Still reeling from the financial toll of the pandemic, senior living providers now are facing a worsening labor crisis and are fearful about complications related to Covid-19 vaccine booster shots for residents.
Meanwhile, federal lawmakers are wrangling over key pieces of President Biden’s agenda, including a budget reconciliation bill and an infrastructure package.
With this as the backdrop, senior living industry association Argentum is launching a new advocacy campaign dubbed “Mr. President, Don’t Leave Us Behind, Again.”
Argentum President and CEO James Balda acknowledges the obstacles in achieving the aims of the campaign, but says that the industry must fight hard for needed support in light of the multifaceted challenges facing providers.
“It’s a difficult environment politically and fiscally, but if we don’t ask, we won’t get anything accomplished,” he told Senior Housing News.
Making the case to Biden
As part of the new campaign, Balda penned a letter to President Joe Biden, asking the commander-in-chief to “correct a past inequity.” This refers to the fact that the private-pay senior living industry has been largely overlooked in federal relief efforts related to Covid-19.
“It wasn’t until six months after the CARES Act was signed into law that facilities were even allowed to apply for funding, and federal relief has remained disproportionately insufficient, with less than 0.4% of the provider relief fund allocated to assisted living providers (according to a March 2021 report from the Government Accountability Office),” Balda wrote. “This is substantially less than nursing homes serving a similar number of high-risk seniors, and even less than other providers such as dentists that are not providing 24/7 direct care to seniors.”
Balda exhorted Biden to get behind more financial support for the senior living industry, and also to ensure that Covid-19 booster shots can be administered smoothly to residents, and to take steps to ease the workforce crisis.
Beyond Balda’s letter, the new advocacy campaign is employing other tactics to command attention from the president and Congressional lawmakers.
The association is creating a “web of billboards, banners and other signage in locations across the country,” according to a press release. One of those locations is Biden’s hometown of Scranton, Pennsylvania — where is scheduled to appear this week.
The campaign also will employ “local political outreach, media placements, and traditional and digital advertising,” Argentum stated.
A new pool of money
In his letter to the president, Balda exhorted Biden to take action in three areas.
The first area relates to financial relief for senior living providers. Perhaps most dramatically, Argentum is pushing for the creation of a senior living “sustainability fund.”
“We’re advocating for a pool of money purely for senior living,” he told SHN.
Such a pool of money is necessary because Argentum estimates that senior living providers have incurred at least $30 billion in pandemic-related losses and expenses, with only $1 billion in relief funds so far allocated.
Argentum is still working through details of a “PRF 2.0” dedicated to senior living — including the dollar amount — with some co-sponsors who are putting together the legislation to create the pool of money, Balda said.
Financial relief also is set to flow to senior living providers through the Phase 4 allocation of the existing Provider Relief Fund. Argentum is pushing for certain policies to be enacted related to the methodology for this allocation.
For instance, bonus payments are available to providers based on their level of involvement in the Medicare and Medicaid programs. Although senior living providers typically are not reimbursed through Medicare and Medicaid, Argentum is pushing for providers to be eligible for some of these bonus payments.
“We are arguing that we serve predominantly a Medicare population,” Balda said.
As of August 2021, the senior living workforce had shrunk 9.1% from the pre-pandemic high of 976,100 jobs, according to an Argentum analysis and Bureau of Labor Statistics data.
The labor crisis is reaching potentially catastrophic proportions, yet the current reconciliation package under consideration in the House of Representatives — which includes many elements of the Biden Administration’s Build Back Better plan — excludes assisted living caregivers from workforce development programs.
“This is in direct opposition to the President’s proposal, which specifically includes assisted living,” Argentum stated in a fact sheet about Build Back Better.
A multifaceted approach is required, Balda told SHN. This means pushing for assisted living to be included in the language of the Build Back Better package, but also working to ensure that senior living can participate in existing programs, such as those under the auspices of the Health Resources and Services Administration (HRSA).
Among the technical corrections that Argentum is calling for in Build Back Better are many instances in which assisted living should be included in grant programs to create health care career pathways and training programs.
Existing HRSA programs include nursing workforce development initiatives, health professions education and training efforts, and geriatrics workforce enhancement programs.
Argentum also is advocating for incentives such as student debt forgiveness and loan repayment assistance, which have proven helpful in bolstering other sectors.
Immigration reforms that would facilitate global recruitment of workers with senior care skills, and the establishment of a Federal Office of Caregiving Workforce Development are among the association’s other priorities and proposals in this area.
Booster shot availability
The third area that Balda highlighted in his letter to Biden related to “direct resources to combat Covid-19,” and he specifically noted that providers are in “critical need” of support for vaccine booster shots.
When booster shots were first cleared for use, many senior living providers expressed confidence that they could work with pharmacy partners to hold booster shot clinics for residents. But concern is brewing, Balda told SHN.
“Now, we’re starting to hear mixed news,” he said. “Increasingly, we’re hearing there are problems in terms of getting those clinics scheduled because LTC pharmacies themselves may be having issues.”
Though he would not describe the problems as “widespread,” Balda cautioned that action is needed to prevent them from growing worse. While it is almost certainly too late to reconstitute the LTC pharmacy program that was in place to administer the initial rounds of Covid-19 vaccines, the federal government could ensure that long-term care pharmacies are prioritized for distribution of boosters, Balda said.
“Our residents were some of the first to be vaccinated, so we’re now at a point where boosters are critical,” he said.
The senior living industry has its work cut out in breaking through the politics of the moment to gain much-needed support in all three of these areas, but Balda is optimistic about the progress that Argentum and other organizations have made in garnering support on the Hill.
“We have goodwill and momentum from our education efforts in Congress,” he said.
To build on this momentum, he is calling on providers to reach out to members of Congress and the White House, and to engage with residents and their family members to also get involved in advocacy.
“This impacts them — these are their homes,” he said.