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,

1. Alison Earle, Principal Research Analyst, University of California Los Angeles
2. Alyssa J Alexander, Ph.D. Candidate
3. Alyssa Schneebaum, Assistant Professor of Economics, Vienna University of Economics
and Business
4. Amy Armenia, Professor of Sociology, Rollins College
5. Andrea Ziegert, Julian Robertson Jr. Professor of Economics, Denison University
6. Anna A. Amirkhanyan, Associate Professor of Economics, American University
7. Arne L. Kalleberg, Kenan Distinguished Professor of Sociology, University of North
Carolina at Chapel Hill
8. Arthur MacEwan, Professor Emeritus of Economics, University of Massachusetts
Boston
9. Barbara E. Hopkins, Professor, Wright State University
10. Barbara R. Lowrey, Retired adjunct faculty member, University of Maryland
11. Beth Almeida, Principal, Cove Research
12. Betsey Stevenson, Professor of Economics and Public Policy, University of Michigan
13. Bina Agarwal, Professor of Development Economics and Environment, University of
Manchester
14. Brenda C. Spillman, Senior Fellow, Urban Institute
15. Brenda Powell, Independent financial adviser
16. Brenda Wyss, Professor of Economics, Wheaton College
17. Camila Bustamante Pérez, Consultant, United Nations Economic Commission for Latin
America and the Caribbean
18. Candace Howes, Ferrin Professor of Economics, Connecticut College
19. Candidus C Nwakasi, Assistant Professor, Providence College
20. Caren Grown, Global Director of Gender Group, World Bank
21. Carmen Diana Deere, Distinguished Professor Emerita of Food & Resource Economics,
University of Florida
22. Carol Scotton, Associate Professor, Knox College
23. Carole Joffe, Professor Emerita of Sociology, U.C.Davis
24. Carrie R. Leans, George H. Love Professor of Organizations and Management,
University of Pittsburgh
25. Carroll L. Estes, Professor and Founding Director Emerita, University of California San
Francisco
26. Chiara Piovani, Associate Professor, University of Denver
27. Chih-ling Liou, Associate Professor, Kent State University at Stark
28. Christian E. Weller, Professor, University of Massachusetts Boston
29. Christina Barmon, Assistant Professor, Central Connecticut State University
30. Christina Matz, Associate Professor, Boston College
31. Christine E. Bishop, Atran Professor of Labor Economics, Brandeis University
32. Clare L. Stacey, Associate Professor of Sociology, Kent State University
33. Colleen Wynn, Assistant Professor, University of Indianapolis
34. Cybelle Fox, Professor of Sociology, UC Berkeley
35. Dara Orenstein, Associate Professor of American Studies , George Washington
University
36. Darrick Hamilton, Henry Cohen Professor of Economics and Urban Policy, The New
School
37. Dean Baker, Senior Economist, Center for Economic and Policy Research
38. Debra Fortune Tomasino, Ph.D. Student, University of Connecticut
39. Diana Strassmann, Carolyn & Fred McManis Distinguished Professor in the Practice,
Rice University
40. Diane Archer, President, Just Care USA
41. Diane Feeney Mahoney, Professor Emerita and Gerontechnologist, MGH Institute for
Health Professions
42. Doree Ann Ventura-Espiritu, MD, Medical Director, Henry Ford Health System
Behavioral Health
43. Douglas A Wolf, Professor, Syracuse University
44. Ebru Kongar, Professor of Economics, Dickinson College
45. Edith Kuiper, Associate Professor, State University of New York New Paltz
46. Edward Alan Miller, Professor, University of Massachusetts Boston
47. Eileen Appelbaum, Co-Director, Center for Economic and Policy Research
48. Eileen Boris, Hull Professor and Distinguished Professor of Feminist Studies, University
of California Santa Barbara
49. Elena Kulikov, Professor and Chair of Department of Public Administration, California
State University Dominguez Hills
50. Elena O. Lingas, Associate Professor, Touro University California
