How the State Should Spend COVID Rescue Plan Funds

AARP Rhode Island Urges Governor McKee to Use American Rescue Plan Act Supplemental Funding to Boost Medicaid Home & Community Based Services and to Support Family Caregivers

PROVIDENCE – AARP Rhode Island today sent a letter to Governor Dan McKee with recommendations for the use of COVID-19 relief funds approved by Congress.

The American Rescue Plan Act, which became law last month, includes enhanced funding for Medicaid home and community-based services (HCBS). Specifically, it establishes a temporary enhanced federal matching percentage (FMAP) that states may use to supplement (not supplant) current state HCBS spending, and to enhance, expand, or strengthen home and community-based services under a state’s Medicaid program.

“With so many people in Rhode Island needing home and community based care, we believe that quickly leveraging these additional resources will significantly improve the lives of many of our fellow Rhode Islanders,” wrote AARP Rhode Island State Director Kathleen Connell and State President Phil Zarlengo.

AARP recommendations include using the funds to reduce waiting time for those applying for care in their communities, expanding nursing home transition programs, supporting family caregivers in a variety of ways and improving care management.

In addition, AARP Rhode Island recommends the state engage the public and community partners to ensure transparency in all steps of the decision-making process.

The full text of the letter:

April 12, 2021

Dear Governor McKee,

AARP Rhode Island, on behalf of our 132,000 members and all older Rhode Islanders, urges you to take advantage of new federal resources to expand access to in-home and community-based care. With an estimated 1610 COVID-related deaths occurring in Rhode Island nursing homes and long-term care facilities, 62 percent of deaths in our state, this help is urgently needed.

On March 11, 2021, President Biden signed into law the American Rescue Plan Act of 2021 (ARPA) a comprehensive COVID-19 relief bill that includes enhanced funding for Medicaid home and community-based services (HCBS). Specifically, ARPA establishes a temporary enhanced state FMAP (federal matching percentage) for state Medicaid HCBS expenditures from April 1, 2021 to March 31, 2022. ARPA stipulates that the enhanced FMAP must be used to supplement (not supplant) current state HCBS spending, and to enhance, expand, or strengthen home and community-based services under Rhode Island’s Medicaid program.

We know that the vast majority of Rhode Islander want to get care in their homes and communities. That is why AARP urges Rhode Island to take advantage of this unique opportunity to use this increased funding to supplement existing state HCBS efforts. Specifically, these funds could be used to:

• Reduce or eliminate HCBS waiver waiting lists. According to the Kaiser Family Foundation, more than three-quarters of states report an HCBS waiting list for at least one Medicaid HCBS Waiver target population, totaling more than 800,000 people nationwide who desire to receive care in their homes and community. Unfortunately, the national average for time spent on a waiting list is 39 months across all waivers with waiting lists, an unacceptable barrier for individuals who desire to receive care in their home and communities.
• Create or expand nursing facility transition programs, to allow beneficiaries to transition out of facility-based care and back to their community. The temporary funding provided during the enhanced FMAP term can include intensive case management services for individuals currently residing in nursing homes who desire to return to the community.
• Expand funding for programs to allow HCBS beneficiaries to physically adapt or modify their homes to accommodate their functional limitations and to access assistive technology software, equipment, or products that can help them improve, increase, or maintain specific functional capabilities.
• Increase Rhode Island’s capacity to assess the needs of family caregivers who care for their loved ones, including identifying at-risk family caregivers before they burn out or compromise their own physical and mental health.
• Develop or expand funding for respite care services to allow family caregivers to take a break from their caregiving duties. Respite care services should be offered in a wide range of settings, and be available to family caregivers who would not otherwise qualify for publicly funded respite services.
• Increase access to family caregiver services such as education and training, counseling, support groups, and legal consultations, to delay or decrease the likelihood of a loved one’s need to seek care in a long-term care facility.
• Expand Aging and Disability Resource Center No Wrong Door Services, to assist beneficiaries in navigating and obtaining the HCBS needed to age in place.
• Expand funding for additional services that support HCBS, such as personal care supports, conflict-free care management, adult day services, and other caregiver support services. Services should be offered in a range of settings, including supportive housing and adult day centers.

Finally, we urge Rhode Island to engage the public and community partners as you consider how to apply the FMAP increase, and ensure that decisions to remain transparent in all steps of the decision-making process.

With so many people in Rhode Island needing home and community based care, we believe that quickly leveraging these additional resources will significantly improve the lives of many of our fellow Rhode Islanders. Thank you for your prompt attention to this issue. We stand ready to help in any way that we can. If you have questions, please contact me at 401-248-2670 or kconnell@aarp.org.

Sincerely,

Kathleen Connell                                                     Phil Zarlengo
State Director, AARP Rhode Island                     State President