Providers On Biden’s Executive Order, Home-Based Care ‘Drumbeat That Won’t Be Ignored’

Home Health Care News | By Andrew Donlan
 
The Biden administration has made mention of home-based care regularly and intentionally during its tenure in the White House. It did so again [last] Wednesday this time through 50-plus directives for government agencies, many of which were home care-related. 
 
Though still just directives, the sitting president making this sweeping of an executive order focused on senior care – in part – is worth plenty of weight. 
 
Home- and community-based care (HCBS) providers believe there will be short- and long-term effects of the directives, as well as tangible and intangible results. 
 
“There’s certainly some symbolism in there that is favorable,” Darby Anderson, chief strategy officer for Addus Homecare Corporation (Nasdaq: ADUS), told Home Health Care News. “It certainly puts a greater wind at our backs, shining a spotlight on home- and community-based services and the overarching caregiver issues. And that’s very good.”
 
The Frisco, Texas-based Addus is an at-home care provider with a heavy focus on Medicaid-driven HCBS. The company has over 200 locations across 22 states.
 
Broadly, the directives from the White House included: a path for more home-based care availability for veterans, of the personal care and primary care variety; a path to uplift the caregiver workforce, utilizing Medicaid funds to do so; and further support for the concept of self-directed care.
 
“There’s real concrete actions that [President Biden] has put into this executive order that are directed at different parts of of the government,” Anderson continued. “We’ll have to see how those are implemented at the end of the day. But there could be some real concrete improvements, hopefully to the services we provide and for the workers in [this space].” 

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The following excerpts were taken by HHAC of pertinent Executive actions taken last week and as described in a White House Fact Sheet:

• Improve access to home-based care for veterans. VA is directed to consider expanding its Veteran Directed Care program to all 172 VA Medical Centers by the end of Fiscal Year 2024. This program provides veterans with a budget to hire personal care assistance including from family members. VA will also consider piloting a new self-directed care program in no fewer than 5 new sites that provides veterans with a budget for personal care assistance while reducing administration burdens related to managing care. Further, VA will consider adding 75 new interdisciplinary teams to its Home-Based Primary Care program to serve an additional 5,600 veterans in their homes.

• Enhance job quality for long-term care workers.  To advance the President’s long-term care priorities, the Executive Order directs HHS to consider issuing several regulations and guidance documents to improve the quality of home care jobs, including by leveraging Medicaid funding to ensure there are enough home care workers to provide care to seniors and people with disabilities enrolled in Medicaid, as well as build on the minimum staffing standards for nursing homes and condition a portion of Medicare payments on how well a nursing home retains workers.

• Support family caregivers. To provide greater support to family caregivers, the Executive Order directs HHS to consider testing a new dementia care model that will include support for respite care (short-term help to give a primary family caregiver a break) and make it easier for family caregivers to access Medicare beneficiary information and provide more support to family caregivers during the hospital discharge planning process. Additionally, VA will consider expanding access to the Program of Comprehensive Assistance for Family Caregivers and provide more mental health support for caregivers enrolled in that program. These actions build on the 2022 National Strategy to Support Caregivers.

• Advance domestic workers’ rights. Care workers should be supported, valued, and fairly compensated, and care workers should have the free and fair choice to join a union. In particular, domestic workers providing care for our loved ones are often underpaid and subject to discrimination and abuse. To provide greater protection for these workers, the Department of Labor will publish a sample employment agreement so domestic child care and long-term care workers and their employers can ensure both parties better understand their rights and responsibilities.