Increasing Access to High-Quality Care and Supporting Caregivers

[Federal Register Volume 88, Number 77 (Friday, April 21, 2023)]

[Presidential Documents]

[Pages 24669-24676]

From the Federal Register Online via the Government Publishing Office [www.gpo.gov]

[FR Doc No: 2023-08659]

[[Page 24667]]

Vol. 88

Friday,

No. 77

April 21, 2023

Part II

The President

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Executive Order 14095--Increasing Access to High-Quality Care and

Supporting Caregivers

Presidential Documents

Federal Register / Vol. 88 , No. 77 / Friday, April 21, 2023 /

Presidential Documents

___________________________________________________________________

Title 3--

The President

[[Page 24669]]

Executive Order 14095 of April 18, 2023

Increasing Access to High-Quality Care and

Supporting Caregivers

By the authority vested in me as President by the

Constitution and the laws of the United States of

America, it is hereby ordered as follows:

Section 1. Policy. High-quality early care and

education and long-term care are critical to our

Nation's economic growth and economic security. Early

care and education give young children a strong start

in life, while long-term care helps older Americans and

people with disabilities live, work, and participate in

their communities with dignity. Access to both types of

care is also critical to our national security because

it helps ensure the recruitment, readiness, and

retention of our military service members.

in life, while long-term care helps older Americans and

people with disabilities live, work, and participate in

their communities with dignity. Access to both types of

care is also critical to our national security because

it helps ensure the recruitment, readiness, and

retention of our military service members.

Throughout this order, early care and education are

collectively referred to as ``child care.'' References

to ``care'' that do not specify the type of care refer

to both child care and long-term care. References to

the ``care workforce'' refer to individuals and

businesses working in the fields of child care and

long-term care.

A sizeable majority of families and individuals in the

United States who require care cannot access the

affordable, high-quality care they need. The markets

for child care and long-term care for persons with

disabilities and older adults who need support in their

homes and communities fail to deliver enough high-

quality care because of a persistent gap between the

costs of providing this care and the prices families

can pay. High-quality care is labor intensive and

requires skilled workers, and providers have limited

ability to reduce costs. As a result, even when high-

quality care is available, it costs far more than many

families and individuals can afford, causing them to

forgo care altogether, seek lower-quality care options,

juggle unconventional shifts at work, reduce their own

paid work hours, drop out of the labor force, or make

other arrangements

n high-

quality care is available, it costs far more than many

families and individuals can afford, causing them to

forgo care altogether, seek lower-quality care options,

juggle unconventional shifts at work, reduce their own

paid work hours, drop out of the labor force, or make

other arrangements. Care expenditures represent a

significant and increasing share of families' budgets,

with child care prices growing by approximately 26

percent and some types of long-term care costs growing

by over 40 percent in the last decade. Inadequate

supply is exacerbated by high turnover in the care

workforce. Care workers--disproportionately women of

color--are among the lowest-paid in the country and

often have to rely on public benefits despite working

complex and demanding jobs. Investments in the care

workforce are foundational to helping to retain care

workers and improving health and educational outcomes.

In recent years, more than half of the long-term care

workforce and nearly 20 percent of the child care

workforce turned over each year. And the workforce

remains 8 percent smaller than before the COVID-19

pandemic.

l to helping to retain care

workers and improving health and educational outcomes.

In recent years, more than half of the long-term care

workforce and nearly 20 percent of the child care

workforce turned over each year. And the workforce

remains 8 percent smaller than before the COVID-19

pandemic.

In 2019, more than three in four United States

households that searched for care reported difficulty

finding adequate care for their young children, and

roughly the same share of center-based child care

providers turned families away because they lacked

enough child care slots. Similarly, more than three in

four long-term care service providers have reported not

being able to accept new clients, making it harder for

older Americans and people with disabilities to find

the care they need. Military families consistently cite

access to high-quality child care as an impediment to

military spouse employment and family economic

security. Difficulty accessing care also poses a

challenge for both spouses--and, as data shows,

particularly for women in dual military couples--to

continuing their service if they have

[[Page 24670]]

caregiving responsibilities. The need for long-term

care is likely to become more acute as our Nation's

population ages. By 2060, there will be approximately

twice as many adults over the age of 65 than in 2016,

and projections indicate that there will be around 8

million long-term care job openings over the next

decade.

ies. The need for long-term

care is likely to become more acute as our Nation's

population ages. By 2060, there will be approximately

twice as many adults over the age of 65 than in 2016,

and projections indicate that there will be around 8

million long-term care job openings over the next

decade.

