This afternoon, the U.S. House of Representatives voted 389-9 to pass H.R. 8371, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act. The Dole Act includes Argentum-supported legislation to expand access to assisted living for Veterans.

The bill was passed under suspension of the rules, allowing it to bypass the lengthier legislative process for quick consideration on the floor. It now heads to the Senate for consideration, where it must pass before the end of the year to avoid having to begin the process anew with the next Congress.

This legislation incorporates language from the Expanding Veterans’ Options for Long Term Care Act (H.R. 1815 and S. 495), legislation that Argentum has strongly supported to allow veterans to choose assisted living for their long-term care benefit, instead of nursing home care.

Former President Donald Trump will once again take the Oval Office, after defeating Vice President Kamala Harris in yesterday's presidential election. Argentum is analyzing the results and will be presenting a special post-election briefing next Wednesday, November 13 at 2:00 p.m. ET to discuss how this election will impact the senior living industry.

We look forward to working with the next Trump Administration on addressing the needs of senior living communities and advancing our policy solutions on workforce and affordability of senior living. Argentum maintained strong working relationships with the prior Trump administration on several issues, including workforce programs like the Healthcare Apprenticeship Expansion Program (HAEP), awarded in 2020 during the Trump Administration, and we also worked closely with the administration during the height of the COVID-19 pandemic, raising awareness on the needs of communities and securing federal financial relief, testing kits for communities, and priority vaccine administration.

We anticipate that among the incoming administration’s priorities will include addressing immigration and border security issues, a major tax-package, housing policy, and increased promotion of home-care in long-term care, where we will be advocating that senior living communities are broadly considered home by our residents.

As we hinted before the election, a major focus will be the expiration of significant portions of the 2017 Tax Cuts and Jobs Act (TCJA, or “Trump Tax Cuts”). Last month, Trump said he would "support a tax credit for family caregivers who take care of a parent or a loved one." Argentum will be working closely with the administration and Congress on opportunities to advance such a proposal as part of the TCJA reauthorization or another vehicle and to ensure it is broadly applicable to help support seniors and their families in choosing senior living for their care needs. Argentum will also look to advance other affordability, housing, and workforce measures as part of the tax package.

Republicans flipped control of the Senate in their favor and may maintain control of the House (numerous elections remain uncalled and control of the chamber may not be settled for several days or weeks). If Republicans are able to keep the House, they may seek to undo several Biden Administration regulatory actions by using the Congressional Review Act, a measure that allows Congress to overturn final rules issued by federal agencies by passing a joint resolution disapproving of the rule and prohibiting it from going into effect. A simple majority in both chambers is needed to send the measure to the president’s desk. Several CRAs were passed in this Congress, but were vetoed by President Biden and did not have the necessary two-thirds votes in both chambers to override the veto.

The change in administration will also bring with it a change in agency heads and administrative policy agendas. This may be particularly pronounced at the Department of Labor, with a potential shift on workforce priorities. At the National Labor Relations Board (NLRB), Democratically-appointed members currently hold a 3 to 1 majority, which will remain until August 2026; two nominations are currently pending in the Senate, a Republican and a Democrat. Additionally, with the change in party leadership in the Senate, the prospects have greatly diminished for passage of the Protecting the Right to Organize (PRO) Act, a longstanding wish-list of pro-labor policies, including provisions that would effectively repeal right-to-work provisions in place in more than half of the states; Argentum opposes the PRO Act with our partners in the Coalition for a Democratic Workplace.

In addition to joining next Wednesday's webinar, Argentum urges all senior living stakeholders to join us in Washington, D.C. next March 12-13 for our annual Public Policy Institute. With the change in administration and changes in Congress, this will be one of the most significant opportunities to advance our policy priorities. Registration information will be available soon.

Congressional Election Synopsis:

Voters are headed to the polls today in what is expected to be one of the highest-turnout elections in recent memory. While it may take time to determine the winners, what we do already know is that the elections will bring a new administration with a new agenda, new agency heads, and new Committee chairs in Congress.

To help make sense of it all and the impact on senior living policy, Argentum will be hosting a special post-election briefing next Wednesday, November 13 at 2:00 p.m. ET to review the results and look ahead to opportunities to advance our public policy priorities.

The biggest legislative opportunity in 2025 will be the expiration of significant portions of the 2017 Tax Cuts and Jobs Act (TCJA, or “Trump Tax Cuts”), including opportunities to advance Argentum-led proposals on workforce programs and policies to increase affordability of long-term care. Argentum's annual Public Policy Institute, in Washington, D.C. next March 12-13, will be a critical event to promote senior living solutions for consideration in next year's legislative packages, regardless of who wins the presidency or control of Congress.

Potential expectations for various scenarios and Argentum’s opportunities:

The North Carolina Assisted Living Association (NCALA) recently hosted its 30th Annual Fall Conference in Winston-Salem. As part of the event, NCALA presented this year's winners of the Community Leadership Award and Hero Awards for individuals who represent the highest levels of excellence, caring, and dedication in senior living.

The award nominees are submitted by regional/company executives and executive directors of senior living communities from NCALA's more than 350 member communities, which collectively serve more than 15,000 seniors. The Community Leadership award is given to one executive director/administrator of a member assisted living community who is an ideal representative and role model for the thousands of executives leading senior living communities; they are responsible for providing overall leadership in the day-to-day operation of a senior living community.

Argentum and our State Partner, the Florida Senior Living Association (FSLA), are closely monitoring the impact and aftermath of Hurricane Milton, which struck near the Tampa Bay area late last night and tracked across the Florida Peninsula today. As of this afternoon, more than 550 health care facilities in the state remain without power. There have been no reported deaths of assisted living residents.

