The American Rescue Plan (ARP) offers states a 10 percentage point enhancement in their Federal Medical Assistance Percentage (FMAP) for Medicaid home and community-based services (HCBS) provided during the year from April 1, 2021 to March 31, 2022. States must use the resulting state share savings, referred to as “State funds equivalent” (SFE), to “enhance, expand, or strengthen” Medicaid HCBS.
On July 9th, New York State (NYS) published its initial spending plan for this funding. In total, the State estimates that it will draw down approximately $5.4 billion in federal funding, including $2.15 billion of SFE and $3.25 billion of additional federal matching funds that will be generated through reinvestment of the SFE funds into matchable HCBS service spending.
The spending plan would fund proposals across the following three categories:
- Supporting and strengthening the direct care workforce ($1.29 billion);
- Building HCBS capacity through innovations and systems transformation, including new pilots and expansion of existing services ($750 million); and
- Investing in digital infrastructure ($104 million).
Please note that amounts listed in the spending plan do not reflect the full federal matching funds that may be available. In most cases, NYS has indicated mechanisms—such as 438.6 directed payments, State plan amendments, or waiver amendments—through which it intends to obtain expenditure authority that would allow this spending to draw down matching funds.
The plan spans services across six state agencies that oversee HCBS provision. The funding is approximately allocated as follows:
- Department of Health (DOH): $1.28 billion
- Office for People with Development Disabilities (OPWDD): $728 million
- Office of Mental Health (OMH): $63 million
- Office of Children and Family Services (OCFS): $9 million
- Office of Addiction Services and Supports (OASAS): $33 million
- State Office for the Aging (SOFA): $30 million
Note that DOH funding primarily reflects spending on long-term services and supports (LTSS) but also incorporates certain spending on children’s services and other areas.
SPG has prepared a reference guide to the spending plan’s proposals in the attached document. The full spending plan is available here. Transcripts and recordings of stakeholder public comment sessions are available here.