NAHC to Congress: Fund Respite Care, Extend Sequestration Moratorium

WASHINGTON, D.C. (December 17, 2020)—The National Association for Home Care & Hospice (NAHC) is expressing support for two measures that would improve reimbursement and respite care services.

Legislation introduced in the House of Representatives would provide for an extension of the Medicare sequestration moratoria. With the end of 2020 fast approaching, and thus the end of the CARES Act-mandated sequestration moratoria, providers across many Medicare sectors remain financially unsteady and in need of further relief. With the introduction of the Medicare Sequester COVID Moratorium Act, the bill sponsors are calling for a further extension to run through the end of the COVID-19 public health emergency. 

As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the $3 trillion COVID-19 stimulus and relief package passed in March, the Congress called for a suspension of Medicare sequestration through the end of 2020. This effectively added two percent to provider reimbursements. Sequestration suspension was one of several relief provisions intended to provide stability and offset COVID-19 related expenses, such as added personal protective equipment and staffing needs. 

NAHC is in support of this legislation and has been actively working with the highest levels of Congressional leadership on a further extension. Previously, NAHC joined forces with the American Medical Association, American Hospital Association, and American Health Care Association on a joint letter to Congressional leadership requesting the extension through the end of the public health emergency.  

The bill was introduced by Representatives Brad Schneider (D-IL), David McKinley (R-WV), Kim Schrier (D-WA), Tom Suozzi (D-NY), and Bobby Rush (D-IL).

NAHC has also joined with other likeminded organizations to write to the Chairs and Ranking Members of the Appropriations Committees in the Senate and House of Representatives to urge Congress to fully fund the Lifespan Respite Care Program, administered by the Administration on Aging, Administration for Community Living. For more than a decade, respite provided by the program has been a vital safety net for the nation’s family caregivers of both children and adults. During this pandemic, social isolation among family caregivers has intensified. Respite providers may be their only immediate contact for relief and other critical supports. 

NAHC appreciates the increase provided in FY 2020 for the Lifespan Respite Care Program. To address the growing need to support family caregivers who are the linchpin of the nation’s long-term services and supports system, advocacy groups are requesting $10 million in FY 2021—the amount included in the House-passed bill. This program has received no additional funding from the recent emergency supplementals, yet Lifespan Respite grantees continue to respond to daily requests for respite and have created innovative and flexible new ways to meet caregiver needs during this pandemic.  

By adapting consumer-directed respite voucher programs that help family caregivers pay for respite, many grantees and their partners were able to continue to offer respite through enhanced flexibilities. The Oklahoma Lifespan Respite program increased the voucher amount; expanded provider eligibility to include someone who lives with the caregiver and care recipient; and lifted the household income requirement. Virginia instituted similar flexibilities to meet increasing requests for respite since the end of April. In Nevada, Colorado and other states, grantees have extended time limits for voucher use to maximize flexibility in meeting family caregiver needs.

To maintain and expand support to isolated family caregivers in their networks, Lifespan Respite grantees and partners provide support through regular check-in phone calls, connections to food and basic supports, live Facebook events, online support groups, online activities to keep care recipients engaged, home-delivered or mailed care packages with activities for caregivers and care recipients, stress reduction and self-care webinars, and other virtual respite strategies.

National, State and local surveys have shown respite to be among the most frequently requested services by family caregivers. Yet, 86% of the nation’s family caregivers of adults do not receive respite. The percentage is similar for parents of children with special needs. For family caregivers caring for someone with Alzheimer’s, adults with developmental disabilities, individuals with Multiple Sclerosis (MS), ALS, spinal cord or traumatic brain injury, rare diseases as well as grandparents raising grandchildren and military caregivers, respite is especially elusive. Families caring for children, teens and adults with autism, physical disabilities or mental health conditions also can’t find or afford respite. 

Lifespan Respite systems, which maximize existing resources, require that respite become more accessible and available to all family caregivers. As importantly, Lifespan Respite systems build respite capacity and improve quality by requiring states to focus on respite provider/volunteer training and recruitment, start-up of new respite services, and affordability issues for family caregivers who struggle financially, but are not eligible for any publicly funded respite services. 

NAHC is grateful for the increase the Lifespan Respite Program received in FY 2020 to $6.1 million. However, additional funding is needed to meet the escalating need, especially in this stressful and isolating time of COVID-19. By investing in Lifespan Respite and other family and caregiver supports, the goal of avoiding or delaying more costly and unwanted institutional care, foster care, hospitalizations and emergency room use, can be reached. 

NAHC strongly urges Congress to fund Lifespan Respite at the modest request of $10 million in the upcoming omnibus appropriations bill.

—Via NAHC