Aging services providers are pushing back against a possible plan to help pay for part of the nearly $1 trillion infrastructure bill by using unused Provider Relief Fund (PRF) money.
Members of Congress were reportedly close to finalizing an infrastructure agreement on Sunday, but ultimately disagreed over public-transit funding. In addition to public transit, Republicans and Democrats continue to debate how the government should fund the once-in-a-generation infrastructure plan, which is where PRF potentially comes into play.
Created as part of the CARES Act, PRF set aside up to $178 billion that could be used to support home health agencies, skilled nursing facilities (SNFs), hospitals and other health care providers. While tens of billions of dollars have already been used, as much as one-quarter of the pot of money — nearly $44 billion — may be left “unobligated,” according to a recent report from the Government Accountability Office (GAO).
The Health Resources & Services Administration (HRSA), a branch of the U.S. Department of Health and Human Services (HHS), is among the main agencies charged with using PRF funds.
“HRSA has not provided time frames for obligating this balance,” GAO investigators wrote in their report. “Of the unobligated funds, according to HHS’s October 2020 spend plan, HRSA reserved a portion of the provider relief funds to respond to needs not identified in the spend plan, and in May 2021 HHS officials told us that the reserved funds were approximately $24 billion.”
Aging services leaders in a letter sent last week urged congressional leaders not to use any remaining relief funds to pay for infrastructure.
Groups that signed on to the letter include LeadingAge, Argentum and others.
“As Congress continues to consider the needs for investment in our nation’s infrastructure, we urge you to ensure that the remaining critically necessary [PRF relief is] not repurposed for infrastructure,” the letter stated. “These funds should be used for the purpose you originally intended.”
Thus far, home health agencies, for example, have used relief money to pay for personal protective equipment (PPE), hazard pay and other expenses related to the COVID-19 pandemic.
While many agencies have recovered from the worst of the public health emergency, many are still struggling financially, particularly those in rural areas. Additionally, with the Delta variant of COVID-19 spreading, there’s a chance some agencies will have to soon battle through another wave of the virus.
“As you know, long-term care providers have been on the front lines of the COVID-19 pandemic, caring for those most vulnerable to this virus,” the letter continued. “In doing so, they have incurred tens of billions of dollars in expenses and losses due to PPE, staffing needs, overtime and incentive pay, and record-low occupancy rates that continue to compound. While the Provider Relief Fund has helped offset some of these losses, more is critically needed to ensure caregivers have the financial resources to continue serving our nation’s most vulnerable seniors.”
In March, 75% of the LeadingAge members who responded to a survey said they still needed more PRF to weather the ongoing expenses and reduced revenues from COVID-19.
What’s more, 17% of respondents said they would be forced to close or sell their businesses if no additional funds were forthcoming.
“Some nursing homes, assisted living, home care and community-based service providers have been pushed to the financial brink,” LeadingAge President and CEO Katie Smith Sloan wrote in a separate letter. “If these providers close, it is not just the loss of a business or the jobs they offer, but it displaces older adults and disrupts families who must scramble to find a new care provider for their loved one.”
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