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THE ISSUE
Americans are living longer and increasingly face the need for long-term services and supports. CHA advocates public policies that promote a high quality, accessible and affordable continuum of care to address the needs of those who, because of frailty or chronic conditions, require continuing care, services and supports.

As people in our communities live longer and the need for long-term care services and supports grows, the Catholic health ministry is challenged to make senior services a priority and to advocate for a financing, regulatory and delivery system that supports a safe and compassionate continuum of care. Older adults and chronically ill persons should be able to live at home with community-based services when possible and desirable and their family caregivers should have the support they need. Paid caregivers in homes or facilities should earn a living wage. Successful programs such as home care, adult day care, small houses and the Program for All-inclusive Services for the Elderly (PACE) should be adequately financed and accessible.

Recently, the coronavirus has unveiled serious problems in our country's approach to serving aging and chronically ill persons in long term care as nursing homes were hit hard by the virus. While nursing home residents and staff represent only 8% of covid cases, they represented about 40% of its deaths. Older adults represented 90% of Covid deaths.

A government sponsored commission has concluded that frail, chronically ill and vulnerable persons conditions are cared for in facilities never designed for an epidemic. Residents live in close quarters and often share rooms, with little capacity to isolate infected persons. The commission also identified long-standing and accelerating staffing problems. At the heart of these problems is the inadequacy of long-term care financing.

In response to these problems, the Centers for Medicare and Medicaid Services has indicated that it plans to add new requirements for skilled nursing facilities including 24- hours registered nurses, increased oversight and greater transparency of facility ownership.

MINISTRY TRADITION
The mission of the Catholic health ministry is to serve those in need, with special concern for those who are vulnerable through poverty or disability, and to create a society in which everyone has the necessary resources to achieve physical, mental, spiritual, emotional and social health. Ensuring the availability of continuing care throughout illness and in frailty is at the heart of our commitment.

CHA'S POSITION AND ACTIVITIES
CHA strongly supports efforts to coordinate and integrate person-centered health care and social services along the continuum of care, to ensure the best outcome for frail and chronically ill people. CHA activities have included:

• Working closely with LeadingAge, which represents nonprofit homes and services for the aging, to advocate for a just regulatory system and adequate funding.
• Sharing information among CHA members on how they are creatively developing a continuum of services, including more home and community-based services; support for family care givers, PACE; the use of tele-health; health homes; hospital at home programs and population health management.
• Developing educational resources for health care organizations to work with faith congregations in order to support older adults and their care givers in the community.
• Studying and working with partners to achieve a high quality and stable work force.
• Promoting Age-Friendly Health Systems, in partnership with the American Hospital Association, in an initiative sponsored by the John A. Hartford Foundation and led by the Institute for Healthcare Improvement.
• With Catholic Charities USA and the Community of Sant Egidio, promoting the Vatican document Old Age, our Future, the elderly after the pandemic and exploring ways ministries of the church can work collaboratively to address needs of older adults.

CHA supports policies that:

• Provide adequate and sustainable financing to ensure the ability of long-term care facilities and services to provide quality and compassionate care.
• Promote improved coordination of care for those with chronic or serious illness.
• Provide older adults and persons with disabilities options to receive long-term care services and supports in the most appropriate care setting, whether at home, in the community (such as PACE) or in a residential facility.
• Ensure an adequate aging services workforce.
• Promote access to affordable senior housing with the necessary and appropriate services and supports.
• Improve access to high-quality palliative care across the continuum of care.
• Promote an effective, fair and consistent nursing home regulatory system that includes an option for deemed status for accredited facilities.

CHA will address these issues in collaboration with partners in the long-term care continuum, including the LeadingAge, the American Health Care Association, Catholic Charities USA and other faith-based providers and consumer organizations.