Financing HCBS

This NRP article discusses the delay many states are experiencing in regard to accessing funding from the American Rescue Plan Act, signed into law in March 2021. The increased funding could be used by states to boost wages, move people off waiting lists for disability services, train more workers, and expand covered services for older adults and people with disabilities, however the Centers for Medicare and Medicaid Services must provide approval before states can fully access their funds.

The Wisconsin Department of Health Services proposes to reinvest ARPA Home and Community Based Services (HCBS) enhanced funding to implement a statewide grant program with HCBS providers, advocates and stakeholders. These grants will address the workforce crisis, support businesses and programs transition to a model that supports individual with intellectual, developmental, and other significant disabilities find and retain work in competitive integrated employment and other innovative solutions.

On January 12, 2022, CMS released the Medicaid LTSS Annual Expenditures Report for Federal Fiscal Year (FFY) 2019. This report discusses the LTSS rebalancing trends and growth in expenditures for home and community-based services as compared to institutional spending during the time period reviewed.

Justice in Aging's new fact sheet, Investing in Medicaid HCBS is Good for Medicare, explains why investing in Medicaid HCBS is good for people with Medicare and the Medicare program. Robust funding for Medicaid HCBS would expand access to services, helping people with Medicare who are dually eligible for Medicaid avoid hospitalizations and other costly care.

The wave of federal funding from programs like the American Rescue Plan and Consolidated Appropriations acts can be overwhelming to comprehend. Many state leaders are wondering how best to invest these funds while keeping future needs in mind. This panel of state-level experts will provide considerations for funding topics including: • Understanding current funding initiatives • Considering the range of options states have to use funds • Implementing innovations like private-pay programs

On June 24, 2021, the Better Care Better Jobs Act, S. 2210, was introduced in the United States Senate and referred to the U.S. Senate Committee on Finance. The bill would expand access to home and community-based services (HCBS) by providing $100 M for states to expand access to Medicaid HCBS and strengthen the HCBS workforce, and provide states a 10% increase in the Medicaid Federal Medical Assistance Percentage (FMAP) for HCBS.

On June 22, 1999, the U.S. Supreme Court issued its ruling in Olmstead v L.C., delcaring that people with disabilities have a civil right under the Americans with Disabilities Act to live and fully participate in their communities. ACL's Acting Administrator and Assistant Secretary for Aging, Alison Barkoff, released a blog post on June 22, 2021 disucssing the significance of this ruling and the importance of expanding our HCBS system following the COVID-19 pandemic.

ATI Advisory, supported by the Robert Wood Foundation, has conducted research to create a package of recommended legislative and administrative reforms around LTSS and the caregiving workforce. The goal of the reforms is to increase access to HCBS, reduce the institutional bias in Medicaid, and create a strong caregiving workforce.

This brief takes a look at multiple measures beyond waiver waiting lists to evaluate state choices about optional Medicaid eligibility pathways, spending, and services for seniors and people with disabilities as of 2018. The analysis draws on KFF resources, including 50-state surveys of Medicaid financial eligibility pathways for seniors and people with disabilities, HCBS waiver programs, and state plan benefits offered, as well as state Medicaid LTSS expenditures reported by Mathematica.

NCOA and Health Management Associates (HMA) have released a new report detailing eight strategies and approaches to expand funding for evidence-based health programs. NCOA and HMA reviewed five states and one city- California, Colorado, Maine, Massachusetts, New York City, and Washington- with community-based organizations that have strong partnerships with Medicaid agencies and managed-care organizations.