HARRISBURG, PA — The Department of Human Services (DHS) has released for public comment Pennsylvania’s proposed spending plan for enhanced federal funding for home and community-based services covered through Medicaid. The enhanced funding is made available to states through the American Rescue Plan Act. The plan was submitted to the federal Centers for Medicare and Medicaid Services (CMS) earlier this week for consideration. DHS is accepting public comment through July 6, 2021.
“Pennsylvania’s Medicaid home and community-based service systems provide care and vital services for people with disabilities, mental illnesses, and substance use disorders, as well as our seniors and children with early intervention needs as well as complex medical needs,” said DHS Acting Secretary Meg Snead. “A robust home and community-based services system allows these Pennsylvanians to live among their family and peers and participate in their community while still receiving the care and support they need to live well. This investment through the American Rescue Plan will allow us to support this system and the dedicated service providers and workforce that fuel our care infrastructure, and we appreciate feedback and perspectives to ensure we are using this opportunity where it is most needed.”
The American Rescue Plan Act provides qualifying states with a temporary 10 percent increase to the federal medical assistance percentage (FMAP) for certain home and community-based services funded through Medicaid. States must reinvest the federal funds attributable to the increased FMAP to enhance, expand or strengthen home and community-based services under the Medicaid program.
Pennsylvania’s proposed plan for this enhanced funding focuses on nine domains:
- Increased access to home and community-based services: The enhanced funding will be used to support county and provider infrastructure necessary to facilitate growth in existing home and community-based services and expand programs to support target populations like children with complex medical needs who require in-home nursing services.
- Home and community-based services payment rate and benefit enhancements: Pennsylvania is seeking to support service providers in staff recruiting and retention efforts by providing additional resources to fund sign-on and retention bonuses and providing the opportunity for increasing rates across home and community-based service systems.
- Support to improve functional capabilities of people with disabilities: Providers may use funding to support increased use of assistive technology for people served through this system and support staff training in infection control and prevention. Funding can also enhance incident detection and monitoring systems for home and community-based services licensing and monitoring.
- Mental health and substance use disorder services: This funding will help support expanded capacity within the mental health and substance use disorder services system. Pennsylvania’s plan proposes supporting access to counseling for COVID-19 frontline workers, building capacity in student assistance programs, expanding telehealth usage, and helping counties implement assisted outpatient therapy for people with serious mental illness involved in the civil court system.
- Workforce support: The funding will allow Pennsylvania to enhance and expand training programs focused on care and service providers within Pennsylvania’s home and community-based service systems, support the workforce through recruitment and retention efforts, and embed trauma-informed care within the system.
- Caregiver support: Pennsylvania is seeking to develop a centralized registry of direct care workers that will help identify supports that best meet their care needs. This funding will also support expanding respite and family support services for individuals waiting for services and for families of children with complex medical needs.
- Transition support: This funding will support adaptations necessary to facilitate successful transitions from institutional or congregate care settings to home and community-based placements. Pennsylvania is also seeking to expand access to home and community-based services by expanding waiver capacity and supporting transitions from institutional settings.
- Supplies and equipment: Pennsylvania is seeking to aid providers working to safely resume in-person services and visitation by reimbursing for supplies and expenses necessary to support safety for people in care, staff, and their families. This funding can also support purchasing of emergency and infection control supplies.
- Home and community-based services capacity building: Funding will support improved care management and coordination, enhance use of technology like electronic health records, expand training for staff, and support work to address social determinants of health.
Interested stakeholders and parties can review Pennsylvania’s submitted plan and provide feedback by July 6, 2021, either in writing or in a virtual public comment session for individuals who are not able to submit written feedback. A more detailed plan for enhanced funding will be released after public comments are considered and the department receives a response from CMS.
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