In the complex care field, we know that providing better care to the people who need it most is more critical than ever. We also know that the healthcare systems we have in place right now aren’t working for populations with complex health and social needs: we need care that is built on personal relationships and that meets people where they are, but our payment and delivery systems aren’t structured to deliver care that way. Transforming the fragmented health and social services systems of today so that they provide the coordinated care we need tomorrow will take a bold vision and collective action toward change. That’s why we chose organizer, activist, best-selling author, and MacArthur “Genius” Grantee Ai-jen Poo as our keynote speaker for Putting Care at the Center 2018.

In 2011, Ai-jen and workforce and labor expert Sarita Gupta formed Caring Across Generations, an organization working to transform the long-term care system in America by elevating the voices of both the people who need care and those who provide it. Caring Across Generations brings professional caregivers and families together to advocate for policies that ensure that home care is accessible to all who need it, that people are able to live and age in the settings best for them, that family caregivers are adequately supported, and that home care jobs are well-paying, protected, and valued.

Drawing on her decades of experience working alongside domestic workers to advocate for better workplace protections, Ai-jen is working for a human and relationship-based reinvention of our care systems, one that puts caregivers and families at the center. Like us, she knows the value of person-centered care, and that creating systems that truly value care requires building coalitions and partnerships across the country.

A movement for care centered on authentic healing relationships

Ai-jen Poo learned the importance of care first-hand. Her grandmother, at 92, still enjoys a rich and active life in her own apartment, thanks in part to the care of Mrs. Li and Mrs. Sun, two homecare workers who cook her traditional Chinese dishes and keep her mahjong skills sharp. Her grandfather, however, did not have access to the same kind of care, and this provided a clear demonstration of the impact of care, both on those in need of caregiving and on their families.

Home-based care is in more demand than ever. Ten thousand people turn 65 in the United States each day, and older people increasingly prefer to age in place, in their own homes. With more women (previously the de-facto caregivers for parents and grandparents) working outside of the home, families often turn to professional caregivers to source the care they need.

Home health workers and other caregivers are perfectly positioned to provide what we at the National Center call “authentic healing relationships:” relationships that are secure, genuine, and continuous, and that allow individuals to actively participate in managing their health.

“Core to doing this work well is caring,” said Ai-jen. “Being able to show care and love for the families that you work for and that you’re really part of in many ways. That bond is so powerful, and is showcased every day in hundreds of thousands of households.”

Authentic healing relationships are key to the interventions that complex care programs across the country are spearheading, and the next step is to scale this person-centered approach across systems. Caring Across Generations’ work is a great example of new ways that communities are coming together to achieve the policy and systems change that will bring new value to care and caregiving relationships. State by state, they are working to transform care by putting people and relationships at the center of care policy.

Organizing for change

Ai-jen began working with domestic workers in 1998, meeting with and organizing nannies in parks in New York City. Domestic workers are the nannies, housecleaners, and home care workers that take care of our loved ones and maintain order in our homes. Domestic workers are mostly women, and disproportionately women of color and immigrant woman—some of the most vulnerable and undervalued workers in the United States. They were excluded from the New Deal legislation that established basic labor protections for most working people and often work in isolation for poverty-level wages.

In 2007, Ai-jen co-founded the National Domestic Workers Alliance (NDWA), an alliance of more than 60 affiliate organizations representing over 80,000 domestic workers and home care workers nationally. NDWA has won workplace protections for domestic workers in eight states and counting, and brought 2 million home care workers nationwide under the protection of the law through a federal rule change. In 2010, Ai-jen noticed that the domestic workers she worked with were increasingly requesting training in elder care, and she recognized the beginnings of a major shift in how we conceptualize and provide care in this country. In 2011, she and Sarita Gupta launched Caring Across Generations to unite the caregiving workforce with families, to advocate together for access to affordable, quality care and a well-trained, well-paid care workforce.

“Our need for care is only increasing. Caregivers are a central part of our economy and society. The care workforce will be central to the future of work, yet we are not investing in this sector to ensure that we can meet the needs for the people who need care.” said Ai-jen. If we want to meet the growing need for this work, home care jobs need to be good jobs.”

People providing care in clinical settings are also looking at problems and solutions more holistically. “Each of us can advocate for our homeless patients to be put on waiting lists for public housing,” medical student Leo Eisenstein wrote in a recent New England Journal of Medicine article. “But what would happen if all doctors with homeless patients organized to demand more affordable housing?”

At the National Center, we’re organizing a wide range of professionals, from social workers to researchers, hospital administrators to physicians, consumers, family members, and more around the goal of a transformed healthcare system that meets people’s complex health and social needs. As we work to organize the field of complex care, we’re looking to work like Ai-jen’s, with her bold policy vision and insistence on a future where everyone is valued and has access to the care they need, as an illustration of what putting care at the center looks like in practice.


Ai-jen Poo will be the conference keynote at Putting Care at the Center 2018, the third annual conference of the National Center for Complex Health and Social Needs. Join us in Chicago, IL, December 5-7 to hear more about the future of care in America. Putting Care at the Center 2018 is co-hosted by Rush University Medical Center and the Robert Wood Johnson Foundation. Tickets will go on sale August 1.

Read our press release announcing Ai-jen Poo’s selection as keynote speaker.