American Rescue Plan Act: Extra Funding for Home and Community-Based Services

Wisconsin’s commitment to home and community-based services (HCBS) received a boost, thanks to the American Rescue Plan Act (ARPA). An estimated $350 million in federal funding will help state residents who are elderly or have a disability receive much-needed services to allow them to live as independently as possible. This new funding supports improvements to Wisconsin’s HCBS programs that are unique to the needs and priorities of our residents. HCBS programs receiving funding include: 

DHS is also using the funding to improve Wisconsin Medicaid services like personal care, private duty nursing, home health, and habilitative services.

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You'll get updates about Wisconsin’s plans for ARPA funding focused on HCBS.

If you have questions about these initiatives, email us at DHSDMSWIARPAHCBS@dhs.wisconsin.gov.

     

    ARPA HCBS funding details

    President Biden signed ARPA into law on March 11, 2021. The act provides a total of $1.9 trillion in economic stimulus to aid the recovery from the COVID-19 pandemic. Of the $350 billion earmarked for state, local, tribal, and territorial governments, Wisconsin is receiving $2.5 billion.

    Section 9817 of ARPA gives qualifying states a temporary 10% increase to their federal matching percentage on specific home and community-based services from April 1, 2021, through March 31, 2022. The Wisconsin Department of Health Services (DHS) applied to use ARPA funds to strengthen our HCBS programs, address direct care workforce issues, and develop strategies to delay the need for long-term care. The Centers for Medicare & Medicaid Services granted conditional approval of the plan, allowing Wisconsin to start claiming the increase. We have until March 31, 2025, to invest approximately $350 million in funding.

    State initiatives

    Nine strategic initiatives led by the Department of Health Services (DHS) and funded by ARPA represent much-needed investments to help our most vulnerable state citizens live their best lives.

    Healthcare provider's hand holding a patient's handMedicaid HCBS Rate Reform

    A 5% rate increase for home and community-based services was rolled out starting January 1, 2022. It applies to multiple service providers who work with Medicaid programs such as Family Care, Family Care Partnership, IRIS, PACE, the Children’s Long-Term Supports waiver program, SSI Managed Care, BadgerCare Plus Managed Care, and Medicaid Fee for Service.

    Wisconsin’s frail elders and people of all ages with disabilities rely on HCBS to meet their daily needs. HCBS are a cost-effective alternative to higher-cost institutional services, such as nursing home care or hospital services. Higher reimbursement rates allow HCBS providers to better recruit the staff who are critical to providing care to our members.


    Older adult laughing with caregiverDirect Care Workforce Reform and Analysis

    Wisconsin’s direct caregiving workforce is the backbone of HCBS. To better recruit, support, and retain these vital workers, our approach to using ARPA funds includes:

    • Conducting a staff stability survey to assess turnover, tenure, wages, benefits, and other factors.
    • Implementing a tiered-rate career ladder for personal care and supportive home care workers that rewards professional advancement.
    • Expanding career opportunities through a statewide professional credentialing and continuing education system.
    • Designing a statewide registry of direct care workers. It will include credentialing details plus specialty education and expertise, so individuals who need care can search for qualified direct care professionals to meet their needs.

    Deadline extended to July 31! Agencies that provide long-term care for adults with intellectual and developmental disabilities can still participate in the Staff Stability Survey and earn an incentive of up to $1,000. Learn more about how you can help us improve the quality and stability of the workforce in organizations like yours.


    Older Woman Comforting Older ManGrants Opportunities

    A new grant-making process will create opportunities to strengthen HCBS programs. Currently, over 100,000 children and adults receive HCBS services in Wisconsin. The program will direct new resources to some of the most pressing issues faced by this population. Grants will assist providers with COVID-19 recovery and improve, enhance, and expand their services.


    Close up of hand and pen completing a surveyTribal Long-Term Care Enhancements

    Members of Wisconsin’s tribal nations should have access to services that address their unique cultural and policy needs. Wisconsin recently completed a survey of all 11 tribes to identify their home and community-based service system needs. DHS is now working with each tribe to develop a plan to use ARPA funds to meet those needs. In addition, we are making arrangements to fund an aging and disability resource specialist for each tribe.


    Younger adult comforting an adult in wheelchair outside.Independent Living Supports Pilot

    Many Wisconsin residents who don't require long-term care services or are not currently Medicaid eligible could benefit from short-term, flexible supports to stay independent and healthy. For example, home modifications or small amounts of supportive home care or respite care would allow more individuals to remain in their own homes, potentially easing the increased burden on Wisconsin’s long-term care system as our population ages.

    We are collaborating with stakeholders to assess the viability of a two-year pilot program that would provide a variety of supports to help residents continue to live independently. Considerations include determining how large the pilot should be, who will administer the program, who is eligible, and the benefit package for the program.


    Young person hug elder person in a wheelchair with a person kneeling on other side of the wheelchair outside.Aging and Disability Resource Center Modernization

    Aging and Disability Resource Centers (ADRCs) serve older adults, adults with disabilities, as well as caregivers and professionals in the community. An ADRC provides unbiased information on a broad range of programs and services, helps people understand the various long-term care options available to them, helps people apply for programs and benefits, and serves as the access point for publicly-funded long-term care. To further support their work, DHS will:

    • Develop a statewide online network for customers to review resources in their community, ask questions about services available to them, and provide a point of contact for their local ADRC. This online resource network will provide an additional, accessible way to review services provided in local, in-person offices throughout the state.
    • Explore creating an online resource portal for members of Medicaid long-term care programs to manage their program benefits, allowing ADRCs to focus on other priorities.
    • Invest in ADRC outreach and education to connect those in need with information on what an ADRC can do, as well as connect them with a referral source.

    A child is doing homework.No Wrong Door – Supporting Kids Together

    Families of children with delays or disabilities should be able to find programs and services easily, no matter which county they live in or where they go for help. The “no wrong door” approach means that no matter where or how a family reaches out, they will be able to connect to the resources they need to thrive. A resource hub team will coordinate between systems and provide targeted support for unique situations. The initial focus will be connecting children newly identified with special needs to programs such as Children’s Long Term Support, the Birth to 3 Program, Children’s Community Options, and Katie Beckett Medicaid.


    close up view of wheeled walker with person in tan top and pants behind on sidewalkAssisted Living Reporting, Assessment, and Certification

    With input from key stakeholders, DHS has identified the need to improve available information on statewide assisted living resources. Comprehensive data collection and analysis are essential to making well-informed decisions on programs and policy, especially given the forecasted growth in the state’s aging population. DHS is evaluating for potential implementation:

    • An assisted living reporting tool to assess how well assisted living facilities can serve Wisconsin residents today and in the future.
    • A member assessment to understand the needs of Wisconsin residents who access services, both in assisted living and in the community.
    • Development of online platforms to track nonresidential HCBS reviews and 1-2 bed adult family homes.

    A young adult feeding a treat to a dogAdult Incident Reporting System

    Ensuring the health and safety of people using HCBS services is critical. Improved coordination between state provider licensing, medical services, and protective services will increase safeguards for vulnerable people. DHS will explore the development and implementation of a system to support increased coordination, with an initial focus on adult long-term care.


    Last Revised: June 30, 2022