Home and Community Based Care Services Legislation Introduced

Legislation outlining potential policy details of President Biden’s proposed investment of $400 billion in Medicaid home and community-based services and the paid workforce providing those services was recently introduced in the House and Senate. These critical Medicaid home and community-based Medicaid home and community-based services (HCBS) enable seniors and people with disabilities to remain in their homes, stay active in their communities, and lead independent lives.  
 
AARP released the following statement from Nancy A. LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer in response to the introduction of the Better Care Better Jobs Act, a bill to provide up to $400 billion for home and community-based services:

 "During the COVID-19 pandemic, more than 184,000 Americans died in nursing homes and other long-term care facilities – more deaths than in any other setting. Our fractured and outdated long-term care system is a national disgrace. The introduction of the Better Care Better Jobs Act is an important first step toward action that is long overdue. The vast majority of older Americans say they want to age at home. We must make investments in home and community services so older Americans are able to choose how they live as they age."

"AARP has led the effort to increase availability of these services in states all across the country as part of our ongoing work supporting older Americans and family caregivers. In addition to drastically expanding access to home and community-based care under Medicaid and supporting and expanding the direct care workforce, AARP strongly supports the bipartisan Credit for Caring Act, which would give some relief to eligible family caregivers who face very high costs of caring for their loved ones. We also support paid leave policies that give caregivers the workplace flexibility they need to care for their families. All of these policies are essential if we want to build a humane, sustainable system of care that works for every American family.”
 
Specifically, the Better Care Better Jobs Act would:
• Enhance Medicaid funding for HCBS: States would be eligible for a permanent 10 percentage point increase in the federal Medicaid match for delivering HCBS as well as enhanced funding for administrative activities associated with improvement efforts.
 • Encourage innovative models that benefit direct care workers and care recipients: Provide additional incentives to help states build HCBS workforce programs that register direct care workers; help connect them to seniors and people with disabilities seeking care; facilitate coordination between the state and direct care workers; support care safety and quality; and help workers organize, among other functions.
• Support quality and accountability: Provide funding to the Centers for Medicare & Medicaid Services to carry out the bill’s programs; conduct oversight and monitoring; and offer technical assistance to states participating in the funding opportunities described above. Additionally, participating states would be required to establish state HCBS ombudsman programs to support care quality. The bill would also require all state Medicaid programs to adopt HCBS quality measures.
 • Facilitate state planning: Provide funding for states to develop HCBS infrastructure improvement plans with public input, to outline how they would expand access to HCBS, strengthen the workforce, and meet requirements tied to increased federal Medicaid funding. States would be required to develop these plans in order to receive enhanced federal Medicaid funding for HCBS.
• Permanent spousal impoverishment protections: Permanently authorize protections against impoverishment for individuals whose spouses are receiving Medicaid HCBS.
• Make Permanent Money Follows the Person: Make the Money Follows the Person Rebalancing Demonstration permanent.

Lead sponsors of the bill include Sens. Casey (D-PA) and Wyden (D-OR) and Reps. Dingell (D-MI) and Pallone (D-NJ).