CMS expands home and community-based services

Oct. 22, 2021

The Centers for Medicare & Medicaid Services (CMS) launched a new "one-stop shop" for state Medicaid agencies and stakeholders on to advance transparency and innovation for home and community-based services. Home and community-based services allow people enrolled in Medicaid to receive services and supports in a preferred setting outside of an institution, such as in their own home. Through this new webpage, state Medicaid agencies and stakeholders can access information about states' plans to enhance, expand, and strengthen home and community-based services across the country using new Medicaid funding made available by the American Rescue Plan Act of 2021 (ARP).

Additionally, CMS is approving today a new Medicaid section 1115 demonstration in Alabama, entitled the "Community Waiver Program," to operate concurrently with a home and community-based services 1915(c) waiver. This new opportunity in the state's Medicaid program will increase access to home and community-based services, and allow the state to meet the needs of additional individuals who prefer to get long-term care services and supports in their home or community rather than an institutional setting.

To encourage states to expand home and community-based services and strengthen their programs, the Biden-Harris Administration implemented a funding increase established by the ARP. The ARP provided states with a temporary 10 percentage point increase in federal Medicaid funding for certain Medicaid home and community-based services from April 1, 2021 through March 31, 2022, if they meet certain requirements. As the COVID-19 pandemic continues, the additional federal funding made available under the ARP allows those enrolled in Medicaid who need long-term services and supports to receive the assistance required to reside in the setting of their choice.

For example, some states are delivering vaccines to people with disabilities and older adults through mobile COVID-19 vaccination programs. Other states are focusing on the potential of home and community-based services to help people with Medicaid coverage receive care outside a skilled nursing facility after a hospitalization, when aligned with the beneficiary's goals. Other activities may include expanding and implementing new, community-based behavioral health crisis response services, ensuring that a qualified provider with training quickly and properly responds to mental health and substance use-related crisis situations. Many states are also providing recruitment and retention bonuses and increasing pay for direct support professionals, as well as implementing new training programs and other strategies to strengthen the direct support workforce.

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