Over the past year, the Indiana Family and Social Services Administration has worked with providers and stakeholders on the best ways to maximize one-time enhanced Federal Medical Assistance Percentage funds from the American Rescue Plan to improve home- and community-based services for Medicaid beneficiaries. Building on feedback from more than 660 stakeholders, FSSA’s Home-and Community-Based Service Spend Plan outlines how FSSA is investing an estimated $817 million into the HCBS landscape through March 2025.
Following an initial round of HCBS stabilization grants, FSSA is focused on targeted investments that support building provider capacity, enhancing HCBS and caregiver support. Recent examples of these investments include the DDRS’ Innovation Pilot Grant, HCBS Provider Readiness grants and 988/crisis response system development.
A key and critical focus of FSSA’s Spend Plan is on developing our direct service workforce. To that end, we are putting the final touches on a Direct Service Workforce State Plan that will include short-, mid-, and long-term strategies around wages and benefits; training and pathways; and promotion and planning. The plan was built in partnership with the Bowen Center for Health Workforce Research and Policy at Indiana University and informed by individuals with lived experience, direct service workers, providers, and others, and we anticipate releasing it next week.
In advance of the DSW State Plan release, FSSA is excited to launch a critical short-term wages and benefits strategy in the form of a Direct Service Workforce Investment grant opportunity. Direct service workers are essential in providing the day-to-day, in-person HCBS supports necessary for people to live, work, and participate in their communities. To recognize the value they bring to HCBS, FSSA is currently engaged in reviewing HCBS waiver rates in partnership with our provider networks. While that important work moves forward, the Direct Service Workforce Investment grants are intended to provide immediate support and offer resources to help retain and maintain a quality direct service workforce.
FSSA is dedicating $130 million to this opportunity with a requirement that 95% of funding awarded flow through to direct service workers. To be eligible for this funding, providers must comply with the following:
- Active during State Fiscal Year 2022: Defined as having submitted claims for qualifying paid expenditures during State Fiscal Year 2022 (July 1, 2021 – June 30, 2022)
- Currently active: Defined as currently providing services to Medicaid beneficiaries
- Medicaid provider that provides services to individuals in the home and community: As of the date of attestation, providers must be an actively enrolled IHCP provider and delivering the following types of services:
- Adult Day Services
- Adult Foster Care
- Assisted Living
- Attendant Care (including Self-Directed Attendant Care)
- Community/Day Habilitation
- Extended Services
- Facility Based Supports
- Facility Habilitation
- Home Health Services
- Homemaker
- Participant Assistance and Care
- Pre Vocational
- Program of All-Inclusive Care for the Elderly (PACE)
- Residential Habilitation and Support (Hourly & Daily)
- Respite Care
- Structured Family Caregiving
- Waiver Transportation
- Workplace Assistance
To receive funding, eligible providers should submit the attestation form at this link by Dec. 22, 2022. The form requires providers to attest that they will:
- Direct 95% of the grant funding to direct service workers
- Develop a plan for how they will direct grant resources to direct service workers. Completed plans must be posted to the provider’s public-facing website and submitted in the attestation no later than Dec. 22, 2022. Respond to a final grant impact survey that captures how the dollars were spent
- Obligate money from each round prior to receiving the next round of funding
- Comply fully with the HCBS Settings Rule: After the March 17, 2023 deadline, providers must be compliant in order to receive further rounds of funding.
FSSA is planning to host a webinar on Dec. 1, 2022, at 1 p.m. ET to provide an overview of the grant. For more information on the grant or the webinar, please see the full announcement and FAQ posted on the FSSA HCBS webpage and look out for further communication from FSSA.
