Following vaccinations and a host of other highly debated legislative proposals on capital hill, the current administration is attempting to advance a 400 Billion dollar investment in Home-Based care within the “American Jobs Plan,” championed by current President Joe Biden.
Recently Unveiled “American Jobs Plan” Pushes 400 Billion Dollars into Home-Based Care
In an attempt to bring to fruition a key campaign promise, this past week President Biden’s administration unveiled the details of a new $2 trillion infrastructure proposal to create jobs in post-Covid ravaged America. In addition to building new roads, repairing bridges, and other infrastructure investments, the legislation which has been given the working title of “The American Jobs Plan,” would also dramatically increase funding for home care and community-based services (aka HCBS).
To provide this expansion access to HCBS within the umbrella of Medicaid, the Biden administration is specifically asking Congress to funnel $400 billion in funds towards home-based care specifically. The going assumption is that this funding would be used to improve salaries for many of the lowest-paying caregiving jobs. Statistics show that many of these jobs are currently held by minorities, women, and/or persons of color.
A recent fact sheet released by the White House touts the needs and some of the benefits including:
- The HCBS expansion under Medicaid will support higher-paying caregiving jobs
- There will be increases in the benefits and the ability for collective bargaining
- The quality of services and support for workers will enjoy greater stability and consistency
- Wages and quality of life for essential home health workers will yield important economic benefits for low-income communities and communities of color.
- More individuals will have the opportunity to receive care at home, in a support-based community, or from loved ones
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The proposed American Jobs Plan also pushes for the expansion of the popular “Money Follows the Person” (MFP) program, which permits certain Medicaid users to move from a nursing home back into a private residence with greater ease. Recently the MFP program was given extra funding (around 165 million) this past September while former President Trump was still in office.
During the current President’s campaigning activities in 2020, Joe Biden proposed a $775 billion overhaul of the U.S caregiving infrastructure, describing the current level of compensation for the majority of in-home care workers as “unacceptable.”
Aside from the proposal’s $400 billion for HCBS, the President’s proposal also includes $621 billion set aside for transportation, $300 billion to the manufacturing sector, and $213 billion towards housing, with another $180 billion dedicated to research and development. Funding allocations for schools, digital infrastructure, the U.S. water infrastructure, and other related areas is also touted in the measure. The American Jobs plan carries a $2 trillion dollar price tag, to which in a budgetary balancing move, the White House is proposing to increase the corporate rate to 28%.
As currently presented, the proposal will undoubtedly face unified Republican opposition, resulting in the tone in DC of single party push-throughs of legislation that has plagued Washington for years will continue. Democrats can likely succeed with passage through using a fast-track budget mechanism known as reconciliation. Advocates of the home health care industry regardless of political affiliations view the current administration’s active support of in-home care at the $400 billion dollar level as a major step in the right direction within an industry that has been overworked and underpaid.
William A. Dombi, president of the National Association for Home Care & Hospice (NAHC), publicly stated that it would be a monumental advancement in the long-standing mission to provide full access to health care outside of an institution. Dombi called on Congress and the American public to throw unified support behind the legislation, highlighting that the U.S health care environment is restrictive particularly for those with disabilities. Other major organizations have also thrown support behind the measure.
The current administration has a strong belief that supporting home-based health care workers through this proposal will continue the much-needed work to ensure that America is a better place for elderly Americans. Factors such as the nation’s consistent underinvestment in home-based care compared to other countries, paired with a shortage of home care workers are the driving force behind the administration’s urgent push to get the legislation passed. Statistics show that less than 16% of U.S. seniors 80 or older receive care at home. Compared to other countries like Switzerland, Denmark, Mexico and Sweden, the U.S numbers stand out as abnormally low, with numbers even higher than 30% in Israel and Lithuania.
While in recent years, Medicaid has slowly evolved by placing greater emphasis on home and community-based services. the progress has been relatively minor compared to investments in other areas. Back in 1995, Medicaid reportedly spent almost 20 cents out of every dollar earmarked for long-term care on HCBS services. Currently, in 2021, that number has reached almost 60 cents per dollar.
Given the massive toll the COVID-19 emergency impacted upon nursing homes and other long-term care facilities, the current administration felt that budgetary action was long overdue. While the numbers have declined since the vaccinations became more available to seniors, nearly 175000 nursing home residents lost their lives due to the COVID-19 virus (according to data released by the AARP which measured the death rates in nursing homes and other facility-based long-term care settings).
Agencies Struggle to Keep Qualified Homecare Workers
For U.S home-based care providers, an injection of funds could be a shot in the arm for the caregiver workforce at a time when the demand for care continues to rise. Even prior to COVID-19, home health agencies nationwide struggled to keep qualified workers or attract long-term employees due to the low pay/high-stress employment of caregiving. Projections suggest that America will soon have more individuals in the aging population than in the younger population, making the case to strengthen the caregiver workforce and infrastructure even more urgent.
Many articles and studies have proven that one of the most significant barriers to the availability of adequate home-based care for Americans is poor caregiver compensation.
Other officials who are in support of the plan, but doubtful of its long-term impact have raised other concerns. Chief among those, many have asked the question of the feasibility and the true impact of meaningful investment within the U.S homecare system if this overhaul features only “New” spending which lasts only a year. While no counter proposals have been introduced by other organizations, Republicans, or other bi-partisan groups, the concerns about maximizing current laws and creating a sustainable improvement to the caregiving conundrum should be top of mind for all government officials.
While some experts say it is hard to tell ultimately if Biden’s proposal will successfully become law, there is optimism that Washington DC has exhibited a history of bipartisanship when it comes to the support of home-based care and workers in the industry.
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Read the Alora blog for industry news, including recent news, articles and commentaries, as well as other issues that pertain to Homecare in the U.S and beyond. For more information on this topic or others affecting caregivers, in-home-care legislation, or Home Health Software, please send us an email to HomeHealthSoftware@Alorahealth.com