Throughout 2012, a variety of federal legislative and regulatory issues arose that will affect senior living communities and senior living residents across the country. From the implementation of the National Alzheimer’s Project Act to proposed revisions to CMS’ waiver program, take a look back at some of the year’s most important initiatives.
Throughout the second session of the 112th Congress, the Senate Special Committee on Aging (SCOA) has been actively addressing a number of issues that touch senior living providers. In June, the committee conducted a hearing on the VA Aide and Attendance Program. The hearing exposed numerous cases of financial exploitation by some unscrupulous financial advisors who were hired to help seniors with the complicated application process. ALFA submitted testimony for the hearing and has been working with Senator Wyden (D-OR) and the Veterans Administration to improve the program and prevent these abuses.
Last year, the SCOA held a hearing on the use of antipsychotics among those living with dementia in nursing homes, and this year the Centers for Medicare & Medicaid (CMS) announced the Partnership to Improve Dementia Care, an initiative aimed at reducing the use of antipsychotic drugs in nursing home residents by 15 percent by the end of 2012. With the goal of ensuring appropriate use of antipsychotics in senior living communities, ALFA has joined with the Senate Special Committee on Aging (SCOA), as well as other stakeholders, in asking the Government Accountability Office (GAO) to conduct a study examining the broad range of interventions and protocols employed by senior living providers to reduce the unnecessary use of psychotropic medication in seniors.
In addition to actions by Congress, some federal agencies have been active in issues that affect senior living providers. For example, the Centers For Medicare & Medicaid (CMS) are in the process of redefining home and community based settings. ALFA has been active in ensuring the new definition will allow low income seniors to reside in assisted living. The latest draft is very supportive of assisted living and reflects a person centered approach that ALFA’s professionally managed communities will likely meet.
CMS has also been actively implementing measures outlined in the Affordable Care Act. Earlier this year, CMS announced the creation of 89 accountable care organizations (ACOs). Senior living providers cannot officially join ACOs, but the new incentives for hospitals and other healthcare providers may allow for senior living communities to engage in meaningful partnerships.
The National Labor Relations Board (NLRB) has also been extremely active in 2012. Earlier this year, the National Labor Relations Board’s rule requiring employers to put up a poster outlining workers’ right to unionize and rule allowing expedited elections were both scheduled to take effect. Due to actions by the courts, neither have been implemented; but both may be pursued by NLRB at a later date. ALFA will continue to monitor these and a number of other labor issues pursued by NLRB and the Department of Labor.
President Obama allocated $80 million for Alzheimer’s research in his 2013 budget, and the Department of Health and Human Services (HHS) finalized the National Plan to Address Alzheimer’s Disease. Although the initial draft did not include mention of assisted living, thanks in part to advocacy by ALFA and its members, the final plan recognized the role assisted living plays in the lives of many individuals with Alzheimer’s disease. The Advisory Council on Alzheimer’s Research, Care and Services has met several times throughout 2012 and will continue to meet in 2013 to implement this comprehensive plan.
Many of these initiatives will carry over into the new year; but with some key members of Congress retiring at the end of the session, the political climate will be different in 2013. For example, the Senate Special Committee on Aging will have both a new chair and ranking member leading the committee. When the new Congress convenes on January 3, 2013, ALFA will begin targeted outreach efforts with new members and staff to begin developing relationships and introduce key policy objectives. Additionally, with President Obama’s second term there will likely be new political appointments. ALFA will proactively engage the new administration officials, including those assigned to the newly created Administration for Community Living, and continue its outreach with career level officials in the key federal agencies with oversight over ALFA issues.
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