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Kaine & Casey Introduce Bill to Expand Access to Home and Community-Based Services for Seniors and People with Disabilities

WASHINGTON, D.C. — U.S. Senator Tim Kaine, a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, joined Senator Bob Casey and colleagues in introducing legislation to expand access to home and community-based services (HCBS) for older adults, people with disabilities, and injured workers, as well as increase pay and improve benefits for caregivers who provide this life-sustaining care. The bill would strengthen the caregiving workforce, improve quality of life for families, and boost the economy by creating good-paying jobs. HCBS are critical to helping people receive care in the setting of their choice, stay active in their communities, and live independently. There are over 650,000 people nationally on waiting lists for HCBS.

“Home and community-based services are critical to helping our nation’s seniors, people with disabilities, and others access the care they need while also living independently in their communities,” said Kaine. “I’m proud to introduce this bill to expand access to home services and boost our economy by creating jobs and increasing wages for family caregivers.”

The COVID pandemic highlighted the urgent need to ensure all Americans have the option to receive quality, long-term care in the setting that best meets their needs and preferences, and the vast majority of Americans prefer to receive such care and support at home. While all states provide coverage for some home care services, there are significant variations and gaps in coverage due to varying eligibility and benefits standards. The home care workforce—a majority of whom are women and people of color—earn a median wage of $13 per hour with few or no benefits, and roughly 18 percent of these workers live in poverty. This results in exceptionally high annual turnover rates, which are estimated to be above 60 percent.

Specifically, the Better Care Better Jobs Act would:

  • Increase the federal funding match for states who provide HCBS as part of their Medicaid program.
  • Strengthen and expand the HCBS workforce by increasing payment rates — or the amount of money direct care workers will earn for their services — to promote recruitment and retention of direct care workers, increasing direct care workers’ wages, and developing and updating training opportunities.
  • Encourage innovation to benefit direct care workers and care recipients, including providing additional incentives to help states build HCBS workforce programs that register direct care workers.

Kaine has introduced legislation that would direct the Department of Health and Human Services (HHS) to award grants to states or eligible entities to build, retain, and train the direct care workforce and family caregivers.

In addition to Kaine and Casey, the bill is cosponsored by Senators Ron Wyden (D-OR), Chuck Schumer (D-NY), Patty Murray (D-WA), Tammy Duckworth (D-IL), Sherrod Brown (D-OH), Maggie Hassan (D-NH), Bernie Sanders (I-VT), Raphael Warnock (D-GA), Jeff Merkley (D-OR), Chris Van Hollen (D-MD), Kristen Gillibrand (D-NY), Sheldon Whitehouse (D-RI), Richard Blumenthal (D-CT), John Fetterman (D-PA), Alex Padilla (D-CA), Dick Durbin (D-IL), Tammy Baldwin (D-WI), Tina Smith (D-MN), Ed Markey (D-MA), Amy Klobuchar (D-MN), Jack Reed (D-RI), Elizabeth Warren (D-MA), Debbie Stabenow (D-MI), Maria Cantwell (D-WA), Ben Cardin (D-MD), Cory Booker (D-NJ), Brian Schatz (D-HI), Angus King (I-ME), Martin Heinrich (D-NM), Mazie Hirono (D-HI), Jeanne Shaheen (D-NH), Peter Welch (D-VT), Chris Murphy (D-CT), Bob Menendez (D-NJ), Ben Ray Luján (D-NM), and Dianne Feinstein (D-CA). Companion legislation was introduced in the U.S. House of Representatives by Representative Debbie Dingell (D-MI-06).

Full text of the legislation is available here, and a summary of the legislation is available here.