[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3000 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 3000
To address the worsening long-term care workforce crisis and increase
access to and affordability of long-term care.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 24, 2025
Mr. Fitzpatrick (for himself and Mrs. Trahan) introduced the following
bill; which was referred to the Committee on Education and Workforce,
and in addition to the Committee on Energy and Commerce, for a period
to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To address the worsening long-term care workforce crisis and increase
access to and affordability of long-term care.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Caring for Seniors Act''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The United States population is aging more rapidly than
ever before, with 10,000 Americans turning 65 each day. In
2034, for the first time, the Nation will have more people over
the age of 65 than under the age of 18. The population
experiencing the fastest growth are persons 85 and older, which
is projected to grow 198 percent by 2060.
(2) The Department of Health and Human Services estimates
that 70 percent of Americans over the age of 65 will require
some form of long-term care in their lifetime. By 2050, the
number of Americans requiring paid long-term care services will
triple from 8,300,000 to 27,000,000.
(3) According to 2020 Census data, more than 40 percent of
baby boomers do not have any retirement savings, let alone
savings for their long-term care needs. A recent report by the
National Council on Aging found that up to 80 percent of older
adults would be unable to afford 4 years in an assisted living
community or more than 2 years of nursing home care. Put
another way, 47,000,000 Americans aged 60 or above do not have
the financial resources to cover the future care they may need.
(4) Caring for America's aging seniors will be the single
most expense domestic priority and is projected to deplete
Federal and State Medicaid budgets. The United States spent
over $400,000,000,000 on long-term care in 2020, nearly 10
percent of all national health care spending.
(5) According to the Congressional Research Service, State
and Federal programs account for 71.4 percent of all long-term
care spending nationwide in 2021. Medicaid and Medicare are,
respectively, the first and second-largest public payers,
accounting for a combined 64.1 percent of all spending.
Medicaid is by far the largest single funding source for long-
term care, spending approximately $135,800,000,000 in 2020, a
figure that is projected to reach $466,000,000,000 by 2050.
(6) A 2023 report by AARP, indicates that at least 9
percent of seniors in skilled nursing homes nationwide have
low-acuity levels that do not warrant high skilled care, but
are forced into a skilled nursing home where assets can be
depleted, and Medicaid can become the primary payer. The report
by AARP indicated that this number is 20 percent in 5 States.
(7) In 2021, the Department of Veterans Affairs testified
to Congress that if veterans in need of long-term care services
could choose assisted living instead of a nursing home, $69,101
per veteran per year would be saved by the Department of
Veterans Affairs.
(8) Strengthening cost-effective models of long-term care
services, providing incentives for Americans to better afford
their care costs, and developing the workforce needed to care
for the Nation's aging population will reduce Federal and State
Medicaid spending.
(9) Congregate care models of long-term care services, such
as assisted living, are half the cost of nursing homes, and
less than a third of round the clock home health aides.
(10) Assisted living provides 24/7 personal care, chronic
disease management, nutrition, room and board, and
socialization. If assisted living were not an option, as many
as 61 percent of senior residents may be forced into far-
costlier skilled nursing facilities at a cost of
$43,400,000,000 per year.
(11) The senior living industry lost approximately 400,000
jobs between 2020 and 2022, leaving the workforce far below
prepandemic employment levels. In order to care for the United
States aging population, the senior care industry will need to
fill more than 20,200,000 jobs by 2040.
SEC. 3. ADDRESSING THE LONG-TERM CARE WORKFORCE CRISIS.
(a) Workforce Programs.--
(1) Expansion of dol workforce programs.--The Secretary of
Labor, acting jointly through the Assistant Secretary for
Employment and Training and the National Director for the
Office of Job Corps of the Employment and Training
Administration, shall establish new and expand existing
education and training grant programs to support the expansion
of the direct care workforce for purposes of caring for a
rapidly aging population and providing home and community-based
services to older adults and people with disabilities. Such
programs shall include support for core certification and
training requirements for the direct care workforce of assisted
living facilities.
(2) Expansion of hrsa workforce programs.--The Secretary of
Health and Human Services, acting through the Administrator of
the Health Resources and Services Administration, shall
establish new and expand existing workforce education and
training grant programs to address shortages in the direct care
workforce serving the rapidly aging population and providing
home and community-based services to older adults and people
with disabilities. Such programs shall include support for core
certification and training requirements for the direct care
workforce of assisted living facilities.
(b) Definitions.--In this section:
(1) Assisted living facility.--The term ``assisted living
facility'' means any licensed, registered, certified, listed,
or State-regulated residence, managed residential community,
building, or part of a building that provides, or contracts to
provide, housing with supportive services on a continuing basis
to individuals who--
(A) are elderly or have a mental health,
developmental, or physical disability; and
(B) are unrelated by blood or marriage to the owner
or operator of the residence, community, building, or
part of a building, if the owner or operator is an
individual.
