Summary of Recent Legislative Activity Surrounding Home Care Industry

Over the last few months, there has been a flurry of legislative activity surrounding home care. From newly introduced bills to Executive Orders to proposed rules from CMS, the attention of federal legislators and regulators is slowly shifting to the needs of our rapidly expanding older adult population. 

​Currently, HCAOA’s Policy Committee is carefully reviewing the new bills and proposals below and crafting comments, as appropriate. HCAOA has listed a brief synopsis of the new bills and initiatives that the association is reviewing below to keep members apprised.

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Senator Bob Casey (D-PA)

Better Care Better Jobs Act (S.100)– This Act is Designed to make a historic investment in home and community-based services older adults and people with disabilities by strengthening and expanding access to quality home care services.

• Introduced January 2023 by Senator Bob Casey, Wyden, Schumer, Murray, Duckworth, Hassan, and Brown
• Enhances Medicaid funding for home and community-based services
• Strengthens and expands the HCBS workforce
• States would receive a permanent 10 percent increase in Medicaid match funding for delivering Medicaid home and community-based services
• Increases funding to CMS to carry out the bill’s programs, provide oversight and monitoring and offer assistance to states
• Makes the Money Follows the Person Rebalancing Demonstration permanent

 
HCBS Access Act (S.762) – This bill is designed to bolster the Better Care Better Jobs Act.

• Introduced in March 2023 by Senators Casey, Hassan, Brown, Kaine, Gilligrand, Blumenthal, Welch, Fetterman, Merkley, Sanders, Baldwin, Duckworth, Warren, Reed, Markey, Shaheen, Murray
• Seeks to eliminate lengthy waiting lists for home care services
• Goal of increasing Medicaid funding for home and community-based services
• Provides grant funding for states to expand their capacity to meet needs of people who prefer HCBS
• Takes steps to improve the stability, availability, and quality of direct providers to help address the decades-long workforce shortage crisis
• Provide states with resources so that caregiving workers—who are disproportionately women of color—have stable, quality jobs and a living wage
• Provide training and support for family caregivers
• Create better evaluation measures to assess the quality of HCBS being provided

 
Supporting Our Direct Care Workforce and Family Caregivers Act (S.1298) – This bill strengthens the HCBS Access Act and increases funding and training for direct care workers and family caregivers.

• Introduced in April 2023 by Senators Kaine, Casey, Gillibrand, Hassan, Reed, Smith, Whitehouse and Wyden
• Awards grants to build, train, retain and promote the direct care workforce and both paid and unpaid family caregivers
• Develops a technical assistance center for grant awardees to support establishing career development and advancement strategies
• Explore national data gaps, workforce shortage areas, and data collection strategies
• Make recommendations for training and education curricula for direct care professionals and family caregivers
• Disseminates information and best practices from lessons learned through grants

 
Executive Order – The Biden-Harris Administration announced a comprehensive set of executive actions to improve care for families and support care workers and family caregivers on April 18, 2023. Actions include:

• Making long-term care more accessible and affordable for families, including military families,
• Improving access to home-based care for veterans,
• Enhance job quality for long-term care workers,
• Support family caregivers,
• Advance domestic workers’ rights, and
• Engage affected communities.

 
CMS’s newly proposed rules are designed to address access to and quality of care across Medicaid programs. The proposed rules were introduced on April 27, 2023. Read more about the rules and a summary here. 
 
HCAOA will continue to monitor these issues.

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