Elderly would receive more care, remain in community with bill backed by Hirono

Hawai’i’s U.S. Sen. Mazie K. Hirono joined colleagues in introducing a bill that would expand access to longterm care, enabling older adults and people with disabilities to receive quality care while remaining in their communities. 

The Better Care Better Jobs Act would enhance Medicare funding for home care, helping many of the 650,000-plus people on waiting lists nationally receive care in the setting of their choice, according to a news release.

Millions rely on Medicaid home and community-based services and hundreds of thousands are still waiting to receive the support they need, Hirono said in the news release. 

“By expanding HCBS services, this bill will enable more people in Hawaii and across the country to access the care they need in home and community-based settings,” she said. “In Hawaii, the Better Care Better Jobs Act would create almost 1,500 new home care jobs, raise wages for care workers, and make it possible for over 3,000 family caregivers to return to the workforce.”

The legislation, led by Sen. Bob Casey (D-PA), would also strengthen the caregiving workforce, improve quality of life for families and boost the economy by creating good-paying jobs.

The COVID-19 pandemic highlighted the need to ensure that all Americans have the option to receive quality, long-term care in the setting that meets their needs and preferences, and the vast majority of Americans prefer to receive such care and support at home, the release said.

While all states provide coverage for some home care services, there are significant variations and gaps in coverage due to varying eligibility and benefits standards. 

The home care workforce — a majority of whom are women and people of color—earn a median wage of $13 per hour with few or no benefits while providing life-sustaining care. Roughly 18% of these workers live in poverty. This results in exceptionally high annual turnover rates, estimated to be above 60%.

The Better Care Better Jobs Act would increase payment rates to promote recruitment and retention of direct care workers, increase wages, and develop and update training opportunities. The legislation would provide support to the Centers for Medicare & Medicaid Services to conduct oversight and encourage innovation to benefit direct care workers and care recipients.