Tag Archives: Care Economy

Biden Administration, Health Care, News & Photo Features

Fact Sheet: Vice President Harris Announces Historic Advancements in Long-Term Care to Support the Care Economy

These advancements in long-term care to support the care economy are the latest the Biden-Harris Administration has taken to improve safety, provide support for care workers and family caregivers, and to expand access to affordable, high-quality care. This fact sheet is provided by the White House:

Vice President Harris is announcing two landmark final rules that fulfill the President’s commitment to safety in care, improving access to long-term care and the quality of caregiving jobs. © Karen Rubin/news-photos-features.com

Everyone deserves to be treated with dignity and respect and to have access to quality care. That’s why, today, Vice President Harris is announcing two landmark final rules that fulfill the President’s commitment to safety in care, improving access to long-term care and the quality of caregiving jobs. Ensuring that all Americans, including older Americans and people with disabilities, have access to care – including home-based care – that is safe, reliable, and of high quality is an important part of the President’s agenda and a part of the President’s broader commitment to care. Today’s announcements deliver on the President’s promise in the State of the Union to crack down on nursing homes that endanger resident safety as well as his historic Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, which included the most comprehensive set of executive actions any President has taken to improve care for millions of seniors and people with disabilities while supporting care workers and family caregivers.


Cracking Down on Inadequate Nursing Home Care


Medicare and Medicaid pay billions of dollars per year to ensure that 1.2 million Americans that receive care in nursing homes are cared for, yet too many nursing homes chronically understaff their facilities, leading to sub-standard or unsafe care. When facilities are understaffed, residents may go without basic necessities like baths, trips to the bathroom, and meals – and it is less safe when residents have a medical emergency. Understaffing can also have a disproportionate impact on women and people of color who make up a large proportion of the nursing home workforce because, without sufficient support, these dedicated workers can’t provide the care they know the residents deserve. In his 2022 State of the Union address, President Biden pledged that he would “protect seniors’ lives and life savings by cracking down on nursing homes that commit fraud, endanger patient safety, or prescribe drugs they don’t need.”

The Nursing Home Minimum Staffing Rule finalized today will require all nursing homes that receive federal funding through Medicare and Medicaid to have 3.48 hours per resident per day of total staffing, including a defined number from both registered nurses (0.55 hours per resident per day) and nurse aides (2.45 per resident per day). This means a facility with 100 residents would need at least two or three RNs and at least ten or eleven nurse aides as well as two additional nurse staff (which could be registered nurses, licensed professional nurses, or nurse aides) per shift to meet the minimum staffing standards. Many facilities would need to staff at a higher level based on their residents’ needs. It will also require facilities to have a registered nurse onsite 24 hours a day, seven days a week, to provide skilled nursing care, which will further improve nursing home safety. Adequate staffing is proven to be one of the measures most strongly associated with safety and good care outcomes.

To make sure nursing homes have the time they need to hire necessary staff, the requirements of this rule will be introduced in phases, with longer timeframes for rural communities. Limited, temporary exemptions will be available for both the 24/7 registered nurse requirement and the underlying staffing standards for nursing homes in workforce shortage areas that demonstrate a good faith effort to hire.

Strong transparency measures will ensure nursing home residents and their families are aware when a nursing home is using an exemption.

This rule will not only benefit residents and their families, it will also ensure that workers aren’t stretched too thin by having inadequate staff on site, which is currently a common reason for worker burnout and turnover. Workers who are on the frontlines interacting with residents and understanding their needs will also be given a voice in developing staffing plans for nursing homes. The Biden-Harris Administration also continues to invest in expanding the pipeline of nursing workers and other care workers, who are so essential to our economy, including through funding from the U.S. Department of Health and Human Services.


Improving Access to Home Care and the Quality of Home Care Jobs


Over seven million seniors and people with disabilities, alongside their families, rely on home and community-based services to provide for long-term care needs in their own homes and communities. This critical care is provided by a dedicated home care workforce, made up disproportionately by women of color, that often struggles to make ends meet due to low wages and few benefits. At the same time, home care is still very inaccessible for many Medicaid enrollees, with more than threequarters of home care providers not accepting new clients, leaving hundreds of thousands of older Americans and Americans with disabilities on waiting lists or struggling to afford the care they need.

The “Ensuring Access to Medicaid Services” final rule, finalized today, will help improve access to home care services as well as improve the quality caregiving jobs through its new provisions for home care. Specifically, the rule will ensure adequate compensation for home care workers by requiring that at least 80 percent of Medicaid payments for home care services go to workers’ wages. This policy would also allow states to take into account the unique experiences that small home care providers and providers in rural areas face while ensuring their employees receive their fair share of Medicaid payments and continued training as well as the delivery of quality care. Higher wages will likely reduce turnover, leading to higher quality of care for older adults and people with disabilities across the nation, as studies have shown. States will also be required to be more transparent in how much they pay for home care services and how they set those rates, increasing the accountability for home care providers. Finally, states will have to create a home care rate-setting advisory group made up of beneficiaries, home care workers and other key stakeholders to advise and consult on provider payment rates and direct compensation for direct care workers.


