Senate Republicans are close to unveiling their latest version of another coronavirus relief bill, with reports suggesting party leaders may do so Wednesday or soon thereafter.
The proposal — first obtained by Washington, D.C.-based newsroom Roll Call — is viewed as a “skinny” version of the previously released HEALS Act from July. Among its provisions, the Republican plan seeks to provide $300 in weekly unemployment insurance, additional money for coronavirus testing and another $158 billion for the Paycheck Protection Program (PPP), which closed for applications on Aug. 8.
Of note for home health providers and other organizations operating in the long-term and post-acute care spaces, the skinny bill appears to do little to alleviate financial and workforce hardships triggered by the public health emergency. In turn, it offers “no real relief” to the older Americans such providers serve, according to Katie Smith Sloan, president and CEO of the national aging services advocacy group LeadingAge.
“When eight out of 10 COVID deaths are among people 65 and older, and infections in nursing homes are breaking new records, it’s shameful to largely ignore the continued deaths and escalating danger to older adults,” Sloan said in a statement Wednesday.
To some extent, a drop in federal unemployment from $600 to $300 per week could lessen the number of in-home care workers opting out of their jobs during the ongoing crisis due to safety concerns. Those anxieties have contributed to some home health and home care agencies losing several workers over the past few months, despite the fact unemployment rates remain high.
Additionally, a reopening of PPP — with the program stocked with fresh funding on top of leftover funds — would likely go a long way in supporting small and mid-sized home-based care businesses.
Overall, more than 15,000 home-based care entities received PPP loans of less than $150,000 under PPP, according to a review of federal data conducted by Home Health Care News. More than 7,400 entities have received loans at or above $150,000, with dozens receiving loans in the $5 million-to-$10 million range.
“For those Interim HealthCare owners who applied and received funding, the PPP loan allowed them to ensure their teams of home health aides, nurses and other staff members could continue to serve their patients, safely in the comfort of their own homes by front-line staff who had access to the right resources, including proper personal protective equipment (PPE),” Jennifer Sheets, president and CEO of Interim HealthCare Inc., told HHCN in an email.
The Republic plan would also allow for a “second draw” on PPP for eligible businesses that have suffered a 35% revenue loss over a designated period, Roll Call reported.
Beyond those provisions, the plan would allocate a total of $16 billion to support COVID-19 testing and contract tracing. But aging services providers alone need at least $10 billion in testing aid, according to LeadingAge.
That’s especially true for long-term care hospitals (LTCHs), in-patient rehabilitation facilities (IRFs) and others, as testing is directly tied to Medicare payments. New guidance from the U.S. Centers for Medicare & Medicaid Services (CMS) says that such providers who want to get paid for treating COVID-19 patients must include a positive test in that patient’s medical record.
“This isn’t just skinny,” Sloan said. “It’s anemic.”
Moving forward, LeadingAge argues, the “continuum of aging services providers” — home health and home care agencies included — need more PPE, testing supplies and funding to cover “hero pay” for front-line workers, among other measures.
Gary Anderson, CEO of Lutheran Senior Services, echoed that call to action. St. Louis, Missouri-based Lutheran Senior Services is a provider of retirement communities, home- and community-based services and affordable housing.
“COVID has made this the most difficult year in our 160-year history,” Anderson said in a statement. “In the early days of the crisis, we lacked the necessary PPE and vendors did not have the inventory to supply us. It’s still hard to locate PPE — and we are spending tenfold on what we can afford.”
Across the organization, Lutheran Senior Services is on track to spend over $1.5 million on testing alone.
Assisted living communities have been hit particularly hard by the COVID-19 emergency and a lack of federal action.
In a survey of 193 U.S. assisted living providers conducted this month by the National Center for Assisted Living (NCAL), half said they were currently operating at a loss. Another 64% of assisted living providers said they won’t be able to sustain operations another year at the current pace of increased costs and revenue loss.
LeadingAge is not the only aging services advocacy organization to call for more federal support.
The Partnership for Medicaid Home-Based Care (PMHC), for example, is urging Congress to create a fund to help pay direct care workers higher wages during the public health emergency. The National Association for Home Care & Hospice (NAHC) has likewise called for more telehealth assistance, while the Partnership for Quality Home Healthcare (PQHH) is seeking an immediate pause to the Review Choice Demonstration (RCD).
The new “skinny” proposal is expected to cost about half as much as the previous $1 trillion COVID-19 relief legislation, according to The Wall Street Journal. Still, that price tag may be too high for some Republicans.
Meanwhile, House Democrats initially floated a $3.5 trillion plan of their own, though they signaled they’d be open to shaving that by about $1 trillion.
Roll Call noted the proposal text it obtained is subject to change.