(2) Direct care workforce.--The term ``direct care
workforce'' means a workforce that is composed of individuals
who, in exchange for compensation, provide services at an
assisted living facility to an individual who is elderly or who
has a mental health, developmental, or physical disability,
that promote such individual's independence, including--
(A) services that enhance independence and
community inclusion for such individual, including
traveling with such individual, attending and assisting
such individual while visiting friends and family,
shopping, or socializing;
(B) services such as coaching and supporting such
individual in communicating needs, achieving self-
expression, pursuing personal goals, living
independently, and participating actively in employment
or voluntary roles in the community;
(C) services such as providing assistance with
activities of daily living (such as feeding, bathing,
toileting, and ambulation) and with tasks such as meal
preparation, shopping, light housekeeping, and laundry;
or
(D) services that support such individual at home,
work, school, or any other community setting.
SEC. 4. SENIOR CARE COST REDUCTION PROGRAM.
Part A of title III of the Older Americans Act of 1965 (42 U.S.C.
3021 et seq.) is amended by adding at the end the following:
``SEC. 317. SENIOR CARE COST REDUCTION PROGRAM.
``(a) Establishment of Program.--The Assistant Secretary, acting
through the Administration, shall establish a `Senior Care Cost
Reduction Program' for making allotments to States to administer
monthly cost reduction amounts to assist low-income seniors to reside
and receive services in assisted living facilities located in the State
as an alternative to more costly institutional care.
``(b) State Application.--In order to be eligible to receive an
allotment under this section, the State shall submit an application to
the Assistant Secretary at such time, in such manner, and accompanied
by such information as the Assistant Secretary may reasonably require.
``(c) Cost Reduction Amount.--
``(1) Initial amount.--Upon establishment of the Program,
the monthly amount provided by the State to eligible recipients
shall be $1,000.
``(2) Adjustments in consumer price index.--Beginning one
year after the establishment of the Program, and each
subsequent year, the monthly amount required under paragraph
(1) shall be increased by the percentage, if any, by which the
Consumer Price Index for all urban consumers (all items; United
States city average) for the most recent calendar year exceeds
the Consumer Price Index for the previous calendar year,
rounded to the nearest dollar.
``(d) Eligibility.--In order to be eligible for a cost reduction
amount under this section, the individual must--
``(1) submit an application to and be approved by the
relevant State agency tasked with administering the Program;
``(2) be at least 70 years old as of the date of
application;
``(3) be accepted for admission as a resident in, or
currently reside in, an assisted living facility which has been
approved by the relevant State agency to participate in this
Program;
``(4) be either a `chronically ill individual' (as defined
in section 7702B(c)(2) of the Internal Revenue Code of 1986) or
eligible to receive long-term services and supports under the
relevant State's Medicaid program; and
``(5) be determined to be financially eligible, pursuant to
subsection (e).
``(e) Financial Eligibility.--An individual is financially eligible
under this section only if the individual's--
``(1) net monthly income is less than the approved monthly
fees for the services provided at the assisted living facility;
``(2) net annual income is not higher than 60 percent of
the median income for the State in which the individual
resides, as determined by the Secretary of Housing and Urban
Development; and
``(3) resources are not greater than $19,000 if single, or
$25,000 if married.
``(f) Implementation.--The Secretary, acting through the Assistant
Secretary, may issue such regulations as may be necessary to carry out
this section.
``(g) Assisted Living Facility Defined.--As used in this section,
the term `assisted living facility' means any licensed, registered,
certified, listed, or State-regulated residence, managed residential
community, building, or part of a building that provides, or contracts
to provide, housing with supportive services on a continuing basis to
individuals who--
``(1) are elderly or have a mental health, developmental,
or physical disability; and
``(2) are unrelated by blood or marriage to the owner or
operator of the residence, community, building, or part of a
building, if the owner or operator is an individual.''.
SEC. 5. AUTHORIZATION OF APPROPRIATIONS.
Amounts that have been returned to or recovered by the Health
Resources and Services Administration or the Department of the
Treasury, including all amounts returned or recovered after the date of
enactment of this Act, from amounts made available and disbursed to
eligible health care providers for health care-related expenses or lost
revenues attributable to coronavirus under the heading ``Public Health
and Social Services Emergency Fund'' in title VIII of division B of
Public Law 116-136, title I of division B of Public Law 116-139, and
title III of division M of Public Law 116-260, are authorized to be
appropriated to carry out this Act and the amendment made by this Act.
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