The Biden Plan for Mobilizing American Talent and Heart to Create a 21st Century Caregiving and Education Workforce

  • Expand access to a broad array of long-term services and supports in local settings, including through closing the gaps in Medicaid for home- and community-based services and establishing a state innovation fund for creative, cost effective direct care services.
  • Ensure access to high-quality, affordable child care and offer universal preschool to three-and four-year olds through greater investment, expanded tax credits, and sliding-scale subsidies.
  • Build safe, energy-efficient, developmentally appropriate child care facilities, including in workplaces, so that parents and guardians never again have to search in vain for a suitable child care option.
  • Treat caregivers and early childhood educators with respect and dignity, and give them the pay and benefits they deserve, training and career ladders to higher-paying jobs, the choice to join a union and bargain collectively, and other fundamental work-related rights and protections.
  • Eliminate the current waitlist for home and community services under Medicaid. Approximately 800,000 people are on the waitlist for home and community care under Medicaid. It can take as many as five years for these individuals to get the services they badly need. Biden will increase Medicaid funding to states, the District of Columbia, and outlying territories to pay for the full cost of ensuring these 800,000 individuals and families receive long-term services and supports in the most appropriate setting, with the support of qualified care providers. Following the elimination of the current waiting list, states will be given a choice to convert their current home and community based care services waivers into a new state plan option with an enhanced federal match. This will enable states to make home and community-based services more available to people in need.
  • Establish a long-term services and supports innovation fund to help expand home- and community-based alternatives to institutional care. Biden believes we must move aggressively to eliminate the institutional bias that pervades our public programs. 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. These could include approaches that provide care while allowing individuals to retain independence, such as day programs and respite services that enable unpaid caregivers to work, alternative home and community models that coordinate or directly provide care, and Medicaid buy-in models. For example, the CAPABLE (Community Aging in Place-Advancing Better Living for Elders) Program provides home repairs and modifications to help create safer, more functional home environments for older adults. An initial trial in Baltimore found about $3,000 in program costs yielded more than $20,000 in savings. The pilot is now being tested in 27 cities in 16 states. Successful, cost-effective approaches to long-term care will be scaled up nationally. This fund will be administered by the Center for Medicare and Medicaid Innovation, which was established by the Affordable Care Act to support innovations that improve health care while constraining costs.
  • Improve caregiving and health outcomes in our nation’s most underserved communities by adding 150,000 community health workers. Addressing our nation’s caregiving challenges also requires investing more in communities that suffer from significant racial health disparities driven by chronic underfunding and systemic racial discrimination. Biden will more than triple the number of community health workers — often workers of color serving the communities where they live — who are part of a national effort to both prevent and treat chronic conditions in underserved, economically-disadvantaged urban and rural communities. He will do this by providing direct grant funding, as well as adding community health worker services as an optional benefit for states under Medicaid. Community health solutions can lead to better health outcomes, allow people to live with more independence, and ease caregiving challenges through a focus on prevention and care coordination, reducing unnecessary and expensive hospitalization. And, in times of a health crisis, they can be repurposed to quickly fill basic public health needs. Repeated studies from across the country, including North Carolina and Philadelphia, have shown that investments in community-based health care and health workers save money by reducing hospitalizations and costly treatments that could have been avoided or better managed, while also improving health and improving career ladders for workers, with annual savings of up to $2,290 per beneficiary. A recent study revealed that every dollar spent on community health workers would yield $2.47 in savings.
  • Fill additional gaps in the nation’s health care infrastructure that impact families’ caregiving responsibilities.
  • Address the opioid epidemic and substance use disorders by training 35,000 workers to provide critical support. Today, we have a shortage of workers to help Americans experiencing substance use disorders. Biden will increase funding and training for workers to provide counseling, care, and peer support for these individuals.
  • Engage in a national strategy to recruit, retain and empower nursing professionals. Biden will fully and rapidly implement the CARES Act which allocated nearly $1 billion over four years to address nursing burnout, faculty recruitment and retention, and increase nursing workforce diversity. A Biden administration will provide additional funding to ensure we are building up the training, clinical and educational capacity to welcome — not turn away — the qualified individuals interested in nursing education and training, bolstering the nursing profession for years to come.
