Friday is the deadline set by House Democrats and Senate Republicans for agreeing to a new coronavirus stimulus package. Home-based care stakeholders have had ample time to review the publicly released details from both parties’ plans — and they have a wishlist of additional provisions they’re still hoping to see.
One of the central pain points sparking disagreement between Democrats and Republicans in the next stimulus package is unemployment benefits.
Previously, individuals who lost their jobs during the public health emergency could receive $600 per week from the federal government, in addition to any state-level benefits.
In many cases, those benefits outpace what home-based care agencies are able to pay their workers.
“The unemployment accelerated benefits definitely have been a challenge,” Jennifer Sheets, the CEO of Interim HealthCare Inc., told HHCN in June. “Early on, we had struggled even with some front-line workers asking to be laid off or let go, which makes you scratch your head and say, ‘How does this make sense?’”
Sunrise, Florida-based Interim HealthCare offers a wide variety of in-home care services, with nearly 300 locations across the U.S.
Part of the Republicans’ proposed HEALS Act has been re-employment bonuses for those who willingly go back to work. Republicans also pitched tax credits for businesses that employ those people.
Additionally, the Republicans’ proposed HEALS Act would cap federal unemployment benefits to $200 weekly until at least October, or cap payouts to 70% of an individual’s previous income.
July 31 marked the end of the CARES Act’s $600 weekly benefit.
In a recent SEIU tele-town hall, more than 80% of the 21,000 home care workers that convened said they felt the federal government had not “done enough to ensure home care workers have what [they] need” during the COVID-19 crisis.
Apart from unemployment-related provisions, home-based care advocates are hoping for more money in the Provider Relief Fund, which previously distributed over $175 billion to health care providers from the CARES Act.
The Democrat-led House of Representatives proposed $100 billion more for the fund. Meanwhile, Republicans suggested a $25 billion infusion in their HEALS Act proposal.
Some believe the latter figure is not even close to where it needs to be. That includes LeadingAge President and CEO Katie Smith Sloan.
“The legislation treats older lives as expendable,” Sloan said in a statement. “The resources provided are woefully insufficient. The package offers only a fraction of the $100 billion that will be needed to help aging services providers protect older adults and offers no specific funds for aging services providers.”
Additionally, multiple organizations have expressed that there needs to be more support for Medicaid home- and community-based services.
The Partnership for Medicaid Home-Based Care (PMHC) specifically did so in a statement on Thursday.
“The financial viability of Medicaid home- and community-based providers is critical to the national health care infrastructure, and the direct care workforce needs financial support to ensure the continuation of these essential services,” PMHC Chairman David Totaro said.
PMHC previously developed a proposal for Congress that included an HCBS Direct Care Workers Fund.
On his end, National Association for Home Care & Hospice (NAHC) President William A. Dombi hopes there may be an extension of the payback timetable and the level of interest under the Centers for Medicare & Medicaid Services (CMS) advanced and accelerated Payment programs.
CMS distributed more than $100 billion in advanced and accelerated payments to all Medicare providers in spring. Home health providers received $1.7 billion.
NAHC is also hoping that the telehealth waivers granted during the public health emergency will become permanent, such as the one that allows the face-to-face requirement to be settled with telehealth technology.
However, for the big domino to fall in telehealth — reimbursement for remote visits — home health providers will need to wait for Congressional action.
“Absence of reimbursement for telehealth [in the bill is a concern],” Dombi told HHCN. “We have significant Congressional support, but the measure may not make it into this stimulus package, and we may need to wait for the next opportunity.”