LisaMcCracken Ruth Katz hedshots

The coronavirus pandemic has challenged the aging services industry to imagine the unimaginable, including increased attention from policymakers, according to Ruth Katz, LeadingAge senior vice president of public policy and advocacy.

“I have never seen it move at the pace that it’s moving now,” she said while presenting a policy update Thursday at the 2021 Ziegler LeadingAge National Virtual Senior Living CFO Workshop.

“It’s moving fast and changing every minute,” Katz said. “I haven’t seen long-term care talked about like this, and haven’t seen a solution come in like a meteor the way vaccines came in.”

Katz predicted that COVID-19 will affect the future, even when the pandemic ends. It’s clear that the Biden administration’s focus will remain on COVID-19 for at least the next year, she added. 

But Katz said that long-term care providers face challenges that need attention now, including the need for additional relief funding, vaccines, visitation and reopening guidance, and more affordable senior housing for low-income older adults. Plus there are challenges related to occupancy, punitive regulatory and enforcement systems and workforce shortages.

Underlying everything, Katz said, is the need for long-term care financing.

“Long-term care financing is essential to make our systems work, and to make it work better,” she said. “We need big time not just plugging the holes today, but we need to have a vision about professionalizing jobs and creating a pipeline to fill these jobs. We need the whole continuum to look different and understand that people move around it.”

LeadingAge’s Blueprint for a Better Aging Infrastructure plan, unveiled earlier this month, will get the industry “caught up on COVID relief” and at a good starting point to go forward into 2040, Katz said. The document highlighted many of what LeadingAge believes are key issues important to the success of long-term care providers, including a living wage for workers, immigration reform, investment in affordable senior housing, and a modernized infrastructure.

Although the American Rescue Plan is not focused on long-term care, it does contain several provisions that Katz described as helpful, including assistance with COVID mitigation and vaccination; additional funding for home- and community-based services; aid to renters, landlords and homeowners to help people keep their housing; and funds for states to provide premium pay to essential workers.


Infrastructure, Katz said, is the next big action on the horizon, with the $2 trillion American Jobs Plan getting the ball rolling.

The fact that the Biden administration recognizes that the aging infrastructure is an essential part of the nation’s infrastructure gives the industry hope, she said. Calling the infrastructure bill a “very ambitious plan,” Katz said that it is focused on jobs and has people talking about HCBS.

Part of those discussions are on the HCBS Access Act, which seeks to mandate HCBS in Medicaid to create national minimum standards for HCBS, and the WISH Act, which creates a public-private partnership for long-term care financing that considers middle-income older adults.

Coming on the horizon, Katz predicted, are updated Centers for Disease Control and Prevention guidance as conditions surrounding the pandemic change, Centers for Medicare & Medicaid Services visitation guidance changes, and a closer look at transparency in the long-term care sector.