  • Create tens of thousands of jobs providing care to veterans by filling severe occupational shortages and vacant positions at almost every U.S. Department of Veterans Affairs facility. Biden will remove existing hiring and pay barriers that make it difficult to replace valued employees once they depart. These investments will ensure we fulfill our sacred obligation to provide high-quality care to our veterans.
  • Provide resources for Indian Health Service to create new health care jobs. The Indian Health Service (IHS) has been underfunded for decades, and does not have enough doctors or nurses to provide necessary care for American Indians and Alaska Natives. Biden has called for dramatically increasing funding for Indian Health Service — and making it mandatory — allowing IHS to recruit, train, and pay health professionals.
  • Create a Public Health Jobs Corps. In partnership with state and local governments, and in consultation with unions, Biden will mobilize at least 100,000 additional Americans with support from trusted local organizations in communities most at risk across the country to perform culturally competent approaches to identify people at risk of contracting or spreading infectious diseases, including COVID-19; staff social isolation hotlines (similar to the data-informed model of the Crisis Text Line); provide COVID-19 vaccinations to immunize the population as quickly as possible; and conduct local outreach efforts to support people who are at high risk of COVID-19, especially low and moderate-income families, communities of color, and older adults. Beyond the current pandemic, those who enter the U.S. Public Health Jobs Corps will be positioned to take on jobs as community health workers and other jobs that help build longer term health infrastructure — including fighting the opioid epidemic and addressing social determinants of health.
  • Provide all 3- and 4-year-olds access to free, high-quality pre-kindergarten, laying a strong foundation for children and saving parents thousands of dollars a year on child care costs. Students who enter kindergarten school-ready are nearly two times more likely to master basic skills by age 11, and high-quality preschool is critical to this preparation. One study found students who enter kindergarten school-ready are also less likely to repeat a grade and are more likely to graduate from high school. And studies show that high-quality preschool reduces the school readiness gap caused by systemic racism. So parents and guardians can choose what works for them, Biden will partner with states to provide a mixed delivery system that includes public school systems, child care centers and family child care providers, and Head Start.
  • Offer low-income and middle-class families an up to $8,000 tax credit to help pay for child care. Families will get back as a tax credit as much as half of their spending on child care for children under age 13, up to a total of $8,000 for one child or $16,000 for two or more children. The tax credit will be refundable, meaning that families who don’t owe a lot in taxes will still benefit, and Biden will actively work with child care experts to explore ways to make it advanced, so cash-strapped families can immediately benefit from the credit. The full 50% reimbursement will be available to families making less than $125,000 a year. And, all families making between $125,000 and $400,000 will receive a partial credit ensuring that in no case will they get less under the Biden plan than they are eligible for today.
  • Provide access to affordable, high-quality child care on a sliding scale for low-income and middle-class families who would prefer this option over the tax credit for young children. For young children ages 0–5, Biden will adopt the child care program envisioned in Senator Murray and Congressman Bobby Scott’s bipartisan Child Care for Working Families Act. He will:
  • Save families money by helping them with child care costs. Biden will partner with states to provide sliding scale subsidies so that the cost of child care for low-income and middle-class families will be based on what they can afford. For children under the age of 5, no family earning below 1.5 times the median income in their state will have to pay more than 7% of their income for quality care, which was the affordable child care benchmark set by the Obama-Biden Administration. A typical family will pay no more than $45 per week. For the most-hard pressed working families, such early childcare costs would be fully covered, saving these families about $200 per week. Biden will also set aside a portion of the funds for tribes to expand access to quality child care for Native children, as well as for outlying areas including U.S. territories.
  • Invest in quality child care standards and a well-trained and well-compensated child care workforce. The quality of care matters: nearly all of brain development happens before a child turns three-years-old. For low-income children, every dollar invested in high-quality child care can result in a $7.30 return with lifetime impacts for children, as they grow up healthier, do better in school, and earn more over the course of their lifetimes. Biden will ensure families have access to the quality care their children need by working in partnership with states to ensure providers meet rigorous quality standards. These standards will include a developmentally appropriate curriculum, small class sizes, and support positive interactions between educators and children that promote children’s socio-emotional development. He will also provide funding reflective of the true cost of quality care. Recognizing that quality begins with supporting the early childhood workforce, Biden will invest in strategies to retain and grow the pool of diverse, talented early childhood educators and give them the time, resources and support — like coaches, training and education opportunities for certification, and financial stability — that they need to provide children an excellent education.
