Veterans, Alzheimer’s Top Senior Living Trade Group’s 2013 Agenda

With several new faces on the Senate Special Committee on Aging, the Assisted Living Federation of America’s (ALFA) top priorities continue to be educating Congress and raising awareness of current senior living issues.

Key congressional goals for ALFA in 2013 include monitoring the implementation of the Affordable Care Act and its impact on the assisted living industry, along with ongoing efforts to find a cure for Alzheimer’s disease.

ALFA is also working to streamline the application process for certain government aid programs and ensure older Americans will maintain the ability to age in the long-term care setting of their choice and access home- and community-based care with the help of Medicaid waivers.


New Members

At this point, the Senate Special Committee on Aging needs general education regarding senior living and care options, ALFA’s federal advocacy team says.

About 25% of the committee’s members are new as of January 2013, and more than 40% of current Congress members have changed in the past few years, says Jordan Bernstein, a lobbyist at Washington, D.C.-based Cassidy & Associates, part of ALFA’s advocacy arm.


Not only does the Committee on Aging have a new chair in Sen. Bill Nelson (D-Fla.) following the retirement of former chair Sen. Herb Kohl (D-Wisc.), it also has a new ranking member, Sen. Susan Collins (R-Maine), replacing former ranking member Sen. Bob Corker (R-Tenn.), along with three other recent additions.

“They haven’t specifically come forward with an agenda yet, but we have met with them to educate them on ALFA and who we are,” says Maribeth Bersani, ALFA’s Senior Vice President of Public Policy.

The new members represent new momentum, says Bernstein, especially considering the committee’s chair represents Florida—or “ground zero” for some senior-related issues that fall under ALFA’s interests.

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“We remain concerned with the implementation of the Affordable Care Act and how it will impact Medicaid and home- and community-based services, as a number of states have Medicaid waivers for assisted living,” Bernstein says.

Despite the program’s exemption from sequestration, states’ budgets may grow even tighter with an expanded Medicaid eligibility, he says, and it could affect the availability of waivers for HCBS.

Other healthcare reform initiatives present new opportunities for assisted living providers, and ALFA and its lobbyists are also having conversations about the industry’s role in Accountable Care Organizations and hospital readmission penalties.

“[We’re looking into] how some of our communities can be used as short-term placements to receive care when individuals leave the hospital before going home,” says Bernstein. “There are different opportunities where we can be on the offensive and look for positives.”

VA Aid & Attendance

One project ALFA hopes the Senate committee will consider is streamlining the Veterans Affairs (VA) Aid & Attendance program, a benefit that helps eligible veterans and surviving spouses to pay for assisted living care.

While the Special Committee on Aging doesn’t have any legislative jurisdiction, it can be used as a platform to raise awareness and bring issues to the forefront.

Last year, it held hearings on the Aid & Attendance program and identified a couple of problems, Bersani says, such as the steering of veterans into the program and a painstaking application process.

“It’s so complicated,” Bersani says of the application process. “Some people are waiting over a year for the benefit. For assisted living, when you need it, you need it right away.”

ALFA intends to use last year’s hearings and their findings as an opportunity to tell Congress how the VA program can improve.

“We’d like to streamline the process and have the VA target more resources so they can process these applications in a timely manner and develop some best practices,” Bersani says.

While ALFA is willing to do more to develop best practices for its members beyond a toolkit for families and providers it released several years ago, VA cooperation is preferred.

So far it has been difficult to get a hold of the VA, Bersani says, but ALFA still hopes to work with the department to simplify the application process.

“We owe it to our veterans to address the program,” she says. “We hear stories all the time of folks who can’t figure out how to apply, or die before they get the benefits.”

ALFA is optimistic about finding the right VA personnel to help, but has a backup plan, as legislative measures won’t necessarily be required. “If we have to do it on our own, we’ll do it on our own. The VA could get this done [without legislation], although legislation may be necessary to get more staff to handle the backlog.”

Alzheimer’s Disease

In addition to the many veterans residing in assisted living settings, the industry cares for more Alzheimer’s residents than any other long-term care setting, Bernstein says, and finding ways to combat the disease is one of ALFA’s top goals.

The Senate Special Committee on Aging’s ranking member Sen. Collins is also a co-chair of a bipartisan congressional task force on Alzheimer’s, representing the possibility to achieve some synergies.

“We’re working with other organizations with a goal to stop Alzheimer’s disease by 2025,” Bersani says. “We hope we can continue to work with Congress on targeting Alzheimer’s disease and finding a cure, or ways to slow its progress.”

Written by Alyssa Gerace

This article is sponsored by the Assisted Living Federation of America (ALFA) as part of its efforts to advance excellence and explore topics impacting the future of senior living. For more information about ALFA, visit