Today in a Rose Garden ceremony, the President signed an Executive Order summarizing his Administration’s caregiver actions and proposals; Katie Smith Sloan was among the invited guests. A Fact Sheet – “Biden Harris Administration Announces Most Sweeping Set of Executive Actions to Improve Care in History” released earlier in the day outlined key measures included in the Executive Order. This LeadingAge article summarizes the Fact Sheet and its implications for LeadingAge members. The set of initiatives released today repeats and consolidates prior budget requests and announcements and adds some new ones. LeadingAge supports the President’s proposed $150 billion expansion of Medicaid home and community-based services funding, including a focus on supporting the HCBS workforce. We question the White House notion that there is a way to leverage Medicaid funds to ensure there are sufficient workers to provide care in HCBS settings. Importantly, the fact sheet includes a statement that the Administration will add regulations and requirements to staffing mandates (which are not yet issued) and withhold Medicare SNF funding for nursing homes that do not retain staff. (It is essential to point out that this implies a new requirement; in fact, the policy of using SNF value-based purchasing to reward SNFs that retain staff has already been proposed.) Overall, LeadingAge is concerned that White House materials continue to frame the debate as “either/or” when talking about HCBS and nursing home funding, when both are needed. Further, we continue to point out that the workforce crisis remains the most challenging issue in long-term care, and it will not be solved without comprehensive immigration reform. We will continue to report on follow-up activities.
