2023 NASDDDS State ARPA Inventory
The American Rescue Plan Act of 2021 (ARPA) was signed into law on March 11, 2021, and provided $350 billion in additional funding for state and local governments. Section 9817 of the ARPA afforded states a temporary 10-percentage point increase to the federal medical assistance percentage (FMAP) to improve certain home and community-based services (HCBS) under the Medicaid program. The Centers for Medicare & Medicaid Services (CMS) required states to submit an initial spending plan and provide quarterly updates describing the activities that the state is implementing through the increased FMAP funding to enhance, expand, or strengthen Medicaid HCBS.
In the fall of 2021, NASDDDS and ADvancing States coordinated to release an overall inventory of all states’ spending plans, specific to the interests of each associations’ respective members. The sister associations are coordinating, once again, to revise the inventories to reflect states’ updates to their spending plan initiatives, as contained in recent reports to CMS, and publicly available information on state activities. Coordination included the gathering of state-produced materials and reports regarding state ARPA 9817 spending plan updates ranging from January 2022 to January 2023.
The NASDDDS 2023 inventory is the Excel workbook at the below link. It is divided into nine tabs reflecting the most common themes across all state ARPA plans germane to I/DD agencies and other elements of interest. Within those tabs, you will find a breakdown of specific topics covered under that theme and designated by each specific state that identified them within their ARPA quarterly report(s). We note that, depending on the state’s approach to reporting and implementation, the inventory may not be inclusive of all ARPA-related activities. For a fuller picture of a state’s entire spending plan, we suggest relying on a variety of sources including NASDDDS’ 2021 inventory; ADvancing States’ 2023 inventory; states’ publicly available spending plans and updates found on state government websites; and/or, the CMS ARPA 9817 webpage.
We recognize that states’ initiatives are evolving and reporting to CMS may not always be inclusive of every ARPA initiative, so NASDDDS frames this as a point in time review of the ARPA spending landscape. We invite you to share with us any changes that you make to your spending plans, as well as corrections or additions to any current entries. We will continue to bring you the most up-to-date picture we can as states’ HCBS improvement efforts unfold.
Additional ARPA Inventories and Topical Briefs
2023 ADvancing States ARPA Inventory
For a fuller picture of a state’s entire spending plan, we suggest relying on a variety of sources including NASDDDS’ 2021 inventory (below), ADvancing States’ 2023 inventory (below), states’ publicly available spending plans and updates found on state government websites and/or the CMS ARPA 9817 webpage.
LINK to ADvancing States 2023 inventory
2021 NASDDDS State ARPA Inventory
In 2021, NASDDDS developed an inventory of the contents of state ARPA spending plans related to state I/DD service systems based on an analysis of 49 states and the District of Columbia. The inventory is divided into tabs reflecting the most common themes across all state ARPA plans. The inventory is a snapshot of the information at that time.
2021 NASDDDS ARPA Topical Brief: States Focus on Quality
ARPA provides a unique opportunity for states to enhance, expand, or strengthen Medicaid home and community-based services (HCBS). A 2021 review of state spending plans found that several states have specific initiatives to improve quality oversight of HCBS. This topical brief offers mini case studies in an interview format. The brief highlights how states are taking varied approaches to creatively and meaningfully influence quality outcomes for individuals with I/DD receiving services and supports in their homes and communities.
2021 NASDDDS ARPA Topical Brief: State Workforce Initiatives
Out of the 49 spending plans NASDDDS examined in 2021, 44 include initiatives aimed at addressing workforce issues. These were largely focused in two main areas—increased compensation for DSPs, and staff or workforce development strategies. A handful of states proposed initiatives that generally influence workforce expansion. The information at the link reflects the initiatives states describe in these plans.