In The News

For Home Care Providers, HCBS Operating Environments Still Vary Greatly From State to State

Home Health Care News | By Joyce Famakinwa
 
More than three years after the start of the COVID-19 pandemic, the U.S. is still seeing major gaps in long-term care for seniors, according to a new AARP report. 
 
“We know that some states are taking steps to innovate or put new policies in place, such as paid leave for family caregivers, or a payroll tax credit for family caregivers, but state action is generally falling short of what the aging populations in these states need, so that people can live their final years or even decades in dignity with access to the best care possible,” Susan Reinhard, senior vice president of AARP Public Policy Institute, said during a Thursday press call.

The report found that 53% of Medicaid long-term services and support spending for seniors and adults with physical disabilities went to home- and community-based services.
 
Plus, 12 states spent the majority of Medicaid long-term services and support funding on home- and community-based services. This is an increase from seven states in 2009.
 
Family caregivers were also a big focus area of the AARP report. 
 
“No.1 is prioritizing family caregivers — 48 million family caregivers who really are the backbone of the long-term care system,” Reinhard said. “They are providing more than $600 billion in unpaid care. They need help – paid sick leave, tax credits and other mechanisms to address the family caregivers’ health and financial needs, so that they can stay on the job, frankly.”
 
The report concluded that states that had policies meant to support family caregivers needed to maintain their policy framework, but also make sure that those policies were effectively implemented. It also found that states with strong family caregiver supports in place tended to have better overall long-term services and support systems. 
 
The report also dug into the home- and community-based care infrastructure. 
 
“It’s important to address a whole infrastructure, such as increasing support and training for home health aides for home visits, supporting the ability to access and use medical devices and equipment, and most important is updating key Medicaid regulations and payment models,” Reinhard said.
 
AARP found that between 2018 and 2020, 21 states improved their Medicaid spending balance by 10% or more, while 6 other states declined by at least 10% during that time period.
 
The report found that 23 states saw a 10% or more increase in home care costs. Inflation, growing demand and consumer preference for home care over nursing homes are some of the contributing factors to these higher costs.
 
Additionally, 16 states saw a 10% or more decrease in home health aide supply, while 18 states saw a 10% or more increase.
 
Ultimately, Reinhard stressed the importance of enhancing long-term care support and services for seniors. 
 
“It’s really critical that we improve the aging experience for all Americans across the country,” she said. “Our ability to get this right largely depends on our ability to care for our loved ones … that requires providing both humane and holistic long-term care support and services.”
 
Click to See State Scorecard
 

Grief 2 Growth Podcast

Hosted by Brian Smith has invited Barbara Karnes, RN to examine how the greatest tragedies of life often are opportunities for the most advancement. 

Planted, not buried is the motto of Grief 2 Growth. Unless a seed is planted, it remains full of unrealized potential. But, once that seed is planted, it can bring forth much fruit. 

Discover How Tragedies Can Be Opportunities for Personal Growth.

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Government Shutdown Averted with Little Time to Spare as Biden Signs Funding Before Midnight

AP News | By Lisa Mascaro, Kevin Freking and Stephen Groves

WASHINGTON (AP) — The threat of a federal government shutdown suddenly lifted late Saturday as President Joe Biden signed a temporary funding bill to keep agencies open with little time to spare after Congress rushed to approve the bipartisan deal.

The package drops aid to Ukraine, a White House priority opposed by a growing number of GOP lawmakers, but increases federal disaster assistance by $16 billion, meeting Biden’s full request. The bill funds government until Nov. 17.

After chaotic days of turmoil in the House, Speaker Kevin McCarthy abruptly abandoned demands for steep spending cuts from his right flank and instead relied on Democrats to pass the bill, at risk to his own job. The Senate followed with final passage closing a whirlwind day at the Capitol.

“This is good news for the American people,” Biden said in a statement.

He also said the United States “cannot under any circumstances allow American support for Ukraine to be interrupted” and expected McCarthy “will keep his commitment to the people of Ukraine and secure passage of the support needed to help Ukraine at this critical moment.”

It’s been a sudden head-spinning turn of events in Congress ahead of the midnight funding deadline after grueling days in the House pushed the government to the brink of a disruptive federal shutdown.

The outcome ends, for now, the threat of a shutdown, but the reprieve may be short-lived. Congress will again need to fund the government in coming weeks risking a crisis as views are hardening, particularly among the right-flank lawmakers whose demands were ultimately swept aside this time in favor of a more bipartisan approach.

