By David M. Goldfarb, Esq., CAE
Many of our priorities have become more urgent, while new issues have moved to the forefront.
Remember February 2020? Doesn't it feels like it was decades ago? To me, the terms BCE and CE have taken on new meanings: BCE is now “Before the COVID-19 Era” and CE is the “COVID-19 Era.” It’s no longer 2020, but COVID-19 Era Year One.
Like you, NAELA advocacy is adapting to this new time period. Many of our priorities, such as access to home and community-based services, have become more urgent, while new issues, such as electronic notarization, have moved to the forefront.
The CARES Act and Other COVID-19 Legislation
With a major public health crisis and the economy shutdown, Congress continues to pass legislation to address both issues. The biggest to date, known as the CARES Act, included extensions of NAELA’s top legislative priorities: extension of Medicaid’s spousal impoverishment protections to home and community-based service (HCBS) waivers and funding for Money Follows the Person (MFP) until November 30.
NAELA had also raised the issue to Congress that any money given out to people must not impact means-tested benefits. Thankfully, Congress crafted “the recovery rebate” as an advance refundable tax credit, which by law exempts those funds from counting for the purposes of public benefits for a whole year.
Now, NAELA continues to work with other organizations and our congressional champions for a long-term, if not permanent extension of the spousal protections for HCBS and MFP. Additionally, advocates are working to try to get additional funding for HCBS, such as in Sen. Bob Casey (D-PA) and Rep. Debbie Dingell’s (D-MI) legislation, the Coronavirus Relief for Seniors and People with Disabilities Act (S. 3544/H.R. 6305).
Moving Forward
Even the short-term remains highly uncertain, but here are some likely trends in advocacy:
1. Nursing Homes: What Is Their Future?
Can nursing homes survive in an era where visitation is banned and approximately 20 percent of all COVID-19 deaths occur there? What will residents’ rights and oversight look like moving forward? Will the large-scale deaths in institutions create the public consciousness and political will needed to finally mandate home and community-based services?
2. Emergency Medicaid Waivers: What Will They Actually Do?
Medicaid’s Section 1135 and Section 1915(c), Appendix K, waivers provide incredible flexibility to states during emergencies. Nearly all states now operate under these emergency waivers. Yet, what they actually mean in practice and what happens when they end remains very unclear.
3. Access to Treatment: Will Your Clients Be Forced to the Back of the Line?
Another trend has come back that has not been seen in the United States in more than 40 years: shortages. Hospitals lack access to critical items, such as ventilators to keep patients alive. This means states, hospital systems, and frontline medical professionals will need to make extremely difficult decisions about who lives and dies. Unfortunately, those decisions may be tied to implicit biases that treats people with disabilities and older adults as less worthy than others.
About the Author
David M. Goldfarb, Esq., CAE, is NAELA's Director of Advocacy.