PHI Statement on the HHS Transformation Plan
Yesterday, the U.S. Department of Health and Human Services (HHS) announced a plan for a dramatic restructuring of the agency—one that raises concern for both the short-term and long-term viability of vital long-term services and supports.
Mandated by a presidential executive order focused on government efficiency, the U.S Department of Health and Human Services transformation plan enacts significant workforce and division reductions—short-sighted and sweeping changes that will effectively eliminate the jobs of at least 20,000 HHS employees (nearly 1 in 4 of the agency’s overall staff).
“Following several months of other disruptive federal actions, the planned restructuring of HHS risks destabilizing critical programs relied upon by millions of older adults and people with disabilities,” according to PHI’s President and CEO, Jodi M. Sturgeon. “These changes will only deepen the challenges faced by the direct care workers and family caregivers who provide essential care and support for so many Americans each day.”
PHI stands alongside other organizations, including National Alliance for Caregiving, Community Catalyst, Justice in Aging, Medicare Rights Center, and a growing list of others—in questioning this planned restructuring.
We have particular concern about the announced reorganization—and what would amount to the effective dissolution of— the Administration for Community Living (ACL). Since being established in 2012, ACL has served as a key focal point within the federal government for programs supporting older adults and people with disabilities, championing policies that promote independence, well-being, and access to community-based services.
ACL’s role since its inception has been to coordinate—and create efficiencies across—a wide range of programs that have impact in local communities. Given the Administration’s stated aims of “making [HHS] more responsive and efficient, while ensuring that Medicare, Medicaid, and other essential health services remain intact,” maintaining ACL in its current form should be a priority.
Instead, this restructuring plan would disperse ACL’s functions across multiple other agencies, raising profound questions about the future coordination, funding, visibility, and overall viability of programs fundamental to caregiving in our nation. We are deeply concerned that this fragmentation will negatively impact the quality and accessibility of long-term services and supports—including further destabilizing the direct care workforce.
PHI continues to analyze the details and consequences of this announcement, and we will offer additional perspective on it in the days ahead. At this moment: We urge HHS and the Administration to reconsider the effective dismantling of ACL. We also urge HHS to provide full transparency about the likely consequences of their planned restructuring, and to prioritize both continuity of care and the well-being of caregivers (including direct care workers and family caregivers) who support older adults and people with disabilities each day. These efforts can have far greater impact if they are done in collaboration, drawing on insights from PHI and other organizations who dedicate our missions to strengthening the nation’s health care systems and the overall care economy.
Identifying a focus on preserving Medicaid and Medicare, while taking steps that will likely diminish the effectiveness, efficiency, and overall impact of these programs, poses questions about the true impact this transformation will have on the health of Americans. Taken alongside active work to advance significant budgetary cuts to Medicaid—yesterday’s announcement raises sharp questions about the future of programs relied upon by millions of American families.
For press inquiries: please contact PHI’s Senior Director of Marketing and Communications, Murray Devine.
