Pushing for the right kinds of change

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Stephen Fleming
Stephen Fleming

Stephen Fleming, president and CEO of the WellSpring Group in Greensboro, NC, was introduced as the new LeadingAge Board chairman at the organization's Annual Meeting & Expo in October in New Orleans and began his two-year term in January. He recently spoke with McKnight's Senior Living Senior Editor Lois A. Bowers.

Q: What policy issues is LeadingAge focused on right now?

A: LeadingAge is watching with great interest immigration reform and what occurs there from a workforce standpoint. I think that affects everybody across the board. How are we going to find enough caregivers for this next 10-year push that we're going to see in terms of demand for our services?

LeadingAge has not developed a policy statement per se on that as of yet but obviously is keenly interested in attracting highly qualified individuals from perhaps outside the United States to fill some of these vacant job postings across the country.

We're also interested in the model we move toward nationally around Medicaid. LeadingAge, the American Health Care Association/National Center for Assisted Living and many other organizations were successful in getting the health bills blocked that essentially block-granted the Medicaid program, but I don't think that fight's over, so we'll continue to watch that.

It's very difficult for us as providers to be sitting here, hearing the words, “This funding needs to be cut” or “This needs to be removed” when we all know it's actually the opposite. Instead of cutting one dollar in funding to fifty cents, we need to increase that one dollar in funding to two dollars.

The fiscal responsibility of the U.S. government to take care of its most vulnerable citizens first is going to be a high priority for LeadingAge, whether that be on the affordable housing side, assisted living, skilled nursing or home- and community-based services. All of those waterfronts need to be protected and shored up over the next decade, and it's going to take a lot of heavy lifting to do that.

Q: What are your thoughts on the Centers for Medicare & Medicaid Services' new approach to “encourage states to propose innovative Medicaid reforms, reduce federal regulatory burdens, increase efficiency and promote transparency and accountability,” in the words of Administrator Seema Verma?

A: We would be very appreciative of any, and I underscore any, flexibility within the programs that are available through the federal government, whether that be Medicaid or Medicare, as it refers to how we pay for long-term services and supports.

In terms of LTSS financing, we need to provide a mechanism for all Americans to pay into the system and for the government to pay more into the system for future catastrophic long-term care needs. It's a strategy that is going to be necessary, both for providers to stay in business and for the general public to be taken care of in the manner that we're used to receiving in this country in LTSS.

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