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Federal Home Health Care Agency Laws and Regulations
The general provisions for Home Health Agencies.
42 CFR 484:
CFR Title 42, Part 484
Home Health Aide Training:
The Federal law requires home health aides to pass a competency test covering 12 areas:
Communication skills; observation, reporting, and documentation of patient status and the care or services furnished; reading and recording vital signs; basic infection control procedures; basic elements of body function and changes; maintenance of a clean, safe, and healthy environment; recognition of and procedures for emergencies; the physical, emotional, and developmental characteristics of the patients served; personal hygiene and grooming; safe transfer techniques; normal range of motion and positioning; and basic nutrition. A home aide may take training before taking the competency test. The Federal law requires at least 75 hours of classroom and practical training supervised by a registered nurse.
42 CFR 484: Condition of participation: Home health aide services CFR Title 42, Part 484, Section 36
Home Health Agency Administration, including conditions of participation.
The conditions laid out in this subpart include: 1) the patient has the right to be informed about his or her rights; 2) The Home Health Agency (HHA) must ensure patient confidentiality; 3) The HHA must comply with all federal, state and local laws; 4) The organization and administrative duties of the agency must be stated clearly in writing; 5) there must be adequate professional personnel; 6) must be able to meet patient needs and develop a plan of care before accepting a patient; 7) report OASIS information.
42 CFR 484.10-484.20, Subpart B: CFR Title 42, Part 484, Subpart B (Section 10 to 20)
Home Health Agency Furnishing of Services, including conditions of participation. The conditions laid out in this subpart include: 1) skilled nursing services in accordance with the plan of care; 2) therapy services given by a qualified therapist or under their supervision; 3) skilled home health aide services; 4) qualified outpatient physical therapy or speech pathology services; 5) maintain a clinical record of past and current findings in accordance with accepted professional standards; 6) evaluation of agency's program at least once a year; 7) comprehensive assessment of patients.
CFR Title 42, Part 484, Subpart C: CFR Title 42, Part 484, Subpart C (Section 30 to 55)
Prospective Payment System for Home Health Agencies
CFR Title 42, Part 484, Subpart D: Not available online
Conditions of participation for home health agencies include: 1) protection of patient rights; 2) notification of State entities; 3) use of home health aides; 4) medical equipment; 5) individual's plan of care; 6) compliance with Federal, State, and local laws and regulations
U.S. Code Title 42 Section 1396n
A home health agency must meet the requirements for participation in Medicare.
42 CFR 440.70: Most recent available section: CFR Title 42 Part 440 Section 70(text)
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Federal Nursing Homes Laws and Regulations
Federal Requirements for Training of CNAs:
The federal requirement for nursing facility administration and the required training of nursing aides:
A Nursing Aide must have completed a state approved training program and competency evaluation and the facility must received verification from the Nurse Aide Registry, unless the nursing aide can prove they have completed a program, but have yet to be included in the registry. If the Aide is enrolled in a program they can work without being on the registry for a period of four months.
CNA Training
The federal minimum requirement for nurse aide training is 75 hours and a competency evaluation:
42 CFR 483.75 Required training of nursing aides (e)(f): Most recent available section: CFR Title 42 Part 483 Section 75 (e)(f) (g)(text)
42 CFR 483.151 Review and approval of nurse aide training and competency evaluation programs and competency evaluation programs. Most recent available section: CFR Title 42 Part 483 Section 151(text)
42 CFR 483.152: Requirements for approval of a nurse aide training and competency evaluation program Most recent available section: CFR Title 42 Part 483 Section 152(text)
42 CFR 483.154: Nurse aide competency evaluation Most recent available section: CFR Title 42 Part 483 Section 154(text)
42 USC 1395i-3(b)(5) & (e)(1)Required training of nurse aides (Medicare facilities): U.S. Code Title 42 Section 1395i-3 (b)(5) & (e)(1)
42USC 1396r(b)(5)Required training of nurse aides (Medicaid facilities): U.S. Code Title 42 Section 1395i-3 (b)(5) & (e)(1)
The State may wave requirements that apply to a nursing aide that completed a training and competency evaluation prior to July 1, 1989:
42 CFR 483.150:Statutory basis; Deemed meeting or waiver of requirements. Most recent available section: CFR Title 42 Part 483 Section 150 (text)
Oversite
42 USC 1395i-3(f)(2) HHS responsibility for the training and competency evaluation program (Medicare facilities): U.S. Code Title 42 Section 1395i-3 (f) (2)
42 USC 1396r(f)(2) HHS responsibility for the training and competency evaluation program U.S. Code Title 42 Section 1396r(f) (2)
CNA Registry:
42 CFR 483.156Registry of nurse aides.: Most recent available section: CFR Title 42 Part 483 Section 156(text)
42 USC 1395i-3(e)(2) Nurse aide registry(Medicare facilities) U.S. Code Title 42 Section 1395i-3 (e)(2)
42 USC 1395i (e)(2)Nurse aide registry(Medicaid facilities):: U.S. Code Title 42 Section 1396r (e)(2)
Staffing Rates:
Nursing facility is required to use the services of a registered nurse 8 consecutive hours a day, 7 days a week. This requirement may be waived given certain conditions.
