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 Centers 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 fiscal year:
2021-2022 Federal Fiscal Year (FFY)
- Initial HCBS Spending Plan Package – July 12, 2021
- CMS HCBS Partial Approval Letter – September 3, 2021
- Updated HCBS Spending Plan Package – October 27, 2021
- Final HCBS Spending Plan Package – October 29, 2021
- CMS HCBS Conditional Approval Letter – January 4, 2022
- HCBS Spending Plan Quarterly Report for Quarter 3 – February 1, 2022
- HCBS Spending Plan Quarterly Narrative Report for Quarter 4 – April 17, 2022
- HCBS Spending Plan Quarterly Spending Plan for Quarter 4 – April 17, 2022
2022-2023 Federal Fiscal Year (FFY)
- HCBS Spending Plan Quarterly Report for Quarter 1 – Originally Submitted: July 8, 2022 and Updated: September 21, 2022
- HCBS Spending Plan Narrative Report for Quarter 1 – Originally Submitted: July 8, 2022 and Updated: November 3, 2022
- HCBS Spending Plan Quarterly Spending Plan for Quarter 2 – October 18, 2022
- HCBS Spending Plan Narrative Report for Quarter 3 – January 17, 2023
- HCBS Spending Plan Quarterly Spending Plan for Quarter 3 – February 2, 2023
- HCBS Spending Plan Quarterly Spending Plan for Quarter 4 – April 17, 2023
2023-2024 Federal Fiscal Year (FFY)
- CMS HCBS Approval Letter – October 26, 2023
- HCBS Spending Plan Narrative Report for Quarter 1 – October 26, 2023
- HCBS Spending Plan Quarterly Report for Quarter 1 – October 26, 2023
- HCBS Spending Plan Quarterly Report for Quarter 2 – December 7, 2023
- HCBS Spending Plan Narrative Report for Quarter 3 – January 17, 2024
- HCBS Spending Plan Quarterly Reporting for Quarter 3 – February 2, 2024
- CMS HCBS Approval Letter – March 1, 2024
- HCBS Spending Plan Quarterly Spending Plan for Quarter 4 – April 17, 2024
2024-2025 Federal Fiscal Year (FFY)
- CMS HCBS Approval Letter – August 29, 2024
- HCBS Spending Plan Narrative Report for Quarter 1 – August 29, 2024
- HCBS Spending Plan Quarterly Report for Quarter 1 – August 29, 2024
- HCBS Spending Plan Quarterly Report for Quarter 2 – November 22, 2024
- HCBS Spending Plan Narrative Report for Quarter 3 – January 15, 2025
- HCBS Spending Plan Quarterly Report for Quarter 3 – January 15, 2025
- State Attestation Letter – April 16, 2025
- HCBS Spending Plan Narrative Final Report – April 16, 2025
- HCBS Final Spending Plan Report – April 16, 2025
- HCBS Spending Plan (CA 9817) CMS Approved Closeout Letter – August 27, 2025