Family caregivers provide informal, often unpaid, care

to help loved ones live in their homes and communities,

including caring for aging family members, people with

disabilities, and children. At least 53 million people

are family caregivers in the United States--including

5.5 million who are caring for wounded, ill, and

injured service members and veterans--and many face

challenges due to lack of support, training, and

opportunities for rest. Family caregivers include

spouses, parents, siblings, adult and minor children,

grandparents, and other relatives. Family caregivers

reflect the diversity of America's communities, and

people can assume family caregiving responsibilities at

any stage of life. Without adequate resources, family

caregiving can affect caregivers' own physical and

emotional health and well-being and contribute to

financial strain. These negative consequences are felt

most acutely by women, who make up nearly two-thirds of

family caregivers and drop out of the workforce at a

rate three times higher than men.

caregiving can affect caregivers' own physical and

emotional health and well-being and contribute to

financial strain. These negative consequences are felt

most acutely by women, who make up nearly two-thirds of

family caregivers and drop out of the workforce at a

rate three times higher than men.

It is the policy of my Administration to enable

families--including our military and veteran families--

to have access to affordable, high-quality care and to

have support and resources as caregivers themselves. It

is also the policy of my Administration to ensure that

the care workforce is supported, valued, and paid well.

Additionally, care workers should have the free and

fair choice to join a union.

The Congress must provide the transformative

investments necessary to increase access to high-

quality child care--including preschool and Head

Start--and long-term care services, as well as high-

quality, well-paying jobs that reflect the value the

care workforce provides to families and communities.

Such investments include removing barriers and

providing the funding needed for Tribal Nations to

effectively provide high-quality child care and long-

term care.

Nearly every other advanced country makes greater

public investments in care than the United States.

Investing in care is an investment in the future of

America's families, workforce, and economy.

funding needed for Tribal Nations to

effectively provide high-quality child care and long-

term care.

Nearly every other advanced country makes greater

public investments in care than the United States.

Investing in care is an investment in the future of

America's families, workforce, and economy.

While the Congress must make significant new

investments to give families in this country more

breathing room when it comes to care, executive

departments and agencies (agencies) must do what they

can within their existing authorities to boost the

supply of high-quality early care and education and

long-term care and to provide support for family

caregivers. Through this order, I direct agencies to

make all efforts to improve jobs and support for

caregivers, increase access to affordable care for

families, and provide more care options for families.

Sec. 2. Increasing Compensation and Improving Job

Quality for Family Caregivers, Early Educators, and

Long-Term Care Workers. (a) To increase compensation

and benefits for early childhood educators and long-

term care professionals who are providing federally

funded services:

options for families.

Sec. 2. Increasing Compensation and Improving Job

Quality for Family Caregivers, Early Educators, and

Long-Term Care Workers. (a) To increase compensation

and benefits for early childhood educators and long-

term care professionals who are providing federally

funded services:

(i) the Secretary of Health and Human Services, through the Administrator

for the Centers for Medicare and Medicaid Services (CMS), shall issue

guidance to States on ways to use enhanced funding to better connect home-

and community-based workers who provide services to Medicaid beneficiaries;

(ii) the Secretary of Health and Human Services shall implement strategies

to encourage comparability of compensation and benefits between staff

employed by Head Start grant recipients and elementary school teachers;

(iii) the Secretary of Health and Human Services shall expand efforts to

improve care workers' access to health insurance; and

[[Page 24671]]

(iv) the Secretary of Education shall use grant notices for the Child Care

Access Means Parents in School (CCAMPIS) program to encourage grantees to

improve quality in funded programs, including by increasing compensation

and providing support services for early childhood educators who serve

children of students at CCAMPIS colleges using Federal and non-Federal

funding as appropriate;