51. Elissa Braunstein, Professor and Chair of Economics, Colorado State University
52. Emily Abel, Professor Emerita, University of California Los Angeles
53. Emily Agree, Professor, Johns Hopkins University
54. Emily Ellis, Ph.D. Student, University of Chicago
55. Emily Franzosa, Assistant Professor, Icahn School of Medicine at Mount Sinai
56. Emma K. Tsui, Associate Professor, City University of New York John Jay College
57. Felicia Kornbluh, Ph.D., Professor of History and Gender, Sexuality, and Women's
Studies, University of Vermont
58. Francesca Degiuli, Associate Professor of Sociology, Fairleigh Dickinson University
59. Geert Dhondt, Associate Professor, City University of New York John Jay
60. Girshriela Green, Senior Organizer, United for Respect
61. Grazielle Figueredo, Graduate student, University of Massachusetts Amherst
62. Gretchen Donehower, Academic Specialist, University of California Berkeley
63. H. Elizabeth Peters, Institute Fellow and Professor Emerita, Urban Institute and
Cornell University
64. Hande Togrul, ParaEducator, Open Classroom
65. Heather L Menne, Senior Health Policy Researcher, RTI International
66. Heidi Hartmann, Distinguished Economist, American University
67. Heidi Shierholz, Senior Economist and Director, of Policy, Economic Policy Institute
68. Holly Reed, Professor, City University of New York Queens College
69. Howard Stein, Professor, University of Michigan
70. Iris Chi, Professor, University of Southern California
71. Isaac Jabola-Carolus, Ph.D. Candidate, City University of New York Graduate Center
72. Iveris L. Martinez, Director & Archstone Foundation Endowed Chair in Gerontology
Center for Successful Aging, California State University Long Beach
73. Ivy Ken, Associate Professor of Sociology, George Washington University
74. Jacqueline Marie McGinley, Assistant Professor, Binghamton University
75. James Heintz, Professor and Chair of Economics Department, University of
Massachusetts Amherst
76. Jamie L. McQueen, Director of Academics and Assistant Professor, Wayne State
University
77. Jane L. Tavares, Research Fellow, University of Massachusetts Boston
78. Janet C. Gornick, Professor of Political Science and Sociology / Director, Stone Center
Graduate Center, City University of New York
79. Janet C. Gornick, Professor of Political Science and Sociology and Director of Stone
Center, City University of New York Graduate Center
80. Jasmine Travers, Assistant Professor, New York University
81. Jayati Ghosh, Professor, University of Massachusetts Amherst
82. Jeanne Koopman, Researcher, Boston University
83. Jeannette Wicks-Lim, Associate Research Professor, University of Massachusetts
Amherst
84. Jeffrey A. Hayes, Chief Data Analyst, Institute for Women's Policy Research
85. Jen S Lendrum, Assistant Professor, Aquinas College
86. Jennie Kaufman, Research Associate, Hunter College
87. Jennifer C Olmsted, Professor, Drew University
88. Jennifer Cohen, Assistant Professor, Miami University
89. Jennifer Craft Morgan, Associate Professor, Georgia State University
90. Jennifer Heston-Mullins, Research Scholar, Miami University
91. Jennifer Mendez, Associate Professor, Wayne State University
92. Jennifer N. Fish, Professor and Chair of Women’s Studies, Old Dominion University
93. Jhumpa Bhattacharya, Vice President of Programs and Strategy, Insight Center
94. Jim Campen, Professor Emeritus, University of Massachusetts Boston
95. Joan C Tronto, Professor Emerita, University of Minnesota and City University of New
York
96. Joan Ilardo, Director of Research Initiatives, Michigan State University College of
Human Studies
97. Joanne Spetz, Director of Philip R Lee Institute for Health Policy Studies, University of
California San Francisco
98. Jocelyn Olcott, Margaret Taylor Smith Director of Gender, Sexuality & Feminist
Studies, Duke University
99. John L. Hall Ph.D, Director Behavioral Health, envoyatHome
