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HCBS Spending Plan For Implementation of American Rescue Plan Act
All Figures are in Millions
FFY Quarter 2, 2022 Update
NYS estimate of funds attributable to the increase in FMAP that the state has claimed and/or anticipates claiming between April 1, 2021, and March 31, 2022. All dollar figures are in millions. Estimates based on proposed spend plan total projections Program FFY21Q3
04/01/21-
06/30/21FFY21Q4
04/01/21-
06/30/22FFY22Q1
04/01/21-
06/30/23FFY22Q2
04/01/21-
06/30/24TOTAL HCBS (Managed Care)* $3,285 $3,443 $3,377 $3,611 $13,715 HCBS (All 1915c Waivers) ** ** $1,777 $1,764 $1,750 $1,737 $7,027 Personal Care Services † $178 $181 $183 $186 $728 Home Health Services † $154 $153 $153 $152 $612 PACE †† $89 $89 $89 $89 $355 Case Management† $10 $10 $10 $10 $41 TOTAL (in millions) $5,493 $5,639 $5,561 $5,784 $22,478 Actuals denoted in blue text and subject to retrospective update upon future submissions.
Footnotes____________________________________________________________________________________________________
* Includes Managed Care & Managed Long Term Care (MLTC) HCBS spend; excluding PACE which is lined out separately below.
** Includes non-DOH/Other State Agency (OSA) Fee-for-Service (FFS) spend and actuals pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.
† These are FFS programs and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.
†† This is an MLTC Managed Care program and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.Note: The expenditure values in the summary table above do not include anticipated HCBS spend resulting from re-invement of funding on HCBS eFMAP spending plan proposals.
Note: The actual expenditure values for FFY21Q3 in the summary table above are estimates based on a draft methodology not yet approved by CMS.Original DOH Projection in Spending Plan
Shared with CMS in July 2021
Original Projection Dollar Difference % Difference TOTAL HCBS (Managed Care)* $12,390 $1,325 10.7% HCBS (All 1915c Waivers) ** ** $7,376 ($349) -4.7% Personal Care Services † $715 $13 1.9% Home Health Services † $534 $78 14.6% PACE †† $398 ($44) -10.9% Case Management† $48 ($7) -15.2% TOTAL (in millions) $21,461 $1,017 4.7% Footnotes____________________________________________________________________________________________________
* Includes Managed Care & Managed Long Term Care (MLTC) HCBS spend; excluding PACE which is lined out separately below.
** Includes non-DOH/Other State Agency (OSA) Fee-for-Service (FFS) spend and actuals pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.
† These are FFS programs and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.
†† This is an MLTC Managed Care program and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.Note: The expenditure values in the summary table above do not include anticipated HCBS spend resulting from re-invement of funding on HCBS eFMAP spending plan proposals.
Note: The actual expenditure values for FFY21Q3 in the summary table above are estimates based on a draft methodology not yet approved by CMS.Original DOH eFMAP Projection in Spending Planan
Shared with CMS in July 2021
FFY Q2 Update Total Projection (10% eFMAP) Original Projection (10% eFMAP) Dollar Difference % Difference TOTAL HCBS (Managed Care)* $1,372 $1,239 $133 10.7% HCBS (All 1915c Waivers) ** ** $703 $738 ($35) -4.7% Personal Care Services † $73 $72 $1 1.9% Home Health Services † $61 $53 $8 14.6% PACE †† $35 $40 ($4) -10.9% Case Management† $4 $5 ($1) -15.2% TOTAL (in millions) $2,248 $2,146 $102 4.7% Footnotes____________________________________________________________________________________________________
* Includes Managed Care & Managed Long Term Care (MLTC) HCBS spend; excluding PACE which is lined out separately below.
** Includes non-DOH/Other State Agency (OSA) Fee-for-Service (FFS) spend and actuals pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.
† These are FFS programs and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.
†† This is an MLTC Managed Care program and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 6/30/21.Note: The expenditure values in the summary table above do not include anticipated HCBS spend resulting from re-invement of funding on HCBS eFMAP spending plan proposals.
