Report outlines how states plan to spend ARPA funds following PHE.
At the height of the COVID-19 pandemic, the American Rescue Plan Act (ARPA) offered a ray of hope for HCBS program improvement or expansion just when aging and disabled populations needed it most.
It’s been almost three years since the funding was announced – a 10 percent enhanced federal medical assistance percentage (FMAP) match for qualifying home- and community-based services programs (HCBS) expenses. Before getting access to the funds, states had to submit proposals for how the money would be spent to improve HCBS programs, and ultimately, beneficiary outcomes.
The proposals are in, and now we can get a glimpse into what state agencies are going to do with this influx of cash. A recent report from the U.S. Centers for Medicare & Medicaid Services (CMS) summarized the plans submitted from all 50 states and the District of Columbia on how they plan to use ARPA funds. The summary report shows the most common priorities for state Medicaid agencies are:
- workforce recruitment and retention
- workforce training
- improving quality of services
- waitlist management
- expanding use of technology
It’s estimated that 4.2 million people nationwide are enrolled in Medicaid HCBS programs. Of that population, 35 percent are over the age of 65. Most younger beneficiaries in long-term services and supports (LTSS) programs have a disability, according to data from the Kaiser Family Foundation.
According to the conditions of the ARPA funding, Medicaid agencies have until March 31, 2025, to spend the allotted increases for their outlined enhancements for the programs that benefit aging and disabled populations living at home or in their communities. Initial estimates were $12.7 billion would be spent to improve HCBS, but the interest in the funding far exceeded expectations. While plans may change – states must update CMS on their spending quarterly – it’s now anticipated that $37 billion, an average of $4,933 per Medicaid HCBS program beneficiary, will be spent on program enhancements before the deadline.
Let’s get technical
Of the $37 billion projected to be spent on program improvements, $1.8 billion is slated for technology. States proposed 96 different ways to use ARPA funds to improve technology infrastructure for HCBS, according to the report. Most commonly, states are looking to improve:
- access to records through updated electronic health record platforms
- infrastructure (monitoring systems, computers, etc.)
- technology that promotes independent daily living for beneficiaries
Technology enhancements can benefit HCBS programs by improving oversight with enhanced electronic visit verification. They also make it easier for providers to work with Medicaid beneficiaries and share health records/information. Additionally, sophisticated case management solutions promote equitable service provision and support communication across the continuum of care.
