Care is a Click Away

On December 12, the Centers for Medicare & Medicaid Services (CMS) presented guidance* to states to leverage worker registries to boost beneficiaries’ access to home- and community-based services (HCBS).

While the American Rescue Plan Act (ARPA) helped HCBS programs tremendously, ARPA says that “states must use funds to implement or supplement activities to enhance, expand, or strengthen Medicaid HCBS.” CMS expects states to utilize these funds by March 31, 2025.

In the December 12 guidance, CMS encouraged states to explore new ways to enhance their HCBS programs, which includes using enhanced worker registries. This echoes an executive order CMS issued in April, issuing guidance for states on “ways to use enhanced funding to better connect home- and community-based workers who provide services to Medicaid beneficiaries.” Worker registries do just that.

In this regard, Palco is ahead of the game with its new self-direction job board, PalCare. PalCare is Palco’s self-direction job board for connecting prospective employers and caregivers for long-term meaningful career relationships. This comes about through part of our efforts to improve the direct care workforce crisis and bridge the gap between self-directing employers seeking caregivers and caregivers seeking work. Not only is it a useful tool for both caregivers and employers, but it’s also totally free!


Caregivers can use PalCare to create a job seeker profile that will allow them to have a home page where they can post jobs, view and manage applications, and monitor how well their postings are performing. Caregivers will provide information for job seekers to contact and learn more about their needs. Using this information, the caregivers can also create a resume through PalCare.

Caregivers can search for and apply to jobs on the PalCare job board. They can search keywords that are relevant to the work they are seeking and can search by location to find jobs that are nearby.


Employers can use PalCare to create an employer profile that will allow them to post jobs, view and manage applications, and monitor how well their job postings are performing. While only job title, type, and category are required fields for posting a job on PalCare, employers are encouraged to give as much detail as they can about the job, such as salary and description, to lead to more applicants. Once posted, an administrator will review the post and activate it once it has been approved.

Employers can review applications and sort them into four different categories:

  • New: This is where all new applications will start. This is a great opportunity to review each application and decide the next step moving forward.
  • Interview: Use this section to filter all of the applications that you wish to contact and interview for your position.
  • Make Offer: This section should be reserved for the applicant(s) you would like to hire. If only hiring one, it is probably good practice to list a couple options if the position isn’t accepted by your first choice.
  • Disqualified: Move any applications here that do not fit your needs at any time during the process.

Why is PalCare so important to the self-direction industry?

  • When a self-directed employer is seeking caregivers, there is often nowhere free for them to go and post an ad. and other services cost money, and Craigslist may be free, but responses are often not legitimate.
  • Caregiving as a career can be difficult to achieve because working for a participant (usually a loved one) does not often equate to 40 hours of care. Often needing flexible working hours to meet the needs of that participant, caregivers are often somewhat stuck working less-than-full-time employment and experiencing poverty. By connecting caregivers with others in their community who may also need care that is less than full time, we bridge the gap, making it more obtainable for them to continue their necessary work as a caregiver.
  • The more resources like this that Palco is able to put in place, the more self-directed programs become legitimized. It is important for the public to understand that these are real programs with real employers and real workers who deserve the same access and benefits as others.

*For the full article on the CMS guidance, visit Administration encourages states to use worker registries to boost HCBS access (

by Mark Biviano
Chief Operating Officer, President

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