100. John Schumacher, Associate Professor, University of Maryland Baltimore
County
101. Joy Swanson Ernst, Associate Professor, Wayne State University
102. Joya Misra, Professor of Sociology & Public Policy, University of Massachusetts
Amherst
103. Judith Lorber, Professor Emerita, City University of New York Graduate Center
104. Julie A. Nelson, Professor Emeritus of Economics, University of Massachusetts
Boston
105. Jun Li, Assistant Professor, Syracuse University
106. Karen V. Hansen, Professor of Sociology and Women's, Gender, and Sexuality
Studies, Brandeis University
107. Kasey Edwards, Helpr Founder, Member of Closing the Women’s Wealth Gap
108. Katharine Ransom, Researcher, California Institute of Integral Studies
109. Kenneth J. Meier, Distinguished Scholar In Residence, American University
110. Keridwyn Spiller, Ph.D. Student, University of California San Francisco
111. Kim Price-Glynn, Associate Professor, University of Connecticut
112. Kimberly Christensen, Economics Professor, Sarah Lawrence College
113. Kimberly Lucas, Senior Director of Civic Research and Innovation, MetroLab
Network
114. Kirenia Brunson, Clinical Psychology Doctoral Trainee, Nova Southeastern
University
115. Kristin Smith, Visiting Research Associate Professor, Dartmouth College
116. Laura Mauldin, Associate Professor, University of Connecticut
117. Laura Punnett, Professor, University of Massachusetts Lowell
118. Leah M. Janssen, Doctoral Candidate, Miami University
119. Leigh Phillips, CEO, SaverLife
120. Len Fishman, Director of Gerontology Institute, University of Massachusetts
Boston
121. Lenore Palladino, Assistant Professor of Economics & Public Policy, University
of Massachusetts Amherst
122. Leslie Salzinger, Associate Professor of Gender and Women's Studies, University
of California Berkeley
123. Lewis Faulk, Associate Professor, American University
124. Lisa Binns-Emerick, DNP, MSN, RN CS FGNLA, Geriatric Nurse Practitioner,
Wayne Health Wayne State University
125. Lisa Levenstein, Director of Women's, Gender, and Sexuality Studies, University
of North Carolina Greensboro
126. Loretta Anderson, Board Member, University of Maryland St. Joseph Medical
Center
127. Lori Simon-Rusinowitz, Associate Professor, University of Maryland
128. Lygia Sabbag Fares, Core Faculty, Brooklyn Institute for Social Research
129. Lynet Uttal, Professor, University of Wisconsin Madison
130. Manuel Garcia Dellacasa, Graduate student, University of Massachusetts
Amherst
131. Marc Cohen, Professor and Co-Director LeadingAge LTSS Center, University of
Massachusetts Boston
132. Marci Cottingham, Assistant Professor, University of Amsterdam
133. Margaret K. Nelson, Hepburn Professor of Sociology Emerita, Middlebury
College
134. Maria Rerrich, Professor Emeritus, Munich University of Applied Sciences
135. Maria S. Floro, Professor, American University
136. Maria T. Brown, Assistant Research Professor, Syracuse University
137. Mark Brennan-Ing, Director of Research and Evaluation, City University of New
York Hunter College
138. Mark Paul, Assistant Professor of Economics, New College of Florida
139. Martha Tepepa, Research Scholar, Bard College
140. Mary C. King, Professor of Economics Emerita, Portland State University
141. Mary C. Tuominen, Professor Emerita, Denison University
142. Mary Catherine Hannah, Executive Director, Perry Farm Village & Presbyterian
Villages of Michigan
143. Mary Louise Pomeroy, Ph.D. candidate, George Mason University
144. Melissa Hodges, Associate Professor, Villanova University
145. Melissa Milkie, President, Work and Family Researchers Network
146. Michael Ash, Professor of Economics & Public Policy, University of
Massachusetts Amherst
147. Michael Logan, CEO, Michigan Masonic Home
148. Michal Engelman, Associate Professor, University of Wisconsin Madison
149. Mignon Duffy, Chair of Sociology Department, University of Massachusetts