42 CFR 483.30: Most recent available section: CFR Title 42 Part 483 Section 30(text)
Financing Nurse Aide Training and Competency Evaluations:
FFP is available for State expenditures associated with nurse aide training and competency evaluation program.
42 CFR 483.158: Most recent available section: CFR Title 42 Part 483 Section 158(text)
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Nurse Reinvestment Act
The Nurse Reinvestment Act, which was signed into law in August 2002 and funded the following year (February 2003), is aimed at encouraging people to enter and remain in the field of nursing. It focuses primarily on licensed nurses, but some sections apply to certified nursing assistants, home health aides, and other direct-care workers, including grants to promote career advancement and special training opportunities.
thomas.loc.gov/cgi-bin/query/D?c107:5:./temp/~c107q93hct::
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Nursing Home Regulations Plus
This a searchable website of nursing home regulations in all fifty states. The site was created by researchers at the University of Minnesota School of Public Health with grant funding from the Hulda B and Maurice L Rothschild Foundation.
www.hsr.umn.edu/NHRegsPlus/index.htm
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Assisted living state regulatory review 2007. Polzer, Karl . March 2007. National Center for Assisted Living.
This report summarizes the state laws and regulations that govern assisted living facilities, including requirements for staff criminal background checks and age minimums, CPR training, staff-to-resident ratios, and training requirements. It also provides contact information for each state's assisted living regulatory agency and offers brief commentary about regulations and legislation currently under consideration.
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Direct-care health workers: The unnecessary crisis in long-term care. Dawson, Steven L., and Rick Surpin. May 2001. The Aspen Institute.
The authors examine the structure of long-term care, its financing, and the impact of the current labor crisis on the three key stakeholders: workers, providers, and consumers. The report recommends a sectorwide restructuring of long-term care, supported by new labor, welfare, and health care policies.
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Direct service workforce activities of the Systems Change grantees. Anderson, Wayne L., Joshua M. Wiener, Angela M. Greene, and Janet O'Keeffe . April 2004. RTI International.
In 2001 the Centers for Medicare and Medicaid Services (CMS) awarded Real Choice Systems Change (RCSC) Grants to states and other entities working to improve state long-term care systems. Twenty grantees began one or more initiatives to improve the recruitment and retention of direct service workers. This report focuses on the workforce initiatives of these 20 grantees, with an in-depth look at 7. The report strongly recomends that policymakers, providers, and consumers address workforce problems.
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GAO testimony: Nursing workforce: Recruitment and retention of nurses and nurse aides is a growing concern. Scanlon, William J. May 2001. General Accounting Office.
In testimony to Congress, the General Accounting Office (GAO) provides a comprehensive analysis of current and future long-term care staffing issues. This report includes data quantifying the shortage of nurses and paraprofessionals across all states and identifying the race, ethnicity, gender, and age characteristics of the workforce; an analysis of critical factors affecting labor, including wages, working conditions, and changing demographics; and a survey of strategies that states are using to address the current shortage of workers.
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Long term care financing and the long-term care workforce crisis: Causes and solutions . Dawson, Steven. January 2003. Citizens for Long-Term Care.
This paper examines the emerging 'care gap' in long-term care and the negative impact of staff shortages on the three primary stakeholders, consumer, providers, and workers. It recommends a national strategy--integrating both federal and state policy into a comprehensive system of long-term support and services--to address the direct-care crisis. Specific recommendations include: 1) Develop a national commitment to long-term care financing; 2) Make direct-care jobs competitively attractive by improving wages, training, opportunities for advancement, employee supports, improved use of technology, and accountability; and 3) Broaden supply by attracting younger and older workers, male workers, workers transitioning from public assistance, and new immigrants.
