American Rescue Plan Act – Medicaid HCBS Spending Plan
Secretary Mark Ghaly, MD, MPH
California Health and Human Services Agency
Re: American Rescue Plan Act – Medicaid HCBS Spending Plan
Dear Secretary Ghaly,
The Alzheimer’s Association® commends the California Health and Human Services Agency for their collective work to hasten recovery for our high-risk population through a combination of financing initiatives outlined in the Agency’s American Rescue Plan Act Medicaid HCBS Spending Plan released last week. Specifically, we applaud the Administration for close adherence to the thoughtfully developed stakeholder recommendations contained in the Master Plan for Aging, the MPA LTSS Report and the Alzheimer’s Prevention and Preparedness Task Force.
California urgently needs a two-pronged approach to simultaneously: 1) fast-track recovery for the 65+ population hardest hit by the global pandemic – older adults and persons with dementia who represent 73.4% of California COVID-19 fatalities, and 2) accelerate capacity building and infrastructure development for 2025 when 840,000 Californians will be living with Alzheimer’s disease or dementia.
COVID-19 Facts:
- Approximately one in five California COVID-19 deaths were reported in long-term care facilities where nearly half of the population has dementia – the need for home and community-based alternatives for this population is vital
- Already the 3rd leading cause of death in California, Alzheimer’s experienced a dramatic 18.8% increase as a cause of death in 2020
- A study led by Case Western Reserve University researchers found that patients with dementia were at a significantly increased risk for COVID-19—and the risk was higher still for African Americans with dementia
In tandem with the Legislature’s proposed budget developed jointly by the Senate and Assembly, the Alzheimer’s Association supports this combined package to reduce systemic inequities, build local capacity and strengthen community infrastructure.
For the 1.8 million Californians today living with Alzheimer’s disease or caring for a loved one with dementia, we want to underscore the immediate need for the following:
American Recovery Plan Act/Medicaid HCBS Spending Plan
| DHCS |
25,000,000 |
“Dementia Aware”
Medi-Cal provider payment incentives to evaluate cognitive health linked to medical education/physician training |
| DHCS CDA |
100,000,000 |
Medicare Partnerships and Shared Savings in partnership with local partners to develop innovative approaches to coordinated, integrated care for duals. |
| DHCS |
85,000,000 |
Eliminate Medi-Cal Assisted Living Waiver Wait List |
| DHCS |
5,000,000 |
Caregiver Resource Centers – enhanced respite and other supports. |
| OSHPD |
100,000,000 |
HCBS Clinical Workforce – CNA, LVN, RN |
| CDA |
10,000,000 |
Restoration of Alzheimer’s Day Care Resource Center (ADCRC) sites |
| CDA |
150,000,000 |
Direct Care Workforce (non IHSS): skill building, career pathways, etc. This is a statewide training and stipend program for CBAS, MSSP and other HCBS settings. |
| DSS |
68,400,000 |
Specialized IHSS Upskilling Pilots to address recipients with Alzheimer’s or dementia among others |
The Alzheimer’s Association is committed to working with the Administration and the Legislature to fast-track recovery, build system capacity and develop local infrastructure for all Californians affected by Alzheimer’s and their caregivers.
Sincerely,
Susan DeMarois, Public Policy Director
Jared Giarrusso, California Government Affairs Director
cc:
Director Will Lightbourne, DHCS Medicaid Director, Jacey Cooper, DHCS Director Kim McCoy Wade, CDA Director Kim Johnson, CDSS
Director Elizabeth Landsberg, OSHPD
Director Tomás J. Aragón, M.D., M.P.H., CDPH Richard Figueroa, Office of Governor Newsom Senator Toni Atkins, Senate President pro Tempore Senator Nancy Skinner, Senate Budget Chair
Senator Susan Eggman, Senate Budget Subcommittee #3 Chair Assemblymember Anthony Rendon, Assembly Speaker Assemblymember Phil Ting, Assembly Budget Chair
Assemblymember Joaquin Arambula, MD, Assembly Budget Subcommittee #1 Chair
Alzheimer's Association
The Alzheimer's Association leads the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia.™ For more information, visit www.alz.org or call the 24/7 Helpline at 800.272.3900.