Health Affairs March 22, 2024
The COVID-19 pandemic intensified shortages in the direct care workforce long driven by low wages, high turnover rates, and recruitment challenges. In some cases, these shortages contributed to the closure of home and community-based services providers, including adult day health programs, group homes, and assisted living facilities, which typically employ direct care workers. These closures then led to still further shortages and added new burdens to family caregivers.
In response, the federal government used the American Rescue Plan Act (ARPA) authorities to provide greater Medicaid funding and flexibility to states on a short-term basis to help stabilize the direct care workforce. ARPA provided a one-year increase of 10 percentage points in the federal matching rate for Medicaid home and community-based...
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