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NCSBN directory of nurse aide registries. . 2007. The National Council of State Boards of Nursing, Inc. (NCSBN).
State contact information for nurse aide registries across the country are collected within this directory, compiled annually by the National Council of State Boards of Nursing(NCSBN).
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Nurse aide training. Rehnquist, Janet. November 2002. Department of Health and Human Services, Office of Inspector General (OIG).
A study of nurse aide training conducted by the Department of Health and Human Services Office of the Inspector General (OIG) finds that nurse aide training has not kept pace with nursing home industry needs, teaching methods are often ineffective, clinical exposure is too short and unrealistic, and in-service training may not meet federal requirements. The report is based on interviews with federal and state officials and 29 nursing homes. 92 nursing aides were interviewed, 889 nurse aides completed surveys, and 17 participated in focus groups.
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Nursing aides, home health aides, and related health care occupations: National and local workforce shortages and associated data needs. National Center for Health Workforce Analyses Bureau of Health Professions Health Resources and Services Administration (HRSA). February 2004. Department of Health and Human Services.
This report on the growing shortage of direct-care workers notes that the supply of certified nursing assistants (CNAs) and home health aides is declining while demand is growing at a record pace. The report finds that the shortage shows no signs of improving, and that it is a matter of retention, not recruitment: the problem is high turnover due to low pay, too few opportunities for professional advancement, and other factors.
The report is based on a review of eight key federal data sets, CNA registries in 45 states and interviews and focus groups with long-term care providers and state officials in four states. The report notes the problem of developing an accurate picture of the shortage, due to data limitations including exclusions, inconsistency of definitions, and categorizations that are in some cases excessively broad.
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Nursing home staffing standards in state statutes and regulations. Harrington, Charlene . January 2008. University of California San Francisco, Department of Social and Behavioral Sciences.
This set of charts lists the state staffing standards for nursing homes in all 50 states and the District of Columbia. It summarizes the requirements for direct-care staff, as well as for licensed staff and caregiving staff overall; estimates the difference between the state requirements and the federal standard for facilities with 100 beds; and includes links to each relevant statute and regulation.
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Paraprofessionals on the front lines: Improving their jobs; Improving the quality of long-term care. Wilner, Mary Ann, and Ann Wyatt. September 1998. AARP.
This background paper explores the role of paraprofessionals in long-term care, highlighting the relationship between direct-care workers and their clients. After introducing basic demographic characteristics of the paraprofessional labor, the report assesses a variety of barriers to decent jobs and high-quality care, including staff shortages and high turnover; the association of caregiving with 'women's work'; inadequate supervision; and inadequate reimbursement keeping wages low. Includes an excellent list of references.
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Results of the 2005 national survey of state initiatives on the long-term care direct-care workforce. Harmuth, Susan, and Susan Dyson. September 2005. The National Clearinghouse on the Direct Care Workforce and the Direct Care Workers Association of North Carolina.
This is the fifth national survey of the direct-care workforce conducted by these authors. It examines public policy actions taken by states to strengthen the direct-care workforce, and updates information collected in prior surveys. Responses were received from 38 states, representing a 76 percent response rate.
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State-by-state projected demand for new direct-care workers, 2006-16. PHI. December 2009.
This chart presents occupational employment projections for direct-care workers in all 50 states, as well as Washington, DC. The projections are organized into three categories: home health aides; nursing aides, orderlies, and attendants; and personal and home care workers. Overall, there were approximately three million direct-care workers employed in the U.S. in 2006; by 2016, however, an additional one million positions must be filled in order to meet the rising demand for direct care.
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State chart book on wages for personal and home care aides, 1999-2006. PHI. July 2008.
This chart book provides information, based on data from the Bureau of Labor Statistics, on the wages received by personal and home care aides in all 50 states and the nation over a 7‐year period. The publication provides information on nominal and real median wages, a time‐series graph analyzing state wages, tables comparing wages across states, a national summary, and technical notes.
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State chart book on wages for personal and home care aides, 1999-2008. PHI. July 2009.
