Long-Term Care Workforce Support Act
Sponsored By: Representative Rep. Dingell, Debbie [D-MI-6]
Introduced
Summary
Boost pay and working conditions for the direct care workforce. This bill creates a cross‑cutting federal plan of grants, Medicaid incentives, training programs, a $5,000 worker tax credit, and new workplace rights to stabilize, grow, and diversify workers who help older adults and people with disabilities.
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- Families and care recipients: Expands home and community‑based services to help people stay out of institutions, makes the Money Follows the Person demonstration permanent with new funding, and prioritizes states with HCBS waiting lists to reduce delays in care.
- Direct care workers: Establishes written employment agreements, fair scheduling rules, meal and rest break guarantees, anti‑retaliation protections, paid sick time accrual of 1 hour per 30 hours worked (up to 56 hours a year), workplace violence prevention plans, training grants, and a $5,000 nonrefundable tax credit for eligible long‑term care workers.
- States and providers: Offers a 10 percentage point Medicaid matching boost for eligible long‑term care spending from FY2026 to FY2035 (capped at 95 percent) and authorizes large state grant programs including a $100.0 billion fund to increase wages, training, and HCBS capacity.
*Authorizes substantial new federal spending, including a $100.0 billion Medicaid grant program and other multi‑year authorizations, so it would increase federal outlays.*
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Bill Overview
Analyzed Economic Effects
11 provisions identified: 11 benefits, 0 costs, 0 mixed.
Stronger spousal HCBS protections
If enacted, the bill would make permanent and widen the rule that protects spouses from impoverishment when their partner gets home and community-based Medicaid services. The change applies to more HCBS eligibility categories and takes effect upon enactment.
New $5,000 worker tax credit
If enacted, qualifying long-term care direct care workers would be able to claim a $5,000 nonrefundable federal income tax credit for tax years beginning after Dec 31, 2024. The credit is nonrefundable, so it cannot exceed your federal income tax liability for the year.
Medicaid match boost and rules
If enacted, eligible States would get a 10 percentage point FMAP boost for long-term care spending each quarter in fiscal years 2026–2035, but the boost cannot raise a State's FMAP above 95 percent. States must apply, make assurances, spend the money by Sept 30, 2037, and show that the funds supplement (not supplant) existing State spending and raise provider reimbursement to support worker pay. The bill also adds annual evaluations and reporting and authorizes $500 million per year for the Money Follows the Person program after FY2026.
Medicare bonus for trained workers
If enacted, direct care professionals who complete qualifying demonstration training would receive an extra payment equal to 25 percent of the Medicare Part B payment for qualifying long-term care services furnished on or after Oct 1, 2026. The extra payment would be paid to the direct care professional in addition to the usual Part B payment.
Mental health and well‑being supports
If enacted, HHS would run a national initiative to prevent suicide and substance problems among direct care workers and fund grants to build mental health and resiliency programs. The bill would require a validated, anonymous biennial well-being survey and report results to Congress. The program is authorized at $20 million per year for grants and $6 million per year for the well-being assessment over specified years.
Better schedules, sick pay, privacy
If enacted, employers of covered direct care workers would have to give 72 hours written notice for schedule changes. If a shift is cancelled after you arrive, you would be paid for the scheduled hours. You would earn at least 1 hour of paid sick time for every 30 hours worked, up to 56 hours a year, usually usable after 60 days. The bill would require written employment agreements for workers expected to work at least 8 hours per week and add limits on monitoring and immigration-related retaliation.
Stronger wage enforcement and grants
If enacted, the Labor Department would get competitive grants to help workers recover unpaid wages and to run outreach and investigations. Grant winners must sign a memorandum with the Secretary within 60 days. Workers could sue for denied wages, interest, and liquidated damages, with most claims filed within 2 years (3 years for willful violations). The bill would authorize $50 million per year for the grant program for 2026–2030.
Grants for training and career pay
If enacted, HHS and HRSA would run many new grant programs to train and advance direct care workers. The bill would authorize $500 million per year for competitive training grants (FY2026–2030). States would get $400 million per year for training grants (FY2026–2030) allocated by older-or-disabled population share, with a 0.25% state minimum and 2% reserved for tribes. Grants must include apprenticeships, progressive trainee wages (at least the federal minimum), and at least 30 percent career-pathway projects. Some grants also fund scholarships and rural student pipeline programs.
National TA, standards, and strategy
If enacted, HHS would stand up a national compensation advisory council and publish a national compensation strategy within 18 months. The bill would fund a national technical assistance center and an equity-focused TA center ($10 million per year each, FY2026–2030) and create a short-lived training standards commission (report due within 3 years). These efforts would support consistent training, equity, and pay guidance for direct care workers.
New workplace violence rules
If enacted, the Secretary of Labor would issue an interim workplace violence standard within 1 year and a final standard within 42 months. Covered employers would need written prevention plans, training, incident logs, and investigations. Medicare hospitals and nursing homes would have specific compliance timing and employers would post annual summaries and file yearly reports.
Grants to help domestic workers
If enacted, the Labor Department would run a competitive national grant program to train and place domestic workers. Grants would fund training, English classes, safety training, and job services. Congress authorized $10 million per year for fiscal years 2026–2030 for this program.
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Sponsors & CoSponsors
Sponsor
Rep. Dingell, Debbie [D-MI-6]
MI • D
Cosponsors
Rep. Matsui, Doris O. [D-CA-7]
CA • D
Sponsored 4/28/2026
Rep. Simon, Lateefah [D-CA-12]
CA • D
Sponsored 5/11/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 5/12/2026
Roll Call Votes
No roll call votes available for this bill.
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