A Look Ahead: Legislative Update from Team Select’s Government Relations Department

By September 6, 2021Food for thought

Our Government Relations department works tirelessly to advocate for decisions made by legislatures at the federal, state, and local levels that benefit home health care patients, families, and employees. With the ever-changing landscape, it’s important to know what home healthcare can expect now and in the years to come.

The Positive

“There is a lot more funding available,” said Bill Sczepanski, Vice President of Government Relations. “And this is a huge generational push that may not come along again in the decades to come.”

Coronavirus Aid, Relief, and Economic Security (CARES) Act and the additional Federal Medical Assistance Percentage (FMAP) is a great example of new funding across the nation. The additional 10% FMAP funding can translate to hundreds of millions of additional dollars per state, for states as population desolate as Montana or Alaska.

According to KFF, FMAP is computed from a formula that considers the average per capita income for each state relative to the national average. By law, the FMAP cannot be less than 50%.

The above formula helps states know what Medicaid changes to invest in. The FMAP can potentially translate to rate increases for home health clinicians, an expansion of services for home health agencies, extra training, and internally for Medicaid – assistance with their training and recruitment.

The additional 10% FMAP funding referred to by Sczepanski was included in the American Rescue Plan Act of 2021 (ARP) (Pub. L. 117-2).

“On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARP) (Pub. L. 117-2). Section 9817 of the ARP provides qualifying states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for home and community-based services (HCBS). States must use the federal funds attributable to the increased FMAP to supplement, not supplant, existing state funds expended for Medicaid HCBS in effect as of April 1, 2021, and states must use state funds equivalent to the amount of federal funds attributable to the increased FMAP to implement or supplement the implementation of one or more activities to enhance, expand, or strengthen HCBS under the Medicaid program.” – Centers for Medicare and Medicaid Services (CMS)

Learn more about the additional 10% funding here.

The Negative

The additional FMAP funding is a temporary solution as it only provides a temporary additional 10% for states. Though this funding can be used in the years to come and does not have a short lifespan, Medicaid has difficulty dispersing the additional funds to the appropriate programs and agencies.

“Medicaid, in most states, is not set up well to give funding away and they need help,” said Sczepanski. “They’re not a bank, so how do they get that money into your hands? Now Medicaid is working to create internal policies and procedures to get this done but that takes time and manpower.”

The nursing shortage has also been an ongoing issue and the home health industry is especially finding it difficult to retain talent. Nurses are leaving or choosing to work for hospitals, facilities, and specialists for a higher pay rate and in some cases, a sign-on bonus.

In a recent article by Ed Crump with ABC 11 News, a North Carolina family shares their frustrations and complications with the lack of available Private Duty Nursing (PDN) for their 6-year-old daughter. This article is just a glimpse into the nursing shortage that families are feeling the ramifications of nationwide.

The Future, 2022 and Beyond

Next year is an election year. This means the United States Senate, Congress, and House of Representatives seats will be up for election, along with some governorships. With this in place, Sczepanski says the general public can expect to see a push for several initiatives because this may be the last chance for these officials to push their political agenda and prior campaign commitments.

“We will still be dealing with the ramifications of COVID-19 as well,” said Sczepanski. “This is important when we discuss all of the emergency orders that have been granted – will these continue to be made permanent? The health care industry will need more clinicians as COVID-19 continues to exacerbate the nationwide nursing shortage the longer this virus continues.”


Resources and References

https://www.kff.org/

https://www.cbpp.org/blog/states-to-get-enhanced-medicaid-funding-through-2021#:~:text=The%20enhanced%20FMAP%20helps%20states,during%20economic%20downturns%2C%20history%20shows.

www.abc11.tv/3iJfTuv

https://www.congress.gov/116/bills/hr748/BILLS-116hr748enr.pdf

https://aspe.hhs.gov/federal-medical-assistance-percentages-or-federal-financial-participation-state-assistance

https://www.medicaid.gov/

https://www.kff.org/medicaid/issue-brief/potential-impact-of-additional-federal-funds-for-medicaid-hcbs-for-seniors-and-people-with-disabilities/