HCAOA Drafting Comments to Voice Concerns about Better Care Better Jobs Act

​Following a discussion last week with the association’s Legislative and Policy and Regulatory committees HCAOA is preparing comments to submit to the sponsors of the new Better Care Better Jobs Act proposal to voice several major concerns. 

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“While HCAOA recognizes and appreciates the increased access to home care the Better Care Better Jobs Act will provide across the country, we do have a few concerns about the legislation in regards to forced unionization, privacy concerns, and more” stated HCAOA Executive Director, Vicki Hoak. 

Areas of Concern
Forced Unionization: The Better Care Better Jobs Act would essentially force unionization of the HCBS workforce by requiring employers to stay “neutral with regard to such workers joining or forming such a labor organization.” HCAOA believes that providers of home care services have the right to voice an opinion on whether unionization is a positive or negative outcome for its workforce.

Emphasis on Non-Profit Providers: The bill allows for states to receive an additional two percentage point FMAP increase for HCBS for one year if they establish certain models for the delivery of self-directed care. States could establish these programs either directly or by contracting with non-profit entities, which would exclude all HCAOA members who are the primary providers of home care in the U.S. 

Direct Care Worker Privacy Concerns: This legislation encourages registration of direct care workers which HCAOA maintains is for unionization purposes and is a violation of the worker’s privacy. 

Emphasis on Independent Contractors: The bill encourages independent contractors to provide HCBS to the aged and disabled. HCAOA has long held that this creates a misclassification of workers, which the Biden Administration opposes. In the role of caring for vulnerable populations, HCAOA feels strongly that home care workers must be supervised, training and have a background check. We believe the employer model is the best way to ensure high-quality care.