Federal Policy Issues and Initiatives

One of CAST's core activities is promoting the development of policy at both the federal and state levels to advance the use of appropriate aging services technologies in order to transform the aging experience and enhance care for older adults. 

Technology Policy Priorities 
Following is a summary of the Technology Policy Priorities discussed by the CAST Commissioners during their March 2014 Meeting:

1. Accelerate adoption: LTPAC providers are important partners for acute care providers. However, the success of these partnerships will depend on the ability of LTPAC providers to use health information technology (IT) and to exchange relevant health information electronically. LTPAC providers with this capability will be able to participate more fully in facilitating smooth transitions of care and in planning and implementing shared care. LeadingAge and CAST would continue to advocate for inclusion of LTPAC settings in national health IT initiatives, including the development, adoption and use of interoperability standards, the certification of IT products, and the engagement of LTPAC providers in health information exchange activities. This exchange of health information would take place both directly and through health information exchange entities.

2. Financial support: LeadingAge and CAST would advocate for the establishment of initiatives to encourage and accelerate the adoption of interoperable EHRs, particularly among smaller, stand-alone and rural LTPAC providers. Such initiatives might include state and federal legislation authorizing grants or low-interest loans to assist with initial health IT investments. Regulatory agencies would be encouraged to provide ongoing payment incentives to LTPAC providers that adopt these technologies and demonstrate that they meet certain quality and cost measures.

3. Telehealth and telemedicine: Telehealth and telemedicine can help LTPAC providers carry out their mission to deliver integrated and person-centered care and services that support the health and wellness of residents and clients across the continuum. These technologies are key enablers of strategic partnerships between LTPAC settings and hospitals, ACOs and other coordinated care delivery models. LeadingAge and CAST would continue to advocate for legislation, including the Fostering Independence Through Technology (FITT) Act, which provides payment incentives for the use of telehealth and telecare when costs are reduced and care quality outcomes are improved. In addition, CAST and LeadingAge would advocate with agencies of the U.S. Department of Health and Human Services, including CMS and its Center for Medicare and Medicaid Innovation, for more demonstration projects focusing on health IT in general, and telehealth in particular. These projects—including demonstrations set in service-enriched housing settings—would engage, or be led by, LTPAC providers.

4. Internet connectivity: Basic Internet connectivity is an essential requirement for delivering technology-enabled care and support services. When such connectivity is made available, a broad array of technology enabled services—including telehealth, telecare and social connectedness—could be provided to support health and wellness, reduce loneliness and isolation, increase quality of life and, ultimately, enhance independence among senior housing residents. LeadingAge and CAST would advocate with the Federal Communications Commission for a program aimed at helping low-income individuals obtain Internet access. This initiative would greatly expand consumer access to many in-home technologies and to technology enabled services. These technologies, coupled with resident assessments and delivery of appropriate services, could help older adults remain healthy and independent for longer and could save health care dollars by improving access to preventative care. Similarly, advocacy with HUD would facilitate and support Internet access in congregate low-income and affordable housing.

5. Housing Plus Services: LeadingAge and CAST would advocate to encourage federal agencies—including CMS and HUD—to work together to make Housing Plus Services models a reality in more housing properties.