A proposal calling for permanent enhanced federal funding to states to expand the Medicaid home- and community-based services program needs to go a step further to emphasize the benefits of assisted living, according to industry experts.
Sen. Bob Casey (D-PA) and Rep. Debbie Dingell (D-MI) on Thursday introduced the Better Care Better Jobs Act to help “close a massive gap” in HCBS for more than 650,000 older Americans on waiting lists for services.
Jeanne Delgado, vice president of government affairs for the American Seniors Housing Association, told McKnight’s Senior Living that the proposal calls for “substantial investment in the caregiving infrastructure” — an estimated $300 million — by enhancing the Medicaid HCBS program, which provides opportunities for individuals to receive long-term services and supports in their homes or community, rather than in institutions such as nursing homes or other isolated settings. In many states, HCBS can be provided at assisted living communities through Medicaid waivers.
“Assisted living is considered a HCBS setting, and so we are encouraged by the efforts to enhance this important program,” Delgado said. But, she added, the decision to include assisted living in a state program is left to individual states.
“An expanded Medicaid HCBS program, as described in the Better Care Better Jobs Act, should take a step further and direct or encourage states to recognize and promote the benefits of assisted living as part of the continuum of care and include these settings in their state plans,” Delgado said. “The inclusion will help facilitate efficient provisions of services to the hundreds of thousands of seniors who are currently on waiting lists.”
With assisted living’s annual cost on par with home healthcare — and about half the cost of nursing home care — Delgado said that assisted living is a good option for older adults who need supportive services and that it will “ultimately create savings for the greater healthcare system.”
LeadingAge President and CEO Katie Smith Sloan said that the need for the type of support the bill addresses has only grown since 2021, when the legislation originally was introduced.
“This is an investment in people — one that ensures older adults and people living with disabilities can access needed care and also supports professional caregivers,” Sloan said. “Increasing compensation is a critical component in recruiting and retaining these valuable workers. Equally important is investment in programs to help train and develop direct care workers and encourage career development.”
Casey and a bipartisan team of lawmakers first introduced the Better Care Better Jobs Act in June 2021. It became part of the Biden administration’s $2 trillion Build Back Better infrastructure deal, which failed to gain traction. The Inflation Reduction Act, which included parts of Build Back Better, passed but did not include $150 million in HCBS funding.