Long-Term Care Workforce Support Act

Key Points

• The bill would boost Medicaid reimbursement to states by 10 percentage points for long-term care services provided by direct care workers, spanning fiscal years 2026 through 2035. States must use the extra federal funds to raise pay, improve benefits, and reduce waiting lists for home and community-based services.
• Congress would appropriate $100 billion in grants to states to strengthen and expand the direct care workforce, with funds distributed based on each state's share of total Medicaid enrollment. States must use the money to improve compensation, reduce waiting lists, and update Medicaid payment rates at least every two years.
• New labor protections would require employers to provide written agreements, at least 72 hours notice before schedule changes, guaranteed meal and rest breaks, and paid sick time of at least 1 hour for every 30 hours worked. Workers would also gain anti-retaliation protections and the right to request temporary schedule changes for personal events.
• A $5,000 annual tax credit would go to health care workers providing services in long-term care settings, including certified nursing assistants, home health aides, personal care aides, and other direct care professionals. The credit would apply to taxable years beginning after December 31, 2024.
• The bill creates multiple training, scholarship, and career pathway programs totaling hundreds of millions in annual spending, with a focus on rural areas and underserved communities. It also permanently extends the Money Follows the Person program at $500 million per year to help people transition from institutions to community-based care.
• A National Direct Care Professional Compensation Strategy and Advisory Council would be established to recommend how to calculate fair wages and ensure Medicaid and other public payers compensate workers at the full cost of their labor. The advisory council would include direct care professionals, disability advocates, and state officials.