Lowell
150. Mindy Fried, Ph.D., Principal, Arbor Consulting Partners
151. Molly Wylie, Ph.D. Student, University of Massachusetts Boston
152. Namkee G. Choi, Professor, University of Texas at Austin
153. Nancy A Naples, Professor of Sociology and Women's Gender, & Sexuality
Studies, University of Connecticut
154. Nancy R Folbre, Professor Emerita of Economics, University of Massachusetts
Amherst
155. Naomi Lightman, Assistant Professor, University of Calgary
156. Nathan Boucher, Dr.PH., Assistant Research Professor, Duke University
157. Nina Elizabeth Banks, Associate Professor of Economics, Bucknell University
158. Orion H. Bell IV, President & CEO, Benjamin Rose Institute on Aging
159. Pamela Nadash, Associate Professor, University of Massachusetts Boston
160. Patricia J Lopez, Assistant Professor of Geography, Dartmouth College
161. Patrick C Cullinane, Immediate Past Director & Council Co-Chair of UC
Berkeley Retirement Center, Member of Advisory Council Kaiser Hospital Oakland
162. Paula England, Silver Professor of Sociology, New York University
163. Peter S. Arno, Senior Fellow, University of Massachusetts Amherst
164. Philip A Rozario, Professor and Associate Dean of School of Social Work,
Adelphi University
165. Pilar Gonalons-Pons, Assistant Professor, University of Pennsylvania
166. Raelene Shippee-Rice, Associate Professor Emerita, University of New
Hampshire
167. Rakeen Mabud, Senior Director of Research and Policy, TIME'S UP
168. Randy Albelda, Professor of Economics, University of Massachusetts Boston
169. Raven Weaver, Assistant Professor, Washington State University
170. Honorable Richard T. Moore, Co-Chair of Legislation Work Group, Dignity
Alliance Massachusetts
171. Rie Harding, Graduate Student, University of Massachusetts Amherst
172. Robin Lynn Bartlett, Professor Emerita in Economics, Women and Gender
Studies and Queer Studies, Denison University
173. Robyn Stone, Senior Vice President for Research and Co-Director of LTSS
Center LeadingAge, University of Massachusetts Boston
174. Ruth Milkman, Distinguished Professor of Sociology, City University of New
York Graduate Center
175. Samara Scheckler, Postdoctoral Fellow, Harvard University
176. Sandra S. Butler, Professor and Director, University of Maine
177. Sara Bybee, Ph.D. Candidate, University of Utah
178. Scott A. Bass, Professor and Provost Emeritus, American University
179. Shawn Fremstad, Senior Fellow, Center for Economic and Policy Research
180. Smita Ramnarain, Associate Professor, University of Rhode Island
181. Spencer Watson, Executive Director, Center for LGBTQ Economic Advancement
& Research
182. Stacey Jones, Senior Instructor of Economics, Seattle University
183. Stefani Boutelier, Associate Professor, Aquinas College
184. Stephan Lefebvre, Assistant Professor, Bucknell University
185. Susan J. Ferguson, Professor of Sociology, Grinnell College
186. Suzanne Helburn, Emerita Professor of Economics, University of Colorado
Denver
187. Taryn Morrissey, Associate Professor, American University
188. Tarynn Witten, Emerita Full Professor, Virginia Commonwealth University
189. Ted Burczak, Professor, Denison University
190. Thomas M. Gill, M.D., Professor of Geriatric Medicine, Yale School of Medicine
191. Traci M. Levy, Associate Professor of Political Science, Adelphi University
192. Verena Cimarolli, Senior Health Services Research Associate, University of
Massachusetts Boston
193. Vivian Ho, Baker Institute Chair in Health Economics and Professor, Rice
University
194. Yana van der Meulen Rodgers, Faculty Director, Center for Women and Work
Rutgers University
195. Yavuz Yasar, Associate Professor, University of Denver
196. Zarrina Juraqulova, Assistant Professor of Economics, Denison University
197. Zdravka Todorova, Professor of Economics, Wright State University

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Year: 
2021