The COVID-19 public health emergency would end on May 11, 2023, the White House told Congress on Jan. 30, 2023, in a statement of administration policy. For disability services, that date and a separate Medicaid deadline set several clocks running.
What was changing
Federal guidance from the Centers for Medicare & Medicaid Services (CMS), issued Jan. 27, said Medicaid's continuous enrollment requirement would end March 31, 2023, and states could begin ending coverage April 1. States had 12 months to start eligibility renewals and 14 months to finish them.
Many states had also used emergency Appendix K flexibilities in their Medicaid waivers. ANCOR, the national provider association, said those included expanded service settings, temporary direct support wage increases and paying family caregivers. The flexibilities were due to end six months after the emergency, on Nov. 11, 2023, unless states made them permanent.
Why this mattered for providers and DSPs
Providers faced two risks at once: people losing Medicaid coverage over paperwork during renewals, and losing staffing flexibilities during a DSP shortage. Disability Scoop reported that 66% of providers in an ANCOR survey were concerned the end of relief funding and regulatory changes would lead to higher vacancy and turnover. In August 2023, CMS gave states more time on Appendix K.