Investments in aging services infrastructure must include a new, $6 billion Provider Relief Fund for those hardest hit by the pandemic, a permanent increase of Medicaid’s Federal Medical Assistance Percentage and support to update nursing home buildings, LeadingAge outlined in a letter to Congressional leaders Thursday. 

The request comes as Congress prepares to tackle the $2 trillion infrastructure package announced by President Joe Biden earlier this week. HIs proposal calls for $400 billion for home- and community-based services. Though the plan is an “ambitious” and “promising start” by the administration, LeadingAge President and CEO Katie Smith Sloan said it’s going to take more to improve the state of aging services’ infrastructure across the continuum.

“Right now, we don’t have the infrastructure for aging services that we need, and the systems that we do have are crumbling,” Sloan said during a media briefing Thursday. 

“Our plan lays out a path that Congress and the administration must consider in the coming weeks as they turn their attention toward infrastructure. I believe now is the best opportunity we’ve had in decades to transform our system,” she added. 

Because the president’s proposal is still taking shape, Washington observers say it may be the best chance in decades for lobbyists and associations such as LeadingAge to influence healthcare and other infrastructure initiatives. Administration officials have said the package unveiled yesterday is just the first of two parts. 

LeadingAge urged Congress to create a strong foundation to build back aging services before it begins work on projects more traditionally viewed as infrastructure. To ensure  providers come out of the pandemic financially stable, the organization proposed the $6 billion “Hardest Hit” Provider Relief Fund for nursing homes and other long-term care providers.

The group also called for a permanent 10% increase of FMAP funding for both nursing homes and HCBS to promote workforce investment. 

For nursing homes and other congregate settings, the plan calls for any infrastructure package to include provisions for rebuilding outdated physical structures, private room conversions, and improved staffing ratios. 

Deke Cateau

“I think the current design and infrastructure of the vast majority of our nursing homes is inadequate,” Deke Cateau, president & CEO of A.G. Rhodes Health & Rehab in Atlanta, GA, said Thursday. 

“We have two choices: Either we can continue as usual with an outdated, undignified — and in some cases — unsafe physical plans and infrastructure, or we can view this as the key and critical community issue that it is and use this opportunity to redevelop and to rebuild our buildings and turn them into true homes for the nation’s seniors,” he added. 

The LeadingAge wish list also includes 24-hour registered nursing, a 30-day minimum supply of personal protective equipment, and improvements to the infection preventionist requirements for providers, which were also included in a reform package unveiled by the group and the American Health Care Association last week. 

LeadingAge is also pushing for improvements to the survey process that enable person-centered resident care and rapidly turn around or close poor-performing facilities, and established federal guidelines for state-allowable cost definitions. 

Additional coverage from LeadingAge’s infrastructure blueprint can be found on our sister sites McKnight’s Senior Living and McKnight’s Home Care.