The Direct Service Provider workforce is the backbone of our country’s home and community-based services (HCBS) system. However, low pay and absence of benefits (together with other factors), have caused high rates of turnover and recruiting challenges. These issues have, in turn, created critical workforce shortages and negatively affected the quality, stability, and availability of services.
- On July 30, CMS published a notice of proposed rulemaking (NPRM)to give states the ability to make health insurance and other employee benefits more accessible to this essential workforce.
- The proposed rule would allow state Medicaid agencies to deduct from a practitioner’s Medicaid payment, with the individual’s consent, to pay third parties for benefits such as health insurance and skills training. This creates a pathway for direct service providers and other practitioners to enroll in, pay for, and retain employee benefits.
- The proposed rule reverses a 2019 final rule that prohibited states from making these types of payments.
- CMS is currently seeking public comment on the proposed rule. Because this rule would affect many in the Medicaid HCBS workforce, which in turn has a direct and immediate impact on the quality of and access to services available to Medicaid beneficiaries, input from the aging and disability networks is crucial. Comments can be submitted online or by mail until September 28, 2021.