Strong Record on Improving Access to Care and Supporting Caregivers


Today’s new final rules are in addition to an already impressive track record on delivering on the President’s Executive Order on Care. Over the last year, the Biden-Harris Administration has:

  • Increased pay for care workers, including by proposing a rule to gradually increase pay for Head Start teachers by about $10,000, to reach parity with the salaries of public preschool teachers.
  • Cut child care costs for low-income families by finalizing a rule that will reduce or eliminate copayments for more than 100,000 working families, and lowering the cost of care for lower earning service members, thereby reducing the cost of child care for nearly two-thirds of children receiving care on military bases. Military families earning $45,000 would see a 34% decrease in the amount they pay for child care.

Supported family caregivers by making it easier for family caregivers to access Medicare beneficiary information and provide more support as they prepare for their loved ones to be discharged from the hospital. The Administration has also expanded access to mental health services for tens of thousands of family caregivers who are helping veterans

Biden Administration, Health Care, Joe Biden

FACT SHEET: Biden-Harris Administration Highlights Substantial Progress on the President’s Care Agenda During Month of Action on Care

President Biden was laid out how he is building a Care Economy on transformational investments in child care, home care, paid family and medical leave, tax cuts for workers and families, and other priorities, which are fully paid for by making the wealthy and big corporations pay their fair share in taxes. © Karen Rubin/news-photos-features.com

This fact sheet on the progress the Biden-Harris Administration has made on the President’s Care Agenda during this proclaimed Month of Action on Care and the comparison to the Republican agenda is from the White House:

During Care Workers Recognition Month, the Biden-Harris Administration is marking the progress we have made to make care more affordable for American families, support family caregivers, boost compensation and job quality for care workers, and expand care options. President Biden was joined by care workers and unions as he laid out how he is building on that progress with transformational investments in child care, home care, paid family and medical leave, tax cuts for workers and families, and other priorities, which are fully paid for by making the wealthy and big corporations pay their fair share in taxes. That is in sharp contrast with congressional Republicans, who would make devastating cuts to funding for care, healthcare, Social Security, and Medicare to pay for massive tax cuts for billionaires and big corporations.
 
The Need to Improve Care
 
Too many families and individuals struggle to access the affordable, high-quality care they need. The cost of child care is up 26% in the last decade and more than 200% over the past 30 years. For older adults and people with disabilities, long-term care costs are up 40% over the past decade. As a result, the cost of care is out of reach for many Americans. At the same time, care workers—who are disproportionately women of color—struggle to make ends meet, even as they care for others. Due to the low pay and the demanding nature of care work, turnover rates are high. In addition, at least 53 million Americans serve as family caregivers—including over 5 million caring for service members or veterans—and many face challenges due to the lack of support, training, and respite.
 
The President’s Plan to Lower Costs for Families for Care
 
The President has made child care, long-term care, family caregiving, and paid leave a core part of his domestic and economic agendas. He has referenced these issues in each of his State of the Union Addresses, and proposed transformative investments in each budget. The President’s most recent budget proposes the following:
 
Affordable, High-Quality Child Care and Universal Preschool
 
High-quality early childhood education improves the lives of both children and their parents. The President’s child care plan provides a lifeline to the parents of more than 16 million children by guaranteeing affordable, high-quality child care from birth until kindergarten for low- and middle-income working families. Right now, the average price of child care is nearly $11,000 a year, with low-income families paying as much as a third of their income for child care. Under the President’s plan, most families would pay $10 per day, saving the average family over $600 per child, per month. The budget also invests in free, voluntary, universal preschool for all of the nation’s 4-year-olds and charts a path to expand preschool to 3-year-olds. Together, these investments will make early care and education programs affordable and available where families live and work in communities across the country, increase wages for early childhood education workers, and strengthen the economy.
 
Child Tax Credit
 
The President’s Budget would restore the expanded Child Tax Credit, lifting 3 million children out of poverty and cutting taxes by an average of $2,600 for 39 million low- and middle-income families that include 66 million children. This includes 18 million children in low-income families who would be newly eligible for the full credit, and 2 million children living with a caregiver who is at least 60 years old. It would also provide breathing room for day-to-day expenses by allowing families to receive their tax credit through monthly payments.
 
Long-term Care and Family Caregiving
 
The President is committed to protecting older adults’ and people with disabilities’ health and dignity. His plan would invest in expanding Medicaid home and community-based services to help a larger number of older adults and people with disabilities receive care in their home or community, and promote better opportunities for home care workers and family caregivers. There has been substantial growth amongst the younger population under 65 with disabilities living in nursing homes. The percentage of individuals younger than 65 living in residential nursing facilities grew from 10.6 in 2000 to 16.2 in 2017. The President’s investments will help ensure that they can receive care in their own homes and communities. The President has also proposed substantial investments for family caregivers serving our nation’s heroes, including stipends and support services for family caregivers of eligible veterans.
 
