Better Care Better Jobs Act*

Proposal Overview

Name: Better Care Better Jobs Act* 

Congress: 118th

Year: 2023

Sponsor:

Senator Robert Casey (D-PA) 

Co-Sponsors:

41 Democratic cosponsors 

Program Details

Overview: This bill creates new programs and funding for state Medicaid programs to improve access to home and community-based services (HCBS) and to support the direct care workforce. The bill is included in the Compendium of Federal Long-Term Services and supports (LTSS) Financing Policy Options. This analysis focuses on the bill’s family caregiving provisions. 

The bill provides HCBS planning grants to states. States must describe: 1) the current Medicaid HCBS landscape; 2) how they will use findings from experience of care surveys from family caregivers to improve quality of HCBS services to family caregivers; 3) how they will use the funds to improve HCBS services; and 4) how they will include input from family caregivers in their plans.

The proposal increases the FMAP for HCBS programs to 80% for qualifying states. States must provide supports to family caregivers, including respite; adopt qualification standards and training programs for caregivers; and update payment rates based on family caregiver feedback. Family caregiver support programs may also include caregiver assessments, peer supports, and paid family caregiving.  

The proposal encourages self-directed service models including family caregivers that might be hired as direct care workers. 

The Secretary of the Department of Health and Human Services (HHS) will report to Congress, including making recommendations to guide HCBS infrastructure improvement as informed by family caregivers.

The Secretary of HHS will develop core HCBS quality measures informed by family caregivers.  

Financing & Implementation

Program Administration

Centers for Medicare and Medicaid Services and state Medicaid programs 

Not specified 

Not specified

Not specified

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