The Biden Plan for Mobilizing American Talent and Heart to Create a 21st Century
Caregiving and Education Workforce
Joe Biden has taken care of aging parents, and he’s been a single parent. Biden knows how hard
it is to raise a family and to care for a sick family member. And, he knows how hard it is for
millions of Americans who are just trying to make ends meet.
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. 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. And, many parents are struggling to find child care while they go to their essential jobs,
or find themselves as 24/7 caregivers trying to keep their children safe and learning while
working remotely. Other parents are caring for their kids, while worrying about how they will
make ends meet after having hours cut or losing their jobs. And, at the same time, professional
caregivers have either lost their jobs or continue to work while putting their lives at risk without
sufficient pay and benefits. President Trump’s failure to take action to control the coronavirus
has worsened all of these challenges facing families across the country.
Even before the pandemic, our country was experiencing a caregiving crisis. Some care needs
were going untended. Other care needs were filled by Americans serving as unpaid caregivers
lacking the financial support or respite care they needed, and sometimes putting their careers on
hold. Often, families made caregiving decisions that came with great financial, professional,
physical and emotional costs. Caregivers and early childhood educators - disproportionately
women of color - have been underpaid, unseen, and undervalued for far too long.
Biden believes that if we truly want to reward work in this country, we have to ease the financial
burden of care that families are carrying, and we have to elevate the compensation, benefits,
training and education opportunities for certification, and dignity of caregiving workers and
educators.
Biden’s​ economic recovery plan​ won’t just build back our economy to the way it was before, but
build it back better - including by building a robust 21st century caregiving and education
workforce. ​As a first step, Biden will immediately provide states, tribal, and local
governments with the fiscal relief they need to keep workers employed and keep vital
public services running, including direct care and child care services.
Once we are able to move from relief to recovery, Biden will make substantial investments in the
infrastructure of care in our country — to make child care more affordable and accessible for
working families, and to make it easier for aging relatives and loved ones with disabilities to
have quality, affordable home- or community-based care. And, he is proposing to give

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 caregiving workers and early childhood educators a raise and stronger benefits, treating them as
the professionals they are.
These steps will mean families will be able to afford better, more productive care and early
education for their loved ones. They will also have a significant jobs impact: ​This plan,
combined with Biden’s proposal to provide families with up to 12 weeks of paid family and
medical leave, will put 3 million Americans to work in new care and education jobs, and increase
overall employment by about 5 million after taking into account the economic impacts of
increased labor force participation after unpaid caregivers - disproportionately women - are freed
up to pursue paid careers if they so choose.
Biden will:
● 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.
The plan will cost $775 billion over 10 years and will be paid for by rolling back unproductive
and unequal tax breaks for real estate investors with incomes over $400,000 and taking steps to
increase tax compliance for high-income earners.
This plan builds on Biden’s proposals to support informal caregivers - family members or loved
ones who do this work unpaid, including a ​$5,000 tax credit​ for informal caregivers, ​Social
Security credits​ for people who care for their loved ones, and ​professional and peer support​ for
caregivers of wounded, injured, or ill active duty service members and veterans​.
EXPAND ACCESS TO DIGNIFIED CARE FOR OLDER AMERICANS AND THOSE
WITH DISABILITIES
Biden will help ease the financial burden on families caring for aging relatives and loved ones
with disabilities and reduce unnecessary and costly hospitalizations, while providing people who
need care with better, more dignified services and supports that meet their specific needs and
personal choices.

