HHS to Provide $110 Million in HCBS for Seniors & Disabled

Scroll down for more info on webinars for funding applicants The Centers for Medicare & Medicaid Services (CMS) announced it will offer more than $110 million to expand access to home and community-based services (HCBS) through Medicaid’s Money Follows the Person (MFP) program. First authorized in 2005, MFP has provided states with $4.06 billion to…

HHS to Provide $110 Million in HCBS for Seniors & Disabled

  • Scroll down for more info on webinars for funding applicants

The Centers for Medicare & Medicaid Services (CMS) announced it will offer more than $110 million to expand access to home and community-based services (HCBS) through Medicaid’s Money Follows the Person (MFP) program.

First authorized in 2005, MFP has provided states with $4.06 billion to support people who choose to transition out of institutions and back into their homes and communities. The new Notice of Funding Opportunity (NOFO) makes individual awards of up to $5 million available for more than 20 states and territories not currently participating in MFP. These funds will support initial planning and implementation to get the state/territory programs off the ground, which would ensure more people with Medicaid can receive high-quality, cost-effective, person-centered services in a setting they choose.

“NAHC has long supported the Money Follows the Person program,” said NAHC Director of Government Affairs Calvin McDaniel. “The announced funds will provide additional investment and opportunities for states to enhance their HCBS offerings. Continued investments in HCBS further rebalances spending on long-term services and supports in favor of the home. This investment is consistent with President Biden’s goals of improving access to care in the home. NAHC encourages the eligible states and territories to apply for these new funds.”

HCBS is a critical component of the Medicaid program and the MFP program has been a critical tool, now with the potential to do more in a broader array of states and territories.

To help additional states and territories implement MFP, these awards will support the early planning phase to get an MFP program off the ground. This includes:

  • Establishing partnerships with community stakeholders, including those representing diverse and underserved populations, Tribal entities and governments, key state and local agencies (such as state and local public housing authorities), and community-based organizations;
  • Conducting system assessments to better understand how HCBS support local residents;
  • Developing programs for the types of community transitions MFP supports;
  • Establishing or enhancing Medicaid HCBS quality improvement programs;
  • Recruiting HCBS providers as well as expert providers for transition coordination and technical assistance; and
  • Conducting a range of planning activities deemed necessary by the award recipients and approved by CMS.

State Medicaid agencies not currently participating in the MFP demonstration may apply through the NOFO no later than May 31, 2022. To access the NOFO, visit Grants.gov or here https://www.grants.gov/web/grants/view-opportunity.html?oppId=334196

For states already participating in MFP, CMS also announced that the agency is increasing the reimbursement rate for MFP “supplemental services.” These services will now be 100% federally funded with no state share. Further, CMS is expanding the definition of supplemental services to include additional services that can support an individual’s transition from an institution to the community, including short-term housing and food assistance. These changes will help further address critical barriers to community living for eligible individuals, as well as increase community transition rates and the effectiveness of the MFP demonstration overall. For more information on current and previous grantees, visit Medicaid.gov. CMS will provide additional information on these changes to MFP grantees.

“Everyone deserves the opportunity to live at home, in their communities, and with their loved ones,” said Health & Human Services (HHS) Secretary Xavier Becerra. “This funding will bring dignity and peace of mind to even more seniors and people with disabilities across the country. We will continue expanding these programs to ensure all Americans have equitable access to the high-quality health care they deserve—no matter where they live.”

Money Follows the Person Demonstration Expansion: Notice of Funding Opportunity (NOFO) Webinars for Applicants

CMS released a Notice of Funding Opportunity that will offer up to $110 million to expand access to home and community-based services (HBCS) through Medicaid’s Money Follows the Person (MFP) program. The new NOFO authorized under the Consolidated Appropriations Act of 2021 (CAA) will make individual awards of up to $5 million to states and territories that are not currently participating in MFP. These funds will support states during the initial planning and implementation of their programs.