Note: The actual expenditure values for FFY21Q3 in the summary table above are estimates based on a draft methodology not yet approved by CMS.
DOH Spending Plan - FFY Quarter
| HCBS Spending Plan For Implementation of American Rescue Plan Act | Spend Progress by Activity | Spend by Federal Fiscal Quarter | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Category | Section | Proposal Name | Lead Agency | Expenditure | SFE Funding (Estimate @ completion) | Estimate to Completion | Total Spend to-Date (Actual Spend) | FFY21Q2 01/01/21 - 03/31/21 | FFY21Q3 04/01/21 - 06/30/21 | FFY21Q4 07/01/21 - 09/30/21 | FFY22Q1 10/01/21 - 12/31/21 | FFY22Q2 01/01/22 - 03/31/22 | FFY22Q3 04/01/22- 06/30/22 | FFY22Q4 07/01/22- 09/30/22 | FFY23Q1 10/01/22 - 12/31/22 | FFY23Q2 01/01/23 - 03/31/23 | FFY23Q3 04/01/23 - 06/30/23 | FFY23Q4 07/01/23 - 09/30/23 | FFY24Q1 10/01/23 - 12/31/23 | FFY24Q2 01/01/24 - 03/31/24 | FFY24Q3 04/01/24 - 06/30/24 | FFY24Q4 07/01/24 - 09/30/24 |
| Support & Strengthening the Direct Care Workforce | A | Transform the Long-Term Care Workforce and Achieve Value-Based Payment | DOH | Directed Payment | $ 722,500,000 | $ 722,500,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | B | Improve thte OPWDD Workforce | OPWDD | 1915 (c) Waiver Amendment, Appendix K | $ 554,400,000 | $ 554,400,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | C | Expand Advanced Training Incentive (ATI) Program for HCBS Transitions from Nursing Home | DOH | State Plan Amendment | $ 55,350,000 | $ 55,350,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | D | Workforce Transportation Incentive | DOH | N/A | $ 10,000,000 | $ 10,000,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | E | Improve the OMH Workforce | OMH | Directed Payment & State Plan Amendment | $ 16,700,000 | $ 16,700,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | F | Improve the OASAS Workforce | OASAS | State Plan Amendment | $ 7,200,000 | $ 7,200,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | G | Increase Medicaid Rehabilitation Rates for OMH Community Residence Programs | OMH | State Plan Amendment | $ 6,900,000 | $ 6,900,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | H | Enhance the Children's Services Workforce | DOH | Directed Payment | $ 5,100,000 | $ 5,100,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | I | Expand Training and Implementation Support for Evidence Based Practices (EBPs) | OMH | N/A | $ 4,000,000 | $ 4,000,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | J | Expand Recruitment and Retention of Culturally Competent, Culturally Responsive and Diverse Personnel | OMH | N/A | $ 4,000,000 | $ 4,000,000 | $ - | $ - | $ - | |||||||||||||
| Support & Strengthening the Direct Care Workforce | K | Expand Certified and Credentialed Peer Capacity | OMH | Directed Payment | $ 4,000,000 | $ 4,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | A | Support Program Growth in Personal Care Services and CDPAP to Ensure Capacity | DOH | State Plan Amendment | $ 415,000,000 | $ 415,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | B | Expand Capacity in Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) | DOH | 1915 (c) Waiver Amendment, Appendix K | $ 47,000,000 | $ 47,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | C | Invest in the Expansion of Community First Choice Option (CFCO) Services | DOH | State Plan Amendment | $ 46,900,000 | $ 46,900,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | D | Support of the Unique Program of All-Inclusive Care for the Elderly (PACE) Fully Integrated Care Model | DOH | PACE Organization Premium Adjustment | $ 40,000,000 | $ 40,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | E | Improve the OPWDD Delivey System | OPWDD | N/A | $ 30,000,000 | $ 30,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | F | Invest in a Community Engagement Initiative- HCBS Day Services | OPWDD | N/A | $ 30,000,000 | $ 30,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | G | Invest in Diversity, Equity, and Inclusion for People with IDD | OPWDD | N/A | $ 30,000,000 | $ 30,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | H | Integrated Housing Pilot | OPWDD | N/A | $ 20,000,000 | $ 20,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | I | Adjust Residental Addiction Treatment Services Rate | OASAS | State Plan Amendment | $ 22,000,000 | $ 22,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | J | Expand and Implement HCBS and Community Oriented Recovery and Empowerment (CORE) Services | DOH, OMH | Directed Payment | $ 12,500,000 | $ 12,500,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | K | Support the Transition to Article 29-1 Health Facility Core Limited Health Related Services | DOH, OCFS | State Plan Amendment | $ 8,600,000 | $ 8,600,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | L | Expand Crisis Services for People with IDD | OPWDD | Appendix K Waiver Amendment | $ 11,400,000 | $ 11,400,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | M | Enhanced Rates for Private Duty Nursing (PDN) | DOH | State Plan Amendment | $ 13,100,000 | $ 13,100,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | N | Provide Incentives for the Development of More Integrated Residential Services | OPWDD | N/A | $ 10,000,000 | $ 10,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | O | Invest in OASAS Outpatient Addiction Rehabilitation Treatment Services Adjustments | OASAS | State Plan Amendment | $ 4,000,000 | $ 4,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | P | Invest in Personalized Recovery Oriented Services (PROS) Redesign | OMH | State Plan Amendment | $ 3,000,000 | $ 3,000,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | Q | CFTSS Rate Adjustments | DOH | State Plan Amendment | $ 2,300,000 | $ 2,300,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | R | Children's Waiver HCBS Rate Adjustments | DOH | 1915 (c) Waiver Amendment, Appendix K | $ 2,300,000 | $ 2,300,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | S | Invest in Assertive Community Treatment (ACT) Services | OMH | State Plan Amendment | $ 2,700,000 | $ 2,700,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | T | Implement Youth ACT Programs | OMH | State Plan Amendment | $ 1,600,000 | $ 1,600,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | U | Health Home Servicing Children (HHSC) Rate Adjustments | DOH | State Plan Amendment | $ 600,000 | $ 600,000 | $ - | $ - | $ - | |||||||||||||
| HCBS Capacity, Innovations, and Systems Transformation | V | Implement Young Adult ACT Teams | OMH | State Plan Amendment | $ 184,000 | $ 184,000 | $ - | $ - | $ - | |||||||||||||
| Digital Infrastructure Investments | A | Modernize OPWDD IT Infrastructure to Support Medicaid Enterprise & Investments to Expand Operational Capacity | OPWDD | N\A | $ 42,400,000 | $ 42,400,000 | $ - | $ - | $ - | |||||||||||||
| Digital Infrastructure Investments | B | Strengthen NY Connects Infrastructure | SOFA, DOH | N/A | $ 29,800,000 | $ 29,800,000 | $ - | $ - | $ - | |||||||||||||
| Digital Infrastructure Investments | C | Advance Children's Services IT Infrastructure | DOH | Directed Payment | $ 8,800,000 | $ 8,800,000 | $ - | $ - | $ - | |||||||||||||
| Digital Infrastructure Investments | D | Extended Short-Term Support for Behavioral Health Care Collaboratives | OMH | Directed Payment | $ 8,000,000 | $ 8,000,000 | $ - | $ - | $ - | |||||||||||||
| Digital Infrastructure Investments | E | Support for Adult Day Health Centers and Social Adult Day Centers Reopening | DOH | Directed Payment | $ 10,000,000 | $ 10,000,000 | $ - | $ - | $ - | |||||||||||||
| Digital Infrastructure Investments | F | Study to Develop new Consumer Directed Personal Assistance Program (CDPAP) Care Technology | DOH | N/A | $ 5,100,000 | $ 5,100,000 | $ - | $ - | $ - | |||||||||||||
| Total | $ 2,247,434,000 | $ 2,247,434,00 | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | $ - | ||||
| Support and Strengthening the Direct Care Workforce Proposal |
| HCBS Capacity, Innovations, and Systems Transformation Proposal |
| Digital Infrastructure Invesments proposal |
| Actual Expenditures reported to date |
| Red text demarcates modifications from the original spending plan submitted to CMS. |
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