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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.

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.

Most recently, EOHHS met with the HCBS and behavioral health community on July 16, 2021 to share additional details on the implementation of funding for time limited rate enhancements outlined in the Initial Spending plan, provide a high-level overview of  investments included in the July Quarterly Spending plan and communicate next steps leading up to the October Quarterly Spending plan.

Upcoming Public Discussion Forums

EOHHS will host a series of public forums providing an opportunity for Stakeholders to engage on key topics, themes and issues related to investments contemplated for inclusion in the October Quarterly spending plan. Thematic areas of focus are listed below. Registration is separate for each forum. Please click on the appropriate link(s) below to register.

Additional Resources

Massachusetts Spending Plans and Narratives

Initial Spending Plan and Narrative (Round 1 Investments)

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. Round 1 will invest approximately $100M of the enhance federal funding in immediate time limited across-the-board payment enhancements to strengthen and stabilize the HCBS workforce.

  • Summary of the Initial Spending Plan & Narrative: Word Doc | PDF
  • Initial Spending Plan & Narrative submitted to CMS on June 17, 2021: Word Doc | PDF

To implement the immediate time limited across-the-board payment enhancements for the HCBS workforce included in Round 1, EOHHS filed regulations under emergency adoption, 101 CMR 447.00:  Rates for Certain Home- and Community-based Services Related to Section 9817 of the American Rescue Plan Act. The time-limited rate enhancements are effective July through December 2021 with the goal of strengthening and stabilizing the state’s HCBS workforce in response to the COVID-19 public health emergency.

Information regarding the allowable use of this enhanced funding can be found below. EOHHS agencies will issue additional guidance and information related to implementation in the coming days based on program/provider specific needs. Providers are encouraged to check this site regularly for updated information.

Quarterly Spending Plan and Narrative

Round 2 Investments

On July 16, 2021, EOHHS submitted to CMS its first Quarterly Spending Plan and Narrative, which builds upon the Initial Spending Plan submitted on June 17, 2021.

The July 2021 Quarterly Spending Plan includes new investments totaling approximately $44M and complement Massachusetts’ long-standing commitment to equitably rebalancing long-term services and supports and behavioral health services towards community living by diverting and/or transitioning individuals away from facility-based settings. The investments detailed in the Quarterly Spending Plan are in addition to the $100M workforce investment detailed in the Initial Spending Plan.

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

Round 3 Investments

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

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