In a followup to his campaign promise to address vital infrastructure updates, President Biden has introduced the American Jobs Plan, which calls for a significant expansion of HCBS, also known as home- and community-based services. Here we’ll cover details of the plan, how it could improve care, and next steps for the proposed legislation.
Background And Purpose
During the election, Biden introduced the idea of investing in America’s infrastructure to boost employment and modernize the country. The sweeping plan encompasses multiple potential expenditures, including addressing crumbling roads and bridges, repairing schools, and improving healthcare offerings for the elderly and individuals with disabilities. As we published last month, part of that vision is to significantly expand HCBS.
After the election, Senate advocates sent a letter urging Biden to put forth a bill backing his campaign promise. In response, the administration unveiled their funding proposal titled the American Jobs Plan in March of 2021, which does include a substantial investment in HCBS that providers have called “a monumental advance.” The plan’s fact sheet states how this investment “will improve wages and quality of life for essential home health workers and yield significant economic benefits for low-income communities and communities of color.”
Impact On HCBS Services And Funding
The White House’s $2 trillion infrastructure proposal includes a $400 billion allocation to expand access for those on Medicaid HCBS waiting lists. Additionally, the plan pledges to extend the popular Money Follows the Person program, which received a $165 million extension in funding under the previous administration. This proposed spending would be spread out over eight years.
To directly invest in caregivers and people with disabilities in the workforce, the funding is meant to improve wages for caregivers and direct service professionals (DSPs) and increase pay above the current average level of $12 per hour. The plan will also grant access to integrative employment for individuals with disabilities, while ensuring employers cannot pay wages below the federal minimum.
Next Steps
Although the plan has been predominantly applauded by homecare providers, there is a concern that existing relief measures need to be clarified and fully enacted. For example, the American Rescue Plan – which boosts the federal matching rate for Medicaid HCBS by 10% – is only in effect from April 1, 2021 through March 31, 2022.
The proposal will move next to Congress, where efforts to reform or improve HCBS have generally received bipartisan support. If approved, the investment would help support one of the country’s fastest growing industries, with demand expected to steadily rise over the next 10 years.