Red pushpin pointing to Pittsburgh city in more than fifty years old map
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Pennsylvania’s master plan on aging, although well-intended, focuses most of its attention on home care and community services and falls short of ensuring a “robust” long-term care continuum for older adults, according to senior living leaders. 

According to the state, Aging Our Way, PA will serve as a roadmap for how state, regional and local agencies work together to meet the needs of the Keystone State’s older adult population, improve commonwealth services for older adults and ensure older adults can age in place with dignity.

The 10-year strategic plan will address issues including long-term care, housing, social connections, healthcare and transportation. It resulted from an executive order that Gov. Josh Shapiro (D) signed in May 2023 directing the Department of Aging and other agencies to draft a master plan on aging.

Earlier this year, the senior living industry expressed disappointment that funding for the state’s master plan on aging did not directly impact providers or workers.

“Aging Our Way, PA presents a bold vision for Pennsylvania’s future, and with the release of this plan we will begin to lay the foundation to build more inclusive, accessible and cost-effective systems and infrastructure that supports the needs of our community members across the commonwealth,” Shapiro said in a statement

The top five priorities of the plan are improving access to healthy aging, eliminating barriers to aging in community, supporting independence through accessible transportation, building caregiver supports, and promoting education and navigation of community services.

Plan neglects long-term care communities

Leaders of senior living and care advocacy organizations in the state, however, assert that the plan neglects congregate care settings, such as senior living communities. 

“To gloss over the complete long-term care continuum is a disservice to older Pennsylvanians more commonly in need of skilled and personal care, especially as that segment of our population continues to grow,” Pennsylvania Health Care Association President and CEO Zach Shamberg told McKnight’s Senior Living. “With a heavy focus on homecare over the next 10 years, it’s possible that Pennsylvania will begin to see more of its population in need of higher levels of care that cannot be supported at home, leaving the state further unprepared.”

Shamberg said that increasing home care will not be financially viable for taxpayers, noting that the current annual cost per person for home care is more than the beneficiary cost for nursing facility service.

In addition, Shamberg said, the plan does not address several “missed opportunities” contained in various PHCA-supported initiatives, including SB 520, which would allow assisted living communities to be Medicaid-eligible. The bill would expand care options for low-income older adults by allowing them to move into an assisted living community or remain in an assisted living community if they don’t have the personal funds to pay for care. 

The Pennsylvania Assisted Living Association similarly said a strategic plan to meet the goals outlined in the Aging Our Way, PA plan must include Medicaid assisted living benefits, noting that Pennsylvania is one of only three states that does not allow Medicaid for assisted living services.

“This fact is simply unacceptable,” PALA Executive Director Susan Saxinger told McKnight’s Senior Living. “As a result, seniors are being forced to leave their homes and communities where they are aging comfortably with dignity, to avail themselves of their Medicaid benefits in a skilled nursing facility.”

The result, Saxinger said, is less choice, a negative effect on older adults’ health, and unrealized savings to the state’s Medicaid budget.

“Most importantly, applying for the [Centers for Medicare & Medicaid Services] waiver would meet the core values of Aging Our Way, PA to allow Pennsylvania’s seniors to age with dignity, self-determination, and the supports and services they need to remain independent,” Saxinger said. “The time is now to allow Pennsylvania’s seniors to join with seniors in 47 other states to utilize their Medicaid benefits in assisted living.”

Shamberg said that the plan’s focus on workforce initiatives also doesn’t mention support for SB 1104, a workforce bill that would allow high school juniors and seniors to obtain credit toward graduation requirements for working in congregate care settings.

LeadingAge Pennsylvania applauded support for the LTC Rise and Living Independent for the Elderly (LIFE) programs in the plan. Chuck Quinnan, senior vice president and chief government affairs officer, said that the association hopes to work with lawmakers to address more immediate workforce and funding needs facing all areas of the aging services ecosystem. 

“The aging services sector is a complex ecosystem, where each type of provider needs to be empowered to work in tandem to deliver high quality care that fits the senior population’s evolving needs,” Quinnan told McKnight’s Senior Living.

The Pennsylvania Department of Aging asked for $11.7 million in the 2024-2025 proposed budget to begin implementing the plan.