PRESS RELEASE | May 19, 2021

Providers Detail Crisis Facing Older Americans Needing Home and Community-Based Care

Lisa Sanders, 202-508-9407

“An unacceptable number of older Americans can’t access the care they need to deal with the changes and challenges of aging.”

May 19, 2021, Washington, DC—As Congress debates infrastructure support, aging services providers outlined the crisis facing millions of older Americans who need home and community-based care to manage their health and prevent costly hospital stays.

The Biden Administration has proposed spending $400 billion to provide home and community-based care and services for older adults and disabled people.

“An unacceptable number of older Americans can’t access the care they need to deal with the changes and challenges of aging,” said Katie Smith Sloan, President & CEO of LeadingAge, the association of nonprofit providers of aging services. “More and more of us try to fill the gap by stepping in as caregivers to parents, grandparents, spouses or other loved ones, and we’re increasingly stressed, stretched and in unsustainable situations.”

Home and community service providers from Massachusetts, New Jersey and Ohio discussed why legislation to bolster America’s aging care infrastructure is urgently needed to ensure that older adults can get the services they need, help families caring for their loved ones get much-needed support, and help aging services providers pay for enough staff to meet the needs of a growing number of older Americans.

“The Biden American Jobs plan calls for $400 billion for these essential services, and LeadingAge wholeheartedly supports that important investment. We’re asking Congress* to address workforce needs and help ensure access to Medicaid home and community-based services by increasing the federal match for Medicaid HCBS by at least 10 points on a long-term basis,” added Brendan Flinn, LeadingAge’s Director of Medicaid and Home and Community-Based Services.

LeadingAge released a new Needs Report documenting the growing care affordability and access crisis facing older Americans–and the need for more government reimbursement to enable care providers to meet this demand. By 2029, it’s estimated that 54% of middle-income older adults won’t be able to afford the housing and long-term care they need.

The telepresser video can be found here.

*For more details, see LeadingAge’s Blueprint for a Better Aging Infrastructure.


Remarks by Home and Community Care Providers

Home care providers joined the press conference to discuss the challenges in their states, and to call on Congress to take the steps needed to build out desperately needed infrastructure for older adults. (Biographical information can be found here.) Key points included:

  • David Totaro, Chief Government Affairs Officer, BAYADA Home Health Care, Headquartered in Moorestown, NJ, services provided in 22 states
    • “For every person who can get home care, another needs it but can’t get it because they can’t afford it, or because there aren’t enough workers to care for them. Too often that means older people end up in a hospital or a nursing home—which is costlier for the government, and which is exactly where that individual, 9 times out of 10, didn’t want to end up.”
    • “Congress can make a real difference here by reversing outdated Medicaid policy that makes it difficult to access home care – and by raising reimbursement rates for these services.”
  • Kara Allread, Senior Vice President & Chief Administrative Officer, Brethren Retirement Community, Greenville, OH
    • “Our HomeCare services provide critical assistance with bathing, toileting, meals and medication, as well as trips to the grocery store and doctor’s appointments for older adults in our community–but it is increasingly hard to find the people we need to meet the demand for care.”
    • “Medicaid reimbursement rates simply do not allow us to pay enough to attract and retain staff in a sustainable way. Just this month we added 27 more people to our home care waiting list and have to discontinue services for 19 more. It’s heartbreaking to turn anyone away, but in a small town like ours, that means hardship for people that we live, work and worship beside.”
  • Dr. Brandi Derr, Director of Programs, Rogerson Communities Adult Day Health Programs, Boston, MA
    • “Adult Day Health offers a unique breadth of services that older adults can access in their communities. We pay close attention to the elders we care for every day, so we can catch problems early and prevent medical crises. Few care models can deliver this high level of care at such a low budget.”
    • “Programs like ours are competing with hospitals, private care and senior living organizations who can pay higher wages. We’re relying on chronically low Medicaid reimbursement to pay our CNAs, nurses, intake coordinators, kitchen coordinators, transportation managers and other critical staff. We can’t compete and we’re losing good people.”


About LeadingAge:

We represent more than 5,000 nonprofit aging services providers and other mission-minded organizations that touch millions of lives every day. Alongside our members and 38 state partners, we use applied research, advocacy, education, and community-building to make America a better place to grow old. Our membership, which now includes the providers of the Visiting Nurse Associations of America, encompasses the continuum of services for people as they age, including those with disabilities. We bring together the most inventive minds in the field to lead and innovate solutions that support older adults wherever they call home. For more information visit