CMS will hold two webinars to provide details about the MFP Demonstration Expansion, and to answer questions from potential applicants regarding this funding opportunity. Registration is required. The webinars will be held:

April 13, 2022 1:00 pm to 2:00 pm (ET)

Registration: Click on https://cms.zoomgov.com/j/1601853787?pwd=Vm9UTUoyRnpVVStjSEo1QlZYWURPUT09

April 27, 2022 1:00 pm to 2:00 pm (ET)

Registration: Click on  https://cms.zoomgov.com/j/1612862544?pwd=MGd3YW5nUVJ4T050bWFraTV6V0Y1UT09

Senate Debates Expansion of Medicaid HCBS

The Senate Special Committee on Aging met this week to debate the improvement and expansion of home-based services, particularly home-and-community based services, a consistent priority for committee chairman Senator Bob Casey (D-PA). Witnesses and Senators frequently cited. Casey’s Better Care Better Jobs (BCBJ) Act, strongly supported by NAHC, as it is the foundation for the HCBS provisions included in the Build Back Better (BBB) Act, the stalled health care, social service, and climate legislation that was a focus for much of 2021.

The most recent version of that legislation passed by the House of Representatives would provide $150 billion investment into Medicaid HCBS, permanency of the Money Follows the Person program, protections against spousal impoverishment for HCBS recipients, and several other policies intended to improved the provision of Medicaid HCBS.

Witnesses testimony focused on the current state of HCBS through explanation of statistics and data on the workforce, wages, patient need, and expected growth over the next eight to ten years. Witnesses highlighted the challenges that recipients are able to overcome with the assistance of home care, as well as the realities they face in the absence of care. They also highlighted challenges caregivers face in wages not competitive with other industries, feelings of isolation, and the grueling work. These accounts were paired with support for the Better Care Better Jobs Act.

While many of the witnesses lauded the HCBS funding included in the American Rescue Plan, passed in March 2021, they did add that it did not provide a permanent solution. Anne Tumlinson likened it to an “umbrella in a hurricane.”

At the hearing, the witness panel was comprised of Lisa Harootunian, Associate Director, Health Program, Bipartisan Policy Center, Anne Tumlinson, CEO, ATI Advisory, Brandon Kingsmore, Disability Advocate, Public Speaker, accompanied by Ms. Lynn Weidner, Home Care Worker, and Alene Shaheed, Home Care Recipient.

While the version of Build Back Better passed by the House is not expected to see further consideration in the Senate, work continues to be done on compiling a package of provisions consistent with the intent of BBB, though no specifics seem to be agreed to at this point.

NAHC will continue to urge Congress to make significant investments into the Medicaid HCBS program.

Senate Debates Expansion of Medicaid HCBS

The Senate Special Committee on Aging met this week to debate the improvement and expansion of home-based services, particularly home-and-community based services, a consistent priority for committee chairman Senator Bob Casey (D-PA). Witnesses and Senators frequently cited. Casey’s Better Care Better Jobs (BCBJ) Act, strongly supported by NAHC, as it is the foundation for the HCBS provisions included in the Build Back Better (BBB) Act, the stalled health care, social service, and climate legislation that was a focus for much of 2021.

The most recent version of that legislation passed by the House of Representatives would provide $150 billion investment into Medicaid HCBS, permanency of the Money Follows the Person program, protections against spousal impoverishment for HCBS recipients, and several other policies intended to improved the provision of Medicaid HCBS.

Witnesses testimony focused on the current state of HCBS through explanation of statistics and data on the workforce, wages, patient need, and expected growth over the next eight to ten years. Witnesses highlighted the challenges that recipients are able to overcome with the assistance of home care, as well as the realities they face in the absence of care. They also highlighted challenges caregivers face in wages not competitive with other industries, feelings of isolation, and the grueling work. These accounts were paired with support for the Better Care Better Jobs Act.

While many of the witnesses lauded the HCBS funding included in the American Rescue Plan, passed in March 2021, they did add that it did not provide a permanent solution. Anne Tumlinson likened it to an “umbrella in a hurricane.”

At the hearing, the witness panel was comprised of Lisa Harootunian, Associate Director, Health Program, Bipartisan Policy Center, Anne Tumlinson, CEO, ATI Advisory, Brandon Kingsmore, Disability Advocate, Public Speaker, accompanied by Ms. Lynn Weidner, Home Care Worker, and Alene Shaheed, Home Care Recipient.