4671]]

(iv) the Secretary of Education shall use grant notices for the Child Care

Access Means Parents in School (CCAMPIS) program to encourage grantees to

improve quality in funded programs, including by increasing compensation

and providing support services for early childhood educators who serve

children of students at CCAMPIS colleges using Federal and non-Federal

funding as appropriate;

(v) the Department of the Treasury shall conduct outreach on the Saver's

Match credit, and the Department of Commerce shall conduct--and the Small

Business Administration is encouraged to consider conducting--outreach on

potential Federal resources available to assist small businesses in

offering retirement plans, including a per-employee credit of up to $1,000,

as provided in the SECURE 2.0 Act of 2022 (Division T of Public Law 117-

328), in order to ensure that the care workforce, including individuals and

small businesses, are aware of Federal retirement assistance for which they

may be eligible.

(b) To improve working conditions and job quality

in federally assisted child care and long-term care

programs, encourage providers to establish incentives

to recruit and retain workers, help prevent burnout,

make it as easy as possible for care workers to access

behavioral health services, and thereby improve the

care that individuals receive, the Secretary of Health

and Human Services shall:

are

programs, encourage providers to establish incentives

to recruit and retain workers, help prevent burnout,

make it as easy as possible for care workers to access

behavioral health services, and thereby improve the

care that individuals receive, the Secretary of Health

and Human Services shall:

(i) consider additional actions--such as providing guidance, technical

assistance, and provider and resident education--and rulemaking on nursing

home staffing transparency to promote adequate staffing at nursing homes,

building on the Department of Health and Human Services' efforts to propose

minimum standards for staffing adequacy at nursing homes;

(ii) consider additional actions to reduce nursing staff turnover in

nursing facilities and improve retention of those staff, advancing the

Department of Health and Human Services' efforts to measure and adjust

payments based on staff turnover; and

(iii) implement strategies to expand mental health support for the care

workforce, including early childhood providers supported through the Child

Care and Development Fund (CCDF) and Head Start.

(c) To expand training pathways and professional

learning opportunities to increase job quality, improve

quality of care, and attract new entrants into the care

workforce, the Secretary of Labor and the Secretary of

Education, in consultation with the Secretary of Health

and Human Services, shall:

(c) To expand training pathways and professional

learning opportunities to increase job quality, improve

quality of care, and attract new entrants into the care

workforce, the Secretary of Labor and the Secretary of

Education, in consultation with the Secretary of Health

and Human Services, shall:

(i) encourage recipients of Federal financial assistance to expand

opportunities for early childhood educators and long-term care

professionals through community college programming, career and technical

education, Registered Apprenticeship, pre-apprenticeships leading to

Registered Apprenticeship, and other job training and professional

development;

(ii) make available innovative funding opportunities, develop and evaluate

demonstration projects for care training and educational attainment, and

provide technical assistance to State, local, and Tribal partners to

improve job quality for care occupations; and

(iii) develop partnerships with key stakeholders, including State, local,

Tribal, and territorial governments; unions and labor organizations; State

and local workforce development boards; institutions of higher education

(including community colleges, Historically Black Colleges and

Universities, Tribal Colleges and Universities, and Minority Serving

Institutions); aging and disability networks; and national- and community-

based organizations that focus on care (including professional membership

organizations).

(d) To support family caregivers of beneficiaries

of Federal health care programs and services, and in

conjunction with implementing the 2022 National

Strategy to Support Family Caregivers:

sability networks; and national- and community-

based organizations that focus on care (including professional membership

organizations).