More than 400 health care facilities evacuated due to the storm, including 222 assisted living communities, making this the largest evacuation of these facilities in Florida’s history. Many communities went above and beyond to help their residents, families, and caregivers through a smooth evacuation process, such as Barrington Terrace in Fort Myers. At least one community in Tampa—not located in an evacuation zone—was forced to evacuate early this morning due to rising flood waters. For any community that had to evacuate, it is the state’s first priority to relocate residents back to their communities.

Argentum and FSLA are monitoring community needs regarding power outages, phone/internet access, water/sewage, or accessibility due to flooding that may prevent safe passage of residents, caregivers, and supplies. To ensure that these needs are communicated to emergency management officials, we ask that operators fill out our brief survey; we will relay these responses to authorities to provide assistance. Communities may also report to Paul Williams with Argentum (pwilliams@argentum.org, 410-900-5100) or Gail Matillo, President & CEO of FSLA, at info@floridaseniorliving.org or 850-496-2562.

Workforce Support
To help with immediate workforce needs due to the storm, now through October 14, Argentum member KARE will waive all fees associated with bringing in Heroes for communities that request help from KARE; the communities will pay only for the cost of labor. For affected Florida communities, KARE will have an operations team standing by to help post shifts and reach out to Heroes to fill open shifts. KARE has around 4,000 Heroes (CNAs, CMAs, LPNs and RNs) in the general area of the storm track. To get started:

Preparations are underway for the expected landfall later today of Hurricane Milton in Florida. The storm is a category 4 hurricane and expected to remain at hurricane strength as it moves across the Florida peninsula, bringing rainfall of 6-12 inches with localized rainfall of 18 inches, and risk of catastrophic and life-threatening flash and urban flooding. During an emergency preparedness briefing held today in Tallahassee, emergency authorities advised:

• Over 300 health care facilities have been evacuated making this the largest evacuation of these facilities in Florida’s history.
• Approximately 217 assisted living communities have evacuated as of this afternoon, with the window for evacuations rapidly closing.
• Assisted living and other health care operators have the authority to exceed resident capacity without approval from the Agency for Health Care Administration for the next two weeks.
• Assisted living communities are advised to update their status in the Health Facility Reporting System daily by 10:00 a.m. or in the event of any change in status.
• Due to the anticipated severity of the storm, authorities are projecting potential long-term utility outages and ask for that everyone prepare for that possibility.
• Power companies throughout the anticipated affected areas are already staging repair and restoration crews.

Argentum’s State Partner, the Florida Senior Living Association (FSLA), is leading efforts to prepare senior living providers for the storm while also helping those recovering from Hurricane Helene. Part of storm preparation includes communicating directly with Florida emergency management operations and regulatory personnel as well as exploring contingencies for providers in meeting resident needs.

Florida, Georgia, North Carolina, South Carolina, Tennessee and Virginia have been severely impacted by Hurricane Helene, which has caused over 100 deaths along with damage and economic losses that may exceed $100 billion. No senior living resident deaths or significant injuries have occurred as a result of Hurricane Helene.

Reports from Argentum State Partners in Florida, Georgia, North Carolina, and Virginia:

Last Friday, September 27, the House of Representatives officially published the text of H.R. 9156, the Health Over Wealth Act, introduced in July by Representative Pramila Jayapal (D-WA). This bill would place new requirements on private investment in the health care industry, to include requiring the Department of Health & Human Services to review and approve any mergers/acquisitions of a "health care facility" by a REIT or Private Equity firm.

Argentum is pleased to confirm that the House version of the bill does not include assisted living in the definitions of covered health care entities subject to the bill’s requirements; it is therefore a direct companion of S. 4804 introduced in July by Senator Ed Markey (D-MA). While we were internally confident that both the House and Senate version were the same, as communicated by lawmakers in our outreach, we were not able to officially confirm this until the House of Representatives published the text of the legislation.

We sincerely appreciate all the advocacy efforts by our State Partner, the Massachusetts Assisted Living Association (Mass-ALA), our members, and other stakeholders who helped make this possible. Excluding assisted living from the bill is a direct result of a months-long campaign to raise serious concerns about the consequences of limiting private capital investment in assisted living.

Argentum's Silver PAC hosted a reception this week attended by nearly two-dozen members of Congress, offering a forum to meet Silver PAC contributors and share ideas on solving the workforce and affordability challenges in senior living.

Among the discussions included ideas on how to make senior living more affordable by working within the tax code, by allowing HSAs, FSAs, and other tax-advantaged savings accounts to be used to pay for long-term care expenses without a penalty, either for the individual or for a family member accessing services. Lawmakers also suggested ideas with long-term care insurance and life insurance.

Lawmakers also shared their interest in addressing the workforce needs across long-term care, with a need to recruit and retain more than 20 million workers by the year 2040. Argentum has already advanced language through the appropriations process to utilize existing federal workforce funding for senior caregiver programs. Lawmakers also expressed concerns about the nursing home staffing mandate and its unintended consequence of pulling workers from assisted living.

Lawmakers attending the event included:

Argentum has been closely monitoring Hurricane Helene, as it makes landfall in the Big Bend area of Florida, tracks across Georgia, and remnants of the storm hit inland areas.

Our thoughts and prayers are with everyone impacted by the storm, including senior living residents and staff. We have been in contact with our State Partners who will be available to help navigate any issues or relay information to the respective state emergency departments.
 
We also ask that anyone impacted by the storm to provide Paul Williams (pwilliams@argentum.org) with a general update on how your residents and communities are doing relative to Hurricane Helene as well as any assistance that you need.