A National Paid Family and Medical Leave Program
 
Many workers with caregiving responsibilities are forced to leave the workforce intermittently or permanently to take care of their loved ones. As of March 2022, only 24% of private sector workers in the United States had access to paid family leave through their employer and only 43% had access to short-term disability insurance through their employer. The President proposes a national, comprehensive paid family and medical leave program, administered by the Social Security Administration (SSA) to ensure that all workers can take time off to care for and bond with a new child; care for a seriously ill loved one; heal from their own serious illness; address circumstances arising from a loved one’s military deployment; or find safety from domestic violence, sexual assault, or stalking; or grieve the death of a loved one.  The vast majority of America’s workers do not have access to employer-provided paid family leave, including 73 percent of private sector workers. Among the lowest-paid workers, who are disproportionately women and workers of color, 94 percent lack access to paid family leave through their employers. Some people’s caregiving responsibilities are so demanding that under the current system they have to give up paid work entirely or retire early to take care of their loved ones.
 
The Biden-Harris Administration’s Historic Actions on Care
 
Since day one of the Administration, President Biden and Vice President Harris have been committed to improving the quality of and access to care while supporting care workers and family caregivers. The President’s American Rescue Plan (ARP) provided an historic $39 billion in child care relief funds to provide relief for child care providers and support for families to afford care. The ARP delivered $37 billion across all 50 states for activities and investments that enhance, expand, and strengthen home and community-based services and $145 million to help the National Family Caregiver Support Program deliver counseling, training, and short-term relief to family and other informal care providers. Moreover, over the past three years, the President has secured close to a 50% increase in federal child care assistance and a $1.5 billion increase in funding for Head Start. And in April 2023, President Biden signed an Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers (Care EO) surrounded by people with disabilities, family caregivers, long-term care workers, early educators, veterans, and aging advocates. The EO was celebrated by leaders from across the country. Over the past year, agencies have made substantial progress implementing the Care EO. For example:  
 

  • The Department of Health and Human Services (HHS), through the Administration for Children & Families (ACF), finalized a rule that will reduce the cost of child care for more than 100,000 low-income working families and make sure that more than 140,000 child care providers are paid more fairly and on-time. It also proposed a rule that would boost Head Start teacher wages by $10,000, on average.
    • For child care providers serving families benefiting from federal child care assistance, HHS, through ACF, adopted a pay floor that will increase child care payments for nearly 47,000 center- and home-based child care providers.
    • HHS, through the Centers for Medicare and Medicaid Services, proposed rules to ensure that home care workers get a bigger share of Medicaid payments; and establish minimum staffing standards in nursing homes receiving Medicare and Medicaid funding.
    • The Department of Defense reduced the amounts that lower-earning Service members pay out of pocket for child care, lowering child care costs for the families of more than 32,000 children aged 0-12 enrolled in installation Child Development Programs. Military Families earning $45,000 would see a 34% decrease in the amount they pay for child care. This also builds on the President’s Executive Order to advance the economic security of military spouses, veterans, caregivers and survivors.
    • The Department of Veterans Affairs launched a pilot program, known as the Virtual Psychotherapy Program for Caregivers, to provide mental health counseling services to family caregivers caring for our nation’s heroes. The program successfully completed its pilot phase and is now a permanent program. Since October 2023, the program has provided over 4,937 psychotherapy sessions to family caregivers.

 
In addition to these actions, federal agencies have taken dozens of others over the past year to improve family caregiving, long-term care, and child care. A full list can be found here.
 
Republican Officials Want to Provide Massive Taxes to the Rich while Making Devastating Cuts to Programs Working Families Count On
 
President Biden is building our economy from the middle out and bottom up—an economy where we invest in all Americans to make sure the middle class has a fair shot and no one gets left behind.
 
House Republicans have a very different economic vision. Under the RSC budget, care would be on the cutting block. Their budget proposal translates to 264,600 fewer child care slots and 253,500 fewer high-quality Head Start slots. These investments are critical to giving children a strong start and making sure that families have the help they need to thrive.
 
Along with damaging cuts to care funding, House Republicans would slash Social Security, Medicare, Medicaid, the Affordable Care Act, the Children’s Health Insurance Program, and other supports that working families count on. House Republicans would make these devastating cuts to pay for another $5.5 trillion in tax cuts skewed to the wealthy and big corporations. Their budget would deliver windfall tax cuts to billionaires and their heirs, eliminate the minimum tax on billion-dollar corporations President Biden signed into law, make it easier for the wealthy and corporations to cheat on their taxes, and preserve policies that encourage corporations to move jobs and profits offshore—all while making it more difficult for families to afford child care and education.