(d) To support family caregivers of beneficiaries

of Federal health care programs and services, and in

conjunction with implementing the 2022 National

Strategy to Support Family Caregivers:

(i) the Secretary of Health and Human Services shall, consistent with the

criteria set out in section 1115A(b)(2) of the Social Security Act

[[Page 24672]]

(42 U.S.C. 1315a(b)(2)), consider whether to select for testing by the

Center for Medicare and Medicaid Innovation an innovative new health care

payment and service delivery model focused on dementia care that would

include family caregiver supports such as respite care;

(ii) the Secretary of Health and Human Services shall consider how better

to evaluate and clearly set expectations for family caregivers in the Acute

Hospital Care at Home program, which allows hospitals to treat in their

homes those who would otherwise be hospital inpatients;

(iii) the Secretary of Health and Human Services shall take steps to ensure

that hospitals are actively involving family caregivers in the discharge

planning process, consistent with CMS condition of participation discharge

planning requirements, including by promoting best practices such as

partnerships with community-based organizations and using resources from

the Administration for Community Living and the Agency for Healthcare

Research and Quality;

(iv) the Secretary of Health and Human Services shall increase beneficiary

communications and support family caregivers by increasing promotion of the

option for Medicare beneficiaries to choose to give family caregivers

access to their Medicare information via 1-800-MEDICARE and the State

health insurance assistance program networks;

iving and the Agency for Healthcare

Research and Quality;

(iv) the Secretary of Health and Human Services shall increase beneficiary

communications and support family caregivers by increasing promotion of the

option for Medicare beneficiaries to choose to give family caregivers

access to their Medicare information via 1-800-MEDICARE and the State

health insurance assistance program networks;

(v) the Secretary of Veterans Affairs shall consider issuing a notice of

proposed rulemaking by the end of this fiscal year that would make any

appropriate modifications to eligibility criteria for the Program of

Comprehensive Assistance for Family Caregivers, which provides services and

benefits, including a monthly stipend, for eligible caregivers of veterans

who sustained a serious injury or illness in the line of duty; and

(vi) the Secretary of Veterans Affairs shall develop and implement a pilot

program to offer psychotherapy via video telehealth to family caregivers

within the Program of Comprehensive Assistance for Family Caregivers to

improve their access to mental health services.

(e) To improve and expand opportunities through

AmeriCorps to encourage more individuals to enter early

learning careers, the Chief Executive Officer of

AmeriCorps is encouraged to consider:

(i) expanding access to Segal AmeriCorps Education Awards, which AmeriCorps

members can use to pay for education and training or reduce their student

debt; providing loan forbearance for AmeriCorps members involved in early

learning; and providing other benefits to supplement national service

activities that support early learning; and

(ii) prioritizing applications that propose to implement or expand high-

quality programs focused on early learning and prioritizing projects

intended to prepare AmeriCorps members and AmeriCorps Seniors volunteers to

enter early learning careers.

riCorps members involved in early

learning; and providing other benefits to supplement national service

activities that support early learning; and

(ii) prioritizing applications that propose to implement or expand high-

quality programs focused on early learning and prioritizing projects

intended to prepare AmeriCorps members and AmeriCorps Seniors volunteers to

enter early learning careers.

(f) To improve jobs of domestic child care and

long-term care workers:

(i) the Secretary of Labor shall create and publish in multiple languages,

as appropriate, compliance assistance and best practices materials--such as

sample employment agreements for domestic child care and long-term care

workers and their employers--to promote fair workplaces and ensure the

parties know their rights and responsibilities, and shall identify other

means to promote employers' adoption of best practices;

(ii) the Secretary of Labor shall work with community and other local

partners to expand culturally and linguistically appropriate community

outreach and education efforts to domestic child care and long-term care

workers in order to combat their exploitation; and

(iii) the Chair of the Equal Employment Opportunity Commission is

encouraged to work with the Attorney General, the Secretary of Labor, and

the Secretary of Homeland Security to develop materials addressing the

employment rights of non-citizen domestic child care and long-term care

workers who are legally eligible to work.

[[Page 24673]]

(g) To improve data and information on the care

workforce:

pportunity Commission is

encouraged to work with the Attorney General, the Secretary of Labor, and

the Secretary of Homeland Security to develop materials addressing the

employment rights of non-citizen domestic child care and long-term care

workers who are legally eligible to work.

