Support Increased Public Investment in Home- and Community-Based Long-Term Care
We support President Biden’s overall plan to improve the care infrastructure of the United States, including his specific proposal to invest $450 billion in expansion and improvement of home and community-based services for the long-term care of those experiencing disability or the frailty of advanced age.
A large body of evidence-based research indicates that this investment will help:
- Increase access to home and community-based services.1 Current Medicaid funding for such services falls far short of serving all eligible families, with elderly women representing a disproportionate share of those in need of assistance. While institutional care is also important, funding shortfalls sometimes lead to unnecessary placements in nursing homes that pose serious risks of exposure to Covid-19 and other infectious diseases.
- Improve the quality of care provided.2 Low wages, stressful working conditions, stunted career ladders, and resulting high rates of turnover in the long-term care workforce limit workers’ ability to provide sensitive care, to collaborate effectively with unpaid family caregivers, and to take full advantage of new medical technologies. Higher pay for long-term care workers has been shown to improve patients’ health outcomes and life expectancy.
- Reduce financial and time pressures on unpaid family caregivers. 3 A $5,000 tax credit for family caregivers and credits toward Social Security will validate the value of unpaid care services. Greater access to high-quality paid assistance will improve collaboration and facilitate respites from family caregiving responsibilities.
- Help create better jobs and career opportunities for home and community-based care workers.4 The current long-term care labor force is comprised largely of immigrants and women of color. This group, many of whom are eligible for public assistance, includes some of the most underpaid and undervalued workers in the U.S. Increasing their financial security can have positive multiplier effects on family and community well-being.
- Enhance the overall efficiency of our long-term care system.5 In recent years, most states have reallocated Medicaid funds from nursing homes to home and community-based care, because most people strongly prefer the latter. Cost savings depend largely on takeup rates and the quality of care provided. The Biden proposal includes funds for research on innovations that could pay off in improved health and reduced hospitalization rates.
- Foster a dynamic, resilient economy by helping families balance care needs and paid employment.6 Unexpected care shocks often create significant downside economic risks for families caught between a rock and a hard place—trying to find time to provide direct care but also earn enough money to pay their bills. Increased employment can contribute to sustainable economic growth. According to one recent estimate, a $77.5 billion public investment in care services would yield 2 million new jobs and $220 billion in new economic activity.
Sooner or later, most of us will need help from others. As social scientists and health care researchers we urge Congress to increase investment in the care workforce and home and community-based care by supporting President Biden’s Build Back Better plan.
Sincerely,
- Alison Earle, Principal Research Analyst, University of California Los Angeles
- Alyssa J Alexander, Ph.D. Candidate
- Alyssa Schneebaum, Assistant Professor of Economics, Vienna University of Economics
and Business
- Amy Armenia, Professor of Sociology, Rollins College
- Andrea Ziegert, Julian Robertson Jr. Professor of Economics, Denison University
- Anna A. Amirkhanyan, Associate Professor of Economics, American University
- Arne L. Kalleberg, Kenan Distinguished Professor of Sociology, University of North
Carolina at Chapel Hill
- Arthur MacEwan, Professor Emeritus of Economics, University of Massachusetts
Boston
- Barbara E. Hopkins, Professor, Wright State University
- Barbara R. Lowrey, Retired adjunct faculty member, University of Maryland
- Beth Almeida, Principal, Cove Research
- Betsey Stevenson, Professor of Economics and Public Policy, University of Michigan
- Bina Agarwal, Professor of Development Economics and Environment, University of
Manchester
- Brenda C. Spillman, Senior Fellow, Urban Institute
- Brenda Powell, Independent financial adviser
- Brenda Wyss, Professor of Economics, Wheaton College
- Camila Bustamante Pérez, Consultant, United Nations Economic Commission for Latin
