Although concrete details are largely unknown, in-home care providers remain on the lookout for the next coronavirus-related stimulus package.
Specifics on a possible fifth stimulus package could be released as early as this week, policy experts believe.
“I think that’s the question, whether or not a package comes together that everyone agrees to before the August recess — or potentially after it,” Joanne Cunningham, executive director of the Partnership for Quality Home Healthcare (PQHH), told Home Health Care News. “We’re seeing new spikes in different parts of the country, which has added renewed pressure.”
PQHH is a home health care advocacy organization based in Washington, D.C.
Senate Majority Leader Mitch McConnell (R-Ky.) and Treasury Secretary Steven Mnuchin have reportedly been working on a draft of the legislation for the past several weeks, with Mnuchin saying the next phase of relief should go toward industries hardest hit by the coronavirus.
“We are monitoring economic conditions closely,” Mnuchin testified on Friday in front of the House Committee on Small Business. “Certain industries, such as construction, are recovering quickly, while others, such as retail and travel, are facing longer-term impacts and will require additional relief.”
Broadly, a fifth stimulus package will likely focus on a number of topics, including funding for school reopenings, litigation immunity for certain industries and continued unemployment benefits, according to reports from The Hill.
“One thing the majority leader in the Senate has said is that there needs to be some form of business immunity from potential liability related to COVID-19,” National Association for Home Care & Hospice (NAHC) President William A. Dombi told HHCN. “The other forces that are in play range from an extension of the federal unemployment insurance to further expansion of the Paycheck Protection Program (PPP).”
NAHC is also a D.C.-based trade organization. Its provider members span the full spectrum of home-based care.
So far, more than 15,000 home-based care companies have received more than $666 million in PPP loans of under $150,000, an HHCN analysis found.
Additionally, the next potential stimulus package could pave the way for an expansion of the Provider Relief Fund. It could also provide added federal support for state and local governments.
One question that looms large is the total amount of the next stimulus package, according to Dombi.
“I think we’ve moved from whether there would be one, to how much it will be and what will be in it,” Dombi said. “Is it going to be a $1 trillion program, a $2 trillion program or a $3 trillion program? This seems to be somewhat fluid. The bill that came out of the House earlier — the HEROES Act — was over $3 trillion.”
The White House has, informally, indicated that a $2 trillion package is a possibility. Meanwhile, McConnell’s office reportedly wants the next stimulus bill to be around $1 trillion.
In-home care providers may benefit from another stimulus bill in several different ways.
One is an additional injection of cash into the Provider Relief Fund. There are parts of in-home care that haven’t received funding, including private-duty home care and private-pay services, for example.
Some providers have only received 2% of their total revenue in terms of financial support, but are experiencing a cost increase that is close to 10%, according to Dombi.
Another measure that would help providers is special funding for front-line workers, who are facing additional risk due to the public health emergency.
“It goes by many different labels: premium pay, hazard pay, combat pay,” Dombi said. “There needs to be something to encourage people to come into doing that work, particularly at the lower end of the wage scale.”
Dombi also called for child care support for essential front-line workers.
“If the schools will not be uniformly open five days a week for all students, somebody is going to need to care for those children,” he said. “Generally, that falls on parents, unless those parents also need to go to work. So how do we take care of those child care needs for those front-line workers?”
On the Medicare home health side, NAHC would like to see authorization for reimbursement of telehealth services.
“Without a doubt, important advances have happened to provide some flexibility, but we think it’s falling short of realizing its value by not having any direct reimbursement for those services,” Dombi said.
For in-home care providers, now is the time to advocate for the industry at the grassroots level, as the situation remains fluid.
“[Providers] need to be engaged and explain why there is still a greater need for support for health care providers than currently exists, and that in-home care needs those supports as much as hospitals do,” Dombi said. “By our very informal count, there are more patients with active COVID-19 infections in home settings than there are in hospital settings. We have opportunities — we have no guarantees that further supports will be made available.”