These past four months have been among the most trying any of us have ever faced. Many of the challenges have been felt particularly hard in senior living communities, compounded by a scarcity of testing supplies and protective equipment. But at the same time the best has shown through, as direct care and support staff have risen to the occasion to care for our nation’s seniors while meeting an ever-expanding list of obligations at home. As we adjust to a new normal, at least for the foreseeable future, Argentum has been working with policymakers in Washington, D.C. and throughout the states to advocate on behalf of residents and staff.
When a shuttered Capitol Hill forced us to abruptly cancel our annual Public Policy Institute & Fly-In, we quickly recalibrated and met with Congressional leaders and administration officials to relay the critical needs of senior living expected in these extraordinary times. With Congress advancing four rapid succession legislative responses, we focused our efforts on prioritizing access to virus testing and PPE, financial relief, and liquidity to meet the increasing financial stresses, and legal protections to defend those on the frontlines.
Our efforts at the national level have been augmented throughout the states. Many legislatures were in the midst of advancing key proposals affecting senior living–from electronic surveillance to medical marijuana and comprehensive reforms to the industry at large. But just as we shifted on Capitol Hill, working in concert with our state partners, we met the new challenges at the state house too by leaning on longstanding relationships with regulators and legislators.
The future may remain clouded in uncertainty, but the need for our industry has never been clearer, and that’s why we will continue to advocate on your behalf to ensure senior living can survive and thrive well after this pandemic fades into a memory.
In the wake of COVID-19, our priorities shifted from retirement income security and workforce development to protecting residents and staff. Early on we recognized how this virus presents unique challenges to senior living, with those at greatest risk being people over 60 years of age with underlying health conditions. As lawmakers crafted response packages, we urged lawmakers to prioritize the well-being of our most vulnerable and their caregivers and to ensure the long-term viability of senior living to meet these needs.
PPE & Testing
The most important of our requests has been in preventing the spread of the virus, where we’ve stressed the critical importance of adequate testing for suspected cases. Protecting healthy residents and staff requires timely and verifiable testing, and we urged policymakers to prioritize tests for our communities to give a better sense of when and where to escalate infection control procedures as needed.
Beyond testing, we underscored the urgent need of our direct care staff for personal protective equipment (PPE) to properly protect against the spread of the virus, such as face masks, respirators, eye protection, gowns and gloves, as well as cleaning supplies and hand sanitizing products. See letters
Families First & Paid Leave
As the scope of the pandemic became clearer and ordinary life ground to a halt, we recognized the need for safe childcare for our employees. In the course of a week, schools went from being in session to more than three in four of the country’s public and private school students facing mass closures. Ensuring that our nurses, care staff, housekeepers, food service workers, and maintenance staff would not have to worry about keeping their children safe or risking a lost paycheck required immediate action to address the childcare crisis.
As part of the Families First and Coronavirus Response Act, the Department of Labor granted certain exemptions to the paid leave provisions for essential healthcare workers, including senior living workers as we requested to ensure that our nation’s seniors would still be able to get the care they need during this crisis.
CARES Act and Supplemental Funding
Senior living has been at the forefront of the pandemic, and as a result, has experienced significant operational and financial stress. As lawmakers moved onto the $2.2 trillion economic-stimulus package, Argentum focused its advocacy efforts to safeguarding the long-term financial viability of the industry, given the additional supplies, overtime costs, and childcare needs that Argentum member companies stepped up to provide their employees.
The CARES Act included several provisions for senior living operators to meet their financial obligations. This included the $100 billion Public Health and Social Services Emergency Fund (PHSSEF) designated for healthcare providers, which was increased to $175 billion as a result of
H.R. 266, a supplemental funding package for the CARES Act. Since passage, Argentum members, lobbyists, and other industry associations have been collectively advocating for senior living to receive funds to offset increased operating expenses and reduced revenue.
Additionally, senior living providers are eligible for funds from the $450 billion Treasury fund for mid-size businesses or the $670 billion for small businesses, depending on particular eligibility. In forthcoming legislation, we are seeking changes to the small business loan eligibility to expand the scope for all communities with fewer than 500 employees to be eligible, regardless of the total corporate size.
Beyond our efforts to prioritize the industry in Congress’s proposals, Argentum and our state partners have been engaging in an extensive initiative to protect the industry from future legal liability. The pandemic has resulted in conflicting guidance issued by regulators and combined with the insufficient protective equipment, we are concerned that the heroic efforts of our front-line workers could be exploited by lawsuits against them.
Argentum and other stakeholders are working in collaboration to have every state governor or legislature address this issue. We’ve provided a model that can be tailored to each state’s needs and have worked directly with each state to determine how best to insert language favorable to both operators and providers. To date, more than half of the states adopted some form of protections, including several that met all or most of the key elements of our model.
Protection for employees during this pandemic is also being pursed at the federal level through the forthcoming legislative package as well as by invoking the PREP Act to ensure that senior living employees are covered on a nationwide basis.
COVID-19 has been all-consuming, but it has not been the only pressing issue facing the industry. Prior to the pandemic coming to the fore, we were active in protesting a regulatory change to CCRCs that could have significant financial impacts. We submitted formal comments in opposition to the Medicaid Fiscal Accountability Regulation (MFAR) that could increase provider taxes by six- or seven- figures annually. We requested the rule be withdrawn or to eliminate the provisions relating to CCRCs. A final rule is expected later this year.
Legislatively, we were also active in opposition to H.R. 2474, the Protecting the Right to Organize (PRO) Act. We are concerned that it would effectively repeal right-to-work provisions currently used in 27 states, strip workers of essential rights, and violate employees right to privacy. This bill was narrowly passed by the House in February but is not expected to be considered by the Senate, although it could be reconsidered in future Congresses.
Finally, we were pleased to see the final passage and enactment of H.R. 4334, the Supporting Older Americans Act. First passed in 1965 and last reauthorized in 2016, the Older Americans Act serves more than 10 million Americans each year by supporting caregivers, providing employment, community service opportunities, nutrition and transportation options, and preventing abuse and neglect. The latest iteration will reauthorize the act for five years with increased funding, improving elder abuse prevention, promoting multigenerational opportunities, expanding the availability of services for those living with younger onset Alzheimer’s disease, and supporting age-friendly communities.
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