LITTLE ROCK, Ark. — Centers for Medicare and Medicaid Services (CMS) has approved Arkansas’s request to use Medicaid funds to temporarily increase the weekly income of long-term services and supports (LTSS) direct-care workers during the COVID-19 public health emergency, Governor Asa Hutchinson announced at a news conference Wednesday (April 15).
On April 8, the Arkansas Department of Human Services (DHS) submitted an emergency state plan amendment and two “Appendix K” amendments to cover services provided under the State Plan and agencies in non-institutional settings for people who get care in their homes and communities. With approval from CMS, DHS will be able to make payments retroactive to April 5, 2020.
“CMS’s approval of this request is welcome news for LTSS direct-care workers, who are working long hours to see that our most vulnerable Arkansans are well-cared for during this public health emergency,” Governor Hutchinson said today. “Not only will these funds help ensure continuity of care, the extra pay will alleviate some of the financial stress for the caregivers, who are selflessly serving in nursing homes, assisted living facilities, and in private homes at increased risk to their own health.”
The additional care continuity pay will go to eligible non-physician direct-care workers employed by or contracted with institutional setting providers, such as nursing homes, intermediate care facilities, and assisted living facilities; and agencies in non-institutional settings for people who receive care in their homes and communities. Eligible workers include those who are continuing to provide face-to-face services to this population and include:
- Registered Nurses
- Licensed practical nurses
- Certified nurse aides
- Personal care aides assisting with activities of daily living under the supervision of a nurse or therapist
- Home health aides assisting with activities of daily living under the supervision of a nurse or therapist
- Nursing assistive personnel
- Direct care workers providing services under home and community-based waiver
- Intermediate Care Facility direct care staff including those that work for a state-run Human Development Center
- Assisted Living direct care staff members
- Hospice service direct care workers
- Respiratory therapists
The weekly care continuity initiative payments are available to direct care workers as follows:
- A) work 20-39 hours per week--$125.00
- B) work 40+ hours per week--$250.00
- C) work a regularly planned split shift schedule that overlap weeks that equal or exceed 150 hours per month, not including overtime--$250.00/week
If a client has tested positive for COVID-19, the direct care workers in that facility or home and community-based setting, will receive an enhanced payment as follows:
- A) work 1-19 hours per week--$125.00
- B) work 20-39 hours per week--$250.00
- C) work 40+ hours per week--$500.00
- D) work a regularly planned split shift schedule that overlap weeks that equal or exceed 150 hours per month, not including overtime--$500.00/week
The payments will be made to a facility or agency providers over a period of eight (8) weeks beginning the week of April 5, 2020 and ending May 30, 2020. The providers will pass the full net value (gross amount minus applicable taxes) of the payments to the eligible direct care workers.
The payments will be available to Medicaid-enrolled providers who employ or contract with LTSS direct care workers. This includes nursing homes, ARChoices providers, Personal Care providers, Area Agencies on Aging, Assisted Living Facilities, Hospice providers, CES waiver providers for supported living services, and agencies in non-institutional settings for people who get care in their homes and communities.
“Medicaid is the largest payer source of LTSS, which is why this sector was the focus of this particular part of the waiver,” said DHS Secretary Cindy Gillespie. “In other sectors, especially hospitals and hospital-based providers, Medicaid generally represents the smallest percentage of payment and federal legislation is providing significant targeted relief for hospitals."
Governor Hutchinson has also directed that DHS develop a similar care continuity payment package for non-physician direct care workers in hospital settings that can be presented to the state task force overseeing COVID-19- specific funding that the still will receive.
DHS will send instructions to the providers on how to submit a claim on behalf of their eligible workers. DHS will update its providers as the situation evolves.