[[Page 24673]]

(g) To improve data and information on the care

workforce:

(i) the Secretary of Labor shall conduct and publish an analysis of early

childhood and home care workers' pay in comparison to the pay of other

workers with similar levels of training and skill;

(ii) the Secretary of Labor shall issue guidance to help States and

localities conduct their own analyses of comparable pay rates for care

workers in their respective jurisdictions; and

(iii) the Secretary of Labor and the Secretary of Health and Human Services

shall, in consultation with relevant agencies and external experts and

organizations, jointly conduct a review to identify gaps in knowledge about

the home- and community-based workforce serving people with disabilities

and older adults; identify and evaluate existing data sources; and identify

opportunities to expand analyses, supplement data, or launch new efforts to

provide important data on the home- and community-based care workforce and

ensure equity for people with disabilities and older adults. The

Secretaries shall publicly release the findings and recommendations of this

review no later than April 2024.

Sec. 3. Making Care More Accessible and Affordable for

Families. (a) To increase access to affordable, high-

quality child care and long-term care for workers

delivering federally assisted projects:

s and older adults. The

Secretaries shall publicly release the findings and recommendations of this

review no later than April 2024.

Sec. 3. Making Care More Accessible and Affordable for

Families. (a) To increase access to affordable, high-

quality child care and long-term care for workers

delivering federally assisted projects:

(i) Agencies shall identify and issue guidance on which agency

discretionary, formula, and program-specific funds can be used for child

care and long-term care as a supportive service for workers who are being

trained for and working on federally funded projects, and in doing so shall

consider agency funds made available by the bipartisan Infrastructure

Investment and Jobs Act (Public Law 117-58); Public Law 117-169, commonly

referred to as the Inflation Reduction Act of 2022; and division A of

Public Law 117-167, known as the Creating Helpful Incentives to Produce

Semiconductors (CHIPS) Act of 2022.

(ii) With respect to the agency funds identified in subsection (a)(i) of

this section:

(A) Agencies shall consider requiring, where appropriate, applicants for

Federal job-creation or workforce development funds to provide affordable,

accessible, safe, and reliable child care and long-term care for workers

carrying out federally assisted projects (including both construction and

operating phases where applicable), or shall consider preferencing

applicants that use the funds for this purpose or encouraging applicants to

use funds for this purpose. Agencies shall provide implementation guidance

to relevant program staff and collaborate with the Department of Labor to

identify potential support for these actions, including technical

assistance for guidance and funding opportunities.

ses where applicable), or shall consider preferencing

applicants that use the funds for this purpose or encouraging applicants to

use funds for this purpose. Agencies shall provide implementation guidance

to relevant program staff and collaborate with the Department of Labor to

identify potential support for these actions, including technical

assistance for guidance and funding opportunities.

(B) Agencies shall consider providing technical assistance to help

funding recipients provide access to child care and long-term care as a

supportive service and to connect funding recipients with potential

partners, including care associations, community-based organizations,

Registered Apprenticeship and pre-apprenticeship programs, and labor

unions.

(C) In cases where child care or long-term care is required or

encouraged, agencies shall consider collecting information from funding

recipients on whether and how they will provide access to child care and

long-term care, and how many workers (including apprentices and pre-

apprentices) would be affected.

(iii) The Secretary of Labor and the Secretary of Health and Human

Services, in consultation with the Secretary of Commerce, shall support the

efforts outlined in subsection (a) of this section by issuing guidance and

providing technical assistance with best practices and models for how to

provide supportive services, including child care and long-term care.

(b) To lower child care costs for families eligible

for Federal programs, the Secretary of Health and Human

Services shall:

[[Page 24674]]

ed in subsection (a) of this section by issuing guidance and

providing technical assistance with best practices and models for how to

provide supportive services, including child care and long-term care.

(b) To lower child care costs for families eligible

for Federal programs, the Secretary of Health and Human

Services shall:

[[Page 24674]]

(i) consider issuing regulations to pursue policies to reduce child care

costs for families benefiting from CCDF;

(ii) identify potential opportunities to reduce barriers to eligibility for

Head Start and CCDF;

(iii) encourage States, through all available avenues, to increase the use

of Temporary Assistance for Needy Families funds for basic assistance and

work supports for families--including access to child care--and to spend

more funds on cash assistance for families; and

(iv) identify other potential strategies to make child care and Head Start

more accessible for those families most in need.

