Today the U.S. Senate Committee on Agriculture, Nutrition and Forestry held a hearing, “Rural Quality of Life: Opportunities and Challenges for the Rural Care Economy.” This hearing discussed issues across the care economy, including childcare, elder care, behavior health and substance use disorders.
In her opening remarks, Chairwoman Debbie Stabenow (D-MI) stated, “Everyone deserves a great quality of life in America and quality care at every stage of life, no matter where they live… Building a sustainable economy starts with reliable access to childcare, elder care, and health care, including mental health and substance abuse services.”
Ranking Member John Boozman (R-AR) said, “There is no question that families in rural America need access to affordable quality health care, child care and elder care in their communities… I strongly support the USDA Rural Development programs that make funding available to these vital services, and we appreciate the Under Secretary’s hard work in providing leadership in this area.” Boozman also discussed the impacts of inflation and economic uncertainty.
The first witness panel featured U.S. Department of Agriculture (USDA) Under Secretary for Rural Development Xochitl Torres Small. In her written statement, Under Secretary Torres Small discussed the importance of a robust care economy in rural America, stating, it “allow[s] families to live their entire lives in the place they want to call home.” She also highlighted important programs in the Rural Business-Cooperative Service, including the Rural Cooperative Development Grant and Community Facilities Grant programs, both of which are working to address childcare and elder/home care. Under Secretary Torres Small noted that rural America is not a monolith, and it is critical that solutions can be tailored to local community needs.
Join NCBA CLUSA in advocating for increased funding to the Rural Cooperative Development Grant Program in Fiscal Year 2023 here.
After opening statements, Senators had the opportunity to ask questions of Under Secretary Torres Small, and among the recurring themes, cooperatives emerged as an important part of the solution.
Senator Kirsten Gillibrand (D-NY) focused her questions on the rural health care workforce. Specifically, she asked what can be done to most effectively invest in the rural health care workforce, particularly when it comes to addressing equitable health outcomes for communities of color?
Under Secretary Torres Small responded that the ideas to solve these challenges have been wide-ranging and innovative. “USDA is uniquely positioned to help communities realize these visions. Whether that is a childcare cooperative—and we’ve seen the wages for cooperatives be higher, up to a dollar higher than the industry standard—and that’s an idea we’d be able to support…”
In a follow up question, Gillibrand asked how Congress should be thinking about incorporating community health workers into the larger framework and if there are models for community health worker that Congress can learn from to strengthen the rural health care workforce.
Under Secretary Torres Small again cited the power of cooperatives. Specifically, Torres Small noted that there has been increased interest in the worker cooperative model and provides an opportunity to share lessons learned. She also discussed, without mentioning it by name, the importance of cooperatives in helping small businesses achieve economies of scale to enable better workforce training opportunities and other shared services to better invest in the next generation of rural health care workers.
Cooperatives were mentioned yet again in a question from Senator Tina Smith (D-MN), who was one of the 2021 Co-op Champions and co-leads the calls for increased RCDG funding in the Senate. Smith discussed the trend of seniors choosing to ‘age-in-place’ at their homes rather than moving to a dedicated care facility, and the importance of staying connected to services and their communities.
Under Secretary Torres Small responded to this topic by describing USDA Rural Development’s role to support the establishment of new models for service and used the example of home care worker cooperatives. Torres Small noted the lower worker turnover at home care cooperatives which further supports quality elder care.
The second panel featured experts across the health sectors. Of note, Dr. Carrie Henning-Smith, who holds many titles at the University of Minnesota School of Public Health, included in her written testimony:
“As the Committee continues to consider ways to enhance access to and quality of health care in rural America, Rural Development programs like Community Facilities and the Rural Business-Cooperative Service programs have been essential programs for resources, as well as associated technical assistance and trainings, that should be used as a blueprint. These have been successful. They have improved health care infrastructure and as we prepare for future public health emergencies, these programs should be part of our public health response for rural communities.”
Throughout the hearing, interagency cooperation was noted as a priority to ensure high quality rural health care at all stages of life. NCBA CLUSA has advocated for the Interagency Working Group on Cooperative Development, which puts USDA at the helm of communications across federal agencies on the ways in which cooperatives can help solve local community economic development challenges and build a more inclusive and resilient economy. Cooperatives in the care sector were discussed in the most recent meeting, which occurred in October 2021. The Interagency Working Group on Cooperative Development’s website is available here.
This hearing made clear that cooperatives play a critical role in the care economy, especially in rural America. The Cooperative Development Foundation and its partners have been leading the Home Care Initiative for several years to help build and grow the home care cooperative sector. Today, there are 17 emerging and established home care cooperatives across nine states, with 1,100 caregiver-owners and employing more than 2,400 caregivers. CDF expects that number to grow with several businesses currently in the exploratory phase. Learn more about the state of the home care cooperative sector on CDF’s website.
In partnership with CDF and the Urban Institute, NCBA CLUSA released a report identifying policy strategies for cooperatives. These recommendations include policies to promote childcare and home care cooperatives to address community needs. You can read the full report here.