While the version of Build Back Better passed by the House is not expected to see further consideration in the Senate, work continues to be done on compiling a package of provisions consistent with the intent of BBB, though no specifics seem to be agreed to at this point.

NAHC will continue to urge Congress to make significant investments into the Medicaid HCBS program.

Senate Debates Expansion of Medicaid HCBS

The Senate Special Committee on Aging met this week to debate the improvement and expansion of home-based services, particularly home-and-community based services, a consistent priority for committee chairman Senator Bob Casey (D-PA). Witnesses and Senators frequently cited. Casey’s Better Care Better Jobs (BCBJ) Act, strongly supported by NAHC, as it is the foundation for the HCBS…

CMS Stakeholder Call on Medicaid and CHIP Access

The Centers for Medicare & Medicaid Services (CMS) is seeking feedback on topics related to health care access in the Medicaid program. Specifically, CMS is interested in hearing from a broad array of stakeholders on topics relating to: enrolling in and maintaining coverage, accessing health care services and supports, and ensuring adequate provider payment rates…

New CMS Website Will Share Innovative State Actions to Expand Medicaid HCBS

  • CMS also approves earlier application for Alabama’s section 1115 demonstration to improve access to home and community-based services

The Centers for Medicare & Medicaid Services (CMS) has launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov 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 has approved 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.

“One-stop Shop” for Plans to Enhance, Expand, & Strengthen Home and Community-based Services

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.

“The Biden-Harris Administration recognizes the value and dignity that come with access to home and community-based services,” said HHS Secretary Xavier Becerra. “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.”

“The ability to access health care at home or in the community is essential for many low-income families, older adults, and individuals with disabilities who rely on Medicaid services — especially during this unprecedented public health emergency,” said CMS Administrator Chiquita Brooks-LaSure. “Thanks to the American Rescue Plan, CMS is providing state Medicaid agencies with the tools and funding needed to expand this important care. We welcome the opportunity to work with states to expand home and community-based services to meet the needs of their communities.”

The announcement issued today reinforces CMS’s commitment to assist states in response to the public health emergency. State administrators and stakeholders are encouraged to visit Medicaid.gov to view states’ programs and activities to identify innovative approaches that can support home and community-based services and improve capacity building and infrastructure in their area by drawing inspiration from other states.

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. These actions allow Medicaid enrollees to receive care in the comfort of their own home or in a preferred community setting.

To view the home and community-based services webpage with states’ ARP section 9817 spending plans and narratives, letters issued to states on their spending plans and narratives, and other important information related to the implementation of ARP section 9817, please visit https://www.medicaid.gov/medicaid/home-community-based-services/guidance/strengthening-and-investing-home-and-community-based-services-for-medicaid-beneficiaries-american-rescue-plan-act-of-2021-section-9817-spending-plans-and-narratives/index.html.

For additional information on ARP funding for home and community-based services, see the guidance that CMS issued to states via a State Medicaid Director Letter in May of this year.

New Demonstration for Home and Community-based Services in Alabama

The Biden-Harris Administration is proud to help states that have long been at work to advance home and community-based services. Separate from the new website launched today, CMS has approved Alabama’s earlier application for a section 1115 demonstration, entitled “Community Waiver Program.” The 1115 demonstration will operate concurrently with a home and community-based services 1915(c) waiver in Alabama, a new opportunity in the state’s Medicaid program 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. Together, Alabama’s 1115 demonstration and 1915(c) waiver will increase access to home and community-based services for many Alabamans who are currently on a waiting list.

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. 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.

“It is important we find ways to collaborate to help Alabamians in need, particularly those with intellectual disabilities. My Administration is pleased to offer the Community Waiver Program, which focuses on serving individuals with intellectual disabilities before they are in crisis,” said Alabama Governor Kay Ivey. “The partnership between the Alabama Department of Mental Health and the Alabama Medicaid Agency will help integrate these individuals in the community, giving them a better chance to develop skills to work and live independently.”

To view Alabama’s section 1115 demonstration approval and the new 1915(c) waiver, visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/101016.

