Biden's Executive Order to Support Care Workers & Family Caregivers
On Tuesday, President Biden Signed an executive order to expand access to affordable, high-quality care and provide support for care workers and family caregivers. This executive order, which includes more than 50 directives for agencies across the government, is the most comprehensive set of executive actions any President has ever taken to make care more affordable and accessible for hardworking families and further support care workers and family caregivers.
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 percent over the past 30 years. For the elderly or people with disabilities long-term care costs are up 40% in the past decade. The result is many Americans – particularly women – stay out of the workforce to care for their families, making it hard for businesses to attract and retain a skilled workforce and for the economy to grow.
“AARP applauds today’s Executive Order recognizing the need to make family caregivers a national priority to meet the rapidly growing needs of families across America. Family caregivers are the indispensable backbone of our health and long-term care system, help their loved ones live at home, and they are exhausted. […] This is a nonpartisan issue that affects us all, but it does not get nearly the recognition or support it deserves. Family caregivers are an essential but often invisible part of almost any care team, who are often in desperate need of more support"
— AARP Executive Vice President and Chief Advocacy and Engagement Officer Nancy LeaMond.
"…the most comprehensive set of executive actions any President has ever taken to make care more affordable and accessible for hard-working families while supporting care workers and family caregivers. The Executive Order will make care more affordable, enhance job quality for care workers, provide greater support for family caregivers, and advance domestic workers’ rights.”
— National Domestic Workers Alliance Executive Director Jenn Stowe.
Specifically, the Executive Order will:
- Improve access to home-based care for veterans. To meet our sacred obligation to our veterans and their families, the Executive Order directs the Department of Veterans Affairs (VA) to improve access to home-based care for veterans who require support with activities of daily living, like bathing and getting dressed, by giving them more decision-making power over who delivers that care and when. VA is directed to consider expanding its Veteran Directed Care program to all 172 VA Medical Centers by the end of Fiscal Year 2024. This program provides veterans with a budget to hire personal care assistance including from family members. VA will also consider piloting a new self-directed care program in no fewer than 5 new sites that provides veterans with a budget for personal care assistance while reducing administration burdens related to managing care. Further, VA will consider adding 75 new interdisciplinary teams to its Home-Based Primary Care program to serve an additional 5,600 veterans in their homes.
- Boost job quality for early educators. Early care and education professionals are among the lowest-paid workers in the country. Child care workers earn a median wage of less than $18 an hour, while the typical nonsupervisory worker in the U.S. earns over $28 an hour. While the average salary of a public preschool teacher and kindergarten teacher is about $49,000 and $60,000, respectively, the average annual salary for Head Start and preschool teachers is about $35,000. To address this, HHS will take steps to increase the pay and benefits for Head Start teachers and staff. HHS will implement policies so that more child care providers benefiting from CCDBG receive higher reimbursements for the children they serve. Additionally, the Department of Education (ED) will encourage grantees of the Child Care Access Means Parents in School (CCAMPIS) program—which supports thousands of student-parents across the country pay for care while going to school—to improve the quality of the services they provide, including higher wages for child care workers.
- Enhance job quality for long-term care workers. The President is committed to improving the quality of long-term care jobs in this country so that Americans can get the reliable, high-quality care they deserve—whether it is in their homes and communities or in nursing homes. To advance the President’s long-term care priorities, the Executive Order directs HHS to consider issuing several regulations and guidance documents to improve the quality of home care jobs, including by leveraging Medicaid funding to ensure there are enough home care workers to provide care to seniors and people with disabilities enrolled in Medicaid, as well as build on the minimum staffing standards for nursing homes and condition a portion of Medicare payments on how well a nursing home retains workers.
- Support family caregivers. Without adequate resources, family caregiving can affect caregivers’ physical and emotional health and well-being and contribute to financial strain. These negative consequences are felt most acutely by women, who make up nearly two-thirds of family caregivers and who drop out of the workforce at higher rates than men. To provide greater support to family caregivers, the Executive Order directs HHS to consider testing a new dementia care model that will include support for respite care (short-term help to give a primary family caregiver a break) and make it easier for family caregivers to access Medicare beneficiary information and provide more support to family caregivers during the hospital discharge planning process. Additionally, VA will consider expanding access to the Program of Comprehensive Assistance for Family Caregivers and provide more mental health support for caregivers enrolled in that program. These actions build on the 2022 National Strategy to Support Caregivers.
- Advance domestic workers’ rights. Care workers should be supported, valued, and fairly compensated, and care workers should have the free and fair choice to join a union. In particular, domestic workers providing care for our loved ones are often underpaid and subject to discrimination and abuse. To provide greater protection for these workers, the Department of Labor will publish a sample employment agreement so domestic child care and long-term care workers and their employers can ensure both parties better understand their rights and responsibilities.