Groups urge changes as Tennessee seeks long-term care funds

June 28, 2021 GMT

NASHVILLE, Tenn. (AP) — Tennessee advocates say the state has an opportunity to increase funding for home-and community-based care, arguing the relief will help provide critical support to the elderly, disabled and their families.

Under the latest COVID-19 relief law, Tennessee is eligible to receive a $157 million increase in its federal matching Medicaid funds for long-term care services.

Groups like the Tennessee Disability Coalition and Tennessee Coalition for Better Aging argue these extra funds can be used as an opportunity to improve caregiver pay and provide better services.

“It is not acceptable to be ranked 49th among all the other states on how we support caregivers in Tennessee. We need to do so much better than that because families are the backbone of our caregiving infrastructure,” said Grace Smith, executive director of AgeWell Middle Tennessee.

Federal requirements state that all state Medicaid programs cover nursing home care for low-income people. However, states vary widely when it comes to covering home- and community-based support services. Home and community care tends to cost less than half as much as institutional care, but there’s disagreement on whether that prevents people from going into a nursing home.


The extra money for Tennessee’s Medicaid program, known as TennCare, will be available over four calendar quarters this year and next. TennCare officials have until July 12 to apply for the funds.

“We are currently working on a plan based on the comments we have received,” said Tenncare spokesperson Connor Tapp in an email Monday. “We are committed to investing funds in ways that will have a sustainable impact on the (home-and community-based services) delivery system in Tennessee, and more importantly, on the lives of those we serve and their families.”

States are likely to push back hard against any federal effort to create a new mandatory Medicaid benefit. There’s also some skepticism about the money in the COVID-19 relief law, if taking it means states would be left holding the bag when the temporary federal funding ends.

The funding boost to help caregivers comes as Tennessee has repeatedly declined to expand the number of people eligible for Medicaid — as allowed under former President Barack Obama’s signature health care law. Thirty-six states have opted for the expansion, but Tennessee has resisted under a GOP-dominated Legislature and Republican governors.

To date, Tennessee has declined to accept the federal government’s financial incentive to begin providing health coverage to more low-income residents as part of the $2 trillion coronavirus relief package.

The enticement would have boosted the federal government’s share of costs in the regular Medicaid program, which offers coverage for the poorest Americans. The bump in federal funding would last two years for the states that join the Medicaid expansion.