American Rescue Plan (ARP) funding has started trickling down to programs aimed at helping seniors age in place.
Earlier in May, the Biden administration released $1.4 billion for Older American Act-enabled initiatives related to vaccine coordination, senior nutrition and more. Meanwhile, the U.S. Department of the Treasury has been overseeing the distribution of $350 billion to help state and local governments respond to the COVID-19 emergency and bring back jobs.
The added resources have already led to some states ramping up their Medicaid funding allotments, according to financial services firm Stephens.
“In the short term, the ARP sugar high is already kicking in,” Stephens analysts wrote in a Thursday note. “In Nevada, the budget subcommittee voted to roll back the previously approved 6% Medicaid rate cut while also approving a 2.5% Medicaid rate increase to acute hospitals.”
Nevada has been a particularly difficult state for Medicaid-reimbursed long-term care providers. In September 2020, for example, Addus HomeCare Corporation (Nasdaq: ADUS) even announced it was leaving the state, partly because of that 6% cut.
“With increases in cost, including minimum wage and mandatory sick time, the rate structure in Nevada no longer provides for the ability to pay workers a living wage, cover rising benefit costs and provide for the management oversight of service delivery to meet industry standards of practice,” Addus EVP and Chief Strategy Officer Darby Anderson told Home Health Care News at the time.
In California, Gov. Gavin Newsom, a Democrat, also released a May budget plan that includes more funding for doula benefits and expanded Medi-Cal coverage for undocumented immigrants, the Stephens analysts pointed out.
Supporting home- and community-based services (HCBS) providers has been a main focus of President Joe Biden and his staff since taking office. On top of the previously mentioned boosts, the ARP also included a 10% increase for the Federal Medical Assistance Percentages (FMAP) for Medicaid HCBS, active from the start of this April 1 through March 31, 2022.
The U.S. Centers for Medicare & Medicaid Services (CMS) released guidance on how states can use that 10% bump last week.
The agency offered further instruction on Thursday in a notice published in the Federal Register.
CMS specifically provided new details on the paperwork states Medicaid programs must submit to receive a funding boost for HCBS. That paperwork includes an initial spending plan and spending narrative, plus subsequent quarterly spending plans and spending narratives.
“To ensure maximum state flexibility and to reduce the reporting burden on states as much as possible, states will submit spending plans and narratives in their own preferred format,” the notice reads. “CMS will not require states to use a standardized template or form.”
In addition to the ARP, the Biden administration is working to advance its American Jobs Plan, a $2 trillion infrastructure proposal. That plan similarly seeks to use upwards of $400 billion to strengthen and expand HCBS.
It is estimated that over 800,000 seniors in need of home- and community-based care are currently on wait lists, according to the American Seniors Housing Association (ASHA), a national business association for senior housing stakeholders.
ASHA put out its own announcement on Thursday, urging the administration to consider senior housing as part of future HCBS plans.
As enhancements to improve the long-term care options for Medicaid eligible seniors advance in Congress, it is critical that senior living settings such as assisted living continue to be defined as [HCBS] settings,” ASHA wrote in a letter to Congress. “Assisted living is an important part of the HCBS settings continuum, but it tends to be misunderstood by policymakers, often confused with skilled nursing facilities (or nursing homes) given its congregate nature.”
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