This chart book provides information, based on data from the Bureau of Labor Statistics, on the wages received by personal and home care aides in all 50 states and the nation over a 9‐year period. The publication provides information on nominal and real median wages, a time‐series graph analyzing state wages, tables comparing wages across states, a national summary, and technical notes.
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State nurse aide training requirements, 2009. . 2009. PHI.
This chart summarizes state requirements for nurse aide training programs that go beyond the federally mandated 75 hours of training.
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States' requirements for Medicaid-funded personal care service attendants. Pattison, Brian T., et al.. December 2006. Office of Inspector General (OIG), Department of Health and Human Services (HHS).
This report examines state requirements for personal care attendants and policies for oversight of those requirements. It finds significant variation, with 301 sets of attendant requirements nationwide. The six most common requirements are background checks, training, age, supervision, health, and education. However, states defined these differently. Frequency and scope of the review process also varied. The report concludes that more consistency or standardization may make monitoring attendant requirements less cumbersome and enhance quality assurance.
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The cost of frontline turnover in long-term care. Dorie Seavey. October 2004. Better Jobs Better Care .
This report details information known about the cost of turnover among direct-care workers. The author argues that it is important to track these costs and presents a framework for measuring them. Research findings indicate that: An expanded accounting model that includes direct and indirect costs provides the most accurate estimate of turnover costs; indirect costs, which tend to be overlooked, may be substantial; and the direct cost of turnover is at least $2,500 per frontline worker. The report offers recommendations for providers, policy makers, and researchers that are designed to improve overall understanding of the costs related to turnover and the effectiveness of various strategies intended to reduce those costs.
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The future supply of long-term care workers in relation to the aging baby boom generation. Department of Health and Human Services and Department of Labor. May 2003. Department of Health and Human Services and Department of Labor.
This report notes that the nation will need between 5.7 million and 6.5 million long-term care nurses, nurse aids, and home health and personal care workers to meet the needs of baby boomers by 2050. It lists a broad range of federal programs that work toward 'developing a committed and quality direct care worker pool in a variety of long-term care settings.' The report lists four issues that need to be addressed in order to retain current workers and attract new ones: 1) Finding workers in new populations 2) Conducting effective initial and continuing education and training 3) Improving working conditions in terms of hours, paperwork, respect, and safety 4) Improving compensation, benefits, and opportunities for advancement.
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Who are direct-care workers?. PHI. January 2009.
This fact sheet gives an overview of the direct-care workforce, describing job titles, responsibilities, worker demographics, wages, benefits, and the growing demand for workers.
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Who will care for older people? Workforce issues in a changing society. Noelker, Linda S. Spring 2001. Generations , Vol. 25, No. 1.
The articles in this special issue describe the nature and scope of the shortage of frontline workers in long-term care and make recommendations for strengthening this workforce. The three sections of this issue outline demographic issues and policy perspectives; address the particular problems of professionals in long-term care; and examine strategies for recruiting and retaining paraprofessionals, suggesting ways to increase job commitment, lower stress, and improve performance.
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Who will care for us? Addressing the long-term care workforce crisis. Stone, Robyn I., and Joshua M. Wiener. October 2001. The Urban Institute and the American Association of Homes and Services for the Aging.
This report analyzes current and future labor shortages across long-term care by analyzing factors that impact the supply and demand of direct-care workers. These factors include public policies as well as workplace culture and practices. The report also summarizes recent public and private efforts to address recruitment and retention issues and to develop a qualified, stable frontline workforce.
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Workers who care: A graphical profile of the frontline health and health care workforce. Schindel, Jennifer, et al.. 2006. Robert Wood Johnson Foundation.
This chart book provides comprehensive employment data on frontline health and health care workforce occupations. It includes three parts: a view of the frontline workforce as a whole; occupational variations across the workforce; and in-depth occupational profiles that provide key information such as per capita employment, occupational growth rates, reported wage gains, and other trends. Long-term care workers such as nursing aides, home health aides, and personal and home care aides are among those profiled.
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Practice Profiles are descriptions of recruitment, education and retention programs.
1199SEIU: Helping workers access affordable child care programs
Alzheimer's Association, Eastern North Carolina Chapter: Adult education methods for teaching dementia care
Apple Health Care: Creating a worker- and resident-centered culture in nursing homes
Ararat Nursing: Performance Improvement Quality Improvement (PIQI).
