President Biden Signs Executive Order Supporting Direct Care Workers & Boosting Access to In-Home Care:

Tuesday, April 18, 2023, President Biden signed an executive order to boost compensation for direct care workers, support family caregivers, and expand affordable care options through 50 directives to federal agencies. 

The Executive Order directs the United States Department of Health & Human Services (HHS) to consider issuing regulations and guidance to improve the quality of home care jobs, including by leveraging funding to ensure there are enough home care workers to provide care to older adults and people with living with a disability enrolled in Medicaid.

Additionally, the Department of Veterans Affairs (VA) is directed to improve access to home-based care for veterans who require support with activities of daily living, like bathing and getting dressed, by giving them more decision-making power over who delivers that care and when. In addition, the VA is directed to consider expanding its Veteran Directed Care program to all 172 VA Medical Centers by the end of Fiscal Year 2024. This program provides veterans with a budget to hire personal care assistance including from family members. Further, VA will consider adding 75 new interdisciplinary teams to its Home-Based Primary Care program to serve an additional 5,600 veterans in their homes.

Building on the 2022 National Strategy to Support Caregivers, the Executive Order directs HHS to consider testing a new dementia care model that includes support for respite care, make it easier for family caregivers to access Medicare beneficiary information, and provide more support to family caregivers during the hospital discharge planning process. Additionally, the VA will consider expanding access to the Program of Comprehensive Assistance for Family Caregivers and provide more mental health support for caregivers enrolled in that program.

“This country's child care and long-term care systems just don’t work well. High-quality care is costly to deliver, labor intensive, and requires skilled workers. Yet care workers—who are disproportionately women and women of color and immigrants—are among the lowest paid in the country, despite working in some of the most important and complex and demanding jobs,” said domestic policy adviser Susan Rice.

Congress continues to consider the president's proposed investments to support high-quality, affordable long-term care in their fiscal year 2024 budget.

Legislation Introduced Based on Michigan Attorney General (AG) Dana Nessel's Elder Abuse Task Force:

Legislation recommended by Attorney General Dana Nessel’s Elder Abuse Task Force to reform the state's guardianship laws was formally introduced in the State Senate earlier this week.

State Senate Bill 254, introduced by State Senator Paul Wojno (Warren-D), and Senate Bill 258, introduced by State Senator Jeff Irwin (Ann Arbor-D), would:

• Require a judge to justify on the record why a family member who is willing to serve as legal guardian is not suitable;
• Eliminate a judge’s ability to preclude a challenge to the appointment of a guardianship/conservatorship for up to six months;
• Create a requirement for guardians and conservators to be certified and require monthly check-ins of their protected persons;
• More thoroughly outline guardian ad litem responsibilities;
• Establish a clear asset/income threshold for appointment of a conservator;
• Improve the basic standards for medical testimony; and
• Require guardians to identify and list protected person’s specific sentimental items and provide a list to an interested person upon request.

“I am encouraged to see, and obviously supportive of, legislation to bring about the specific policy recommendations of the Elder Abuse Task Force,” said Michigan Attorney General Dana Nessel. “Many of these proposed changes to the state's guardianship laws come directly from the incredible work of the Task Force, and we’ll be working with the legislature to enact those recommendations we see in these bills, as well as working to ensure the rest of the package reflects and respects the recommendations put forth by the experts.”

The Senior Alliance will continue to track these bills and provide updates as they move through the legislative process in Lansing.

Priorities in the FY 2024 Health & Human Services Budget:

The Senior Alliance (TSA) along with the Area Agency on Aging Association of Michigan (4 AM) continues to monitor HB 4310, the MDHHS appropriations bill. TSA along with 4AM and the 15 other Area Agencies on Aging continue to advocate and testify in support of the following budget requests:

• $16.8 for Statewide Caregiver Resource Centers
• An additional $1.50 an hour raise for Direct Care Workers, raising the total aggregate raise to $3.85 an hour
• $3 million to add 33 new staff statewide to the Long-Term Ombudsman Program
• $9 million increase for Michigan Administration for Community Living Supports (ACLS) in-home services and $1 million for home-delivered meals.
• Urge MDHHS to raise the MI Choice reimbursement rates to keep up with inflation and the increased costs of providing care.  

Michigan Senior Advocates Council Seat Available:



The Michigan Senior Advocates Council (MSAC) is a group of older adult advocates (delegates) who travel to Lansing monthly and/or meet virtually from across the state. Delegates study older adult issues and devote a significant portion of each Lansing meeting to visiting legislative offices.

MSAC consists of a group of 30 or more older adults appointed by Area Agencies on Aging (AAAs). Delegates have three things in common:

• Age - Delegates are age 55 or older;
• Ties to AAAs - Many delegates also serve on AAA's Advisory Councils or are AAA Board Members;
• Knowledge - Delegates gain knowledge and understanding of aging programs and services. They become recognized as leaders for their communities.

Beyond these similarities, MSAC is a diverse group that cuts across racial, ethnic, and economic categories. Delegates hail from big cities and rural communities. In this way, MSAC represents Michigan's diverse senior population. MSAC is nonpartisan and does not endorse political candidates.

MSAC has also left its mark on many pieces of legislation benefiting older adults such as elder abuse prevention, nursing home quality regulations, and Medicare supplemental insurance standards. patient rights legislation. Blue Cross Blue Shield reform, and guardianship reform. These are but a small sample of MSAC's accomplishments.

MSAC works together with Michigan's 16 AAAs, who appoint its members and provide financial and staff support through their statewide association (4AM). If you are interested In applying to be an MSAC delegate for The Senior Alliance, email Edward Webster at ewebster@thesenioralliance.org.

Advocacy Questions: Please contact Edward Webster, Government Relations Assistant, with any advocacy or public policy questions via e-mail at ewebster@thesenioralliance.org

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