A “win-win” is how LeadingAge describes the proposed 10% increase in funding to Medicaid for home- and community-based services (HCBS). The increase was part of the $1.9 trillion stimulus package that the U.S Senate passed on Saturday and that the House is likely to approve today. President Biden is expected to sign the legislation by this weekend.
Brendan Flinn, LeadingAge director of Medicaid and Community-based Services, told McKnight’s Home Care Daily that counties can use the additional funding to shore up HCBS programs in a variety of ways, but he expects many will put the money toward staff.
“They could certainly add staff. It could also be rehiring staff they were not able to keep on because their center was closed (during the pandemic). They could increase worker pay and they could expand services to more people,” Flinn said.
Wendy Price Kiser, division president of Ohio Living Home Health, told McKnight’s Home Care Daily that, if the legislation passes, her company might use additional funding for “compensation and benefit enhancements, expanding recruitment efforts and conducting aggressive educational efforts to mitigate isolation.”
The Federal Medical Assistance Percentages (FMAP) rates are used to determine the matching funds allocated annually to Medicaid, as well as other medical and social service programs. The Centers for Medicare and Medicaid Services allocate HCBS funds to state Medicaid agencies, which then pass the money down to counties.
In the earlier version of the American Rescue Plan, the House of Representatives included only a 7.35% FMAP increase for HCBS. Flinn saw the smaller amount as positive but admitted the 10% increase will allow the nonprofit housing and aging services groups LeadingAge represents to recover more quickly from the pandemic.
The 10% FMAP increase, if signed into law, would be in effect from April 1 to March 31 of next year. Flinn thinks at that point COVID-19 will be under control and there will be less need for federal relief. Still, he’s hopeful there will be continued strong interest in HCBS.
“I think there is definitely an opportunity to rethink how we do aging services and long term care,” Flinn said.
Sequestration setback
One downside for home care in the stimulus bill is the absence of the extension of the moratorium on the 2% Medicare sequestration, which is scheduled to resume on April 1.
“This funding would allow for continued support of providers’ COVID-19- related lost revenues, as well as additional expenses due to activities such as purchasing supplies and equipment, standing up emergency testing centers and the construction and retrofitting of facilities,” several associations, including the the National Association for Home Care & Hospice and the National Hospice and Palliative Care Organization said in a recent letter to Senate leaders.
Aging services providers also have been disappointed the legislation does not include a requested $120 billion for the Provider Relief Fund. The Senate’s version includes $8.5 billion for the fund to provide COVID-19 relief for struggling healthcare providers in rural areas.
