US: Joe Biden outlines $400B plan to expand home and community-based care and improve workers’ wages

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The US President wants to improve access to long-term care at home for older Americans and increase wages for home care workers – a shift in policy that could further damage occupancy in nursing homes and skilled nursing facilities across the country.

The $400 billion funding – announced as part of a wider $2 trillion infrastructure plan titled ‘The American Jobs Plan’ – would deliver funding over eight years to improve access to long-term care under the country’s Medicaid, the public health insurance program for people with limited income and resources, and also increase wages for home care workers.

The plan would tackle the long waiting lists to access home or community-based care – currently around 820,000 people in the US – and low wages for workers, who are paid an average of US$12.15 (AUD$15.86) per hour, or US$25,280 (AUD$32,997) per year.

Medicaid’s Money Follows the Person (MFP) program – which has helped over 101,000 people move out of institutional care since 2008 – would be extended, and home care workers’ power to bargain collectively expanded.

“These investments will help hundreds of thousands of Americans finally obtain the long-term services and support they need, while creating new jobs and offering caregiving workers a long-overdue raise, stronger benefits, and an opportunity to organise or join a union and collectively bargain,” the White House said in a statement.

The pledge follows an earlier $775 billion plan to overhaul home care, announced by Biden in July 2020 during the lead-up to the US election, with a focus on home care workers.

But with nursing home occupancy at record lows of 75% in the last quarter of 2020, according to research group National Investment Center for Seniors Housing & Care, the plan could see more residential care operators go to the wall.