CMS and Medicaid leaders have been weighing in on Medicaid Home and Community Based Services (HCBS) possibilities during these historic times of federal investment. On the July 19^th National Stakeholder Call, CMS Administrator Chiquita Brooks-LaSure said, “The American Rescue Plan has given new opportunities to expand services and access to strengthen home and community-based service provider workforce, impacting social determinants of health and improving quality.”

In that same vein, National Association of Medicaid Directors’ Deputy Executive Director Dianne Hasselman shares in her blog that Medicaid Directors are committed to getting needed resources out to Home and Community Based Services, which have historically experienced underinvestment, and that Medicaid Directors of more aware now than ever before that they are part of a broader ecosystem that includes public and private payers, federal partners, as well as state and local stakeholders. Medicaid Directors are looking for sister state agencies, elected officials, providers, and advocates to join together in these transformative times for Medicaid.

The Medicaid Leadership Exchange podcast drilled down on Medicaid HCBS this month on an episode called “Big Stakes in Home and Community Based Services,” exploring how Medicaid leaders can leverage the current spotlight on HCBS to drive improvements in care and delivery, now and in the future. Lee Grossman, administrator for Home and Community Based Services Section at the Wyoming Department of Health and Kevin Bagley, Medicaid director for the Nebraska Department of Health and Human Services, shared thoughts on the role of HCBS in fulfilling the priorities of the Medicaid program. Their insights included the following themes:

• This is a once in a career opportunity for Medicaid leaders and stakeholders to focus on HCBS. There has never been this much attention paid to HCBS from the federal government since its inception in the 1980s.
• The vision for HCBS cannot work without the workforce.
• Medicaid leaders and stakeholders must use strategic thinking and funding opportunities available with ARPA to push longer-term perspectives with policymakers, with a focus on budgeting now with investments for the future of access and service quality.

The podcast concluded with the big idea that Medicaid directors and stakeholders must not let the crisis of the pandemic go to waste. LeadingAge could not agree more. The time continues to be now to work together to bolster HCBS systems and funding that accomplishes long-term solutions for older adults and their caregivers. LeadingAge’s Workforce Now Campaign policy asks include our call for passage of the Better Care Better Jobs Act (S. 2210) or enactment of the Home and Community Based Services (HCBS) provisions of H.R. 5376. We emphasize that any HCBS extension should include a permanent HCBS Federal Medical Assistance Percentage (FMAP) bump, and provisions to provide direct pass throughs for workers and to update Medicaid rates regularly.