At a time when the older population was expanding and speeding up the need for home healthcare services, along came the COVID-19 pandemic, exacerbating matters tremendously. Today, more people than ever are electing to receive care services in the comfort of their own homes rather than spending time in a hospital or other traditional healthcare facility. This trend appears to be here to stay, bringing with it an ever-increasing demand for homecare workers – a profession that was already in short supply and experiencing a decline due to employee burnout, long hours and low wages.

These converging factors have made expanding access to homecare services a priority. The American Rescue Plan Act (ARPA), a stimulus package passed in March 2021 to assist in economic recovery following the pandemic, provided for an estimated $12.7 billion in additional funding for certain Medicaid expenditures related to homecare and community-based services (HCBS). This infusion of substantial funding provides a unique opportunity for states to address challenges related to home healthcare, including growing the workforce, expanding capacity of critical services, meeting the needs of those on waitlists, and leveraging technology to facilitate more effective and efficient delivery of care.

More Time to Ensure Careful Use of Funds

The Department of Human Services Office of Long-Term Living (OLTL) developed a funding opportunity that will provide ARPA funds to HCBS providers. Initially, that funding was to be available for three years – from April 1, 2021 to March 31, 2024. However, the Centers for Medicare & Medicaid Services (CMS) recently extended the availability of the funding through March 31, 2025. CMS also updated requirements to reduce states’ reporting burdens while still ensuring the agency receives timely, up-to-date details about their spending under the act. 

CMS recently signed off on HCBS investment plans for all 50 states. The agency noted that in their spending plans, the states each plan to spend between $31.6 million and $4.63 billion in state and federal funds on activities that enhance, expand, or strengthen HCBS under Medicaid. 

According to, states are undertaking a variety of initiatives using the funds, such as: 

  • Expanding coverage to those currently on waitlists
  • Implementing in-home and mobile COVID-19 vaccination programs for people with disabilities and older adults
  • Developing deed-restricted accessible and affordable housing units for people with disabilities
  • Implementing new behavioral health crisis response services for people with intellectual and developmental disabilities
  • Providing additional home-based services to support and aid patients returning home, enabling them to avoid admission to a skilled nursing facility following a hospitalization
  • Increasing access to assistive technologies to promote independence and community integration
  • Expanding HCBS eligibility to children with disabilities in the TEFRA group (commonly referred to as the Katie Beckett waiver)

Workforce, Technology Popular Choices for Funds

A recent half-day White House Summit on the “American Rescue Plan and the Workforce” focused on different components of the American Rescue Plan’s investment, with the creation of a diverse and skilled infrastructure workforce taking top priority. In addition to using funds to attract and retain homecare professionals, states may use the money to purchase technology to support the homecare industry. States must ensure the technology they choose meets ARPA guidelines; however, the Treasury wrote the spending criteria broadly to allow local governments to utilize resources in ways that best address their unique situations.

Nearly every state spending plan includes workforce development. States are using the funds for recruitment and retention bonuses, pay increases, and student loan forgiveness for those working on the front lines – from homecare workers to behavioral health providers. And they’re developing certification and training programs that directly benefit homecare workers by offering the support they need to be successful and fulfilled in their jobs, which creates a path that encourages employees to see themselves remaining in long-term homecare careers. 

Other initiatives include purchasing and deploying software and technology to integrate with electronic health records (EHR), or to support quality or risk-management functions. By having access to these types of solutions, providers are better able to connect and communicate in real-time with homecare payers patients’ medical providers. Additionally, this helps to ensure patients receive the best possible care and allows providers to address any problems arising in the home that could impact patients’ outcomes or result in the need for emergency care or hospital admission.

With spending plans in place and the extension through March 2025 to use the ARPA funding, states have a great opportunity to address the shortage of homecare workers, ensure that more patients have access to their services, and employ technology in a way that makes homecare more efficient, allowing them to play a pivotal role in monitoring and improving the health of those in their care.

For more information on ARPA funding and what this means for you, contact our team.