ABSTRACT
The COVID-19 pandemic has had an enormous impact on older adults and people with disabilities everywhere, but one area that has not been fully examined is how it affected home- and community-based services (HCBS) systems. This article fills some of that gap and identifies how policy responses to COVID-19 deprioritized HCBS systems. It discusses the implications of this for consumers, providers, and government programs. The authors make recommendations for action to prepare for and better support HCBS in the future. The article also discusses the urgent need to strengthen the HCBS workforce. COVID-19 exacerbated the long-existing worker shortage, which must be addressed to meet the large and growing demand for HCBS. © 2022 American Society on Aging. All rights reserved.
ABSTRACT
Medicaid provides essential coverage for health care and long-term services and supports (LTSS) to low-income older adults and disabled individuals but eligibility is complicated and restrictive. In light of the current public health emergency, states have been given new authority to streamline and increase the flexibility of Medicaid LTSS eligibility, helping them enroll eligible individuals and ensure that current beneficiaries are not inadvertently disenrolled. Though state budgets are under increased pressure during the economic crisis created by the coronavirus, we caution states against cutting Medicaid LTSS eligibility or services to balance their budgets. These services are critical to an especially vulnerable population during a global pandemic.
Subject(s)
Coronavirus Infections/epidemiology , Eligibility Determination/organization & administration , Long-Term Care/organization & administration , Medicaid/organization & administration , Pneumonia, Viral/epidemiology , Aged , Betacoronavirus , Budgets , COVID-19 , Health Expenditures , Home Care Services/organization & administration , Humans , Long-Term Care/economics , Medicaid/economics , Pandemics , SARS-CoV-2 , United StatesABSTRACT
What services are available and where racial and ethnic minorities receive long-term services and supports (LTSS) have resulted in a lower quality of care and life for racial/ethnic minority users. These disparities are only likely to worsen during the COVID-19 pandemic, as the pandemic has disproportionately affected racial and ethnic minority communities both in the rate of infection and virus-related mortality. By examining these disparities in the context of the pandemic, we bring to light the challenges and issues faced in LTSS by minority communities with regard to this virus as well as the disparities in LTSS that have always existed.