Letter to Hon. Charles Schumer, Senate Majority Leader; and Hon. Mitch McConnell, Senate Minority Leader - Rosen Calls for Support for Home and Community Based Care Funding in Upcoming COVID-19 Relief Package

Letter

Dear Majority Leader Schumer and Minority Leader McConnell:

We are glad that Senate Democratic leadership supports dedicated emergency funding for Medicaid Home and Community Based Services (HCBS), and that the House Energy and Commerce Committee has included a 7.35% increase to Federal Medical Assistance Percentages (FMAP) for HCBS in its proposed budget reconciliation legislation for the next COVID-19 relief package. We urge that the increased FMAP included in the House proposed legislation remains in the final package. This targeted relief funding is essential for older Americans and people with disabilities who live and receive services in their homes, and the workforce that supports them, as well as for state Medicaid programs. Without these dedicated funds for HCBS, the fragile infrastructure supporting over 4 million older adults and people with disabilities is at risk of collapsing.

The coronavirus pandemic has devastated our Nation's nursing homes and long-term care settings, resulting in more than 160,000 deaths among residents and workers and accounting for 36 percent of the pandemic deaths nationwide. This tragedy has brought to light the urgent need to invest in HCBS. Congress and the Administration must work together to provide this necessary funding for HCBS to support states in meeting this most basic strategy to defeat the spread of the virus. The currently proposed dedication funding will allow state Medicaid programs to expand access to vital home and community based services and appropriately support the providers and workers who deliver this essential care.

Prior to this pandemic, HCBS providers were operating with limited resources and experiencing workforce challenges, such as high vacancy and turnover rates. These challenges have been further exacerbated because there has been no dedicated emergency support to meet the essential needs of older adults and people with disabilities and to stabilize the caregiving system. With an already stretched workforce, providers have worked to meet quarantine requirements while addressing the increased demand for HCBS caregiving. In addition, they have struggled to secure the necessary personal protective equipment (PPE) and testing supplies to keep their workers and those receiving services safe. More recently, the HCBS workforce and those they serve have also faced challenges accessing COVID-19 vaccinations, despite being prioritized early in the distribution process according to public health guidance. The $9.7 billion in support included in the budget instructions will help address these needs and will be a down payment to reimagining a caregiving economy that can support older adults, people with disabilities and the workforce that makes independent living possible.

These relief funds will also help make an important investment in the entire caregiving workforce system. As you know, HCBS caregiving workers are often paid low wages and experience high rates of turnover that disrupts the continuity of care. In addition, home care workers are disproportionately women of color who are statistically more likely to contract COVID-19, be hospitalized with the virus or die from it. In cases where HCBS services have fallen short during the pandemic, family caregivers have been relied on to fill the gaps. In many cases, family caregivers have been forced to leave the workforce entirely -- a burden that has disproportionately been born by women and having long-term implications for their economic health. This funding included in the budget reconciliation instructions can be used to provide these workers and family caregivers with hazard pay and wage increases, paid sick and family medical leave, training and access to COVID-19 vaccines, among other vital supports.

As Congress continues to develop the next COVID relief package, we strongly support the continued inclusion of dedicated HCBS funding to help ensure that there is continuity of care for at-risk Americans and that HCBS providers have support to meet the increased demand for home care precipitated by the COVID-19 pandemic.