Avante at Ormond Beach: Department head management training, nurse management training, and a staff advisory council
Catalina In-Home Services: Recruitment and screening of caregivers for consumer-directed home care
Cooperative Care: A worker-owned cooperative of caregivers
Cooperative Home Care Associates: Employment counseling
Cooperative Home Care Associates: Integrated model for recruitment, training, and retention
Direct CareGiver Association: Comprehensive model training program for caregivers
Foundation for Long-Term Care (FLTC): Growing Strong Roots Peer- Mentoring System
Genesis Eldercare: Geriatric Nursing Assistant Specialist (GNAS) program
George G. Glenner School of Dementia Care: Dementia care specialist training program
Golden Care Academy
Home Care Associates: The 4Ps
Hope Haven, Inc.: Career ladder for direct support professionals
Iowa CareGivers Association: Certified nursing assistant mentor training program
Kahl Home: Employee assistance program
Leelanau Memorial Health Center: Strategies to Reduce Turnover
Linking Employment, Abilities, and Potential (LEAP) of Cuyahoga County: Personal care attendant and state tested nurse aide training
Loomis House: Inspiring workers through education and resident-centered care
Luther Manor Nursing Home and Retirement Center: Train the Mentor
Marian Estates: Individualized bathing
Marian Estates: Peer mentoring program
Martin Luther King Economic Development Corporation: Maximizing Opportunity in a Restructuring Economy (MORE)
Masonic Home of New Jersey: Peer mentoring preceptor program
Mather Life Ways: LEAP for a 21st Century Workforce
Mennonite Manor: Manor Care Attendant (MCA) program
Mercy Health Partners: Quality improvement process
NewCourtland Elder Services: Employee PRIDE program. PRIDE stands for Provide Respect, Incentives, Career Development, and Education
Northern Pines Community: Culture change initiative
OHI: Comprehensive retention program for direct support professionals
Presbyterian Home of Moshannon Valley: Kaleidoscope Initiative
Rest Haven Christian Services: Director of CNAs
San Francisco In-Home Supportive Services Public Authority: Improving the quality of direct-care workers' jobs
Schoellkopf Health Center: Consistent scheduling
Sisters of Bon Secours Nursing Care Center: Wage Parity Initiative
St. Peter Villa Nursing Home: Career ladder
The Care Advantage Nurse Aide Academy: Certified nursing assistant training program
The Good Faith Fund: Careers in Health Care
The Ray Graham Association: Community learning center mentoring program
The Shirley Ware Education Center: Certified nursing assistant training program
The Topeka Independent Living Center, Inc.: Personal Assistant Management Services (PAMS)
Vinfen Corporation: Self-managed teams
Visiting Nurse Service of New York: Recognizing Home Health Aides As Vital Partners in Quality Improvement
Wellspring Innovative Solutions, Inc.: The Wellspring model of quality improvement
WIN A STEP UP: Improving job quality and increasing retention
These individuals and organizations are included here because they are actively involved in leading direct-care workforce activities in this state.
Nursing Assistant Resources on the Web
www.nursingassistants.net
e: mail@nursingassistants.net
National Association for Home Care (NAHC)
www.nahc.org
228 7th Street, SE
Washington, DC, Entire US 20003
t: (202) 547-7424
American Health Care Association (AHCA)
www.ahca.org
1201 L Street, N.W.
Washington, DC , Entire US 20005
t: (202) 842-4444
American Association of Homes and Services for the Aging (AAHSA)
2519 Connecticut Ave., NW
Washington, DC , Entire US 20008
t: (202) 783-2242
Family Caregiver Alliance
180 Montgomery St.
Suite 1100
San Francisco, CA , Entire US 94104
t: (415) 434-3388 or (800) 445-8106
e: info@caregiver.org
The Urban Institute
www.urban.org
2100 M Street, N.W.
Washington, DC , Entire US 20037
t: (202) 833-7200
The Hudson Institute
www.hudson.org
National Alliance for Direct Support Professionals (NADSP)
www.nadsp.org
The Research and Training Center on Community Living , University of Minnesota
rtc.umn.edu/main/
Amy S. Hewitt, Ph.D.
