LeadingAge Response to DSHS Request to Pause FMAP Funding for HCBS 

LeadingAge Response to DSHS Request to Pause FMAP Funding for HCBS 

Dear Secretary Cheryl Strange:

On behalf of the over one-hundred not-for-profit and mission driven community-based senior care providers, I urge your immediate reconsideration of the decision to delay FMAP related funding to all but skilled nursing and DDA residential providers.

Assisted living is an essential healthcare provider that offers housing, supportive, and nursing care to older adults. Assisted living communities are seeing many of the same increased costs for PPE, cleaning supplies, and staffing that skilled nursing facilities and even hospitals are experiencing.  Assisted living communities around the state are working with hospital partners to appropriately readmit residents after transferring for medical care.  And assisted living communities are working to identify symptomatic and asymptomatic residents to isolate those who are contagious. 

However, we know that many elderly may be asymptomatic and yet shed the virus which defeats efforts to isolate and contain the spread.  Broad-based testing and aggressive prevention are measures to reduce the spread of this virus and to avoid admissions to hospitals by keeping residents virus-free.  Without broad-based testing, we will continue to see a surge in COVID + and symptomatic patients and we will miss critically important opportunities to decrease the surge and burden on our acute care hospital partners.

As important as testing is, so is access to vitally important PPE in assisted living.  We must protect health care workers regardless of the setting in which they work to care for our most vulnerable and those are sick from COVID, other chronic and acute illnesses and the infirmities of aging.  Without adequate PPE, it won’t be long before our health care workers become sick and then our worry becomes who will be left to care; provide for basic needs, nursing care and comfort for our elderly?

And funding is the third critical rail of any successful treatment protocol.  We must have the funding necessary to purchase PPE and pay our staff who are working overtime and placing themselves and their families at risk.  We must have the funding necessary to purchase disinfectant and other supplies including PPE.  As of late last week, there are now 75 assisted living communities with suspected or active COVID cases.  That number is undoubtedly higher since testing isn’t available and we can’t confirm the asymptomatic positive cases.

I am both surprised and astounded that the April 5th memo, here for ease of reference, from your office to DSHS Executive Cabinet and Budget Directors ignores the funding needed by assisted living and many other home and community-based settings.  The memo suggests that this decision will not be made until at least the end of April or later.  These communities cannot wait.  I urge that you immediately prioritize funding to these critically important settings.  FMAP funding is available to states and several have already issued payments to skilled nursing and assisted living as a well as adult day programs and others.   Assisted living providers admit patients from hospitals and they also transfer residents to hospitals when in need of acute care.  If assisted living communities are successful in treating residents in place, with PPE and testing used to cohort COVID + residents, these communities can actually help reduce the surge and avoid overloading the hospital system.    

Funding must be made available regardless of whether the health care provider serves a Medicaid population or not.  This is a public health crisis and the cost to respond to COVID must be socialized across all citizens.  So while some assisted living communities may serve a private paying elderly clientele, they too need necessary funding perhaps through the emergency funding made available through HB 2965.

We cannot ignore the funding needs of any part of our long term care delivery system; doing so invites preventable death and illness as COVID spreads through a system that is simply overwhelmed, unprepared and unable to defend against its scourge.  Please provide funding immediately to assisted living and the full long term care continuum.  Give them a chance to fight back and win against this horrible disease.  If they win, we all win.  View 


Questions? Contact: 

Alyssa Odegaard- Vice President, Public Policy 

c: 206.948.2279