Home Health & Hospice Week

It comes on the heels of the administration’s 2024 budget proposal that included a $150 billion boost in spending for home- and community-based services (see HHHW by AAPC, Vol. XXXII, No. 10).

While the directives remain somewhat vague and include no additional funding, the order:

• “directs [the Department of Health & Human Services] 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,” according to the fact sheet.
• “directs HHS to consider testing a new dementia care model that will include support for respite care … 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.”
• says 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.”
• “directs the Department of Veterans Affairs (VA) to improve access to home-based care for veterans who require support with activities of daily living … by giving them more decision-making power over who delivers that care and when.”
• also directs the VA “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.”
• And tells the VA to “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,” as well as boosting the VA’s Home-Based Primary Care program.

Industry reaction to the news is mixed.

The National Association for Home Care & Hospice “applauds President Biden’s vigorous efforts to support home and community-based care through a series of executive orders affecting Medicaid, VA health benefits, and more. We face significant and growing challenges to meet the needs of our country’s increasing aged population that warrants improved access to home care,” says NAHC President William Dombi in a release. “This is an investment that will benefit all Americans.”

But LeadingAge says the executive order “brings much-needed attention, but not adequate solutions,” according to a release.

The order “shows that the Biden White House has been listening — but, sadly, the order does not meet the ever-growing needs of America’s older adults and families,” says LeadingAge CEO Katie Smith Sloan, who attended the order’s signing ceremony in the White House Rose Garden.

The policy fails to address non-home care settings and services such as hospice, Smith Sloan notes. And “the country must address immigration to build a pipeline of new workers through proven programs and pathways for those ready and willing to work in our field,” she says.