(c) To help more Federal employees access

affordable care:

(i) the Director of the Office of Personnel Management shall consider

establishing criteria that support equitable and accessible employee

participation in child care programs, to include agencies' adoption of

income thresholds that are aligned with increasing costs of child care;

(ii) the Director of the Office of Personnel Management shall conduct a

review of child care subsidy policy and agency program data to determine

the effectiveness of current child care subsidies within the Federal

Government;

(iii) the heads of agencies are encouraged to expand employee access to

child care services through Federal child care centers, child care

subsidies, or contracted care providers; and

or of the Office of Personnel Management shall conduct a

review of child care subsidy policy and agency program data to determine

the effectiveness of current child care subsidies within the Federal

Government;

(iii) the heads of agencies are encouraged to expand employee access to

child care services through Federal child care centers, child care

subsidies, or contracted care providers; and

(iv) the Department of Defense shall take steps to enhance recruitment and

retention of the Department's child development program workers and to

improve the affordability of child care for service members by September

2023, in addition to its ongoing efforts as part of the Fourteenth

Quadrennial Review of Military Compensation to assess how child care costs

impact the ability of the military to attract and retain its workforce.

Sec. 4. Expanding Options for Families by Building the

Supply of Care. (a) To provide families with more

options for high-quality long-term, home-, and

community-based care and early learning services:

(i) The Secretary of Health and Human Services shall consider rulemaking to

improve access to home- and community-based services under Medicaid. As

part of any such rulemaking, the Secretary shall consider taking steps to

support provider participation in Medicaid home- and community-based

programs.

(ii) The Secretary of Health and Human Services shall issue policies that

would support child care providers to give families more options to access

high-quality child care providers, and shall update payment practices to

improve provider stability and supply.

(iii) The Secretary of Education shall update a guide for schools and

districts to expand high-quality early learning programming using Federal

funds so that more preschoolers are fully prepared to succeed in school.

pport child care providers to give families more options to access

high-quality child care providers, and shall update payment practices to

improve provider stability and supply.

(iii) The Secretary of Education shall update a guide for schools and

districts to expand high-quality early learning programming using Federal

funds so that more preschoolers are fully prepared to succeed in school.

(iv) The Secretary of Education and the Secretary of Health and Human

Services shall identify and disseminate evidence-based practices for

serving children with disabilities and their families in high-quality early

childhood education programs, including Head Start. The Secretaries shall

also take steps to ensure that services are inclusive of children with

disabilities and their families; highlight any resources that are available

to aid in that effort, including for preschool-aged children with

disabilities under section 619 of the Individuals with Disabilities

Education Act (IDEA) and for infants and toddlers with disabilities and

their families under Part C of the IDEA; and provide information to support

all early childhood programs in meeting their obligations under section 504

of the Rehabilitation Act of 1973 and the Americans with Disabilities Act

of 1990.

(v) The Director of the Bureau of Consumer Financial Protection is

encouraged to consider developing financial guidance resources that support

families during their care planning.

[[Page 24675]]

(vi) The Secretary of Health and Human Services shall take steps to

streamline processes for Tribes to use CCDF and Head Start funding to

construct and improve facilities, including facilities that are jointly

funded.

the Bureau of Consumer Financial Protection is

encouraged to consider developing financial guidance resources that support

families during their care planning.

[[Page 24675]]

(vi) The Secretary of Health and Human Services shall take steps to

streamline processes for Tribes to use CCDF and Head Start funding to

construct and improve facilities, including facilities that are jointly

funded.

(vii) The 12 agencies that signed the October 2022 Memorandum of Agreement

to implement Public Law 102-477 (the ``Tribal 477 Program'') shall increase

the effectiveness of Tribal employment and training programs to ensure

child care can be used as a support for families by reducing and

streamlining administrative requirements, including through consolidation

of budgeting, reporting, and auditing systems.

(b) To expand options for quality home- and

community-based services to veterans:

(i) The Secretary of Veterans Affairs shall consider expanding the existing

Veteran Directed Care Program--which provides veterans who need help with

daily living with a budget to spend on home- and community-based services

including personal care services--to all Department of Veterans Affairs

Medical Centers by the end of Fiscal Year 2024, and shall consider

developing an implementation plan for this expansion by June 2023.

