US president-elect Joe Biden, who at 78 is set to become the oldest US president ever sworn in, has identified “protecting older Americans” as one of his priorities and promised to cut home care waiting lists and improve access to community services for the nation’s seniors.

As part of a10-year vision outlined in July, Mr Biden promised $US450 billion (more than $AU600 billion) to give more people the choice to receive care at home and to boost the caregiving and community health workforce by some 1.5 million jobs.

Expanding access to community support

Sounding a tune familiar to Australians, Mr Biden pledged to eliminate the waiting list for home and community services.

There are currently 800,000 Americans waiting for home and community care under the Medicaid program, which is designed to help medical costs for people with limited income and resources, with a wait of up to five years to access services.

Joe Biden

Once the waiting list is eliminated, which Mr Biden says he’ll do by increasing Medicaid funding, states will be given a choice to convert their existing home and community based Medicaid care services into a new state plan with enhanced federal funding.

He would  also establish a long-term services and support innovation fund to help expand home community based alternatives to residential care.

“A Biden Administration will dedicate substantial resources to this fund to help states and locally based entities test innovative models that expand home- and community-based alternatives to institutional care,” he said.

These could include day programs and respite services that enable unpaid caregivers to work, alternative home and community models that coordinate or directly provide care, or Medicaid buy-in models.

Rewarding careworkers

The president-elect said caregivers in the US have been unseen, underpaid and undervalued for too long and promised that under his administration they would be treated with respect and dignity and properly compensated.

Direct support professionals in the US earn around $US25,000 (less than $AU35,000) a year, Mr Biden said.

Under the Biden plan, they would get a pay rise and improved benefits, with training and career pathways to higher paying jobs, and the choice to join a union and collectively bargain.

Mr Biden has also pledged to ease the financial burden on families caring for aging relatives or family members with disabilities, and is proposing more to support informal caregivers via tax and social security credits.

“People in nursing homes have been hit especially hard by the coronavirus, shining a bright light on the fact that many would prefer to be in a home or community based setting,” he said in July.

“The pandemic has laid bare just how hard it is for people in this country to find access to quality caregiving they need for themselves, or to juggle the responsibilities of working and also caring for family members.”

The proposed aged care initiatives are part of a 10 year, $US775 billion overhaul of the nation’s caregiving framework, which will be paid for by rolling back tax breaks for real estate investors and increasing tax compliance from high-income earners.

This story first ran on Community Care Review.

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