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State Files Two State Plan Amendments for ALP Funding

LeadingAge NY is pleased to report that the State has submitted Medicaid State Plan Amendments (SPAs) for the Assisted Living Program (ALP) Medicaid rate increase of 6.5 percent, which would be effective April 1, 2023, and an American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Supplemental Payment for the Improve and Support the ALP Workforce initiative. While both are subject to approval by the Centers for Medicare and Medicaid Services (CMS), we are pleased to see this step forward in getting needed funds to our ALP members.

Medicaid Rate Increase

The ALP Medicaid rate increase is a result of our collective advocacy during the State budget process. While it was less than we had hoped for, it is the largest Medicaid rate increase in recent memory. LeadingAge NY will continue to advocate for a statutory change to update the nursing home base year that is used to calculate the ALP Medicaid rate in the next budget process. This will help to ensure that the rate calculation reflects more real-time costs moving forward.

ARPA Supplemental Payment

The ARPA funding stems from federal dollars that were made available to support certain HCBS providers that were affected by the COVID-19 pandemic. Members may recall that LeadingAge NY worked to develop recommendations to the State about how the funds could be used in a way that would be most meaningful to our members, while also consistent with the federal purpose. While the details in the SPA are minimal, we are pleased to see that the plan is consistent with our recommendations, which largely focused on workforce initiatives.

The SPA proposes to provide a total of $40 million in supplemental payments to support ALPs impacted by the pandemic. The State plans to distribute these funds based on unique members served at each program site through a one-time lump sum payment on or before Dec. 31, 2023. Of the total funds available, 90 percent would be distributed proportionally by members served by each facility. The remaining 10 percent would be distributed to facilities serving fewer than 30 members also by members served at each facility.

The proposal indicates that sites will be able to use these funds to support workforce development strategies. To be eligible, program sites must hold a valid operating certificate and be actively working toward or confirm their compliance with the HCBS Settings Rule and programmatic regulations as stated in the HCBS Final Rule Statewide Transition Plan. Sites must also submit an attestation of their intended use of funds and confirm that funding will not be used for capital investments.

The SPA includes the following parameters:

Excluded sites:

  • Sites that are not fully compliant with the HCBS Settings Rule or working toward completing activities related to a corrective action plan.
  • Sites that do not submit an accepted attestation of their intended use of funds.
  • Sites that do not confirm that funds will not be used for capital investments.
  • Sites that are closed.

Eligible sites:

  • Open sites are defined as those with the appropriate staff and that are either actively providing services or have planned an opening date before June 1, 2023.
    • Sites that are not open before Oct. 1, 2023 will not be eligible for supplemental payments.
    • Sites must also be open at the time at which payments are distributed on or before Dec. 31, 2023.


Ultimately, both SPAs are subject to approval by CMS before funds will be distributed. We will keep members apprised of developments.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828