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Strengthening Home and Community Based Services and Behavioral Health Services Using American Rescue Plan (ARP) Funding

The Massachusetts Strategy to use enhanced federal funding through Section 9817 of the American Rescue Plan Act (ARPA) will enhance, expand, and strengthen certain Medicaid home and community-based services (HCBS) and behavioral health services.

Table of Contents

Overview

On March 11, 2021, President Biden signed into law the American Rescue Plan Act. Section 9817 provides enhanced federal funding for Medicaid home and community-based services (HCBS) and certain behavioral health services through a one-year 10% increase to the share of state Medicaid spending that is paid for by the federal government. This one-year increase in federal matching funds would result in new, time-limited dollars that can be invested in certain Medicaid HCBS and behavioral health services through March 2024. These services strive to enhance the quality of life and independence of people in their home and community. This is an exciting opportunity to further strengthen such services.

The Executive Office of Health and Human Services provided initial information about its strategy on March 31, 2020 here.

Massachusetts Spending Plans and Narratives

Initial Spending Plan and Narrative

On June 17, 2021, the Executive Office of Health and Human Services (EOHHS) submitted to the federal Centers for Medicare and Medicaid Service (CMS) its initial spending plan to enhance, strengthen and expand Medicaid (MassHealth) home and community-based services using an anticipated $500 million in estimated new, time-limited dollars that can be invested in home and community-based services through March 2024. The initial spending plan proposes a phased approach in which EOHHS will finalize initiatives over three “rounds”.

EOHHS’s initial spending plan incorporates stakeholder feedback to outline a strong framework to enhance, strengthen and expand home and community-based services (HCBS) across MassHealth populations both immediately and in the long-term

Use of enhanced federal funding will reinforce the Commonwealth’s commitment to improve equity and access to HCBS for those with physical disabilities, intellectual and developmental disabilities, and behavioral health needs. To achieve these goals, the Commonwealth of Massachusetts will implement initiatives supporting three key structural pillars: 

  1. HCBS Workforce, retaining and building a high-quality network;
  2. Access to and Promotion of HCBS Services and Supports, including navigation, transitions, family supports, diversion and enhanced care models; and
  3. HCBS Technology and Infrastructure, to enable more effective care coordination, access, and delivery.

Massachusetts’s will implement three rounds of initiatives tied to the three structural pillars. Round 1 will invest approximately $100 M of the enhance federal funding in immediate time limited across the board payment enhancements to strengthen and stabilize the HCBS workforce. Rounds 2 and 3 will invest the remaining funds to support strategic and structural investments.

  • Summary of the Initial Spending Plan & Narrative: Word Doc | PDF
  • Initial Spending Plan & Narrative submitted to CMS on June 16, 2021: Word Doc | PDF

Spending Plan: Round 2

The Spending Plan for Round 2 funding will be posted here once finalized and submitted to CMS for approval.

Spending Plan: Round 3

The Spending Plan for Round 3 funding will be posted here once finalized and submitted to CMS for approval.

Public Engagement

EOHHS welcomes community feedback on ways to enhance, expand, and strengthen Medicaid home and community-based services (HCBS) and certain behavioral health services through one-time and tie-limited investments. This section will continue to be updated with notices, meeting information, and documents related to community input.

EOHHS encourages community members to submit questions and comments directly to arpamedicaidhcbs@mass.gov.

EOHHS first met with the HCBS and behavioral health community about the American Rescue Plan Act on Wednesday, March 31, 2021.

On April 16, 2021, the Commonwealth issued a Request for Information (RFI) to gather community feedback on strategic areas for investment. Responses were due May 7, 2021. The Commonwealth received 203 proposals in response to the RFI. A summary document of the responses is posted below.

EOHHS met again with the HCBS and behavioral health community on June 8, 2021 to provide an overview of the Initial Spending Plan and the steps that are being taken to enhance, expand and strengthen HCBS.

Additional Resources

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