The U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) sent notification to states that they now have an additional year—through March 31, 2025—to use funding made available by the American Rescue Plan Act (ARPA) to enhance, expand, and strengthen home- and community-based services (HCBS) for people with Medicaid who need long-term services and supports.

As the primary funder of HCBS nationally, Medicaid plays a critical role in supporting states’ efforts to strengthen these services for their beneficiaries. Section 9817 of the American Rescue Plan Act provides states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for HCBS. As a result of the ARPA increase in the federal matching rate on activities, states originally had a three-year period —from April 1, 2021, through March 31, 2024—to use the available state funds, attributable to the ARPA’s increased FMAP, on activities to enhance, expand, or strengthen HCBS in Medicaid. The extended timeframe of an additional year will help to facilitate high-quality, cost-effective, person-centered services for people with Medicaid. This will allow Medicaid beneficiaries to remain in the setting of their choice—whether it is their home or another setting—and remain a valued part of their communities.

This policy update impacts the spending timeline for the $85 million investment to expand Ohio’s behavioral health workforce through paid internships, scholarships, and recruitment and retentions bonuses that was announced by Governor DeWine last month (discussed in more detail in the state policy section). Additionally, the remaining, yet-to-be-approved components of the Ohio Department of Medicaid HCBS Plan will follow this extended deadline.