204 Pattee Hall
150 Pillsbury Drive S.E.
Minneapolis, Entire US 55455
t: (612) 625-1098
e: hewit005@umn.edu
The Workforce Alliance
www.workforcealliance.org
Andy Van Kleunen
1701 K Street, NW
Suite 750
Washington, D.C. , Entire US 20006
t: (202) 338-0737
e: info@workforcealliance.org
Service Employees International Union (SEIU)
www.seiu.org
Cathie Sullivan, Home Care Policy Analyst
1313 L Street, N.W.
Washington, DC 20005, Entire US
t: (202) 898-3275
e: sullivac@seiu.org
National Commission on Nursing Workforce for Long-Term Care
Dr. Brian Biles
t: (202) 416-0066
e: bbiles@gwu.edu
National Network of Career Nursing Assistants
www.cna-network.org
Genevieve Gipson RN MEd RNC
3577 Easton Road
Norton, OH , Entire US 44203
t: (330) 852-9342
f: (330) 852-9378
e: cnajeni@aol.com
National Association for Direct-Care Workers of Color
www.directcareworkersofcolor.org
John Booker
t: (574) 289-9326
e: jbooker@directcareworkersofcolor.org
Culture Change Now
www.culturechangenow.com
LaVrene Norton
t: (414) 258-3649
e: lavrene@actionpact.com
The Direct Care Alliance (DCA)
www.directcarealliance.org
Leonila Vega, Esq., Executive Director
349 East 149th Street, 10th Floor
Bronx, New York , Entire US 10451
t: (718) 928-2063
f: (718) 585-6852
e: LVega@directcarealliance.org
National Association of Geriatric Nursing Assistants (NAGNA)
www.nagna.org
Lisa Cantrell
2709 West 13th Street
Joplin, MO, Entire US
t: 800-784-6049
e: info@nagna.org
National Association of Health Care Assistants (formerly NAGNA)
www.nahcacares.org
Lori Porter
2709 West 13th Street
St. Joplin, MO, Entire US 64801
t: (417) 623-6049
e: lporter@nahcacares.org
Institute for the Future of Aging Services
www.futureofaging.org
Robyn I. Stone
2519 Connecticut Avenue, NW
Washington, DC , Entire US 20008
t: (202) 508-1208
e: rstone@aahsa.org
The Pioneer Network
www.pioneernetwork.net
Rose Marie Fagan
PO Box 18648
Rochester, New York , Entire US 14618
t: (585) 271-7570
e: RoseMarie.Fagan@PioneerNetwork.net
Paraprofessional Healthcare Institute (PHI)
www.paraprofessional.org
Steve Edelstein, National Policy Director
349 East 149th Street
10th Floor
Bronx, NY , Entire US 10451
e: Edelstein@paraprofessional.org
Administration on Aging
www.aoa.gov
Washington, DC , Entire US 20201
The Agency for Healthcare Research and Quality (AHRQ)
www.ahrq.gov
540 Gaither Road
Rockville, MD , Entire US 20850
t: (301) 427-1364
e: info@ahrq.gov
Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services
aspe.hhs.gov/_/index.cfm
200 Independence Avenue, S.W.
Washington, D.C., Entire US 20201
Administration on Aging
www.aoa.gov
Washington, DC, Entire US 20201
t: (202) 619-0724
The Clearinghouse for the Community Living Exchange Collaborative
www.hcbs.org
Division of Long Term Care Policy
aspe.hhs.gov/daltcp/home.shtml
Andreas Frank, Director
US Department of Health & Human Services
Office of Disability, Aging, and Long-Term Care Policy, (ASPE)
Washington, D.C. 20201, Entire US (202) 401-7123
e: andreas.frank@hhs.gov
The Centers for Medicare and Medicaid Services (CMS)
www.cms.hhs.gov
Kate King, Health Insurance Specialist
7500 Security Blvd.
Mail Stop S2-14-26
Baltimore, Maryland , Entire US 21244-1850
e: Kking@cms.hhs.gov
US Department of Labor , Employment & Training Administration (ETA)
www.doleta.gov/
Laura Ginsburg, Office of Apprenticeship Training, Employer and Labor Services
200 Constitution Avenue, NW
Suite N4671
Washington, DC , Entire US 20210
t: (202) 693-2803
e: ginsburg.laura@dol.gov
U.S. Department of Labor, Office of the Assistant Secretary for Policy (OASP)
www.dol.gov/asp/welcome.html
Stephanie Swirsky
200 Constitution Avenue, NW
Room S2312
Washington, DC , Entire US 20210
t: (202) 693-5909
e: swirsky.stephanie@dol.gov
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