Change is in the Air

Conversations with Katie | April 14, 2021

President and CEO Katie Smith Sloan describes LeadingAge’s recommendations for modernizing our system of service, care, and support.

I've worked in aging services since the 1980s, and as 2021 unfolds, I‘ve come to an empowering realization: there has never been a greater opportunity than now to change long-term services and supports (LTSS)—forever and for the better.

I’m pleased to report that change is the air. The Administration and Congress are turning their attention to rebuilding our country’s infrastructure—and LeadingAge is ready to ensure that investment includes the essential needs of our growing population of older adults.

On March 31, the Biden Administration released its ambitious American Jobs Plan, which includes important support for aging services, including a significant investment in home-based care. A day after the White House announcement, LeadingAge released its own “Blueprint for a Better Aging Infrastructure,” a series of recommendations that we hope will stimulate a conversation about what it will take to modernize our system of services, care, and support for the 21st century.

After this pandemic year, it feels good to be looking to the future. We need to work hard to make sure we invest in repairing the fragile state of our aging services infrastructure—and address challenges that existed well before COVID-19. Our blueprint calls for that investment in six areas:

Workforce: We propose several ways to address our acute workforce shortages and ensure we can recruit enough high-quality workers to fill the jobs needed to serve a growing older population. Among them: increased staff training, enhanced career pathways, and meaningful changes to immigration policies. We also support a living wage, determined by locality, for aging services workers across the continuum, with providers fully reimbursed to cover wages and benefits paid for, in part, by an increased Medicaid match for LTSS.

Care in the Home and Community: We’re seeking expanded funding and support for service and care at home. We have a long list of “asks” in this area, such as ensuring full access to Medicaid home and community-based services, expanding access to integrated models of care like the Program of All-Inclusive Care for the Elderly (PACE), and investing in programs to design, revamp, and build accessible physical spaces like day centers used by community-dwelling older adults.

Affordable Senior Housing: Our plan includes recommendations for investing $2.5 billion in the federal Section 202 program and $5 billion to enable equal access to the health/telehealth, economic, and social connectedness benefits of the internet.

Nursing Homes: We recommend updating the aging physical structures of nursing homes so they are home-like and so all residents can have private rooms. We also call for collaborative approaches to regulation and enforcement so we are all working together to ensure quality of care and quality of life among residents.

LTSS Financing: We repeat our long-standing goal to establish an affordable, meaningful set of policies to finance long-term care for those who need it.

A COVID Comeback: We recommend several steps that would allow hard-hit providers to rebound from the massive financial costs of the pandemic while protecting residents and staff from continued outbreaks of the virus. Among other things, our blueprint calls for a $6 billion “Hardest Hit” Provider Relief Fund, and an investment in a national broadband infrastructure to sustain the technology use that became so important during the pandemic.

This is the most important moment in a generation for aging services. Unlike so many issues our country faces, support for stronger aging services infrastructure enjoys very broad bipartisan support—often topping voters’ infrastructure wish lists.

If we’re going to succeed in building up our critical part of the care economy, we need to leverage that support for real change. Everyone has a part to play, including Congress, the administration—and you.

First, I hope you will read the Blueprint for a Better Aging Infrastructure.

Second, I’d like you to consider inviting your member of Congress to visit your community and meet with your staff. Let them see firsthand the irreplaceable care and services you provide to older Americans throughout the continuum, and the pressing needto invest in your important work.