LeadingAge Urges Congress to Invest in Senior Care Infrastructure

WASHINGTON, D.C. (May 19, 2021)—At a recent recruiting event at a local high school, the health care providers present received “zero interest” from students, said Kara Allread, senior vice president and chief administrative officer of Greenville, Ohio-based Brethren Retirement Community and Brethren HomeCare. “They know we can’t compete” with retail and other industries, she said.

Allred’s comments were part of a press conference hosted by LeadingAge, a national association of nonprofit aging services providers, where providers explained of the legislative priorities for home- and community-based services providers surrounding reimbursement and staffing challenges. 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 and CEO of LeadingAge. “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.” 

Sloan also said that the system is “under growing strain. Federal and state reimbursement rates are chronically inadequate to cover the costs of quality care and services—or to pay a living wage for our professional caregivers.”

Panelists on the call included Kara Allread, senior vice president and chief administrative officer of Brethren Retirement Community and Brethren HomeCare; Dr. Brandi Derr, director of programs for Rogerson Communities Adult Day Health Programs; and David Totaro, chief government affairs officer of BAYADA Home Health Care.

BAYDA tries to offer better-than-average wages, but is dependent on government reimbursement to cover salaries, said Totaro. In 2020, “Our costs for care have increased, without us being compensated,” he said. “Also, many states are raising minimum wage without increasing [Medicaid] reimbursement.” Totaro added that BAYADA had to turn away more than 1500 people in New Jersey from care services due to lack of staff. 

Totaro and Allred emphasized that the poor reimbursement rates do not allow homecare agencies to attract and retain staff, a fact that Allred said “is devastating in a small town.” Brethren added 25 people to their wait list in the first quarter of this year and discontinued services for 19 more. These people could end up in skilled nursing or the emergency room, she said, because their health care needs are not being met. 

“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.

For more details on the association’s plan for Congress, see LeadingAge’s Blueprint for a Better Aging Infrastructure.