Hello LeadingAge Missouri Members!
New Administrations in Washington DC and Jefferson City, Missouri are hard at work. Their early actions and omissions seize my February perspective.
President Trump’s Executive Orders and announcements dominated headlines, social media, and sound bites during the first week of his second Administration. The President moved quickly to deliver on campaign promises to address illegal immigration and to make the federal government more businesslike. Disruptive change is in the air, and our field is paying attention and responding.
LeadingAge reacted to a White House Office of Management & Budget (OMB) memo seeking a temporary pause on federal grants, loans, and financial assistance. The Trump Administration wants its new agency leadership to evaluate possible savings and how payments conform to new policies and requirements. While new Administration “harmony checks” are typical for prospective expenditures, expectant payees cried “foul” over the President’s payment freeze on Biden Administration authorizations – arguing the freeze violates both tradition and law. Members of Congress, several State Attorneys General, and payment beneficiaries also think it unconstitutionally undermines Congress’ “power of the purse,” so litigation ensued!
While confusion reigned, OMB said its memo didn’t apply to Social Security, Medicare, or Medicaid. That’s reassuring, but some LeadingAge members were blocked from Medicaid and HUD rental assistance funding portals, so LeadingAge immediately worked to address the confusion and unfreeze all funding relied upon by aging services providers. LeadingAge communicated with its members, with the Administration, and with Congress – directly, and via this member Action Alert. And all LeadingAge actions were well underway before a Federal Judge stayed OMB from moving forward and before OMB responded by withdrawing its directive. All three branches of government squaring off in week one! Battleground Washington is nothing if not exciting!
While less dramatic, Missouri’s new Administration is also at work. For aging services providers, the initial concern is less about Administration action than omission. In his State of the State speech, new Governor Kehoe shared priorities and “put money where his mouth is” in his first budget. Sadly, the speech was devoid of reference to older adults or to aging services, focusing entirely on public safety, education, agriculture, government improvement, and economic development. On the last topic, the Governor devoted considerable time and attention to childcare funding in order to grow the Missouri workforce. But there was nary a mention of senior care funding to support Missouri’s older citizens and their families!
In Governor Kehoe’s defense, seldom do older adult issues get a nod in gubernatorial pronouncements. But omitting Medicaid reimbursement increases from his budget proposals is troubling. LA MO has work to do. While the Governor’s budget proposals authorize available federal dollars for HCBS, there are no increases for SNFs in either the FY 2025 Supplemental Budget or the FY 2026 State Budget. LA MO and its members will rally in support of residents who depend on Medicaid. Stay tuned for how you can help! Today’s perspective is tomorrow’s advocacy action!
LA MO advocacy will also include opposition to several ill-advised bills negatively impacting aging services. One bill would double surveys for long-term care, and another would impose staffing mandates on ALFs. Other bills propose creating new RCF oversight and imposing fines for compassionate care visitation rule violations. On the positive, helpful side, LA MO will support bills introduced to expand APRN practice rights; to offer guidance for necessary healthcare decisions for incapacitated residents who don’t have advance directives; to require reasonable disclosures by commercial LTC referral agencies, and to provide a grace period for communicating about survey citations. LA MO and its members will be busy between now and May 16!
Whether we’re playing legislative offense or defense, we need you on the playing field for our team. Look for communications urging grassroots outreach with legislators and sign up today to join LA MO colleagues on Advocacy Day at the Capitol March 12. You are the trusted voice for aging in Missouri!
Yours in service,
Bill