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DOH Submits Spending Plan for Enhanced HCBS FMAP

The Department of Health (DOH) has submitted its spending recommendations for the 10 percent enhanced Home and Community-Based Services (HCBS) Federal Medical Assistance Percentage (FMAP) funding it will receive from the American Rescue Plan Act (ARPA) enacted in March 2021. The letter that DOH submitted to the Centers for Medicare and Medicaid Services (CMS) is available here. LeadingAge NY provided comments to DOH, and DOH held stakeholder calls with provider associations to obtain input on its spending plan. The letter, transcripts of the stakeholder calls, and all documents moving forward, including DOH's quarterly reports, will be housed on a new webpage for the enhanced HCBS FMAP here.

The spending plan includes 43 proposals over the following three categories: 

  • Supporting and Strengthening the Direct Care Workforce
  • HCBS Capacity, Innovations, and Systems Transformation
  • Digital Infrastructure Investment

    The proposals include projects under the jurisdictions of the Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), Office of Addiction Services and Supports (OASAS), and DOH. DOH may have to pursue state plan amendments, waiver amendments, directed payment authorizations, and other authorizations that may accompany reinvestment of the enhanced FMAP into new or supplemental HCBS programs and services.

    Of significance are the following categories of interest to LeadingAge NY members. Not outlined below are recommendations for spending proposals for programs or initiatives under OASAS, OPWDD, and OMH. Each DOH spending recommendation in the plan includes the title and cost, expenditure authority, eligible provider types, a description of the program, and monitoring plans.

    • Transform the Long-Term Care Workforce and Achieve Value-Based Payment (VBP) Readiness: $623 Million State Funds Equivalent
    • Expand Advanced Training Incentive (ATI) Program for HCBS Transitions from Nursing Homes: $55.35 Million State Funds Equivalent
    • Workforce Transportation Incentive: $10 Million State Funds Equivalent
    • Support Program Growth in Personal Care Services and CDPAP to Ensure Capacity: $415 Million State Funds Equivalent
    • Expand Capacity in Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI): $47 Million State Funds Equivalent
    • Invest in the Expansion of Community First Choice Option (CFCO) Services: $46.9 Million State Funds Equivalent
    • Support of the Unique Program of All-Inclusive Care for the Elderly (PACE) Fully Integrated Care Model: $40 Million State Funds Equivalent
    • Invest in a Community Engagement Initiative (OPWDD) – HCBS Day Services: $30 Million State Funds Equivalent
    • Enhanced Rates for Private Duty Nursing (PDN): $10 Million State Funds Equivalent
    • Strengthen NY Connects Infrastructure: $29.8 Million State Funds Equivalent
    • Support for Adult Day Health Centers and Social Adult Day Centers Reopening: $10 Million State Funds Equivalent
    • Study to Develop new Consumer Directed Personal Assistance Program (CDPAP) Care Technology: $5.1 Million State Funds Equivalent
    New York expects to generate $5.4 billion in federal funding under Section 9817 of the American Rescue Plan. This includes the initial 10 percent enhanced FMAP generated on the State's HCBS spending between April 1, 2021 and March 31, 2022, $2.15 billion, and the amount generated through reinvestment of these funds, $3.25 billion. 

    LeadingAge NY will review this plan, provide additional comment, and communicate with the Department as it continues to flesh out this programmatic spending moving forward. Members should feel free to communicate feedback and additional recommendations to LeadingAge NY staff.

    Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342