A month after the House of Representatives passed the Build Back Better bill, LeadingAge and other aging services organizations are urging lawmakers not to reduce the legislation’s investments into home- and community-based services.
“The Senate is considering the most important legislation in a generation for older Americans,” Katie Smith Sloan, president and CEO of LeadingAge, said during a teleconference on Tuesday. “Build Back Better has the potential to significantly impact the lives of today’s older adults, and all of us who hope to grow old with health and dignity.”
Among other things, the $1.9 trillion bill earmarks $150 billion toward reducing waiting lists for in-home care services.
This is especially important because over three-quarters of states’ waiting lists for home care total more than 820,000 people, with an average wait time of more than three years, Kristen Kiefer, chief advocacy and engagement officer at National Council on Aging said during the teleconference.
“When people cannot get the care they need, caregiving falls to the family,” Kiefer said. “And it takes an enormous physical and financial toll.”
The $150 billion would also be used to improve wages for home-based care workers. This would be a lifeline for home-based care providers that are facing serious workforce shortages.
Specifically, the turnover rates for home care workers and nursing assistants hover around 60% to 90%, with most of those workers leaving within the first 90 days of employment, according to data from PHI.
Additionally, due to the growing demand for care and high turnover, the long-term care sector will need to fill roughly 7.4 million jobs in direct care between 2019 and 2029, Robert Espinoza, vice president of policy at PHI, noted during the teleconference.
“When jobs aren’t filled or workers constantly turn over, older adults and people with disabilities see the quality of their care go down,” he said. “Imagine needing this level of paid support in your home, or in a nursing home, or an assisted living setting, and not knowing whether the services will be staffed — much less by a qualified worker.”
Build Back Better also includes $1 billion for direct care workforce competitive grants, $130 billion to provide tax credits for uninsured people in states that have not expanded Medicaid benefits, and $20 million for hospice and palliative nursing programs.
Plus, $150 billion is geared toward increasing the supply of affordable housing.
“The Senate’s job is clear: to adopt these investments without shaving off $1 and, indeed, to increase them by at least doubling the investment in affordable housing for low-income older adults,” Sloan said. “Demand is growing. Homelessness is rising. Without a safe place to live, older adults won’t be able to access the community-based care and services that the legislation calls for. What happens in the next few weeks will determine whether millions of Americans can access the care they need as they grow older.”
Sloan said that the public conversation about Build Back Better fails to recognize seniors. In fact, only a little over 6% of Build Back Better’s media coverage included even a reference to older Americans, according to an analysis conducted by LeadingAge.
“The COVID pandemic made clear the tragic human consequences that can happen when we ignore the needs of older adults,” Sloan said.
During the teleconference, Kiefer also called on Congress to maintain $1.3 billion in funding for Older Americans Act programs, which allows seniors to live in communities for longer.
“The Older American Act funds senior centers, meal programs, job training and placement for older adults, [as well as] transportation, health programs and during the pandemic even vaccine education and shots,” she said.
Democrats are hoping to pass President Joe Biden’s Build Back Better package by Christmas. Yet that’s looking increasingly uncertain, as negotiations continue among their own ranks.
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