Sen. Casey’s Workforce Bill Aims To Provide $320B, Seen as Funding Mechanism for Nursing Home Staffing Rule

As part of already proposed legislation, U.S. Democratic Sen. Bob Casey of Pennsylvania is pushing for an injection of billions of dollars to increase the direct care workforce and improve pay.

Casey’s Long-Term Care Workforce Support Act could be viewed as a funding mechanism for the Biden administration’s federal nursing home staffing mandate, which would raise the federal match for Medicaid by up to 10% for each state across 10 years, according to a report from CNHI News.

That’s an estimated $220 billion in reimbursements. And, at least 85% of rate increases would be earmarked for boosting compensation among direct care workers and managers. Priority would be given to workers in states with a waitlist, CNHI said, but it appears that’s only for home and community-based staff.


An additional $100 billion in grants, on top of reimbursements, is also part of the legislation. The grants would be available across five years, allowing states and other qualifying entities to address job training, career advancement and related evaluation projects. This funding would be open to employers, labor groups and nonprofits.

“We have a crisis of caregiving in this country, and it’s a crisis that stems largely from a lack of support for and investment in our caregiving workforce,” Casey said when the bill was first introduced. “We cannot claim to be the greatest country in the world if we do not have the greatest caregiving in the world. We need to invest in these workers not just to ensure that caregiving can be a sustainable, lifelong career, but to improve the quality and availability of care for all who need it.”

While the bill has 25 co-sponsors, there are no Republicans that have signed on yet. And, while the bill was introduced in April, details were announced last week. The original legislation was put forward in the House of Representatives by Democratic Rep. Debbie Dingell of Michigan, and in the Senate by Democratic Sens. Tim Kaine of Virginia and Tammy Baldwin of Wisconsin, along with Casey.


Overall, the legislation dives into expanding training opportunities and initiatives to recruit and retain employees, all in an effort to improve access to long-term care among the aging population. The funding support is of course vastly different from what has been offered as part of the federal minimum staffing mandate – which includes $75 million for the same efforts.

Casey’s number is closer to what would actually be needed to meet a staffing mandate across the country, with studies by CliftonLarsonAllen (CLA) estimating the rule will cost the industry $5.8 billion over ten years.

Even a study commissioned by the Centers for Medicare & Medicaid Services (CMS) and conducted by Abt Associates estimated the rule would incur an annual cost of $5.3 billion, along with the conclusion that no solitary staffing level measure could ensure high-quality care.

Legislation details come amid a lawsuit from the American Health Care Association, its Texas affiliate and select operators disputing the mandate.

Companies featured in this article:

, ,