Long-Term Care Workforce Support Act
Summary
What This Bill Does
The Long-Term Care Workforce Support Act is a broad workforce package for direct care professionals who provide Medicaid long-term services and supports, home care, domestic services, and other support for older adults and people with disabilities. It increases federal Medicaid support for long-term care services provided by direct care professionals, creates additional HHS grants for Medicaid long-term care services and workers, and permanently extends the Money Follows the Person rebalancing demonstration. It also creates grant programs for direct care workforce projects, domestic worker workforce investment, career advancement demonstrations, health career pathways, allied health workforce diversity, rural health workforce development, apprenticeship reviews, a technical assistance center, and mental health services for direct care professionals.
The bill also creates enforceable workplace rules for direct care work. It funds wage theft prevention and recovery grants, requires written agreements between covered entities and direct care professionals, creates fair scheduling and temporary schedule-change rights, restricts privacy-invasive monitoring, requires meal and rest breaks, bars retaliation, gives enforcement authority to the Department of Labor, and preserves stronger collective bargaining or state-law protections. It directs the Secretary of Labor to issue a workplace violence prevention standard for health care and social service employers, applies that standard to certain Medicare-funded facilities, and defines the covered facilities, employers, and safety-plan requirements.
The bill adds a paid sick time title for covered direct care professionals, requiring employers to provide at least 1 hour of earned paid sick time for every 30 hours worked, notify workers of their rights, and comply with Labor Department enforcement. It authorizes a $20,000,000 education and outreach campaign for paid sick time, requires regulations within 180 days, and directs the Bureau of Labor Statistics to collect data on paid and unpaid sick time. Finally, it creates a National Direct Care Professional Compensation Strategy, a National Direct Care Professional Compensation Advisory Council, a 10-year sunset for that title, and an external evaluation by HHS and Labor.
Who Benefits and How
Direct care professionals benefit from new training funds, career pathways, apprenticeship review, mental health supports, a $5,000 health care professional tax credit, wage theft recovery, written agreements, fair scheduling, privacy protections, meal and rest breaks, workplace violence standards, paid sick time, and national compensation planning. Older individuals and people with disabilities who rely on long-term services benefit if the bill improves recruitment, retention, training, and stability of the care workforce. State Medicaid agencies, labor organizations, joint labor-management organizations, nonprofit workforce entities, schools, rural health partnerships, domestic worker organizations, and long-term care providers benefit from grant opportunities and technical assistance.
Who Bears the Burden and How
HHS, CMS, the Department of Labor, the Department of Education, NIOSH, OSHA, BLS, IRS, and external evaluators must administer new grants, tax credits, technical assistance centers, reports, standards, data collections, advisory councils, and evaluations. Employers of direct care professionals, domestic work employers, health care employers, social service employers, long-term care facilities, and certain Medicare-funded facilities must comply with new written agreement, scheduling, privacy, break, anti-retaliation, workplace violence, notice, paid sick time, and recordkeeping rules. Federal taxpayers bear the cost of higher Medicaid support, grant programs, tax credits, outreach, and federal administration.
Key Provisions
- Expands federal Medicaid and grant support for long-term care services provided by direct care professionals and permanently extends Money Follows the Person.
- Creates workforce grants for direct care career pathways, domestic workers, career advancement demonstrations, allied health diversity, rural health workforce development, training standards, and mental health supports.
- Creates a $5,000 tax credit for certain health care professionals.
- Funds wage theft prevention and recovery grants and creates written agreement, fair scheduling, temporary schedule-change, privacy, meal-break, rest-break, anti-retaliation, and enforcement rights for direct care professionals.
- Requires a workplace violence prevention standard for health care and social service employers and applies it to certain Medicare-funded facilities.
- Requires paid sick time for covered direct care professionals, Labor Department notice and enforcement, public outreach, regulations, and BLS sick-time data collection.
