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Biden Executive Order Provides Sweeping Support to Family Caregivers, Long-Term Care Workers

Directives expand access to affordable, high-quality care and assist family members and workers who care for older adults


spinner image President Biden speaking in the Rose Garden of the White House on April 18, 2023 at an event to recognize family caregivers
President Biden speaking in the Rose Garden of the White House
Cheriss May for AARP

Access to high-quality care for older Americans and support for family caregivers, long-term care workers, early educators and veterans will be improved under an executive order President Joe Biden signed on April 18. AARP has long called for increased support for family caregivers and workers.

In a White House Rose Garden ceremony, the president called the order the “most comprehensive set of actions any administration has taken to date” on care issues. Biden said that with almost every federal agency involved, they will collectively take “over 50 actions to provide more peace of mind for families, and dignity for care workers, who deserve jobs with good pay and good benefits.”

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According to a recent AARP report, the care Americans provide to their family and friends totals an estimated $600 billion in unpaid labor per year.

“AARP applauds today’s Executive Order recognizing the need to make family caregivers a national priority to meet the rapidly growing needs of families across America,” Nancy LeaMond, AARP executive vice president and chief advocacy and engagement officer, said in a statement.

“Today’s Executive Order is an important step forward, building on the first-ever National Strategy to Support Family Caregivers released last fall, the result of years of bipartisan effort in Congress,” LeaMond added. “We stand ready to work with the Administration to advance the important policies to support family caregivers and the long-term workforce. We will continue to work with bipartisan leaders in Congress to advance legislation that can further deliver relief to family caregivers such as paid leave, family caregiver tax credits and other reimbursement programs, and other supports.”

Angie and Phil Roman of Pennsylvania said they were honored to be at the White House. They joined an audience of caregivers, workers and advocates invited to witness the signing of the executive order.

spinner image Angie and Phil Roman at the White House
Angie and Phil Roman at the White House
Cheriss May for AARP

The couple tirelessly advocated for and provided care to both sets of their parents for seven years, an endeavor that impacted “literally every member of the family,” Angie Roman said. She acknowledged that being able to have her loved ones age in place in a home setting among their family was priceless. “When we started caregiving [my husband] said, ‘I don't think we can do this. I don't think I can do this.’ And when it ended, he said, ‘I'm glad we were able to do this.’”

The executive order includes action to:

Improve access to home-based care for veterans. The order directs the Department of Veterans Affairs (VA) to improve access to home-based care for veterans who need support with activities of daily living. The VA will also consider adding 75 new interdisciplinary teams to its home-based primary care program to serve an additional 5,600 veterans in their homes.

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Enhance job quality for long-term care workers. The order directs the Department of Health and Human Services (HHS) to consider issuing guidance to improve the quality of home care jobs by leveraging Medicaid funding to ensure there are enough home care workers to aid seniors and people with disabilities enrolled in Medicaid.

Support family caregivers. The order directs HHS to consider testing a new dementia care initiative that will include support for respite care and provide more support to family caregivers when a loved one is being discharged from the hospital. The VA will also consider expanding access to its Program of Comprehensive Assistance for Family Caregivers and provide more mental health support for caregivers enrolled in that program. 

During the ceremony Biden spoke anecdotally about his time as a solo caregiver after his first wife and daughter died and said that he couldn’t have managed without family support. He acknowledged the dilemma facing many today in the sandwich generation.

In the “United States of America no one should have to choose between caring for the parents who raised them, the children who depend on them or the paycheck they rely on to take care of both,” he said. “Folks lie awake at night wondering, if mom can’t take care of herself at home, what are we going to do? She’s about to move into a nursing home. Are we going to be able to afford it? Can I still afford to get the kids to college and save for retirement? How do I do it all?”

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