Investment in the home care workforce is long overdue

The U.S. is in the midst of a caregiving crisis. Seniors and people with disabilities across the country struggle to find reliable home and community-based services to preserve their quality of life. Hundreds of thousands more linger on waiting lists. And, despite the importance of this critical care to so many American families, the caregivers who provide these services are paid, on average, $12 per hour for their work. It is far past time for a historic investment in these life-saving services and the people who provide them.

Recently, I visited the home of two of my constituents, Hillary Rothrock and Craig Benish, in Harrisburg, Pennsylvania. Craig has Duchenne muscular dystrophy and requires round-the-clock support, much of which is provided by his sister, Hillary, with the support of a small team of additional caregivers. Craig needs help with most facets of everyday life—to eat, drink, bathe, use the bathroom, move around his house and interact with neighbors and friends.

Craig’s caregivers are essential. But the approximately 2.4 million home care workers, the majority of whom are women, are only paid a median of $26,440 annually. Hillary and the other members of Craig’s caregiving team keep him alive, healthy and as independent as possible, yet Hillary had to take an additional part-time job to make enough money to support herself and her children. 

It’s not just caregivers that our current system leaves behind. Seniors and people with disabilities have made their desire to live in their own homes resoundingly clear. When asked, 90% of older adults and people with disabilities say they want to be at home. Currently, 820,000 people sit on waiting lists to receive home care across the country. This number does not account the estimated millions more who could use the services but are not currently on a waiting list, knowing they will have to wait behind thousands of other people. We cannot claim to be the greatest country in the world if we do not allow people to live and receive care where they want.

My bill, the Better Care Better Jobs Act, would invest in home care by expanding service use to 3.2 million more Americans as well as raising wages, improving benefits and making it possible for caregivers to join a union. To date, over 800 national and state organizations have voiced support for this legislation. This bill also makes financial sense; the average annual cost of home care is $26,000 per person, while congregate care costs $90,000 per year.

Under this proposal, states would be eligible for a permanent increase in the federal Medicaid match for delivering home care, including supports for family caregivers and ensuring those who are eligible receive personal care services, like those Craig receives. It would also provide support to workers by requiring states to evaluate and improve their Medicaid rates to ensure workers receive competitive wages and benefits. States that participate in the Better Care Better Jobs Act would also be required to demonstrate that workers are receiving adequate pay to continue to receive funds.

The Better Care Better Jobs Act would provide additional incentives to help states build home care workforce programs that register direct care workers, providing the support that caregivers need to access training. It would help workers organize, ensuring that caregivers can enjoy the support and resources of a union.

As I learned from my visit to Harrisburg, Craig Benish was not expected to live past his teenage years. Yet because of the high-quality care and support he has received from his sister and his other caregivers, he is 29 years old, lives in his home and is an active member of his community.

It’s simple—anyone who needs home care should be able to access it, and their caregivers should earn family-sustaining wages and receive quality benefits. This investment is long overdue.