The end of the public health emergency could have consequences for people with disabilities

Government officials and disability advocates are preparing for a possible end to the public health emergency. (Brian Cassella/Chicago Tribune/TNS)

As attention on COVID-19 fades and the federal government considers ending the pandemic-triggered state of emergency, officials are warning big changes are coming for some disability programs.

Currently, the nation is under a public health emergency. With that in place, states were able to access additional federal funds for Medicaid as long as they didn’t cut most beneficiaries from the program. Federal authorities have also granted additional flexibility to home and community service providers who have struggled to maintain their workforces during the pandemic.

US Health and Human Services Secretary Xavier Becerra recently extended the public health emergency through July 15, but it’s unclear whether the Biden administration will renew the designation beyond that point. Now the Department of Health and Human Services’ Community Life Administration is telling people with disabilities to prepare.

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“When the federal declaration of a public health emergency (PHE) expires, many flexibilities initiated during PHE will need to be reversed. This return to pre-pandemic operations will have far-reaching impacts for older people and people with disabilities,” reads a notice from the agency. “The changes in Medicaid enrollment and eligibility will be particularly significant — and potentially confusing or disruptive — for current enrollees.”

After the state of emergency expires, states will have 12 months to reassess the eligibility of nearly every one of their Medicaid beneficiaries.

A new fact sheet from the Administration for Community Living advises Medicaid recipients to make sure their contact information is up-to-date with their state’s program and to mail back any Medicaid forms they receive. People who lose coverage due to an error can request an appeal, the fact sheet says.

“Once PHE is completed, millions of people on Medicaid, including people with disabilities, will need to go through a reassessment process in which their financial eligibility is reassessed. It can be complicated and there are frequently mistakes made or people inadvertently filling out the wrong documents, etc. said Bethany Lilly, senior director of revenue policy at The Arc.

The situation could be even more complex, Lilly noted, if people try to iron out issues with Social Security, which has just reopened its field offices after being closed for more than two years.

The Biden administration has pledged to provide at least 60 days notice before the end of the public health emergency. But disability advocates are asking for more time, arguing that states are ill-prepared.

Beyond new determinations for Medicaid recipients, advocates say states need more guidance on what tools they will have to meet the challenges of maintaining their direct support staff once some of the flexibilities related to the pandemic they took advantage of will no longer be available. .

“We urge HHS not to terminate PHE until the agency can be confident that states and providers have sufficient personnel, processes, and plans in place to ensure access to HCBS and prevent individuals from being wrongfully withdrawn from benefits,” read a recent letter to Becerra and Chiquita Brooks-LaSure, Administrator of the Centers for Medicare & Medicaid Services, Disability and Aging Collaborative that was signed by more than 30 advocacy groups.

In particular, an amendment to the states’ Schedule K Section 1915(c) emergency authorities allowed the use of telehealth and adjusted staffing ratios for Medicaid home and community services, said Elise Aguilar, director of advocacy at the American Network of Community Options and Resources, or ANCOR.

“ANCOR appreciates the guidance CMS has issued to state health officials to promote continuity of coverage for Medicaid beneficiaries, but also urges the administration to continue to provide additional guidance to states to address the crisis of direct care workforce before PHE ends,” Aguilar says. “Without this additional guidance and support, people with I/DD risk losing their already threatened access to home and community services that have been essential for so many throughout the pandemic and will continue to be so. after the end of the PHE.”

A spokesperson for the Centers for Medicare & Medicaid Services said “ensuring states are ready to successfully return to normal eligibility and enrollment operations is a top priority.” And, CMS pointed to a recent $12.7 billion investment for home and community services that was part of the U.S. bailout as one of many steps the agency has taken to address the shortage of professionals. direct support.

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