Funding Home Care for Elderly and Disabled

Tuesday, August 4th, is call-in day to push for dedicated funding of home and community-based services (HCBS) in the new COVID-19 relief legislation that is being negotiated in the U.S. Senate.  This measure is desperately needed in Texas, where HCBS funding has been greatly reduced during the pandemic, resulting in long delays for individuals waiting on the Interest List for an opportunity to apply for HCBS-Star Plus Waiver benefits.

As recently discussed in this blog, Medicaid requires states to provide nursing facility services, but does not mandate home and community-based care for elderly and disabled beneficiaries.  States have developed Medicaid HCBS programs, like the Texas HCBS Star Plus Waiver, to comply with the Americans With Disabilities Act (ADA), which requires states to provide services in the least restrictive community setting appropriate to the affected individual.  Generally these are waiver programs, not part of the Medicaid entitlement, giving states the flexibility to use waiting lists that move at a “reasonable pace.”  There has been little movement in the HCBS-SPW waiting list since the governor declared the spread of COVID-19 a public health emergency. In contrast, the nursing home program must continue to certify benefits for all new applicants who are eligible because these benefits are part of the Medicaid entitlement.

The National Academy of Elder Law Attorneys and other aging and disability advocates are joining in a day of action on August 4th to urge senators to include HCBS funding in coronavirus relief legislation.  Please take a moment to contact U.S. Senators Cornyn and Cruz to express your support for HCBS and share your family’s experience.