Stethoscope sits on American currency

The Better Care Better Jobs Act, which would expand home- and community-based services, received a boost Thursday with the introduction of a companion bill that provides permanent funding to support HCBS programs.

Senate Special Committee on Aging Chairman Sen. Bob Casey (D-PA) announced the HCBS Access Act during a hearing in Washington on ways to increase the nation’s supply of direct care workers.

“[Better Care Better Jobs] is an investment to create a robust HCBS provider infrastructure for the recruitment and retention of workers,” Casey explained at the hearing. “The second bill establishes a permanent funding stream to keep the infrastructure strong and to make sure we’re able to continue to pay direct care professionals at a rate that ensures qualified, reliable services in a qualified reliable workforce into the future.” 

The introduction of the companion legislation drew immediate support from LeadingAge, which represents 5,000 nonprofit aging services providers.

“Substantial investments in the direct care workforce, such as those in the HCBS Access Act, are exactly what’s needed to begin to solve the current workforce crisis in aging services,” LeadingAge President and CEO Katie Smith Sloan said in a statement. “Rather than target one or two areas, this legislation rightly aims to spread workforce resources widely.”

Casey and Rep. Debbie Dingell (D-MI) reintroduced BCBJ in January. The bill would provide enhanced Medicaid funding to HCBS programs in an effort to get more than 650,000 off of wait lists for home caregivers. The $300 million piece of legislation is a scaled-down version of a similar bill introduced in 2021. 

Still, BCBJ and the new companion HCBS Access legislation could face headwinds in Congress. During Thursday’s hearing, ranking committee member Mike Braun (R-IN) cautioned that both bills could face intense scrutiny by Republicans trying to hold the line on spending as inflation continues to dog the U.S economy.

“Sometimes we do things here — even though well-intended — that might be counterproductive,” Braun said. “The federal government wants to rebalance spending on long-term services.” 

The United States faces a critical shortage of direct care workers. The home care workforce is projected to grow 46% by 2040, according to a report released Wednesday by Argentum. The report said the U.S. will need nearly 700,000 new home care workers and another 4.3 million workers to replace caregivers who are retiring or transitioning to other jobs.

Experts testifying at Thursday’s hearing called for better training programs, consistent credentialing and a national registry to help increase the size of the direct care workforce and make it easier for families to find caregivers.

Casey first introduced Better Care Better Jobs in June of 2021. Valued at $150 billion, it ultimately did not make it into the Inflation Reduction Act, which Congress passed.