“We’re going to do our job,” McCarthy, R-Calif., said before the House vote. “We’re going to be adults in the room. And we’re going to keep government open.”

If no deal was in place before Sunday, federal workers would have faced furloughs, more than 2 million active-duty and reserve military troops would have had to work without pay and programs and services that Americans rely on from coast to coast would have begun to face shutdown disruptions.

“It has been a day full of twists and turns, but the American people can breathe a sigh of relief: There will be no government shutdown,” said Senate Majority Leader Chuck Schumer, D-N.Y.

The package funds government at current 2023 levels until mid-November, and also extends other provisions, including for the Federal Aviation Administration. The package was approved by the House 335-91, with most Republicans and almost all Democrats supporting. Senate passage came by an 88-9 vote.

Read Full Article 
 

URGENT: HCBS BASE WAGE RATE INCREASE ATTESTATION (Non-Compliance Could Impact Pay)

HHAC’s advocacy team received direct communication from HCPF, indicating that SEIU has asked for data around which employers are providing the base wage, which ones are not doing the attestation and several other data sets.

Because much of the information requested can be found from the HCBS Base Wage Rate Increase Attestations that providers were asked to complete previously, HCPF generously gave us a heads up that they will be enforcing the attestation deadline. Only about 30% of agencies have filled out the attestation deadline for 2023 thus far. HCPF will be sending letters to those who have not completed the attestation, and potentially clawing back money from those who don’t come into compliance.

Though we don’t have an exact date yet of when this will happen, the lobbyists had the sense that completion with the attestation was urgent. In addition to helping to avoid any lost revenue, completing the attestation will help provide more accurate and complete data to both HCPF and SEIU, rather than leaving them to make assumptions on a limited number of respondents.

Please click on the following link to an older operational memo that explains what the attestation entails: https://hcpf.colorado.gov/sites/hcpf/files/HCPF%20OM%2022-022%20Home%20and%20Community-Based%20Services%20%28HCBS%29%20Base%20Wage%20Rate%20Increase%20Attestation%20Reminder.pdf

HHAC Board and Staff
 

Justice Department Sues Colorado for Allegedly Segregating People with Disabilities

The Denver Post | By Meg Wingerter

The U.S. Department of Justice sued the state of Colorado on Friday, alleging the state failed to take steps to stop segregating people with disabilities in nursing homes.

The department’s civil rights division sent a letter in March 2022 outlining alleged violations. It said Colorado had more nursing home residents with “low care needs” – who could presumably live at home with some support – than most states, and ranked poorly in transitioning people out of institutions.

Under the Americans with Disabilities Act and other federal laws, states are supposed to pay for support services through Medicaid so that low-income people with disabilities can live in the least restrictive setting that meets their needs. Those could include help managing medications, housekeeping, meal preparation and help with personal care like bathing and dressing, among other services.

Colorado has too few service providers, the lawsuit said, especially those helping people find housing that meets their needs. It alleged the state’s decision to regularly increase payments to nursing homes, but not to providers working in the community, contributed to the problem by making it financially unattractive to offer home services.

Representatives for Gov. Jared Polis’ office and the Colorado Department of Health Care Policy and Financing, which runs the state’s Medicaid program, didn’t immediately respond to requests for comment.

The lawsuit also said the state indirectly pushed people toward nursing homes by:

• Not requiring home service providers to have plans if clients’ assigned workers are sick, which contributed to unreliable service

• Only paying for home modifications (for example, installing wheelchair ramps) for people currently living in the community, not those wanting to move out of nursing homes

• Not offering assistance finding housing to people who are at-risk of moving into a nursing home

• Not informing people with disabilities of services that may be available

• Delaying transitions out of nursing homes with a lengthy process to determine if residents qualify financially

The lawsuit didn’t say exactly what the Justice Department wants the state to do, though it noted Colorado could take steps to expand its home-care workforce, incentivize the creation of affordable housing that’s accessible to people with disabilities and do more to help connect eligible people to housing. It also said the state could streamline its processes to move people who’ve said they want to leave their nursing homes.

“Far too often, people with physical disabilities – including older adults – are institutionalized in nursing facilities when they could live in their own homes,” Civil Rights Division Assistant Attorney General Kristen Clarke said in a news release. “The Justice Department is steadfast in its commitment to protect the rights of people with disabilities and ensure the promise of community integration enshrined in the Americans with Disabilities Act.”
 
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