ExecutiveOrdersEO
EO 14095Executive OrderBiden · D

Executive Order 14095

Increasing Access to High-Quality Care and Supporting Caregivers

This executive order directs federal agencies to use existing authorities to expand access to affordable, high-quality child care and long-term care, and to improve wages and working conditions for caregivers. It includes specific actions across HHS, Labor, Education, Veterans Affairs, and other agencies to boost compensation, increase training pathways, support family caregivers, and leverage federal infrastructure and workforce funding for care services. Most provisions are framed as considerations, guidance, or encouragement rather than mandates.

Federal Register Open PDF 88 FR 24669

Impact dates

  1. VA consideration of expanding Veteran Directed Care to all medical centers

  2. HHS/Labor public release of home/community-based workforce review findings

  3. VA consideration of NPRM for Comprehensive Assistance for Family Caregivers eligibility

  4. DOD steps to improve child care affordability for service members

  5. VA implementation plan for Co-Employer Option pilot (if implemented)

  6. VA implementation plan for Veteran Directed Care expansion

Key directives

  • HHS/CMS: Issue guidance to states on enhanced funding for home/community-based Medicaid workers
  • HHS: Implement strategies to encourage Head Start staff compensation comparability with elementary teachers
  • HHS: Expand care workers' access to health insurance
  • Education: Use CCAMPIS grant notices to encourage compensation increases for early childhood educators
  • Treasury: Conduct outreach on Saver's Match credit; Commerce/SBA: Outreach on SECURE 2.0 retirement plans for care workforce
  • HHS: Consider rulemaking on nursing home staffing transparency and minimum standards
  • HHS: Consider actions to reduce nursing staff turnover and adjust payments based on turnover
  • HHS: Expand mental health support for CCDF and Head Start providers
  • Labor/Education: Encourage training pathways through community colleges, CTE, Registered Apprenticeship
  • HHS: Consider CMMI innovation model for dementia care with family caregiver supports including respite
  • HHS: Ensure family caregiver involvement in hospital discharge planning
  • VA: Consider NPRM by end of FY2023 on Comprehensive Assistance for Family Caregivers eligibility

Who is ordered

Timeline

Immediate

  • EO signing and policy announcement
  • HHS/CMS guidance to states on enhanced Medicaid funding for home/community-based workers

Near term (90d)

  • VA consideration of NPRM for Comprehensive Assistance for Family Caregivers eligibility by end of FY2023 (September 30, 2023)
  • VA pilot program for video telehealth psychotherapy for family caregivers
  • DOD steps to improve child care affordability by September 2023
  • VA implementation plan for Veteran Directed Care expansion by June 2023
  • VA implementation plan for Co-Employer Option pilot by August 31, 2023

Long term

  • HHS/Labor joint review of home/community-based workforce data due April 2024
  • VA consideration of expanding Veteran Directed Care to all medical centers by end of FY2024
  • Potential rulemaking on nursing home staffing transparency and Medicaid HCBS access
  • Ongoing agency guidance on using infrastructure/CHIPS/IRA funds for care supportive services

Risks & tensions

  • Most directives use permissive language ('consider,' 'encourage,' 'is encouraged to') rather than mandates, weakening enforceability
  • Implementation explicitly 'subject to availability of appropriations' per Section 5(b), constraining action without congressional funding
  • EO acknowledges Congress must provide 'transformative investments,' highlighting limits of executive authority
  • Potential tension between encouraging unionization (Section 1) and political opposition to labor organizing in care sector
  • VA deadlines (end of FY2023, June 2023, August 2023) may be tight for rulemaking and pilot design
  • Data review deadline of April 2024 extends beyond potential administration transition window
  • Multiple agency coordination required (HHS, Labor, Education, VA, Treasury, Commerce, SBA, CFPB, USDA, OPM, DOD, AmeriCorps) creates implementation complexity
  • Tribal provisions depend on sustained interagency commitment to 477 Program streamlining
Executive Order 14095: Increasing Access to High-Quality Care and Supporting Caregivers · Executive Orders