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DHS to Invest $104 million in HCBS

Thursday, July 22, 2021


Earlier this year, Congress passed the American Rescue Plan Act (ARPA for short). The Plan allows states to draw down 10% more in federal Medicaid matching funds to support, enhance and strengthen home and community based services (HCBS for short). These funds ($104 million total) must be used by 3/31/2022, but states must submit a plan on how they will use it. The Federal government wants to make sure states do not use these funds to replace state spending - it's new money to be invested in ways that expands options for people with disabilities and older persons to live and work in the community.
DHS submitted its plan for using these additional federal dollars last week. You can view this plan here. Below are highlights of what is included in this plan:
  • $80 million for increased training and support for HCBS providers. These funds will develop a statewide training system to increase access to specialized training and expanded services to individuals with more complex needs; employee training and scholarships for education/training in nursing, behavioral health, and other healthcare fields; crisis response provider training for those serving people with intellectual disabilities (ID) or developmental disabilities (DD); and resources and training for parents and caregivers of children with ID/DD.
  • $84 million to expand access to HCBS services by conducting a behavioral health, aging and disability services system evaluation; realigning the services system to address issues identified in the evaluation; expanding targeted case management to help people apply for appropriate waiver services; fund a community-based neurobehavioral rehabilitation services pilot for children, a residential services pilot for children with complex behavioral needs, a residential services pilot for adults transitioning out of prison/jail/community corrections, and a therapeutic foster home pilot; and provide grants to help providers upgrade technology that improves the delivery of home and community based services.
  • $57 million to support the state's HCBS workforce by expanding the direct care registry (a priority of the Iowa DD Council's for many years) and recruitment and retention payments to providers.
The state plan for using these ARPA funds must still get federal approval, but DHS worked closely with partners to develop this proposal, which should help it be approved quickly. More than 100 Iowans participated and shared their ideas in a public forum, where workforce, training, and access were all brought up as top concerns. Iowa advocates spoke; DHS listened. Now comes the hard part, making it all happen. Stay tuned for updates.

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