CMS Details State Spending Plans for HCBS Under American Rescue Plan

CMS released state spending plan summaries for section 9817 of the American Rescue Plan Act of 2021 (ARP) on January 4. The spending plan summaries illustrate how states expect to spend $36.8 billion on activities to enhance, expand, or strengthen home and community-based services (HCBS) under Medicaid.

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​States’ activities focus on workforce recruitment and retention, workforce training, quality improvement, efforts to reduce or eliminate waiting lists, expansions of the use of technology, opportunities to support caregivers, and ways to address social determinants of health and promote equity.

​Each state summary contains summarized spending plan information with graphs, data, and at least one example to highlight from each of the 50 states and the District of Columbia (DC). The level of detail greatly varies across state spending plans, and states are in various stages of implementing activities. Therefore, details of each state summary vary from one to another. For example, reported spending is not included for all states because some state spending plans did not include these figures yet (either because of data lags or because states were still early in the implementation phase of their activities).

According to the report, the six most populous states plan to spend the following amounts on HCBS thanks to ARPA funding:

California: $4.4 billion
Texas: $964.5 million
Florida: $1.2 billion
New York: $5.2 billion
Pennsylvania: $2.6 billion
Illinois: $629.9 million