American Rescue Plan Act of 2021 – HCBS Programs

The American Rescue Plan Act of 2021 (ARPA) was signed into law by President Biden on March 11, 2021 and provides additional Federal relief to address the continued impact of Coronavirus Disease 2019 (COVID-19) on the economy, public health, state and local governments, individuals, and businesses. It is intended, in part, to support states in enhancing services for individuals who are eligible for long-term care and home and community-based services (HCBS), including participants of the Comprehensive, Supports, and Community Choices Waiver programs.

Section 9817 of ARPA addresses additional support provided to Medicaid home and community-based services (HCBS).  The law includes a provision to increase the Federal Medical Assistance Percentage (FMAP) for Medicaid HCBS by 10% from April 1, 2021 through March 31, 2022.  According to this Section, in order to be eligible to receive the increase, the State must use the Federal funds to supplement, and not supplant, the level of State funds expended for HCBS programs in effect as of April 1, 2021.  Additionally, the State must implement, or supplement the implementation of, one or more activities to enhance, expand, or strengthen HCBS under the State Medicaid program.

On May 13, 2021, the Centers for Medicare and Medicaid Services (CMS) issued guidance in State Medicaid Director Letter (SMD) #21-003 detailing further federal requirements for states to access the enhanced federal funding. As a part of this guidance, states are required to submit to CMS a spending plan and narrative that details a proposed approach to leveraging this federal funding.

Spending Plans and Narratives

In accordance with CMS guidance, the Division must develop and submit an initial spending plan and narrative that describes the activities the Division intends to implement, the expected cost of each activity, and the overall estimated funds attributable to the increase in the FMAP that the Division anticipates claiming between April 1, 2021 and March 31, 2022.  Subsequent plans must be submitted quarterly,  Please refer to this section to review the spending plans that have been submitted to CMS.  To review spending plans submitted by other states, please visit the CMS website.

• Updated Initial Spending Plan and Narrative – Resubmitted to CMS September 3, 2021
  • Response to Question presented in Partial Approval Letter – submitted to CMS September 3, 2021
  • CMS Partial Approval Letter – Received August 9, 2021
  • Initial Spending Plan and Narrative – Submitted to CMS July 8, 2021
• Spending Plan and Narrative – Submitted to CMS October 27, 2021

Spending Plan and Narrative – due to CMS January 14, 2022
Spending Plan and Narrative – due to CMS April 15, 2022
Spending Plan and Narrative – due to CMS July 18, 2022
Spending Plan and Narrative – due to CMS October 18, 2022

Public Input Opportunities

The Division welcomes input from participants, providers, case managers, and other stakeholders of the Comprehensive, Supports, and Community Choices Waiver programs on how to best utilize this temporary influx of federal funding for the long-term benefit of these programs. Please visit this section for the updates on public meetings that will be held to obtain stakeholder feedback. Stakeholders may submit written feedback at any time to shirley.pratt@wyo.gov.

The Division will publicize upcoming formal feedback sessions when they are scheduled.