Posted Thursday, October 26, 2023
McKnight’s Home Care
By: Liza Berger
Home care providers praised a bill introduced Tuesday that would give states a 10 percentage-point increase in their Federal Medical Assistance Percentage (FMAP) for Medicaid to enhance home- and community-based services (HCBS).
“The looming expiration of the additional HCBS funding provided by the American Rescue Plan Act (ARPA) will put further pressure on states that are already struggling with growing long-term services and supports budgets and caseloads,” Damon Terzaghi, director of Medicaid HCBS for NAHC, said in a statement to McKnight’s Home Care Daily Pulse. “We greatly appreciate Senator Casey for recognizing this challenge and introducing this legislation.”
Jason Lee, the new CEO of the Home Care Association of America, which concluded its two-day conference in Chicago, Tuesday, told McKnight’s Home Care Daily Pulse in a statement that he “appreciates Sen. Casey’s continued focus on home care.”
The HCBS Relief Act would allow states to use the increase in the FMAP to increase direct care worker pay, provide benefits such as paid family leave or sick leave, and pay for transportation expenses to and from the homes of those being served. The additional funds also could be used to support family caregivers, pay for recruitment and training of additional direct care workers, and pay for technology to facilitate services. Sen. Bob Casey (D-PA) introduced the bill on Tuesday with 17 other Democratic senators.
“A vast majority of seniors and people with disabilities would prefer to receive care at home or in their communities,” Casey said in a statement. “Unfortunately, because of our nation’s caregiving crisis, home and community-based care has become increasingly difficult to access. By stabilizing and investing in the caregiving workforce, we can better provide seniors and people with disabilities with a real and significant choice to receive care in the setting of their choosing.”
The bill come as the Kaiser Family Foundation on Tuesday released a report that found that states are struggling with shortages of HCBS workers, particularly direct support professionals, personal care attendants, nursing staff and home health aides. Most states (43) reported permanent closures of HCBS providers within the last year. Increasing provider payment rates is the most common strategy to increase the number of HCBS workers, the report found.
LeadingAge CEO Katie Smith Sloan noted that the bill would help providers struggling with a dire workforce shortage.
“Older Americans increasingly want choices that allow them to stay in their homes and communities as they age — but it’s increasingly difficult for people to access the care and services they need,” she said in a statement to McKnight’s Home Care Daily Pulse. “Home health providers are already forced to reject referrals due to workforce shortages, an extremely competitive labor market, financial pressures and drastic cuts to Medicare payment rates in 2023 [with more anticipated in 2024.] The kind of support Senator Casey’s bill offers for providers of home health and other services is massively needed to keep the country’s ability to support older adults intact.”
In April, the Biden administration, to increase access to HCBS, proposed a rule that would require that 80% of Medicaid payments go toward direct care worker wages. In January, Casey reintroduced the Better Care Better Jobs Act, which would permanently increase the FMAP by 10%. The American Rescue Plan included a 10% increase in the FMAP, but that provision sunsetted with the end of the public health emergency.
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