At Hearing, Warren Calls for Passing Historic Investments in Home and Community-Based Care
Treating Home Care Workers with Dignity and Providing Them with Living Wages and Real Benefits Will Increase Access to Care for Adults and People with Disabilities
Washington, D.C. – At a hearing of the Senate Special Committee on Aging, United States Senator Elizabeth Warren (D-Mass.) called for historic investments in home and community-based care to expand access to services and ensure that home care workers can earn a living wage, enjoy real benefits, and can form and join a union. Despite providing essential support for adults, people with disabilities, and their loved ones, home care workers are three times more likely to live in poverty than other workers. Senator Warren argued that home-based care is essential infrastructure for families. By making these investments, Congress can ensure more people have access to the care they need in the setting of their choice and live with dignity.
The chronic underfunding of home-based care has left hundreds of thousands of adults and people with disabilities on waitlists for care. The lack of investment has also forced family members to take leave from work to provide uncompensated care for their loved ones and created a low wage environment with minimal benefits that put many home care workers in poverty. Home care workers – who are more likely to be women and people of color – earn a median wage of $12 per hour and often lack employer-sponsored benefits like health care and paid leave.
Senator Warren called for Congress to make significant investments in home and community-based care, including strengthening and expanding the home care workforce. She has advocated for these investments throughout the nation’s COVID-19 recovery and amidst the Biden administration’s efforts to pass historic investments in American jobs and families:
- In June 2021, Senator Warren co-sponsored the Better Care Better Jobs Act, which would invest $400 billion over 10 years to expand home and community-based services.
- In March 2021, during a hearing of the Special Committee on Aging, Senator Warren called for making home and community-based care a mandatory benefit in Medicaid and expanding Medicare to cover more at-home, long-term care services.
- In July 2020, Senator Warren and Senator Bob Casey (D-Pa.) sent a letter to then-Majority Leader Mitch McConell (R-Ky.), urging him to include key provisions related to Medicaid home and community-based services in any future COVID-19 relief package.
- In April 2020, Senator Warren and Senators Casey, Kirsten Gillibrand (D-N.Y.), Sherrod Brown (D-Ohio), Maggie Hassan (D-N.H.), and Tammy Duckworth (D-Ill.) sent a letter to Senate and House leadership, calling on them to provide at least $50 billion in additional funding for Medicaid home and community-based services in the next COVID-19 relief package.
Transcript: An Economy That Cares: The Importance of Home-Based
Services
U.S. Senate Special Committee on Aging
Wednesday, March 23, 2022
Senator Elizabeth Warren: Thank you, Mr. Chairman, and thank you for holding this hearing, and your steadfast advocacy on this. You know, we know that the majority of adults and people with disabilities want to live at home. We also know that chronic underfunding of home-based services has taken this option off the table for many, and it’s left hundreds of thousands of people on waitlists all across this country.
The failure to invest in home-based services not only harms people who need care, it also harms the workers who deliver it. Home care workers – who are more likely to be women and people of color – earn a median wage of just $12 an hour, and they are three times as likely to be in poverty compared to other workers, and they are less likely to have employer-sponsored benefits like health care and paid leave.
The COVID-19 pandemic has made these challenges even worse, as caregivers have delivered essential services in jobs where social distancing was nearly impossible and personal protective equipment was alarmingly scarce.
Ms. Weidner, you’ve shared that as recently as last year you were earning $12 an hour as a home care worker. Can I ask you to say a word about how that has affected your financial security?
Lynn Weidner, Home Care Worker, United Homecare Workers of Pennsylvania - SEIU Healthcare PA: Yes, thank you. So the low wages in home care have been really difficult. I, it usually means I need to work more than one job to make my ends, to make ends meet.
I’m working more than 80 hours a week, I don’t have days off. I get paid 8 hours a day but I really provide 24 hour care. And a lot of that means that I end up in a lot of debt. A lot of it is medical debt, but there is others as well.
And it’s nearly impossible to climb out of that debt when you’re living paycheck-to-paycheck. It’s emotionally and physically taxing, and then having that financial storm looming over you just makes it that much harder to get in the correct headspace to complete my job the way I want to.
Senator Warren: Wow, well I very much appreciate your sharing that.
You know, under these conditions, it’s no surprise that states are reporting a shortage of dedicated home care workers. And despite the growing demand for home-based care, the turnover rate in direct care jobs is as high as 60 percent.
Ms. Shaheed, you’ve spoken about the shortage of home care workers where you live. How has this affected your ability to get the care that you care you need?
Alene Shaheed, Home Care Recipient and Former Florida Health Justice Project Client: Senator Warren, thank you. You’re asking, how has the shortage affected me?
Senator Warren: Uh huh.
Ms. Shaheed: It, the shortage greatly, because I’m unable to access, without the home health aid coming into my home and assisting me with my daily living, my world comes to, it slows down where I’m not able to access outside of my front door, because I’m totally dependent on them to do things for me that I am now unable to do for myself.
So the shortage, my quality of life goes downhill when I don’t have the home health aid coming in to the home to assist me with those things that I need to do in order to be living independent. The shortages have just, my, things are not well, because of the shortage of workers. And there is a shortage of workers because there is low pay.
Senator Warren: Yeah.
Ms. Shaheed: And until that is resolved, we’re gonna continue, this will, you know, it just continues.
Senator Warren: Yeah. I appreciate your underscoring this. And I think Mr. Kingsmore said earlier that if he couldn’t get access to home-based care, then he would be forced to live in a nursing home, or he would be back at home without the quality of life that he has now.
You know, I worry about the fact that too many people are forced into nursing homes or other congregate care facilities because they can’t access the care they need at home. And the pandemic has made clear just how devastating the consequences of those decisions can be: as of January, 23 percent of all COVID-19 deaths in the United States happened in long-term care facilities.
So, right now, Congress is considering legislation that would make an historic investment in home and community-based care to ensure more people can access these services. And that starts with treating home care workers like the essential workers that they are – by paying home care workers a living wage, by providing them with good benefits, by ensuring they have the right to join a union.
Ms. Weidner, I know we’re running out of time here, but can I just ask you, just to say a word about what would those investments mean for you and the people around you?
Ms. Weidner: Yeah, absolutely. I mean, investing, an increase in funding in home care would change absolutely everything, honestly. Having access to a living wage and benefits, I don’t know what a day off is. Health insurance is incredibly expensive for me on the marketplace right now. And most home care workers can’t even afford it. So we’re health care workers who go without health care.
And it would mean turning home care jobs into a professional health care career. That means that we would increase the workforce. People would be able to stay in their jobs. And that means that people would be receiving care, the care that they need, and they care that they want.
Families, families need this investment and care workers need this investment as well.
Senator Warren: Well, you put this very well and thank you very much for that summation of what’s going on here. You know, home-based care is essential infrastructure for families. These investments will provide necessary financial security for home care workers, they ensure more adults and people with disabilities live in dignity in the setting of their choice, and they would also allow unpaid caregivers – who have taken leave from their jobs to care for a loved one – to be compensated for their work or to return to the workplace, if that’s what they want to do.
As our population ages, demand for home-based care is only going to increase – so the time to act is now. I am ready to join you, Mr. Chairman, in getting this done. Thank you.
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