America and the Caribbean
- Candace Howes, Ferrin Professor of Economics, Connecticut College
- Candidus C Nwakasi, Assistant Professor, Providence College
- Caren Grown, Global Director of Gender Group, World Bank
- Carmen Diana Deere, Distinguished Professor Emerita of Food & Resource Economics,
University of Florida
- Carol Scotton, Associate Professor, Knox College
- Carole Joffe, Professor Emerita of Sociology, U.C.Davis
- Carrie R. Leans, George H. Love Professor of Organizations and Management,
University of Pittsburgh
- Carroll L. Estes, Professor and Founding Director Emerita, University of California San
Francisco
- Chiara Piovani, Associate Professor, University of Denver
- Chih-ling Liou, Associate Professor, Kent State University at Stark
- Christian E. Weller, Professor, University of Massachusetts Boston
- Christina Barmon, Assistant Professor, Central Connecticut State University
- Christina Matz, Associate Professor, Boston College
- Christine E. Bishop, Atran Professor of Labor Economics, Brandeis University
- Clare L. Stacey, Associate Professor of Sociology, Kent State University
- Colleen Wynn, Assistant Professor, University of Indianapolis
- Cybelle Fox, Professor of Sociology, UC Berkeley
- Dara Orenstein, Associate Professor of American Studies, George Washington
University
- Darrick Hamilton, Henry Cohen Professor of Economics and Urban Policy, The New
School
- Dean Baker, Senior Economist, Center for Economic and Policy Research
- Debra Fortune Tomasino, Ph.D. Student, University of Connecticut
- Diana Strassmann, Carolyn & Fred McManis Distinguished Professor in the Practice,
Rice University
- Diane Archer, President, Just Care USA
- Diane Feeney Mahoney, Professor Emerita and Gerontechnologist, MGH Institute for
Health Professions
- Doree Ann Ventura-Espiritu, MD, Medical Director, Henry Ford Health System
Behavioral Health
- Douglas A Wolf, Professor, Syracuse University
- Ebru Kongar, Professor of Economics, Dickinson College
- Edith Kuiper, Associate Professor, State University of New York New Paltz
- Edward Alan Miller, Professor, University of Massachusetts Boston
- Eileen Appelbaum, Co-Director, Center for Economic and Policy Research
- Eileen Boris, Hull Professor and Distinguished Professor of Feminist Studies, University
of California Santa Barbara
- Elena Kulikov, Professor and Chair of Department of Public Administration, California
State University Dominguez Hills
- Elena O. Lingas, Associate Professor, Touro University California
- Elissa Braunstein, Professor and Chair of Economics, Colorado State University
- Emily Abel, Professor Emerita, University of California Los Angeles
- Emily Agree, Professor, Johns Hopkins University
- Emily Ellis, Ph.D. Student, University of Chicago
- Emily Franzosa, Assistant Professor, Icahn School of Medicine at Mount Sinai
- Emma K. Tsui, Associate Professor, City University of New York John Jay College
- Felicia Kornbluh, Ph.D., Professor of History and Gender, Sexuality, and Women’s
Studies, University of Vermont
- Francesca Degiuli, Associate Professor of Sociology, Fairleigh Dickinson University
- Geert Dhondt, Associate Professor, City University of New York John Jay
- Girshriela Green, Senior Organizer, United for Respect
- Grazielle Figueredo, Graduate student, University of Massachusetts Amherst
- Gretchen Donehower, Academic Specialist, University of California Berkeley
- H. Elizabeth Peters, Institute Fellow and Professor Emerita, Urban Institute and
Cornell University
- Hande Togrul, ParaEducator, Open Classroom
- Heather L Menne, Senior Health Policy Researcher, RTI International
- Heidi Hartmann, Distinguished Economist, American University
- Heidi Shierholz, Senior Economist and Director, of Policy, Economic Policy Institute
- Holly Reed, Professor, City University of New York Queens College
- Howard Stein, Professor, University of Michigan
- Iris Chi, Professor, University of Southern California
- Isaac Jabola-Carolus, Ph.D. Candidate, City University of New York Graduate Center
- Iveris L. Martinez, Director & Archstone Foundation Endowed Chair in Gerontology
Center for Successful Aging, California State University Long Beach
- Ivy Ken, Associate Professor of Sociology, George Washington University
- Jacqueline Marie McGinley, Assistant Professor, Binghamton University
- James Heintz, Professor and Chair of Economics Department, University of
Massachusetts Amherst
- Jamie L. McQueen, Director of Academics and Assistant Professor, Wayne State
University
- Jane L. Tavares, Research Fellow, University of Massachusetts Boston
