To support the direct care professional workforce, and for other purposes.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
The Long-Term Care Workforce Support Act addresses the severe shortage of direct care professionals (home health aides, nursing assistants, personal care aides) who care for older Americans and people with disabilities. It increases Medicaid funding to states that raise wages for these workers, creates workforce training programs, and establishes workplace protections including paid sick leave, fair scheduling, and workplace violence prevention standards.
Who Benefits and How
Direct care professionals (nearly 5 million workers) benefit through: $5,000 annual tax credits, higher wages from increased Medicaid reimbursements, paid sick leave requirements, fair scheduling protections, and expanded training opportunities. Older individuals and people with disabilities benefit from improved access to care as workforce shortages are addressed. States receive a 10 percentage point increase in Federal Medicaid matching for long-term care services (fiscal years 2025-2034).
Who Bears the Burden and How
Long-term care employers (nursing homes, home care agencies, assisted living facilities) face new compliance requirements including: written employment agreements, fair scheduling practices, workplace violence prevention plans, and paid sick leave mandates. Federal government bears significant costs through increased Medicaid matching rates, grants totaling hundreds of millions annually, and foregone tax revenue from the $5,000 tax credit.
Key Provisions
- 10 percentage point increase in Federal Medicaid matching for long-term care services (Section 101)
- $5,000 annual tax credit for direct care professionals working in long-term care settings (Section 235)
- Mandatory paid sick time: 1 hour per 30 hours worked, up to 56 hours annually (Section 332)
- Workplace violence prevention standards for healthcare and social service employers (Section 321-326)
- National Direct Care Professional Training Standards Commission to develop portable, competency-based credentials (Section 222)
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Comprehensive legislation to address the long-term care workforce crisis by increasing compensation, improving working conditions, expanding training programs, and providing workplace protections for direct care professionals who serve older individuals and people with disabilities.
Key Policy Areas
Healthcare, Labor, Social Services, Medicaid, Workforce Development, Tax Policy
Primary Purpose
Comprehensive legislation to address the long-term care workforce crisis by increasing compensation, improving working conditions, expanding training programs, and providing workplace protections for direct care professionals who serve older individuals and people with disabilities.
Policy Domains
Title I - Medicaid Long-Term Care Services
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals
- Older individuals receiving Medicaid long-term care
- People with disabilities
- State Medicaid programs
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Federal government (increased spending)
- State governments (reporting requirements)
Contextual inference, no direct clause citation
Title V - Evaluation
Identified Gains
Contextual inference, no direct clause citation- Congress and policymakers (informed decision-making)
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Federal government (evaluation contract costs)
Contextual inference, no direct clause citation
Title IV - National Compensation Strategy
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals
- Policy advocates
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Federal government (administrative costs)
Contextual inference, no direct clause citation
Title II, Chapter 1 - Workforce Development Grants
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals
- Community colleges
- Nonprofit training organizations
- Labor organizations
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Federal government (grant appropriations)
Contextual inference, no direct clause citation
Title II, Chapter 2 - Direct Care Professional Well-Being
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals
- Mental health service providers
- Healthcare workers in long-term care
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Federal government (tax expenditure and grants)
- IRS (administration of tax credit)
Contextual inference, no direct clause citation
Title III, Subtitle A - Wage Theft Prevention
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals subject to wage theft
- Nonprofit worker advocacy organizations
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Employers who violate wage laws
- Federal government (enforcement grants)
Contextual inference, no direct clause citation
Title III, Subtitle B - Worker Protections
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Long-term care employers (nursing homes, home care agencies, assisted living facilities)
Contextual inference, no direct clause citation
Title III, Subtitle C - Workplace Violence Prevention
Identified Gains
Contextual inference, no direct clause citation- Healthcare workers
- Social service workers
- Direct care professionals
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Hospitals
- Nursing homes
- Home care agencies
- Social service agencies
Contextual inference, no direct clause citation
Title III, Subtitle D - Paid Sick Time
Identified Gains
Contextual inference, no direct clause citation- Direct care professionals
- Care recipients (reduced illness transmission)
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Employers of direct care professionals
Contextual inference, no direct clause citation
Legislative Progress
IntroducedMrs. Dingell introduced the following bill; which was referred to …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Direct care professionals, Direct care professionals and health care workers, Direct care professionals experiencing wage theft
Bureau of Labor Statistics, Congress, Department of Health and Human Services
Department of Labor faces effects in multiple directions
Positive-direction: Congress, Indian tribes and tribal organizations
Negative-direction: Bureau of Labor Statistics, Department of Health and Human Services, Federal government, Federal government (foregone revenue), Government Accountability Office, HHS, HHS and CMS, HHS, NIOSH, HRSA, IRS
Certified nursing assistants, Employers who violate wage laws, Institutional care facilities (nursing homes)
Long-term care employers faces effects in multiple directions
Positive-direction: Certified nursing assistants, Licensed practical nurses in long-term care, Long-term care facilities
Negative-direction: Employers who violate wage laws, Institutional care facilities (nursing homes), Long-term care employers violating sick time requirements, Long-term care providers and employers, Nursing homes and long-term care facilities, Skilled nursing facilities receiving Medicare
State Medicaid agencies, State Medicaid programs, State governments
State workforce agencies faces effects in multiple directions
Positive-direction: State Medicaid programs, State governments, State labor departments and enforcement agencies, States and nonprofits, States with stronger worker protections
Negative-direction: State Medicaid agencies
Community colleges, Community colleges and training providers, Consortiums of LEAs and health institutions
Positive-direction: Community colleges and training providers, Consortiums of LEAs and health institutions, Educational institutions, Educational institutions offering health programs, Eligible entities (states, nonprofits, colleges), Eligible partnerships (universities, disability orgs, provider associations), Local educational agencies in rural areas
Negative-direction: Grant applicants
Eligible individuals in training, Low-income individuals seeking health careers, People with disabilities transitioning from institutions
Health care and social service employers, Health care facility employers, Healthcare employers
Positive-direction: Healthcare employers
Negative-direction: Health care and social service employers, Health care facility employers, Hospitals and health care facilities, Hospitals receiving Medicare funds, Mental health and substance abuse treatment centers
Direct care professional advocacy organizations, Eligible entities in rural and underserved areas, Grant applicants (states, nonprofits)
Positive-direction: Direct care professional advocacy organizations, Eligible entities in rural and underserved areas, Nonprofit organizations representing domestic workers
Negative-direction: Grant applicants (states, nonprofits), Grant recipients
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Labor
- "the_secretary"
- → Secretary of Labor
- "the_secretary"
- → Secretary of Labor
- "the_secretary"
- → Secretary of Labor
- "the_secretary"
- → Secretary of Health and Human Services
- "the_secretary"
- → Secretary of Health and Human Services
Note: The Secretary refers to Secretary of Health and Human Services in Titles I, II, IV, and V but Secretary of Labor in Title III
Key Definitions
Terms defined in this bill
Any person or agency providing compensation to a direct care professional for long-term care services
As defined in Violence Against Women Act, including dating violence
Nursing homes, assisted living facilities, home and community-based services settings, and other care environments
Includes certified nursing assistants, home health aides, personal or home care aides, and similar workers providing hands-on care
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology