Editor’s note: The following is the concluding Part 7 of a special report, “The High Cost of Long-Term Care.” The entire series can be read now at enewscourier.com.

Describing the nation’s caregiving industry as one in crisis, U.S. Sen. Bob Casey proposes injecting billions of dollars into the direct care workforce to improve pay, expand training opportunities and recruit and retain employees, all toward improving access for the country’s graying population.

One in 5 U.S. residents will be age 65 or older by 2030, according to the U.S. Census Bureau, and with the growth in that demographic, the need for professional caregivers is growing, too. At least 800,000 new jobs will be added in direct care through 2032, an AP-CNHI News analysis of Bureau of Labor Statistics data found.

Employers are already struggling to hire workers. Turnover at some nursing homes exceeds 100%, with shortages threatening to limit the availability of care.

Wages are a big factor. The average annual salary for home health and personal care aides was $33,380 in May 2023, according to the Bureau of Labor Statistics, putting the work in line with cafeteria attendants and retail sales workers. A Department of Health and Human Services report found that nearly half of direct care workers rely on public assistance.

The Long-Term Care Workforce Support Act would raise the federal match for Medicaid by up to 10 percent for each state across 10 years, adding an estimated $220 billion in reimbursements.

At least 85 percent of the rate increases would be passed through to boost compensation for direct care workers and managers. Priority would be given to home and community-based service workers in states with a waitlist.

Additional targeted grant funding would be available across five years to allow states and other qualifying entities including employers, labor groups and nonprofits to address job training, career advancement and related evaluation projects.

Addressing needs in rural areas and diversifying the workforce are among the proposed legislation’s goals.

A person familiar with the proposal estimates the combined value of the grants at an additional $100 billion.

Casey, a Democrat, chairs the U.S. Senate Special Committee on Aging. The bill has 25 co-sponsors but none from the Republican Party. It was first announced in April but the full language of the bill was released last week.

“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 introducing the bill in mid-April. “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.”

The Long-Term Care Workforce Support Act can be viewed as a funding mechanism for the Biden Administration’s unfunded minimum staffing mandate staggered implementation beginning in 2026.

The rule establishes specific hourly minimums for nursing staff and mandates that a registered nurse be on site 24 hours each day.

Nursing home administrators predict the worst, that it will lead facilities to reduce patient populations and outright closures. A survey by the American Health Care Association saw 96 percent of respondents express concern about meeting the mandate led by worries they won’t be able to find enough staff.

“This industry is already on the brink,” said Susie-Tack Beardsley, chief administrative officer with Quality Life Services, which operates 10 facilities in western Pennsylvania. “To issue a mandate like they have without additional funding, it truly has the potential to be catastrophic.”

Last week, the AHCA and its affiliate organization in Texas filed suit in federal court against the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services in dispute over the mandate. The lawsuit accuses the agencies of overstepping their legal authority in issuing the minimum staffing standards finalized in early May. They ask the court to halt the rule’s implementation.

“We had hoped it would not come to this; we repeatedly sought to work with the Administration on more productive ways to boost the nursing home workforce. Unfortunately, federal officials rushed this flawed policy through, ignoring the credible concerns of stakeholders and showing little regard for the negative impact it will have on our nursing home residents, staff, and the larger health care system,” Mark Parkinson, President and CEO of AHCA, said in a statement announcing the lawsuit. “We cannot stand idly by when access to care is on the line and federal regulators are overstepping their authority. Hundreds of thousands of seniors could be displaced from their nursing home; someone has to stand up for them, and that’s what we’re here to do.”