- Janet C. Gornick, Professor of Political Science and Sociology / Director, Stone Center
Graduate Center, City University of New York
- Janet C. Gornick, Professor of Political Science and Sociology and Director of Stone
Center, City University of New York Graduate Center
- Jasmine Travers, Assistant Professor, New York University
- Jayati Ghosh, Professor, University of Massachusetts Amherst
- Jeanne Koopman, Researcher, Boston University
- Jeannette Wicks-Lim, Associate Research Professor, University of Massachusetts
Amherst
- Jeffrey A. Hayes, Chief Data Analyst, Institute for Women’s Policy Research
- Jen S Lendrum, Assistant Professor, Aquinas College
- Jennie Kaufman, Research Associate, Hunter College
- Jennifer C Olmsted, Professor, Drew University
- Jennifer Cohen, Assistant Professor, Miami University
- Jennifer Craft Morgan, Associate Professor, Georgia State University
- Jennifer Heston-Mullins, Research Scholar, Miami University
- Jennifer Mendez, Associate Professor, Wayne State University
- Jennifer N. Fish, Professor and Chair of Women’s Studies, Old Dominion University
- Jhumpa Bhattacharya, Vice President of Programs and Strategy, Insight Center
- Jim Campen, Professor Emeritus, University of Massachusetts Boston
- Joan C Tronto, Professor Emerita, University of Minnesota and City University of New
York
- Joan Ilardo, Director of Research Initiatives, Michigan State University College of
Human Studies
- Joanne Spetz, Director of Philip R Lee Institute for Health Policy Studies, University of
California San Francisco
- Jocelyn Olcott, Margaret Taylor Smith Director of Gender, Sexuality & Feminist
Studies, Duke University
- John L. Hall Ph.D, Director Behavioral Health, envoyatHome
- John Schumacher, Associate Professor, University of Maryland Baltimore
County
- Joy Swanson Ernst, Associate Professor, Wayne State University
- Joya Misra, Professor of Sociology & Public Policy, University of Massachusetts
Amherst
- Judith Lorber, Professor Emerita, City University of New York Graduate Center
- Julie A. Nelson, Professor Emeritus of Economics, University of Massachusetts Boston
- Jun Li, Assistant Professor, Syracuse University
- Karen V. Hansen, Professor of Sociology and Women’s, Gender, and Sexuality Studies, Brandeis University
- Kasey Edwards, Helpr Founder, Member of Closing the Women’s Wealth Gap
- Katharine Ransom, Researcher, California Institute of Integral Studies
- Kenneth J. Meier, Distinguished Scholar In Residence, American University
- Keridwyn Spiller, Ph.D. Student, University of California San Francisco
- Kim Price-Glynn, Associate Professor, University of Connecticut
- Kimberly Christensen, Economics Professor, Sarah Lawrence College
- Kimberly Lucas, Senior Director of Civic Research and Innovation, MetroLab Network
- Kirenia Brunson, Clinical Psychology Doctoral Trainee, Nova Southeastern University
- Kristin Smith, Visiting Research Associate Professor, Dartmouth College
- Laura Mauldin, Associate Professor, University of Connecticut
- Laura Punnett, Professor, University of Massachusetts Lowell
- Leah M. Janssen, Doctoral Candidate, Miami University
- Leigh Phillips, CEO, SaverLife
- Len Fishman, Director of Gerontology Institute, University of Massachusetts Boston
- Lenore Palladino, Assistant Professor of Economics & Public Policy, University of Massachusetts Amherst
- Leslie Salzinger, Associate Professor of Gender and Women’s Studies, University of California Berkeley
- Lewis Faulk, Associate Professor, American University
- Lisa Binns-Emerick, DNP, MSN, RN CS FGNLA, Geriatric Nurse Practitioner, Wayne Health Wayne State University
- Lisa Levenstein, Director of Women’s, Gender, and Sexuality Studies, University of North Carolina Greensboro
- Loretta Anderson, Board Member, University of Maryland St. Joseph Medical Center
- Lori Simon-Rusinowitz, Associate Professor, University of Maryland
- Lygia Sabbag Fares, Core Faculty, Brooklyn Institute for Social Research
- Lynet Uttal, Professor, University of Wisconsin Madison
- Manuel Garcia Dellacasa, Graduate student, University of Massachusetts Amherst
- Marc Cohen, Professor and Co-Director LeadingAge LTSS Center, University of Massachusetts Boston
- Marci Cottingham, Assistant Professor, University of Amsterdam
- Margaret K. Nelson, Hepburn Professor of Sociology Emerita, Middlebury College
- Maria Rerrich, Professor Emeritus, Munich University of Applied Sciences
- Maria S. Floro, Professor, American University
- Maria T. Brown, Assistant Research Professor, Syracuse University
- Mark Brennan-Ing, Director of Research and Evaluation, City University of New York Hunter College
