​​​​Home and Community-Based Services ​Spending Plan

California's HCBS Spending Plan provides $3 billion in enhanced federal funding to support initiatives that enhance, expand, and strengthen Medi-Cal's HCBS services​. The CMS  approval of the state's proposal will support services provided by six state departments. On March 11, 2021, President Biden signed the American Rescue Plan Act (ARPA). Section 9817 of ARPA provides qualifying states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid expenditures for HCBS from April 1, 2021 through March 31, 2022. 

States must use the federal funds attributable to the increased FMAP to supplement, not supplant, existing state funds expended for Medicaid HCBS in effect as of April 1, 2021. In addition, states must use state funds equivalent to the amount of federal funds attributable to the increased FMAP to implement or supplement the implementation of one or more activities to enhance, expand, or strengthen HCBS under the Medicaid program by March 31, 2024. 

As submitted to the Cent​ers for Medicare & Medicaid Services (CMS) on July 12, 2021, and updated on October 27, 2021, California's initial HCBS Spending Plan and initial HCBS Spending Plan Narrative involve several the state departments, and total approximately $3B in enhanced federal funding for the following categories of services: 

  • Workforce: Retaining and Building a Network of HCBS Direct Care Workers
  • HCBS Navigation
  • HCBS Transitions
  • Services: Enhancing HCBS Capacity and Models of Care
  • HCBS Infrastructure and Support

The following departments are assigned as leads for the initiatives identified in California's initial HCBS Spending Plan and initial Spending Narrative:

  • Department of Aging (CDA)
  • Department of Social Services (CDSS)
  • Department of Developmental Services (DDS)
  • Department of Health Care Services (DHCS)
  • Department of Rehabilitation (DOR)
  • Department of Health Care Access and Information (HCAI, formerly OSHPD)

Supplemental Resources by Year:​

2021
Last modified date: 4/21/2022 1:43 PM