- Requires a national direct care professional compensation strategy, an advisory council, a 10-year sunset for that title, and an external implementation evaluation.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
The Long-Term Care Workforce Support Act funds and regulates direct care workforce recruitment, training, compensation, labor standards, workplace safety, paid sick time, and national workforce strategy for long-term care services.
Key Policy Areas
Healthcare, Labor, Social Welfare, Tax, Government Operations
Primary Purpose
The Long-Term Care Workforce Support Act funds and regulates direct care workforce recruitment, training, compensation, labor standards, workplace safety, paid sick time, and national workforce strategy for long-term care services.
Policy Domains
Medicaid Support, Workforce Development, Training, and Tax Credit
Identified Gains
- Direct care professionals
- State Medicaid agencies
- Long-term care providers
- Older individuals using long-term services
- People with disabilities using long-term services
Identified Costs
- Department of Health and Human Services
- Centers for Medicare and Medicaid Services
- Department of Labor
- Internal Revenue Service
- Federal taxpayers
Wage Theft, Fair Scheduling, Workplace Violence, and Paid Sick Time
Identified Gains
- Covered direct care professionals
- Direct care professionals experiencing wage theft
- Direct care professionals facing workplace violence
- Direct care professionals needing paid sick time
Identified Costs
- Employers of direct care professionals
- Domestic work employers
- Health care employers
- Social service employers
- Department of Labor
National Compensation Strategy, Advisory Council, Sunset, and Evaluation
Identified Gains
- Direct care professionals affected by compensation strategy
- National Direct Care Professional Compensation Advisory Council
- Congressional health workforce committees
Identified Costs
- Department of Health and Human Services
- Department of Labor
- External evaluation contractors
Sponsors
Legislative Progress
In CommitteeReferred to the Committee on Energy and Commerce, and in …
Introduced in House
Mrs. Dingell (for herself and Ms. Matsui) introduced the following …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Community wage enforcement organizations, Covered direct care professionals, Covered direct care professionals earning paid sick time
Direct care workforce grant applicants faces effects in multiple directions
Positive-direction: Community wage enforcement organizations, Covered direct care professionals, Covered direct care professionals earning paid sick time, Covered direct care professionals needing temporary schedule changes, Covered direct care professionals receiving sick time notices, Covered direct care professionals receiving written agreements, Covered direct care professionals using paid sick time, Covered direct care professionals with scheduled hours, Direct Care Professional Workforce Equity Technical Assistance Center, Direct care apprenticeship participants, Direct care professional representatives, Direct care professionals, Direct care professionals affected by compensation strategy, Direct care professionals asserting workplace rights, Direct care professionals experiencing wage theft, Direct care professionals facing workplace violence, Direct care professionals in Medicaid programs, Direct care professionals in Medicare-funded facilities, Direct care professionals learning paid sick time rights, Direct care professionals needing meal breaks, Direct care professionals needing mental health services, Direct care professionals needing mental health support, Direct care professionals owed workplace remedies, Direct care professionals paid through Medicaid, Direct care professionals protected by violence prevention plans, Direct care professionals receiving generous leave, Direct care professionals receiving standardized training, Direct care professionals receiving training grants, Direct care professionals seeking career advancement, Direct care professionals seeking sick time remedies, Direct care professionals served by grant projects, Direct care professionals using private spaces, Direct care professionals with stronger sick leave benefits, Direct care professionals with stronger state protections, Direct care professionals with substance use needs, Direct care professionals with workplace stress, Direct care workforce development grantees, Direct care workforce equity grantees, Direct care workforce researchers, Direct care workforce technical assistance center, Direct support professional trainees, Direct support professional trainees receiving stipends, Domestic worker organizations, Domestic workers providing household services, Labor organizations representing direct care professionals, Rural direct care professional trainees, Unionized direct care professionals