New CMS Website Will Share Innovative State Actions to Expand Medicaid HCBS

CMS also approves earlier application for Alabama’s section 1115 demonstration to improve access to home and community-based services The Centers for Medicare & Medicaid Services (CMS) has launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for home and community-based services. Home and community-based services allow…

New CMS Website Will Share Innovative State Actions to Expand Medicaid HCBS

  • CMS also approves earlier application for Alabama’s section 1115 demonstration to improve access to home and community-based services

The Centers for Medicare & Medicaid Services (CMS) has launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov 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 has approved 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.

“One-stop Shop” for Plans to Enhance, Expand, & Strengthen Home and Community-based Services

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.

“The Biden-Harris Administration recognizes the value and dignity that come with access to home and community-based services,” said HHS Secretary Xavier Becerra. “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.”

“The ability to access health care at home or in the community is essential for many low-income families, older adults, and individuals with disabilities who rely on Medicaid services — especially during this unprecedented public health emergency,” said CMS Administrator Chiquita Brooks-LaSure. “Thanks to the American Rescue Plan, CMS is providing state Medicaid agencies with the tools and funding needed to expand this important care. We welcome the opportunity to work with states to expand home and community-based services to meet the needs of their communities.”

The announcement issued today reinforces CMS’s commitment to assist states in response to the public health emergency. State administrators and stakeholders are encouraged to visit Medicaid.gov to view states’ programs and activities to identify innovative approaches that can support home and community-based services and improve capacity building and infrastructure in their area by drawing inspiration from other states.

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. These actions allow Medicaid enrollees to receive care in the comfort of their own home or in a preferred community setting.

To view the home and community-based services webpage with states’ ARP section 9817 spending plans and narratives, letters issued to states on their spending plans and narratives, and other important information related to the implementation of ARP section 9817, please visit https://www.medicaid.gov/medicaid/home-community-based-services/guidance/strengthening-and-investing-home-and-community-based-services-for-medicaid-beneficiaries-american-rescue-plan-act-of-2021-section-9817-spending-plans-and-narratives/index.html.

For additional information on ARP funding for home and community-based services, see the guidance that CMS issued to states via a State Medicaid Director Letter in May of this year.

New Demonstration for Home and Community-based Services in Alabama

The Biden-Harris Administration is proud to help states that have long been at work to advance home and community-based services. Separate from the new website launched today, CMS has approved Alabama’s earlier application for a section 1115 demonstration, entitled “Community Waiver Program.” The 1115 demonstration will operate concurrently with a home and community-based services 1915(c) waiver in Alabama, a new opportunity in the state’s Medicaid program 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. Together, Alabama’s 1115 demonstration and 1915(c) waiver will increase access to home and community-based services for many Alabamans who are currently on a waiting list.

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. 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.

“It is important we find ways to collaborate to help Alabamians in need, particularly those with intellectual disabilities. My Administration is pleased to offer the Community Waiver Program, which focuses on serving individuals with intellectual disabilities before they are in crisis,” said Alabama Governor Kay Ivey. “The partnership between the Alabama Department of Mental Health and the Alabama Medicaid Agency will help integrate these individuals in the community, giving them a better chance to develop skills to work and live independently.”

To view Alabama’s section 1115 demonstration approval and the new 1915(c) waiver, visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/101016.

Administration Begins American Rescue Plan Rural Funding to Support Providers Impacted by Pandemic

Today, Tuesday, November 23, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), released the vast majority ($7.5 billion) of the $8.5 billion American Rescue Plan (ARP) Rural payments to providers and suppliers who served rural Medicaid, Children’s Health Insurance Program (CHIP), and Medicare beneficiaries from January 1, 2019 through September 30, 2020.

Hundreds of home health care and hospice agencies received this funding and we strongly encourage them to attend the stakeholder briefing mentioned below.

You’re Invited: Stakeholder Briefing

HRSA’s Provider Relief Bureau (PRB) will hold a stakeholder briefing on:

  • December 2, 2021
  • 1:00-1:30 p.m. ET

This briefing will provide key information, dates, and data about the payments. Stakeholders must register to attend.