The order from Superior Court Judge Allen Baddour mandates alternatives to institutionalization — shining a light on the hard, critical work of the state’s nearly 120,000 direct care workers who help people in their homes. A group of leaders in the aging and direct care workforce are currently amplifying the direct care worker and care recipient voice in North Carolina, but every state must do this to be a wise steward of Medicaid dollars. States must seek, amplify, and document the voices of those these policies affect — direct care and support professionals, those receiving care, and families hiring and managing care for their loved ones.