Appropriations Bill Funds Key Priorities

The 2020 appropriations package that was signed into law in late December features key initiatives and funding for workforce, dementia, veterans and potential transportation solutions for rural and underserved communities.   

WORKFORCE: The appropriations package includes:

  • Encouraging investment in interprofessional networks that address social determinants of health including field placements programs for rural and medically-underserved populations;
  • $2 million in competitive grants to enhance nurse education and strengthen the nursing workforce through expanding experiential learning opportunities. Focus will be on grantees in medically-underserved areas with an age-adjusted high burden of stroke, heart disease, obesity and high poverty;
  • $5 million to establish or expand optional community-based nurse practitioner fellowship programs that are accredited or in the accreditation process for practicing postgraduate nurse practitioners in primary care or behavioral health; and
  • $1 million to support a model program to increase and strengthen the eldercare workforce in rural counties where there are health care disparities related to access and delivery of care. Priority is placed on eligible entities with training programs that serve one or more communities that have both high poverty rates and in states with an elderly population that exceeds 15% of its population.

Alzheimer’s Disease and Related Dementias: $10 million to implement the BOLD Infrastructure for Alzheimer’s Act, which establishes Alzheimer’s and related dementias public health centers of excellence, awards funding to public health departments to implement effective Alzheimer’s interventions, and increases data analysis and timely reporting.

Rural Health Continuity of Care for Veterans: As the transition to a new community care program established by the VA MISSION Act is underway, the appropriations package encourages Veterans Affairs to sustain continuity of care for rural veterans through provider agreements, based on previous models such as the Access Received Closer to Home pilot program, to ensure veterans do not experience a lapse in existing healthcare access during the transition to the new community care program and any resulting integrated networks. There is also continued support for Veterans Affairs to enter into provider agreements with non-VA long-term care providers, including skilled nursing settings.

Other Veterans Long-Term Care Provisions: $10 billion for long term care needs of veterans and encouragement for the VA to cooperate with community, state and federal partners to expand and accommodate veterans’ preferences in receiving care across settings. The VA is also directed to submit a report on their work to addressc hospice needs of Vietnam-era veterans and to engage nonprofit hospice and palliative care providers as part of their effort.

Transportation in Rural and Underserved Communities: $300,000 for the Medicaid and CHIP Payment Advisory Commission to examine the benefits of nonemergency medical transportation from State Medicaid Programs on Medicaid beneficiaries, including those with chronic diseases, substance abuse disorders, pregnant women and those who live in remote, rural areas. The study will also explore the benefits of improving coordination with public transportation and other federally-assisted transportation services. No federal regulatory action on the availability of non-emergency medical transportation service will take place until the study is complete.

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