Negative-direction: Covered entities issuing written agreements, Covered entities monitoring direct care workers, Covered entities under Labor Department investigation, Direct care employers managing schedule changes, Direct care employers scheduling workers, Direct care employers staffing around breaks, Direct care workforce grantees, Employers issuing paid sick time notices, Employers paying direct care sick time, Employers retaliating against direct care professionals, Employers violating direct care wage laws, Employers violating paid sick time rules
Bureau of Labor Statistics labor data staff, Centers for Medicare and Medicaid Services certification staff, Congressional health workforce committees
HHS compensation strategy staff faces effects in multiple directions
Positive-direction: Congressional health workforce committees, Congressional long-term care oversight committees, Direct care workforce program administrators, Federal workforce grant funds, State Medicaid Money Follows the Person programs
Negative-direction: Bureau of Labor Statistics labor data staff, Centers for Medicare and Medicaid Services certification staff, Department of Health and Human Services evaluation staff, Department of Health and Human Services grant staff, Department of Labor apprenticeship reviewers, Department of Labor direct care enforcement staff, Department of Labor equity technical assistance staff, Department of Labor evaluation staff, Department of Labor paid sick time enforcement staff, Department of Labor paid sick time outreach staff, Department of Labor paid sick time rule writers, Department of Labor workforce staff, Federal Medicaid spending, Federal income tax revenue, Federal taxpayers funding outreach, Federal taxpayers funding the credit, HHS Medicaid workforce grant staff, HHS allied health diversity grant staff, HHS behavioral health best-practice staff, HHS career pathway evaluators, HHS career pathway grant staff, HHS direct care workforce policy staff, HHS mental health communications staff, HHS rural workforce grant administrators, HHS technical assistance grant staff, HHS training grant administrators, HHS worker mental health grant staff, HHS workforce grant reviewers, Internal Revenue Service tax administration staff, National Direct Care Professional Compensation Advisory Council, National Direct Care Professional Training Standards Commission, National Institute for Occupational Safety and Health, Occupational Safety and Health Administration, Occupational Safety and Health Administration inspectors, State agencies reporting training grant outcomes, Wage and Hour Division enforcement staff, Wage and Hour Division grant administrators, Wage and Hour Division retaliation enforcement staff, Wage and Hour Division schedule rights staff
Allied health training programs, Clients exposed to sick direct care workers, Covered health care facilities writing violence prevention plans
Positive-direction: Allied health training programs, Clients exposed to sick direct care workers, Eligible health care professionals claiming the credit, Health career pathway participants, Long-term care workforce grantees receiving assistance, Low-income health career trainees, Medicaid beneficiaries transitioning from institutions, Medicaid long-term care providers, Medicaid long-term care service providers, Mental health service providers serving care workers, Older individuals using long-term services, People with disabilities using long-term services, Qualifying health care professionals, Rural health workforce training programs, Rural long-term care providers, Rural patients needing direct care
Negative-direction: Covered health care facilities writing violence prevention plans, Health care employers covered by violence standard, Medicare-participating health care facilities
Allied health students receiving scholarships, Career pathway grant applicants, Direct care professional training providers
Social service employers covered by violence standard
External long-term care workforce evaluators
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "secretary"
- → Secretary of Health and Human Services
- "cms_administrator"
- → Administrator of the Centers for Medicare and Medicaid Services
- "secretary_of_labor"
- → Secretary of Labor
- "direct_care_professional"
- → Worker providing long-term care services and supports
- "administrator"
- → Administrator of the Wage and Hour Division
- "covered_entity"
- → Employer or hiring entity covered by direct care labor standards
- "secretary_of_labor"
- → Secretary of Labor
- "covered_direct_care_professional"
- → Direct care professional covered by the labor standards titles
- "secretary"
- → Secretary of Health and Human Services
- "advisory_council"
- → National Direct Care Professional Compensation Advisory Council
- "secretary_of_labor"
- → Secretary of Labor
Key Definitions
Terms defined in this bill
The National Direct Care Professional Compensation Strategy required by title IV.
The Administrator of the Wage and Hour Division of the Department of Labor.
Services that help older individuals and people with disabilities live with health, independence, and daily support.
A worker providing long-term care services and supports, including assistance with activities of daily living and related support.
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