The State of America’s Direct Support Workforce Crisis 2022

The longstanding direct support workforce crisis, exacerbated by the COVID-19 pandemic, has led to closures of critically needed services and a denial of access to community-based supports.
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Stateside Report - 04.06.20

Stateside Report: April 6, 2020

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Medicaid, Medicaid Expansion, Medicaid LTSS

Nevada – (KTNV Las Vegas, 04/01/20) In response to COVID-19, the state’s Medicaid office has announced that they are expanding access to telehealth and has encouraged uninsured Nevadans to apply for Medicaid health coverage.  Currently the state Medicaid program covers approximately 20% of all residents.  Nevada Medicaid Administrator Suzanne Bierman said, “During the COVID-19 pandemic, it is critical that people are covered by health insurance in case they need to see a doctor, if we are not healthy, our community suffers.”

New Mexico – (Albuquerque Journal, 03/31/20 and Law360, 04/01/20 )  Navajo Tribal President Jonathan Nez has vetoed a resolution that tried to capitalize on the spread of Coronavirus” as he stated.  The resolution passed by the Navajo Nation Council last week urged New Mexico to expedite the approvals, contracts and infrastructure for the Naat’aanii Development Corporation (NDC) in partnership with Molina Healthcare Indian Managed Care Entity, which would manage Medicaid on the tribe’s reservation.  “It is regrettable that, during a time of danger surrounding COVID-19, the Office of the (Navajo Nation) President and Vice President has chosen to spread misinformation and to cast the Navajo Nation Council in a bad light,” Navajo Nation Council Speaker Seth Damon said in a statement TuesdayAccording to President Nez’s statement, the NDC is “circumventing the standard regulatory approvals (which state officials have said would take more than 20 months) and holding desperately needed medical supplies hostage to strong arm the state of New Mexico…”

Tennessee – (Tennessean, 04/02/20)  Tennessee is seeking approval to establish a $104 million safety net fund to cover treatment for uninsured Coronavirus patients using Medicaid funds.  The state is proposing a waiver that would use the reserve fund of an obscure TennCare program (AccessTN) to cover the state’s portion of the deal, approximately $30 million.  According to a TennCare spokesperson, the intent is to reimburse Medicaid providers for treatment given to uninsured patients during the COVID-19 crisis. The plan does not involve enrolling new populations, but provides funding for physicians, hospitals and labs who accept the payment they receive from Medicaid as payment in full for their service.  The current reserve balance in the AccessTN program is $48 million and it is projected to need only $18 million for those enrolled in the program.

Utah  – (KSL.com, 04/03/20)  The Utah Department of Health announced that it is suspending the state’s Medicaid work requirement during the COVID-19 crisis to ensure that people continue to have access to medical care during this time.  Medicaid Director Nate Checketts was quoted as saying, “Suspending the community engagement requirement during this state of emergency recognizes the unique challenges created by this public health crisis.”  Currently participation in the Medicaid for the expansion population requires that recipients must complete an online job assessment, workshops, and provide evidence that they have applies for at least 48 jobs within a three-month window to remain eligible for coverage.

 

State Budget

New York – (Gotham Gazette, 04/06/20)  Last week Gov. Cuomo and the Legislature agreed on a $177 billion budget for FY21.  The budget was given final approval on April 3rd, a few days after the start of the state’s fiscal year on April 1st.  The plan is $1 billion less than the governor recommended and anticipates state revenues decreasing by $10 billion from the current fiscal year.  Regarding Medicaid, the Medicaid Redesign Team put forth a proposed $1.6 billion in savings for the new fiscal year which was short from the $2.5 billion they were tasked with finding. The plan also cuts $400 million to hospitals, and limits Medicaid spending growth to only 3%, down from the recent 6% growth trend.