(ii) The Secretary of Veterans Affairs shall consider designing and

evaluating a pilot program in no fewer than five veteran sites or in five

States for a new Co-Employer Option for delivering veteran home health

services. Features of the program may include allowing veterans to choose

who provides their care and to determine when and how that care is

delivered, and connecting veterans with a third-party agency that would

help coordinate administrative tasks and act as an intermediary between

veterans and their home health workers

States for a new Co-Employer Option for delivering veteran home health

services. Features of the program may include allowing veterans to choose

who provides their care and to determine when and how that care is

delivered, and connecting veterans with a third-party agency that would

help coordinate administrative tasks and act as an intermediary between

veterans and their home health workers. Should the Department of Veterans

Affairs implement this pilot program, it shall provide an implementation

plan--including cost estimates and evaluation strategy--to the President,

through the Assistant to the President for Domestic Policy, before August

31, 2023.

(iii) The Secretary of Veterans Affairs shall consider expanding the Home-

Based Primary Care program by adding 75 new interdisciplinary teams to

provide care to veterans in their homes.

(c) To increase the supply of providers and options

for families by encouraging greater private financial

protection, support, and technical assistance for care

providers:

(i) the Secretary of the Treasury shall consider providing information to

and sharing industry best practices with Community Development Financial

Institutions to facilitate capital flows and support to care providers;

(ii) the Administrator of the Small Business Administration is encouraged

to consider publishing a guide on how individuals in the care workforce may

start and sustainably operate care businesses locally and through Small

Business Administration programming; and

(iii) the Director of the Bureau of Consumer Financial Protection is

encouraged to consider issuing guidance addressing financial institution

practices that may increase the burden on the care workforce, discourage

their work, and harm their financial well-being.

(d) To build the capacity of local communities to

better coordinate and deliver care:

ing; and

(iii) the Director of the Bureau of Consumer Financial Protection is

encouraged to consider issuing guidance addressing financial institution

practices that may increase the burden on the care workforce, discourage

their work, and harm their financial well-being.

(d) To build the capacity of local communities to

better coordinate and deliver care:

(i) the Secretary of Health and Human Services shall review existing

policies to identify opportunities--including among Tribal communities--to

increase the capacity of community care entities by providing operational

support to these networks of providers; and

(ii) the Secretary of Agriculture shall use the Rural Partners Network and

issue guidance developed in partnership with the Secretary of Health and

Human Services to promote opportunities--including by hosting workshops--to

increase access to child care and long-term care in rural and Tribal

communities.

[[Page 24676]]

(e) To make the delivery and design of Federal care

assistance and programs work better for families, the

care workforce, and people seeking care, the

Secretaries of the Treasury, Defense, Agriculture,

Labor, Health and Human Services, Education, and

Veterans Affairs shall consider--and the Administrator

of the Small Business Administration is encouraged to

consider--prioritizing engagement with parents,

guardians, and other relatives with care

responsibilities; individuals receiving long-term care;

State and local care experts; care providers and

workers; employers; and labor unions.

Sec. 5. General Provisions. (a) Nothing in this order

shall be construed to impair or otherwise affect:

h parents,

guardians, and other relatives with care

responsibilities; individuals receiving long-term care;

State and local care experts; care providers and

workers; employers; and labor unions.

Sec. 5. General Provisions. (a) Nothing in this order

shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or

the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget

relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with

applicable law and subject to the availability of

appropriations.

(c) Where not already specified, independent

agencies are encouraged to comply with the requirements

of this order.

(d) This order is not intended to, and does not,

create any right or benefit, substantive or procedural,

enforceable at law or in equity by any party against

the United States, its departments, agencies, or

entities, its officers, employees, or agents, or any

other person.

(Presidential Sig.)

THE WHITE HOUSE,

April 18, 2023.

[FR Doc. 2023-08659

Filed 4-20-23; 11:15 am]

Billing code 3395-F3-P