Congress Continues Discussions on COVID-19 Relief

Congress is now in the process of considering the $1.9 trillion COVID-19 relief package proposed by President Biden. This legislation, being considered through a budget-reconciliation vehicle that only needs simple majorities in both the House and the Senate and may be passed exclusively with Democratic-votes.

The reconciliation process instructs 12 House Committees to write proposals that would provide $1.9 trillion in budgetary relief that fulfills the provisions of President Biden’s COVID-19 American Rescue Plan.  Under the budget reconciliation process, the House Budget Committee will combine the separate bills into one package. The goal is to have the relief package signed into law by mid-March.

The following are some of the key provisions that are advancing in the House that will be of interest to LeadingAge Minnesota members:

Medicaid.  The bill makes major investments in the Medicaid program. Significantly, the bill would provide enhanced Medicaid-financed home and community-based services. States would get a 7.35% HCBS specific federal match (FMAP) bump for one year, with a “supplement not supplant” provision that makes the state use the additional dollars for HCBS, which can include (but is not limited to) rate increases, wait list reduction efforts, pay/paid leave for workers, and non-time limited retainer payments. This would be good news for Minnesota HCBS providers, as a key priority is to support rate enhancements to the Elderly Waiver program.  Enhanced federal money could help at least temporarily. 

Vaccine funding. The House Energy and Commerce Committee included a provision to provide $7.5 billion dollars in funding for the Centers for Disease Control and Prevention (CDC) to prepare, promote, administer, monitor, and track COVID-19 vaccines. While all of the money is allocated to the CDC, the money can be utilized for a wide variety of purposes including distribution and administration of vaccines and ancillary supplies, support for state, local, tribal, and territorial public health departments, community vaccination centers, mobile vaccination units, information technology and data enhancements, facility enhancements, and public communications related to where, when, and how to get a vaccine. The funds are flexible enough that the CDC can utilize them for national support or target them to states, localities, or providers to help with the vaccination effort.

An additional $1 billion dollars is also allocated for CDC to strengthen vaccine confidence, further information and education with respect to authorized or licensed vaccines and improve vaccination rates. We believe this will be helpful to boost vaccine confidence among caregivers working in our member settings.

Testing and PPE. The bill allocates $46 billion to HHS to detect, diagnose, trace, and monitor COVID-19 infections, and for other activities necessary to mitigate the spread of COVID-19. Specified activities include implementing a national strategy for testing, contact tracing, surveillance, and mitigation of COVID-19; guiding state and local public health departments in their work to implement the national strategy; support developing, manufacturing, procuring, distributing, and administering tests, personal protective equipment (PPE), and other supplies necessary for COVID-19 testing; establishing and expanding federal, state, or local testing and contact tracing capabilities, including investments in laboratory capacity, community-based testing sites, and mobile testing units; and sustaining our nation’s public health workforce.

The bill allocates $1.8 billion to HHS to support the purchase, procurement, or distribution of COVID-19 tests and testing supplies, PPE, and vaccines for staff and individuals in congregate settings including long term care. While there has been some concern that the definition of congregate settings is broad and there is concern that more funding will be necessary to cover the needs, this is a step in the right direction.

Nursing Home Strike Teams. The proposal authorizes distributing up to $200 Million to states and territories to support strike teams that would assist nursing homes during COVID-19 outbreaks. In addition, CMS receives up to $200 Million to contract with the QIOs to develop and distribute infection control protocols.

Funding for Elder Abuse Prevention. The bill ensures the Elder Justice Act (EJA), a program administered by Administration for Community Living (ACL) that provides protections for residents of long-term care facilities, will receive at least $188 million in funding for fiscal year 2021 and 2022, and $10 million shall be for the long-term care ombudsman program.

Funding for Older Americans Act. An additional $1.4 billion in ACL funding was allocated for programs authorized under the Older Americans Act (OAA), which includes: $750 million to support nutrition programs for older adults and $25 million for Native American’s nutrition programs; $480 million for HCBS supportive services, which includes $44 million for vaccination outreach and coordination. These funds can also be allocated for health promotion and disease prevention and prevention and mitigation activities related to addressing extended social isolation among older individuals and including investments in technological equipment and solutions.

We will continue to keep members informed on developments related to this important legislation. 

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