Legislation Spotlight: Federal Bills Aimed at Improving Access to Home and Community Based Services and Supporting for the Direct Care Workforce
Over the last two years, Representative Debbie Dingell and Senator Bob Casey introduced several bills to their respective chambers that seek to address the U.S. caregiver crisis and increase access to in-home services for older adults and people with disabilities. Both of these issues are at the forefront of what The Senior Alliance, as well as many other organizations serving aging individuals, believe is essential to responsibly and compassionately planning for the aging of the U.S. population over the next several decades.
Right now, direct care workers are widely underpaid, earning a median wage of $15.43 an hour and often living in poverty as a result. Because of this, direct care workers are in short supply, with a recent survey revealing 92% of nursing homes and nearly 70% of assisted living facilities having a significant or severe workforce shortage. Another recent survey of home and community-based services (HCBS) providers showed all 50 states experiencing home care worker shortages, and 43 states reported that some HCBS providers have closed due to worker shortages. As our nation ages and there are more people needing care with fewer people providing it, this caregiver shortage is projected to keep expanding.
However two bills, the Long Term Care Workforce Support Act (S. 4120, HR 7994) and the Better Care Better Jobs Act (S.100, H.R.547), could change this. Both of these bills seek to stabilize the current direct care workforce, attract new employees to the field, and support the 53,000 family caregivers who often replace or work in conjunction with direct care workers to provide high quality care for their loved ones. They would do this by increasing direct care workers’ wage, expanding efforts to professionalize the field, and enhancing access to training course for both direct care workers and family caregivers.
Another set of bills HCBS Access Act (S. 762, H.R. 1493) and the HCBS Relief Act (S. 3118, H.R. 6296), along with the Better Care Better Jobs Act, would ensure eligible older adults and people with disabilities have a real choice between home care and institutional care. The bill would eliminate HCBS waiting lists, end the process of states having to repeatedly reapply for HCBS waivers, and create uniform and expanded eligibility criteria for HCBS. Additionally, the bills would increase Medicaid funding for HCBS, create better evaluation measures to assess the quality of HCBS being provided, and require states to undertake activities to improve service delivery, such as providing helping individuals who were relocated to nursing facilities move back home.
The Senior Alliance and its federal association, USAging, will continue to advocate for these bills and the additional measures to fix the key issues they address.
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