Policy Corner: April 24, 2020

Congress returned to Washington, D.C. this week for a short business session to address the coronavirus pandemic. As a result, President Trump is expected to sign a fourth stimulus bill today that Congress passed to provide aid to hospitals and small businesses. The Paycheck Protection Program and Health Care Enhancement Act, H.R. 266, will add $320 billion to the Small Business Administration (SBA) Paycheck Protection Program loans and $60 billion to SBA Economic Injury Disaster Loans grants and loans. It also includes $75 billion for health care providers and $25 billion for virus testing. The entire bill is $484 billion. This funding will help states, localities, territories, and tribes purchase and perform COVID-19 tests, conduct contact tracing, scale up laboratory capacity, and support the public health workforce. The bill requires the administration to develop a national testing strategy. Funds will also be used to reimburse hospitals and health care providers for their expenses and revenue losses related to COVID-19, support the purchase of desperately needed Personal Protective Equipment, and help keep hospitals open.

Preceding this bill are three others with the first stimulus, the Coronavirus Preparedness and Response Supplemental Appropriations Act bill, which provided emergency funding relief for domestic and global efforts. The second bill enacted was the Families First Coronavirus Response Act, which included paid sick leave, insurance coverage of coronavirus testing, nutrition assistance, and unemployment benefits. Work and work training requirements were lifted for the Supplemental Nutrition Assistance Program or food stamp program beginning April 2020, and for each subsequent month through the end of the month following the month when the COVID-19 public health emergency declaration by the Secretary of Health and Human Services is lifted.

In late March, Congress passed the CARES Act, the third bill that provided $2.2 trillion in funding for financial assistance to Americans, health care workers, hospitals, small businesses, and state and local governments. It provided financial relief to laid-off or furloughed workers through increased and extended unemployment insurance, checks to those within certain incomes, and grants and loans to small businesses. Among the provisions,$995 million in additional funding was appropriated to the Administration for Community Living for aging and disability programs, including Centers for Independent Living, National Family Caregiver Support Program, Long-term Care Ombudsman Programs, Aging and Disability Resource Centers, nutrition programs, and Home and Community Based Services (HCBS) under the Older Americans Act.

Administration Requires Nursing Homes to Report COVID-19 Cases

The Trump Administration announced new regulatory requirements by the Centers for Medicare & Medicaid Services (CMS) that will require nursing homes to inform residents, their families, and representatives of COVID-19 cases in their facilities. CMS will now require nursing homes to report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC). This information must be reported in accordance with existing privacy regulations and statute. CMS will also require nursing homes to fully cooperate with CDC surveillance efforts around COVID-19 spread.

CMS Allows States to Apply for Emergency Measures for HCBS

CMS has made provisions for states and territories to prepare for emergencies and ensure that acute and primary medical resources are available to meet the needs of individuals receiving these services. With regard to HCBS for individuals with brain injury, other disabilities and older adults, states are submitting changes to their HCBS programs during the COVID-19 crisis. They may seek amendments to their state plans; submit a 1135 waiver or submit an Appendix K, which is a standalone appendix to approved 1915(c) waivers. These changes are related to activities that are not addressed with their 1915(c) HCBS waivers, such as establishing a hotline; adding services, such as meals and transportation; and increasing the scope and duration of services and supplies, such as extending refills for medications.