President Announces Executive Order, Including Actions on Long-Term Care Staffing
Last week, President Biden signed an executive order that included more than 50 directives to expand access to affordable, high-quality care as well as provide support for care workers and family caregivers. Included in his order is an action to reduce nursing staff turnover in nursing facilities by adjusting Medicare payments to facilities based on staff turnover. It also builds on efforts to propose minimum staffing standards by providing further guidance, technical assistance, and education to providers and residents. The Society will closely monitor these proposals and continue to work with the administration to ensure there is a systems approach to establishing appropriate staffing standards and encourage ongoing active engagement with both the medical directors and adjunct provider teams in the process.
Specifically, this Executive Order will improve working conditions and job quality in federally assisted child care and long-term care programs, encourage providers to establish incentives to recruit and retain workers, help prevent burnout, make it as easy as possible for care workers to access behavioral health services, and thereby improve the care that individuals receive. The secretary of Health and Human Services (HHS) shall:
- Consider additional actions—such as providing guidance, technical assistance, and provider and resident education—and rulemakings on nursing home staffing transparency to promote adequate staffing at nursing homes, building on the Department of HHS’ efforts to propose minimum standards for staffing adequacy at nursing homes
- Consider additional actions to reduce nursing staff turnover in nursing facilities and improve retention of those staff, advancing the Department of HHS’ efforts to measure and adjust payments based on staff turnover
- Expand training pathways and professional learning opportunities to increase job quality, improve the quality of care, and attract new entrants into the care workforce; to do so. the secretary of labor and the secretary of education, in consultation with the secretary of HHS, shall:
- Encourage recipients of federal financial assistance to expand opportunities for early childhood educators and long-term care professionals through community college programming, career and technical education, registered apprenticeship, pre-apprenticeships leading to registered apprenticeship, and other job training and professional development
- Make available innovative funding opportunities, develop and evaluate demonstration projects for care training and educational attainment, and provide technical assistance to state, local, and tribal partners to improve job quality for care occupations
- Develop partnerships with key stakeholders, including state, local, tribal, and territorial governments; unions and labor organizations; state and local workforce development boards; institutions of higher education (including community colleges, historically black colleges and universities, tribal colleges and universities, and minority serving institutions); aging and disability networks; and national- and community-based organizations that focus on care (including professional membership organizations)
- To support family caregivers of beneficiaries of federal health care programs and services, and in conjunction with implementing the 2022 National Strategy to Support Family Caregivers:
- The secretary of HHS shall, consistent with the criteria set out in section 1115A(b)(2) of the Social Security Act (42 U.S.C. 1315a(b)(2)), consider whether to select for testing by the Center for Medicare and Medicaid Innovation an innovative new health-care payment and service delivery model focused on dementia care that would include family caregiver supports such as respite care
- The secretary of HHS shall consider how better to evaluate and clearly set expectations for family caregivers in the Acute Hospital Care at Home program, which allows hospitals to treat in their homes those who would otherwise be hospital inpatients
- The secretary of HHS shall take steps to ensure that hospitals are actively involving family caregivers in the discharge planning process, consistent with CMS’ condition of participation discharge planning requirements, including by promoting best practices such as partnerships with community-based organizations and using resources from the Administration for Community Living and the Agency for Healthcare Research and Quality
- The secretary of HHS shall increase beneficiary communications and support family caregivers by increasing the promotion of the option for Medicare beneficiaries to choose to give family caregivers access to their Medicare information via 1-800-MEDICARE and the state health insurance assistance program networks