  • Expand access to care that works for working parents. Biden will provide incentives for providers to fill critical child care shortages, including in the early mornings, evenings, and weekends, and in many rural communities that have few providers today. He will offer bonus payments to providers who operate during nontraditional hours and create a Child Care Growth and Innovation fund that will provide grants to programs filling essential needs, including expanding access to high-quality care for families with high barriers to care. He will also ensure all families will be able to choose high-quality child care that works for them, whether a child care center, home-based care with a family child care provider, or an informal arrangement with a friend, family member, or neighbor. And, Biden will build on the Obama-Biden Administration’s efforts to ensure Early Head Start is an option for families that will benefit from comprehensive family support and child development resources, including through doubling Early Head Start-Child Care Partnerships.
  • Ensure families with school-aged children have expanded access to after-school, weekend, and summer care. Biden will expand Child Care Development Block Grant subsidies to increase the number of school-aged children up to age 13 in low-income families who can benefit from the program. Low- and middle-income families will also be able to take advantage of Biden’s expanded, refundable tax credit to help cover after-school, weekend, and summer care costs. And Biden will expand support for community schools, which often provide before, after-school, and summer learning opportunities, and increase funding for after-school programs, community centers, and extracurriculars to keep children safe, learning, and having fun when school is not in session. This includes expanding the 21st Century Community Learning Centers that provide critical enrichment opportunities for school-aged children.
  • Invest in child care and other wraparound services at community colleges, so parents don’t have to choose between their own education and their children. One in four community college students is a parent — and these parents are disproportionately students of color, and over half are Black women — yet most colleges do not offer child care. It can be hard for many of these parents to graduate while juggling an extra job to pay their bills or caring for their children. Biden will provide funds for states, the District of Columbia, and outlying territories to invest in wraparound services at community colleges, which could include child care for students’ children, while also creating new jobs for early childhood educators in the process.
  • Make sure more military children have access to the quality child care Department of Defense provides. Biden will fully fund installation-based child care facilities and expand awareness of the U.S. Department of Defense fee assistance program, as supported by leading advocates for military families, so that military spouses can more easily pursue their education and careers and tap into respite care to relieve the stresses of deployments, and members of our military can rest easier knowing their children are well cared for.
  • Increased pay. No one should have to work more than one job to make ends meet. Biden will ensure caregivers and early childhood educators receive a raise, and get the pay they deserve, including by setting standards for the funding allocated under this plan. And, there is no reason an educator teaching toddlers should be making less than a similarly qualified kindergarten educator — Biden will also ensure early childhood educators in child care settings and public schools receive similar pay and benefits to elementary school teachers if they have similar qualifications and experience.
  • Benefits they have earned. Benefits include affordable health care through their jobs or Biden’s new public option, federally-provided paid family and medical leave for up to 12 weeks, up to 7 days of paid sick leave, and affordable child care for their own children.
  • Stronger legal protections and the choice to join a union and collectively bargain. Biden will work to ensure all workers — including direct support workers and early childhood educators — have an effective, meaningful way to unionize and collectively bargain, whether they work in a center- or home-based setting. He will make it easier to organize by signing the Protecting the Right to Organize (PRO) Act and providing local and state government workers with bargaining rights, fully restoring collective bargaining to federal government workers, and also improving the conditions of many care jobs by signing into law the Domestic Workers’ Bill of Rights.
  • Training and career ladders. Home care workers and early educators deserve opportunities for quality training and education and meaningful credentials so they can earn higher wages, develop rewarding and lasting careers, and stay in their jobs for longer, critical ingredients to delivering high-quality care and education. Biden will expand opportunities for these workers to earn needed credentials by investing in high quality training and education programs that lead to a certificate, as well as ongoing, job-embedded training and professional development through programs like labor-management training and registered apprenticeships. He will work with employers, unions and worker organizations, community colleges, the public workforce system, and organizations representing older Americans and people with disabilities and early childhood educators to modernize and develop new training programs for these jobs. Critically, he’ll provide funding for states to hire coaches for early childhood educators to continuously help them deliver high-quality learning experiences. And, he will create opportunities for these workers to further upskill, while building a pipeline of diverse early educators and health workers, through his plan for Education Beyond High School.



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Joe Biden

Joe Biden

Senator, Vice President, 2020 candidate for President, husband to Jill, proud father and grandfather. Join our campaign: