Omnibus Budget Legislation: Relevant Provisions Affecting Home Care

  • GO HERE to see the portions of omnibus budget legislation that impacts home health and hospice

The Omnibus bill is massive at over 4100 pages. We have distilled those provisions that directly or indirectly affect home care and hospice. Those include both policy changes and funding actions through federal appropriations. NAHC will continue to keep the community aware of and understanding the implications of this end-of-the-year legislation.

Relevant links:

Medicaid Home Care

  • Section 5114 Extends Money Follows the Person demonstration program through 2027 at $450 million per year
  • Section 5115 Extends HCBS spousal impoverishment protections through FY2027
  • Section 5131 Provides funding for transitioning Medicaid from the 6.2% enhanced FMAP (not HCBS specific)
    • Quarter ending 3/31/23 — 6.2%
    • Quarter ending 6/3/23  — 5.0%
    • Quarter ending 9/30/23 — 2.5%
    • Quarter ending 12/31/23 — 1.5%     

VA Health Care

  • Section VA Medical Foster Home
    • Includes “home health services” access as part of the MFH change

Earmarked Appropriations and Guidance

  • $236,000 Androscoggin Home Health and Hospice, Maine—for nurse practitioner fellowship program
  • $1,940,000 Hospice of Connecticut, Branford, CT—for facilities and equipment

Skilled Care Workforce.

The agreement urges the Employment and Training Administration (ETA), in collaboration with the Department of Health and Human Services, to support the expansion of the skilled care workforce to care for a rapidly aging U.S. population and provide home and community-based services to older adults and people with disabilities, including through education and training grant programs, as well as traditional and nontraditional apprenticeship programs.

Addressing Workforce Shortages.-

The agreement supports HRSA’s efforts to develop the workforce needed to care for a rapidly aging U.S. population. The agreement encourages HRSA to address the skilled care workforce needs of seniors through existing workforce education and training programs.

Nurse Education, Practice, Quality and Retention (NEPQR)

The agreement includes $59,413,000 for competitive grants within the NEPQR program. Within this total, the agreement provides $10,750,000, an increase of $5,000,000 above the fiscal year 2022 enacted level, to expand competitive grants to enhance nurse education through the expansion of experiential learning opportunities. The grants shall include as an allowable use the purchase of simulation training equipment. HRSA shall prioritize grantees with a demonstrated commitment to training rural health professionals in States with high rates of chronic age-related illness, including stroke, heart disease, and chronic obstructive pulmonary disease.


Protection of Vulnerable Older Americans.-

Within the total, the agreement includes an increase of $2,000,000 for the long-term care ombudsman program.

National Family Caregiver Strategy.-

The agreement continues to provide $400,000 for the Family Caregiving Advisory Council.

Aging Network Support Activities.-

The agreement includes $5,500,000 for the Care Corps grant program , with an increase of $1,500,000 for subgrants to programs that are capable of building a network of screened and trained volunteer chaperones to accompany older adults and adults with disabilities in need to and from non-emergency medical appointments and outpatient procedures.

The agreement includes $2,000,000 for a direct care workforce demonstration project to identify and reduce barriers to entry for a diverse and high-quality direct care workforce, and to explore new strategies for the recruitment, retention, and advancement opportunities needed to attract or retain direct car e workers.