WASHINGTON—U.S. Sen. Bob Casey (D-PA), chairman of the U.S. Senate Special Committee on Aging, and U.S. Rep. Debbie Dingell (D-MI-6) have introducing legislation to expand access to home- and community-based services (HCBS) for older adults, people with disabilities and injured workers, while increasing pay and improving benefits for in-home caregivers. 

The Better Care Better Jobs Act would enhance Medicaid funding for homecare and help move some of the 650,000 people on HCBS waiting lists nationally receive care in the setting of their choice, Casey's office said in a news release. 

"This legislation would also strengthen the caregiving workforce, improve quality of life for families and boost the economy by creating good-paying jobs to make it possible for families and workers alike to thrive economically," the release said. 

“The United States is in the midst of a caregiving crisis. Across this nation, seniors and people with disabilities are struggling to find and afford care, forcing families to make difficult decisions like leaving the workforce in order to care for a loved one," Casey added. "The Better Care Better Jobs Act is a generational investment in homecare—it’s about both caring for our loved ones and making the smart economic choice for families and communities across all levels of the government to strengthen this workforce. This is not a Democrat or Republican issue. It’s an American issue.” 

According to a fact sheet provided by Casey's office, the legislation would: 

  • Make states eligible for a permanent 10-percentage-point increase in the federal Medicaid match for delivering HCBS as well as enhanced funding for administrative activities associated with improvement efforts.
  • Provide additional incentives to help states build HCBS workforce programs that register direct care workers, help them organize and facilitate care coordinate. 
  • Fund the Centers for Medicare & Medicaid Services (CMS) to carry out the bill’s programs and require all state Medicaid programs to adopt HCBS quality measures.
  • Provide funding for states to develop HCBS infrastructure improvement plans with public input.
  • Permanently authorize protections against impoverishment for individuals whose spouses are receiving Medicaid HCBS.
  • Make the Money Follows the Person Rebalancing Demonstration permanent.

The Better Care Better Jobs Act would increase payment rates to promote recruitment and retention of direct care workers, increase wages, and develop and update training opportunities. 

“More than 50% of Americans 50 or older serve as a caregiver, and family caregivers need relief. As many know, this is deeply personal for me—I was lucky to have my husband John receive care at home, which showed me the significant fractures in this system, from low wages for workers to thousands on HCBS waitlists to so many people not knowing how to get the care they desperately need," Dingell said. "Aging Americans and individuals with disabilities overwhelmingly prefer to receive care in the comfort of their homes and within their communities. Better Care Better Jobs moves us closer toward ensuring that no one must wait to get the care they deserve."