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Proposed Federal Funds for Home Care Services for the Elderly

McNair Dallas Law

Caregiving Burnout

For older people and people with disabilities, solving everyday practical problems can be the difference between being able to live at home or being forced to move to an institution. Sometimes people need help getting dressed or making meals. Sometimes they need help managing medications or shopping for groceries.

President Biden has proposed $400 billion over a span of eight years on Medicaid coverage of long-term care such as in-home and community-based services as part of his $2 trillion infrastructure bill, the American Jobs Plan. The plan would cover professional nurses, therapists and personal care aides, but it also includes family members and friends.

WOUB’s recent article “New federal funds spur expansion of home care services for the elderly and disabled” explains that originally, these things weren’t paid for by Medicaid, the federal health care program upon which many low-income and disabled Americans rely. In recent years, the program has worked to expand coverage of home-based care, but it’s still optional for states.

In April, the Biden administration rolled out funding from the American Rescue Plan to help states boost these services. The federal Department of Health and Human Services recently unveiled every state’s plan for how they’ll use the funds. An estimated $12.7 billion dollars in federal matching funds are available to “encourage states to expand home and community-based services and strengthen their programs,” according to an agency press release.

“More and more people are saying, if I need care, I’d like it to be done at home or here in my community versus an institution or a hospital or a nursing home,” says Health Secretary Xavier Becerra. “In the 21st century, we’re moving closer to a care model that’s based on giving people services in their home.”

Becerra adds that his own father spent his last few months in hospice at home. “When he passed, he was in my home, he was surrounded by family,” he says.

The move towards home- and community-based care has been gradual since Medicaid started, says MaryBeth Musumeci, an associate director at the Kaiser Family Foundation’s program on Medicaid and the uninsured. “This proposed bill is really the first new funding that we’re seeing for home and community- based services really since the Affordable Care Act in 2010,” she says.

These days, it’s both possible and preferable for everyday help to be provided to people at home, Musumeci added.

Many Medicaid advocates are hoping that more permanent support for these services will come through in the proposed budget bill getting hammered out in Congress.

“We’re hoping that Congress will continue to provide additional resources so we can make those increased services in home and community-based settings permanent,” Becerra says. Through the COVID-19 pandemic, he adds, “Medicaid proved its value.”

Reference: WOUB (Oct. 25, 2021) “New federal funds spur expansion of home care services for the elderly and disabled”

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