- Mark Paul, Assistant Professor of Economics, New College of Florida
- Martha Tepepa, Research Scholar, Bard College
- Mary C. King, Professor of Economics Emerita, Portland State University
- Mary C. Tuominen, Professor Emerita, Denison University
- Mary Catherine Hannah, Executive Director, Perry Farm Village & Presbyterian Villages of Michigan
- Mary Louise Pomeroy, Ph.D. candidate, George Mason University
- Melissa Hodges, Associate Professor, Villanova University
- Melissa Milkie, President, Work and Family Researchers Network
- Michael Ash, Professor of Economics & Public Policy, University of Massachusetts Amherst
- Michael Logan, CEO, Michigan Masonic Home
- Michal Engelman, Associate Professor, University of Wisconsin Madison
- Mignon Duffy, Chair of Sociology Department, University of Massachusetts Lowell
- Mindy Fried, Ph.D., Principal, Arbor Consulting Partners
- Molly Wylie, Ph.D. Student, University of Massachusetts Boston
- Namkee G. Choi, Professor, University of Texas at Austin
- Nancy A Naples, Professor of Sociology and Women’s Gender, & Sexuality Studies, University of Connecticut
- Nancy R Folbre, Professor Emerita of Economics, University of Massachusetts Amherst
- Naomi Lightman, Assistant Professor, University of Calgary
- Nathan Boucher, Dr.PH., Assistant Research Professor, Duke University
- Nina Elizabeth Banks, Associate Professor of Economics, Bucknell University
- Orion H. Bell IV, President & CEO, Benjamin Rose Institute on Aging
- Pamela Nadash, Associate Professor, University of Massachusetts Boston
- Patricia J Lopez, Assistant Professor of Geography, Dartmouth College
- Patrick C Cullinane, Immediate Past Director & Council Co-Chair of UC Berkeley Retirement Center, Member of Advisory Council Kaiser Hospital Oakland
- Paula England, Silver Professor of Sociology, New York University
- Peter S. Arno, Senior Fellow, University of Massachusetts Amherst
- Philip A Rozario, Professor and Associate Dean of School of Social Work, Adelphi University
- Pilar Gonalons-Pons, Assistant Professor, University of Pennsylvania
- Raelene Shippee-Rice, Associate Professor Emerita, University of New Hampshire
- Rakeen Mabud, Senior Director of Research and Policy, TIME’S UP
- Randy Albelda, Professor of Economics, University of Massachusetts Boston
- Raven Weaver, Assistant Professor, Washington State University
- Honorable Richard T. Moore, Co-Chair of Legislation Work Group, Dignity Alliance Massachusetts
- Rie Harding, Graduate Student, University of Massachusetts Amherst
- Robin Lynn Bartlett, Professor Emerita in Economics, Women and Gender Studies and Queer Studies, Denison University
- Robyn Stone, Senior Vice President for Research and Co-Director of LTSS Center LeadingAge, University of Massachusetts Boston
- Ruth Milkman, Distinguished Professor of Sociology, City University of New York Graduate Center
- Samara Scheckler, Postdoctoral Fellow, Harvard University
- Sandra S. Butler, Professor and Director, University of Maine
- Sara Bybee, Ph.D. Candidate, University of Utah
- Scott A. Bass, Professor and Provost Emeritus, American University
- Shawn Fremstad, Senior Fellow, Center for Economic and Policy Research
- Smita Ramnarain, Associate Professor, University of Rhode Island
- Spencer Watson, Executive Director, Center for LGBTQ Economic Advancement & Research
- Stacey Jones, Senior Instructor of Economics, Seattle University
- Stefani Boutelier, Associate Professor, Aquinas College
- Stephan Lefebvre, Assistant Professor, Bucknell University
- Susan J. Ferguson, Professor of Sociology, Grinnell College
- Suzanne Helburn, Emerita Professor of Economics, University of Colorado Denver
- Taryn Morrissey, Associate Professor, American University
- Tarynn Witten, Emerita Full Professor, Virginia Commonwealth University
- Ted Burczak, Professor, Denison University
- Thomas M. Gill, M.D., Professor of Geriatric Medicine, Yale School of Medicine
- Traci M. Levy, Associate Professor of Political Science, Adelphi University
- Verena Cimarolli, Senior Health Services Research Associate, University of Massachusetts Boston
- Vivian Ho, Baker Institute Chair in Health Economics and Professor, Rice University
- Yana van der Meulen Rodgers, Faculty Director, Center for Women and Work Rutgers University
- Yavuz Yasar, Associate Professor, University of Denver
- Zarrina Juraqulova, Assistant Professor of Economics, Denison University
- Zdravka Todorova, Professor of Economics, Wright State University
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