Sec. 2. Findings and purposes
663 words·~3 min read·
/bill/119/hr/8541/ih/section-2·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Congress finds the following: The nearly 5,000,000 direct care professionals in the United States play a vital role in supporting the health, well-being, and independence of older individuals and people with disabilities. The United States faces a growing crisis in its direct care professional workforce at the same time that demand for services is rising at unprecedented rates. There will be an estimated 9,300,000 total direct care professional job openings from 2021 to 2031, including new jobs to support the growing number of people who need care and to fill the jobs of such professionals leaving the direct care professional workforce.
Workforce turnover and shortages have a direct impact on older individuals, people with disabilities, and their families who suffer because they cannot get the high-quality care that they need and deserve. The median hourly wage for all direct care professionals in 2022 was only $15.43, with home care workers earning the least. One in 8 direct care professionals live in poverty and three quarters earn less than the average living wage in their State. Forty-six percent of direct care professionals rely on public assistance, such as Medicaid, food and nutrition assistance, or cash assistance.
Direct care professionals report high levels of burnout and professional fatigue from their physically and emotionally demanding work, lack of respect for the essential, skilled care they provide, and lasting trauma from battling the COVID–19 pandemic, all of which further drives high turnover. The long-term care industry is struggling to hire and retain direct care professionals, with a national turnover rate between 77 to nearly 100 percent. Ninety-two percent of nursing home respondents and nearly 70 percent of assisted living facilities surveyed report significant or severe workforce shortages.
More than half of nursing homes surveyed in 2022 reported that they limited new patient admissions due to staffing shortages. A survey of State home and community-based services (referred to in this section as HCBS ) programs showed that every State reports a shortage of workers, and in 43 States, some HCBS providers have closed permanently. The low-quality of direct care professional jobs reflects and perpetuates the racial and gender inequities faced by direct care professionals, who are disproportionately women, immigrants, and people of color.
Efforts to support the direct care professional workforce have focused on specific care settings, even though these issues are widespread across the long-term care landscape and direct care professionals across settings face similar challenges of low wages, few benefits, limited training and support, worker exploitation, and a lack of meaningful career ladders. Stabilizing, growing, and supporting the direct care professional workforce across the continuum of long-term care is essential to ensuring a strong, qualified pipeline of workers, and improving the lives of direct care professionals and the older individuals, people with disabilities, and the families and communities that they support.
The purposes of this Act are as follows: To increase the capacity of the direct care professional workforce to ensure that older individuals, people with disabilities, and their families receive the services they need in the settings of their choice as they deserve to live healthy, independent lives. To increase compensation so that direct care professionals are paid a living wage and have access to essential job benefits, and so that direct care professional jobs are good jobs.
To ensure that direct care professionals are treated with respect, provided with a safe working environment, protected from exploitation, and fairly compensated for the skilled work they do. To improve access to and quality of long-term care, including collecting meaningful and actionable data on the direct care professional workforce and the people they support. To eliminate the race, gender, sexual orientation, age, and gender identity disparities that exist across the direct care professional workforce.
To strengthen the direct care professional workforce in order to support the 53,000,000 unpaid family caregivers who are often providing complex services and supports to their loved ones who are older individuals and people with disabilities in their homes, communities, and residential settings.