In response to the announcement of the President's Nursing Home Quality Initiative, unveiled during a national radio address on September 16, 2000, GNYHA has written two letters to the White House highlighting the Association's concerns and priorities. The centerpiece of the initiative is the proposed creation of a $1 billion grant program designed to assist facilities in increasing staffing levels, improving recruitment and retention of staff, and providing additional training to direct caregivers. Under the plan, at least 75% of these new funds would be awarded to states with the lowest relative staffing levels. In both letters to the White House, GNYHA stressed that the Administration should ensure that the funding is allocated in a way that does not disadvantage states such as New York, which, as a result of having large numbers of not-for-profit nursing homes, are likely to have staffing levels higher than those found in other states. Further, GNYHA urged the White House to target the new funding to those facilities with the greatest demonstrated financial need. Finally, GNYHA took the opportunity to urge the White House to become actively involved in seeking fiscal relief for nursing homes with high capital costs, arguing that the dramatic shortfall in capital payments under the Medicare skilled nursing facility prospective payment system for many facilities presents a significant barrier to investments in additional direct care staff.