CMS Launches ‘One-Stop Shop’ for States’ HCBS Investment Plans

The U.S. Centers for Medicare & Medicaid Services (CMS) on Thursday launched a “one-stop shop” for state Medicaid agencies and in-home care stakeholders.

The goal of the new digital tool is to “advance transparency and innovation” for home- and community-based services (HCBS), according to the agency. The one-stop shop specifically offers detailed information on how states are using American Rescue Plan funding to enhance, expand and strengthen HCBS.

“The Biden-Harris administration recognizes the value and dignity that come with access to home- and community-based services,” Xavier Becerra, secretary of the U.S. Department of Health and Human Services (HHS), said in a statement. “Thanks to the American Rescue Plan, we can support states working to expand access to home- and community-based services for Medicaid beneficiaries. With the launch of this new online hub, we’re making it easy for states to exchange ideas on how best to care for their residents.”

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The American Rescue Plan provided states with a temporary 10 percentage point increase in federal Medicaid funding for HCBS from April 1, 2021, through March 31, 2022, if they meet certain requirements.

Two dozen states, for example, are using the additional funds to increase HCBS provider payment rates. Another 20 or so are using the boost to offer special bonus payments to HCBS workers.

And that’s just the tip of the iceberg, according to CMS.

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“Some states are delivering vaccines to people with disabilities and older adults through mobile COVID-19 vaccination programs,” the agency explained in an announcement on its new tool. “Other states are focusing on the potential of [HCBS] to help people with Medicaid coverage receive care outside a skilled nursing facility after a hospitalization, when aligned with the beneficiary’s goals.”

Additionally, almost 30 states are using the 10 percentage point increase in federal Medicaid funding to build more robust training programs for HCBS workers, in turn creating career ladders that help with retention while improving quality of care.

A screenshot from the new one-stop shop from CMS, taken on Oct. 21, 2021.

Nearly every state has already filed the necessary paperwork to secure a funding increase to support HCBS, with either conditional or partial approval from CMS, a Home Health Care Review found. Delaware, New Mexico and Ohio are the only three states awaiting approval of their spending plans.

States’ spending plans — all made available via the new one-stop show — are generally between 20 and 35 pages in length. Some, such as Louisiana’s plan, are significantly less than that.

On top of explaining how they plan to invest in HCBS, states also estimate just how big of a Medicaid boost they expect to receive thanks to the American Rescue Plan. Indiana, for instance, projects a payment increase of $226 million, while neighboring Illinois anticipates an increase of about $349.2 million.

The one-stop shop for HCBS comes a day after CMS officials touted a “strategy refresh” promising further support and flexibility for in-home care moving forward.

Separate from the one-stop shop, CMS on Thursday also highlighted a new HCBS demonstration program in Alabama.

“The state will now be able to redesign its home- and community-based services delivery system to address concerns, such as long waiting lists, high use of residential services and out-of-home placements, and low integrated community employment rates among its residents,” the agency stated. “CMS will also provide the authority needed for Alabama to create a new program that supports individuals with intellectual disabilities who choose to work, live with family, or live independently.”

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