The Budget – On August 2, 2019, the President signed the Bipartisan Budget Act of 2019 (H.R. 3877/Public Law 116-37), which set the parameters for this year’s spending and the 12 appropriations bills that Congress must pass to keep the federal government open. Speaker Pelosi negotiated the deal with Secretary of Treasury Steven Mnuchin. This provides us with the total funding levels for FY 2020 and 2021 so that the 2011 Budget Act is no longer relevant, and we will not have cuts or automatic rescissions for these two years.
Appropriations Process – The process continues, but here are the highlights so far:
- Current GWEP/GACA funding: $40.7 million in FY 2019 final appropriations bill.
- NAGE requested for appropriations for FY 2020: At least $51 million to support geriatrics programs under the Geriatrics Workforce Enhancement Program in Title VII and Title VIII of the Public Health Service Act.
- The House Appropriations Committee with approval by the full House, provided $43,384,000 for the GWEP/GACA, which is $2,647,000 above the fiscal year 2019 enacted level. This is a very good starting point, but we continue to advocate for the $51 million.
- Here is the language from the House Report:
“Geriatrics Program – The Committee provides $43,384,000 for the Geriatrics Workforce Enhancement Program (GWEP), $2,647,000 above the fiscal year 2019 enacted level and $43,384,000 above the fiscal year 2020 budget request. This program provides grants for training across the provider continuum to integrate geriatrics and primary care delivery systems.
Health Professional Staffing Shortages.—The Committee recognizes the current and growing shortage of primary care physicians, psychiatrists, behavioral health specialists, and geriatric medical professionals. The Committee requests a report within 120 days of enactment of this Act on ways HRSA can support efforts to recruit, train, and support health professionals in these fields, including existing workforce training opportunities and recommendations to address health professional staffing shortages.”
- The Senate Appropriations Committee released its draft bill for LHHS and provided level funding of $40.7 million for geriatrics (GWEP/GACA) programs.
- Most programs were funded at FY 2019 levels because the Senate Committee does not have their final allocation level for LHHS.
- It is unlikely that the Senate appropriations Committee will have a mark-up of their LHHS bill.
- Now the House and Senate will go ahead and try to work out the differences in their LHHS appropriations bills.
- They were not able to do this prior to the beginning of the 2020 fiscal year beginning on October 1, so Congress passed, and the President signed a Continuing Resolution to keep government running through Nov. 21 and avoid a government shutdown.
- NAGE, the Eldercare Workforce Alliance, and AGS recently held a Hill Day to educate and advocate for the full $51 million appropriations. The EWA set up meetings for a number of NAGE members who were in DC for the AGS GWEP center advisory panel.
- Also, this week I have met with both Republican and Democratic staff of the Senate Appropriations Committee to reinforce our position on the need for the $51 million in light of the NOFO and the many high-scoring GWEP sites that were not funded.
- It is likely that there will be another Continuing Resolution needed before everyone comes to agreement on the final FY 2020 appropriations bills.
GWEP Reauthorization Progress – The process continues slowly. Here are the highlights.
- The House Energy and Commerce Committee passed the EMPOWER Act (H.R. 2781 Rep Schakowsky) which includes the language that NAGE helped to draft that reauthorizes the GWEP and GACA programs at $51 million.
- The full House should pass the bill without objection in the near future.
- Remember that this just authorizes Congress to spend that much; the appropriators still must decide how much to spend on the programs each year.
- The Senate Health, Education, Labor, and Pensions Committee (HELP) has been focused on the Older Americans Act and other priorities and has not considered a GWEP/GACA reauthorization bill.
- Senators Collins and Casey have introduced the Geriatrics Workforce Improvement Act, S. 299, which is a bill that NAGE helped to draft. This bill is likely to be included in a larger bill that HELP will consider sometime this Fall.
- NAGE continues to advocate for moving a reauthorization bill as soon as possible. This could help us get a larger appropriation.
Reauthorization of the Older Americans Act – Lots of action on this legislation:
- The House Education and Labor Committee introduced their bill and passed it the same week – H.R. 4334, the Aging with Dignity Act (passed September 18).
- It is expected to be passed by the full House in the near future and may be taken up by the Senate instead of their bill.
- The Senate has a staff draft bill the has not been introduced by the Chair of the HELP Committee and the Ranking Member (Senators Alexander and Murray).
- Key issue negotiations are still pretty much on hold because the of the discussions around the funding formula…how funds are divided among states.
- A couple senators are negotiating how to protect states that have lost aging population and those that have gained that want more resources.
- If the Senate can work out this issue and a few others, the House may amend their bill to reflect the Senate negotiations and send it over to the Senate for approval. This avoids the need for a conference committee to work out differences in two bills.
- This process may slow down or help move along the GWEP/ title VII and title VII bills…we just don’t know yet.
Brian W. Lindberg
NAGE Public Policy Advisor|
1612 K Street, NW, Suite 200
Washington, DC 20006