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Summary of Executive Actions to Improve Care

Summary of Executive Actions to Improve Care


Earlier this year, President Biden announced and signed an executive order that includes 50-plus administrative directives designed to increase access to quality child care and long-term care, and to better support family caregivers.


$150 billion to expand Medicaid home care services


The President’s budget includes $150 billion over the next decade to improve and expand Medicaid home care services. This would make it easier for seniors and people with disabilities to live, work, and participate in their communities. This funding would improve the quality of jobs for home care workers and support family caregivers. The Biden Administration is also promoting the use of apprenticeship programs and partnering with employers, unions, and others to recruit, train, and keep long-term care workers on the job while also helping them advance their careers as registered and licensed nurses.


Long-term care costs are up 40% in the past decade. If we’re going to meet these challenges, we need to build up our home care worker pipeline and enhance their job quality.

H-CAP works to build the equitable caregiving infrastructure our nation needs by working to raise job quality and breaking down occupational segregation within long-term care. To learn about H-CAP’s registered apprenticeship opportunities, click here.

The past informing the present


In 2018, the International Labor Organization reported that the 16 billion hours spent on unpaid care every day would represent nearly a tenth of the world’s entire economic output if it was paid at a fair rate – and even paid workers are severely underpaid, undervalued, and underrepresented.


What’s happening now


Of the 50+ directives to cabinet-level agencies the order contains, here are a few highlights that directly affect the healthcare industry:

  • Enhance job quality for long-term care workers. Americans need long-term care jobs to serve them throughout their lives. President Biden seeks to improve these jobs by directing the Department of Health and Human Services (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.

  • 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.

  • 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. 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.


From home care workers to nursing home workers, women and especially women of color in our industry are underpaid, undervalued, and overworked. These encouraging measures can serve as a start for more critical reforms to find, recruit and retain more caregivers through effective models like Labor-Management Training Partnerships.




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