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“I have a lot of questions that haven’t been answered yet.”: Home healthcare providers want clarity about US rescue plans.

As part of the recently passed $ 1.9 trillion US rescue program, the state’s Medicaid program appears to have significantly increased funding for critical home and community-based services (HCBS).

In theory, Bump is designed to help HCBS operators expand their services, attract new workers and attract more clients. Still, some home care providers and other professionals are questioning the applicability of the new law.

Specifically, home-based and community-based service provision American rescue plan —The COVID-19 Relief Package, which President Joe Biden signed the law on March 11, — began in early April. This provision will increase the federal matching rate for Medicaid HCBS spending by 10% from April 1, 2021 to March 31, next year.

“Going through the American rescue program is one thing,” Biden said in a speech on March 12. “Implementing it will be another thing. You need to be very careful to make sure there is no waste or fraud, and the law does what it is designed to do. And I mean that: we have to get this right. “

Biden has promised to support HCBS as president since the early days of the campaign trail.

However, the US rescue program was driven by efforts to move care to a home and community-based environment, given that the COVID-19 emergency caused significant damage to nursing homes and other long-term care facilities. There is no doubt that.

“There was a lot of interest in expanding among Democrats on the hills, and even among some Republicans. [home- and community-based services]Howard Grecman, a senior fellow at the Urban Institute and an aging expert, told Home Health News. “I think this is just accelerating what was already a pre-COVID trend and making it more aggressive.”

The Urban Institute is an economic and social policy research organization based in Washington, DC.

According to AARP statistics, the number has begun to decline since the vaccine began to be deployed, but the COVID-19 virus has resulted in the deaths of more than 174,000 nursing home residents. This includes nursing homes and other facility-based long-term care facilities.

According to the Kaiser Family Foundation, the 10% FMAP bump from the American Rescue Plan will add a total of $ 11.4 billion to home-based and community-based services next year.

Kate Rolf, CEO of Nascentia Health, told HHCN that for providers, this new boost could mean many new possibilities.

“We look forward to increased provider funding for access to care in rural areas and improved access for providers to receive services such as telemedicine,” Rolf said. “”[Home care] Reimbursement is delayed when compared to other medical institutions. I think this helps us to get some rationale. ”

Nascentia Health is a home health care system based in Syracuse, NY. The organization’s home care institutions operate in five counties in northern New York.

According to Rolf, Nascentia Health has already begun to develop strategies on how to improve care services and delivery.

“We are already beginning to look at ways to restructure home and community-based services to improve the quality of care, especially in some rural areas,” she said. “And perhaps change the model of care so that care can be delivered more efficiently and access can be improved.”

Additional funding may also support provider recruitment and retention efforts as the demand for care continues to grow. In general, the demand for caregivers exceeds the number of workers available and is expected to be so for the foreseeable future.

“Workforce issues continue to be our biggest challenge,” David Totaro, chairman of the Medicaid Home Care Partnership (PMHC), told HHCN.

Based in Washington, DC, PMHC is an industry advocacy group representing home and community-based care providers working in the Medicaid space.

Waiting game

Despite all the possibilities, the American Rescue Plan does not explicitly state how the funds should be spent.

Instead, the state states that Medicaid’s home and community-based services need to be used to “implement or supplement the implementation of one or more activities to enhance, expand, or enhance.” I will.

This lack of clarity has become a major issue surrounding the new law.

“There are many unanswered questions — mainly about what the phrase” supplement rather than supplement “means in the submission and approval process and presentation,” Totaro said. .. “CMS held a listening session last month with hundreds of providers and other stakeholders, but CMS listened and did not provide a response. Still waiting for answers to the issues raised. We hope to get more information in the near future. “

Another problem, according to Grecman, is that the law is not permanent.

“It is an important new incentive for the state to expand its home and community-based service programs, but it is temporary and poses some challenges to the state,” he said. “I think many of these will be used for the benefit of a shorter-term kind, as they don’t want to launch a new program if it doesn’t last long.”

Some experts are questioning how providers can make meaningful investments in the system if the law only allows new spending. This only lasts for a year.

With this in mind, Gleckman pointed out Biden administration’s recent US employment plan proposal, Calls Congress to devote $ 400 billion to home care as a possible permanent expansion of Medicaid HCBS.

In addition to new funding, the proposal is driving the expansion of the Money Follows the Person (MFP) program, which enables certain Medicaid users to seamlessly move from nursing homes to homes.

According to Grecman, Biden’s recent proposal shows a “strong commitment” from the government to expand Medicaid HCBS.

However, in the future, Medicaid will need to make even broader changes when it comes to supporting home care.

“The Medicaid program isn’t enough for people to get the level of care they need at home,” Grecman said. “They still need a wider range of benefits infrastructure that Medicaid doesn’t necessarily have to pay for, such as transportation, home delivery meal programs, and adult day services. Allowing people to live in their homes. Many are indispensable to make it. “

“I have a lot of questions that haven’t been answered yet.”: Home healthcare providers want clarity about US rescue plans.

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