You need to know the risks the new administration poses to home-based, Medicaid-paid services. McKnight's Home Care published the article below today and I want you to see it. Also, a shout-out to Utah's state association executive director, Matt Hansen, a champion for home-based services everywhere in the nation.
Utah home care association sounds alarm on HCBS access crisis
Adam Healy | January 17, 2025
The Homecare and Hospice Association of Utah (HHAU) is calling for greater Medicaid support of home- and community-based services as beneficiaries in the state face worsening access barriers.
“Our biggest concern, and the most pressing one, is with the HCBS waiver rates,” Matt Hansen, executive director of HHAU, said Wednesday in an interview with McKnight’s Home Care Daily Pulse. “If [providers] are still participating in the HCBS waivers, they’re doing it as a charity in most cases. We’ve had 64% of providers exit these programs between December 2022 and December 2023, so that’s 64% fewer providers.”
Providers are exiting HCBS programs in the state because of rising costs, according to HHAU. Utah’s last Medicaid rate increase for home care was in 2019, and providers’ staffing costs have risen by an average of 20% in the years since. Given inflation and financial pressures due to the COVID-19 pandemic, providers are past due for another increase, Hansen said.
Meanwhile, HCBS beneficiaries in Utah have faced widening access gaps and lengthening wait lists, especially those who live in rural communities. San Juan County, a rural area in southeast Utah that includes part of the Navajo Nation, can be particularly difficult to reach for providers, Hansen noted.
“There literally has to be a fleet of four-wheel drive vehicles to get out there, and it can be a two-hour drive one way to Navajo Mountain in some of these places,” he explained. “We’re seeing a lot of places where we’re getting these home care deserts, I’ve heard it referred to, just because people cannot afford to provide care anymore.”
The incoming presidential administration may cause further strain. On a national level, home care providers have raised concerns that President-elect Donald Trump may cut Medicaid rates or programs, further harming HCBS access. Hansen said that any decrease in federal matching funds for Medicaid programs would exacerbate Utah’s existing access challenges.
“We are concerned that the match is most likely going to be chopped, decreased.” Hansen said. “So I think there’s going to be a rollback in Utah, and I think the way that they will address that is just by shrinking the pool in eligibility.”
To protect home care programs and their beneficiaries, HHAU urged lawmakers and other industry stakeholders to support Medicaid reimbursement rate increases for HCBS, private duty nursing and home health waivers during the state’s legislative session for 2025.
“Together, we can ensure that our most vulnerable neighbors have access to the care they deserve while fostering a sustainable and resilient healthcare system,” the association said in a statement.