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 Biden will allocate $450 billion to give more people the choice to receive care at home or in
supportive community situations, or to have that choice for their loved ones. He will help states
offer cost-effective options for affordable primary and preventive care, and affordable support
services like help with meals, transportation, home safety, and quality day programs for older
Americans. This commitment will reduce health expenditures, help more Americans avoid
unnecessary and expensive hospitalizations, and result in an expansion of the caregiving and
community health workforce by roughly 1.5 million jobs. Specifically, Biden will:
● 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 homeand 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
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 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
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 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.
It is also just too hard to figure out how to get care when you need it. ​As part of his proposal,
Biden will work with states to set up a simpler way for Americans searching for caregiving help
to go online, find out what financial support they might be eligible for based on their income,
and identify potential caregivers.
MAKE HIGH-QUALITY CHILD CARE AFFORDABLE AND PRESCHOOL
UNIVERSAL
The pandemic has highlighted what has always been true: child care and early learning are
essential to many Americans, providing a nurturing environment for children to learn and grow
and allowing parents and guardians the choice to pursue careers and contribute to the economy
while supporting their families. The pandemic has also reminded parents around the country just
how valuable caregivers and educators are – and how challenging and important their jobs are.
Even before the pandemic, millions of parents ​struggled to find​ a space for their child in a quality
care and educational setting, keeping parents – primarily mothers – out of the workforce or
causing them to settle for lower-paying jobs that allowed them time to provide their own child
care. And now, many more parents are worrying how they will educate and care for their
children while they work, while schools and child care providers are facing extreme financial
challenges and uncertainty. Many child care facilities have lost much of their revenues and are
struggling to pay their bills and stay afloat. Providers who already operate on extremely thin
margins are spending money on personal protective equipment and cleaning supplies to keep
children and early childhood educators safe, while facing falling revenues as they serve fewer
children to make it easier to physically distance. If they don’t get help soon, a sizable portion of
child care providers might have to close their doors permanently and as many as ​half of all child
care slots could disappear​. The danger of a radical decline in the child care sector will increase
the challenges parents face as they seek to return to work, make it harder for the economy to
recover, and force many early childhood educators – who are disproportionately ​women of color
– out of their jobs.
President Trump has failed to effectively respond to the caregiving crisis for months, while
exacerbating it by letting the virus continue to spread. He should immediately work with
Congress to provide emergency relief to save child care centers and family child care providers
and support child care workers. This urgent action is critical to investing in the care and
education of our youngest children and ensuring that parents and guardians have the support they
need to return to work when it is safe to do so.

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 Beyond addressing the pandemic-driven child care crisis, Biden will build our child care
infrastructure back better for the long-term, including by making high-quality child care
affordable and preschool universal for three- and four-year-olds. His plan will cultivate the
potential of young children, provide parents – primarily mothers – with career opportunities and
economic security, create an additional 1.5 million new, good, early education jobs, and improve
the existing jobs for the essential workers who educate our young children.​ ​Biden will:
● 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
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 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
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 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.
Not only will these investments ​create jobs for new early educators, Biden’s ​plan to support our
public schools​ will also create new jobs by tripling Title I funding, fully-funding IDEA, funding
community schools, and doubling the number of psychologists, counselors, nurses, social
workers, and other health professionals in our schools so our kids get the mental health care they
need.
BUILD SAFE CHILD CARE FACILITIES
Our nation faced a massive shortage of child care facilities before the pandemic, and the shortage
has only intensified since then. One survey found that, even before COVID-19 hit, ​43% of
parents​ had difficulty locating child care, and many more struggled to find convenient,
affordable care. This shortage stresses parents and guardians, hurts family pocketbooks, and
disadvantages children in areas with insufficient child care options.
Biden will address this shortage by accelerating the construction and renovation of safe and
developmentally appropriate child care facilities in communities and in workplaces, so parents
do not have to search in vain for a suitable child care option. Specifically, ​Biden will create a
new child care construction tax credit to encourage businesses to build child care facilities at
places of work. Employers will receive 50% of the first $1 million of construction costs per
facility, so that employees can enjoy the peace of mind and convenience that comes with on-site
child care. At the same time, he’ll make direct investments in building new child-care facilities
and upgrading existing facilities around the country that are not accessible for people with
disabilities, or safe or developmentally appropriate for young children who are especially
vulnerable to environmental contaminants like lead and mold, and to safety hazards like
electrical outlets. I​f his tax credit is fully utilized, and coupled with direct investments, these
policies will lead to tens of thousands of new child care facilities across the country.
All infrastructure investments will require high standards for the quality of the facilities,
including ensuring they are healthy, energy efficient, climate resilient, developmentally
appropriate places to learn and accessible for children with disabilities. And, they will require
high labor standards​ for the people who build the facilities, creating thousands of middle-class
construction jobs with a choice to join a union.

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 REWARD CAREGIVERS AND EDUCATORS WITH THE BENEFITS AND
PROTECTIONS THEY DESERVE
While we rely on our nation’s caregivers and educators to play essential roles in the lives of our
loved ones, their current pay and benefits are abysmal. Caregivers and early childhood educators
-- who are disproportionately women and people of color -- are poorly compensated. ​Direct
support professionals​ and ​child care​ workers earn on average less than $12 an hour and $25,000
annually. This low pay contributes to extremely ​high rates of turnover​ in the care workforce,
which hurts these workers and those for whom they care.
Biden will maintain and grow a diverse, talented care and education workforce by providing
increased pay and benefits, and access to collective bargaining, training and education, and
career ladders. He will ensure these workers receive:
● 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

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 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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