Updated 4/15/2020, 3:15 PM
As most Arkansans continue to try to adjust to life during a global pandemic and to find a “new normal,” health care workers, like doctors and nurses, are at the center of this public health emergency. Working long hours and many additional shifts to ensure patients stay safe and help those with COVID-19, these individuals are heroes. There are ways we, as a state, can help support these heroes, but we must be firm in our commitment to doing so.
Nobody knows how long this virus will continue dramatically affecting the lives of Arkansans. But just as they do every other time they’re called upon, Arkansas’s health care professionals will be there to serve their fellow Arkansans.
In March, Gov. Asa Hutchinson announced a plan that would help our health care workers during the pandemic. The “Arkansas COVID-19 Care Continuity Initiative” was sent to the Centers for Medicare and Medicaid (CMS) with a $116 million price tag. Of that, $55 million was to go to Arkansas’s non-physician, direct care professionals tasked with the care of those who get sick with COVID-19. The Governor announced these workers would receive an additional payment of $1,000, which was increased to $2,000 for those non-physician, direct care professionals working directly with patients who test positive for COVID-19.
The plan submitted to CMS by the state was a little different from what was announced, however. In the waiver request, Arkansas asked for approval to give these “care continuity” payments to non-physician direct care workers taking care of patients in the long-term services and supports (LTSS) domain. These health care workers are tasked with protecting the highest-risk populations from COVID-19, but this cohort comprises a dramatically smaller group of health care workers than was previously announced.
In theory, Arkansas is “filling the gap” with its Care Continuity Initiative, as it states in a DHS Frequently Asked Questions publication. According to the document, the state chose to target LTSS employees because “they were not covered in the federal legislation,” and Arkansas’s waiver will include “CNAs, LPNs, RNs, home health, respiratory therapists, and personal care aides working in institutional and non-institutional settings.” It also states that the payment will not apply to a hospital or hospital staff because of “federal legislation that will significantly increase payments to hospitals that can use that funding for hospital staff.”
Gov. Hutchinson announced on April 15 that Arkansas has been approved to provide payment to LTSS employees. This was approved by CMS separate from the original waiver request, but achieves the same purpose. Under this “Disaster State Plan Amendment,” Medicaid can be used to pay non-physician direct care employees at LTSS facilities. In his announcement of this approval, the Governor also directed the CARES Act steering committee, which he created in March, to provide this same payment for non-physician, direct care hospital workers, as well as employees who do not work in direct care at LTSS facilities (like sanitation/janitorial staff).
Unfortunately, this still does not cover all of our health care workers that are on the front lines of the COVID-19 emergency in Arkansas. Especially in rural Arkansas, health care professionals who aren’t employed through LTSS facilities or a hospital are still at risk of exposure and are faced with treating patients who are potentially infected with COVID-19, yet will receive nothing extra for their work. It is a strong first step for the individuals at LTSS facilities and at hospitals to receive the “care continuity” payments, but it is important to extend this past that subgroup – to all the health care workers at risk on the job.
As a result of increased contact with people with COVID-19, Arkansas has 215 health care workers who have tested positive for the virus, as of April 15. Many of these workers were infected through their jobs, where they are tasked with working long hours and isolating from family members to try to protect the rest of Arkansas from COVID-19.
Arkansas needs to support our direct health care professionals and increase their financial assistance. We should think of it as taking care of our community heroes to ensure they have what they need to keep protecting us all.