HCBS Access Act

March 17, 2021

Senators Hassan, Brown and Casey along with Representative Dingle, all strong advocates for Home and Community Based Services (HCBS) and the driving forces behind the recent inclusion of the 10% dedicated FMAP in the American Rescue Plan Act, released yesterday a working draft of the HCBS Access Act.  This is a plan long in the making which has had, over the years, multiple names and constructs.  It has some very attractive components, a few are:

  • Minimum standards to be provided by state HCBS
  • Sufficient rates to support required services and provide adequate pay for direct support staff
  • Workforce development and support, wages and benefits, recruitment, training and retention
  • HCBS infrastructure in states that support family caregivers, provider agencies and independaent providers
  • Role of managed care in providing HCBS including network adequacy standards and consumer direction, etc.

It maybe, however, a “be careful what you ask for” scenario. In establishing a federal baseline to create a minimum set of services, eliminating the repeated waiver requests and driving states to eliminate their waiting lists, it may remove much of the opportunity to innovate, drive baseline services for the largest number and will most certainly be very expensive!  The devil, as they say, is in the details!

Take a look for yourself and see what you think, we’ll talk about it on the Member Call of Friday.