessed August 15, 2022. https://www.linkedin.com/in/robertespinoza1