Kamala Harris photo

FACT SHEET: Vice President Harris Announces that American Rescue Plan Investments in Home and Community-Based Care Services for Millions of Seniors and Americans with Disabilities Reach About $37 billion across all 50 States

December 12, 2023

New data featured as part of White House convening with care leaders, workers, and champions, including Senator Bob Casey (PA), Governor Janet Mills (ME), Governor Josh Shapiro (PA), and Governor Jared Polis (CO) highlighting historic Biden-Harris Administration investments in long-term care and the care workforce and lifting up the President's proposal to expand federal support for these services going forward.

Nationally, over seven million seniors and individuals with disabilities and their families rely on home and community-based services (HCBS) to help meet their long-term care needs in their home or community, rather than in institutions or other isolated settings. Facing unprecedented shocks and pressures during the pandemic and responding to a significant need for more investment in home-based care, the American Rescue Plan included significant support to help states strengthen and expand home care programs and better attract, retain, and more fairly compensate their care workforces.

All 50 states are using this funding to improve their long-term care systems. With the need for home-based care continuing to grow, this 50-state decision to expand access to home-based care and invest in care workers underscores the need for the President's proposed investment of significant, sustained funding to improve and expand Medicaid home and community-based services.

Today, the White House is announcing actions and new data reflecting this administration's commitment to expanding access to long-term care and investing in our direct care workforce:

  • New data released today by the Centers for Medicare and Medicaid Services (CMS) show that the American Rescue Plan is helping to deliver about $37 billion in support across all 50 states for activities and investments that enhance, expand, and strengthen home and community-based services programs. All 50 states have taken advantage of this additional funding, with the majority of it helping providers retain, recruit, and train care workers and provide bonuses and pay increases for care workers.
  • Key Care Worker Registries deliverable from the historic Executive Order To Support the Care Economy: The Centers for Medicare and Medicaid Services (CMS) is releasing new guidance outlining how states can use worker registries for Medicaid-funded Home and Community Based Services to ensure beneficiaries have awareness of and access to qualified workers to deliver these critical services. Worker registries are an important tool – helping families that need care match with care professionals as well as helping workers find clients and build sustainable work schedules. This is a key deliverable from President Biden's historic care executive order in April. Today's guidance details best practices for states in developing worker registries and how they can receive enhanced federal funding to develop and maintain them.
  • White House Convening on the American Rescue Plan's Major Investment in Home & Community-Based Care: The convening will feature speakers including:
    • HHS Secretary Xavier Becerra
    • Senator Bob Casey (PA)
    • Governor Josh Shapiro (PA)
    • Governor Janet Mills (ME)
    • Governor Jared Polis (CO)
    • SEIU Secretary-Treasurer April Verrett
    • National Domestic Workers Alliance President Ai-Jen Poo
    • Domestic Policy Advisor Neera Tanden
    • American Rescue Plan Coordinator Gene Sperling
    • National Council on Independent Living Executive Director Theo Braddy

New Data Shows How American Rescue Plan Investments are Delivering Stronger and Expanded HCBS for Millions of Seniors and Americans with Disabilities
New CMS data shows that all 50 States are leveraging American Rescue Plan support to expand and strengthen home and community-based services. In total, states have committed about $37 billion in American Rescue Plan funding, including:

  • All 50 states are investing over $25 billion to help retain, expand, and train their direct care workforces – funding worker retention, recruitment, training, and other efforts to keep providers staffed to improve services for seniors and individuals with disabilities: States are investing over $25 billion to help providers support, recruit, retain, and train their care workforce, and to increase pay, improve benefits, and expand opportunities for career advancement for care workers. These funds are also allowing states to create Direct Care Worker registries, professional certification programs, scholarships, and tuition supports that help the direct care workforce. These investments are critical to all 50 states' efforts to keep their providers open and improve service to seniors and individuals with disabilities. For example:
    • Colorado is using ARP funds to substantially raise base wages for thousands of direct care workers providing a range of services. Colorado's base wage increases are helping as many as 60,000 direct care workers across the state who provide in-home care to seniors and individuals with disabilities. In addition to significantly raising wages for thousands of workers, the state is providing grants to fund a range of training efforts, from Registered Behavior Technician Training with certification from a Registered Behavior Technician Training to providing training on Alzheimer's and Dementia caregiving at home.
    • Maine provided well-deserved bonuses to over 24,000 direct care workers in every county in the state worth $3,429 per worker – driving significant retention of Maine's Home and Community Based Services workforce, an overall increase in the number of direct care workers, and other critical workforce efforts, including wage increases.
    • North Carolina invested ARP funds in rate increases – with 80% of the funds directly supporting worker wage increases – impacting thousands of North Carolina direct care workers. North Carolina is also using ARP resources to establish a Direct Care Jobs Innovation Fund to support initiatives that improve recruitment and retention among the direct care workforce, including training opportunities and workforce supports.
    • Ohio is using ARP funds to create a HCBS Workforce Development Strategic Fund to expand its behavioral health workforce. Ohio is expanding residency training and fellowship programs for providers dedicated to serving the behavioral health, geriatric, and developmental disability community and supporting the growth of existing career-focused programming in behavioral health at the state's two- and four-year colleges and universities. A student pursuing a degree or certificate in a behavioral health field will be eligible for up to $10,000 during their undergraduate and graduate studies and up to an additional $5,000 post-graduation in recruitment and retention bonuses for obtaining employment in a community behavioral health center in Ohio.
    • Wisconsin is developing a professional statewide registry for direct care workers which will incorporate data on professional credentialing and specialty education experience to assist those who struggle to identify qualified direct care support professionals. Wisconsin also increased wages for care workers substantially using ARP funds and invested in a statewide effort to recruit and train 10,000 new Certified Direct Care workers and develop innovative strategies to increase access to services.
    • Pennsylvania is investing in a range of efforts to support its home care workforce, including increasing payment rates, raising wages, and recruiting and retaining workers. Pennsylvania is increasing rates to improve wages for thousands of care workers, including helping raise wages for the state's approximately 55,000 direct support workers who support individuals with intellectual and developmental disabilities. The state is investing in training for home-based care nurses, including by paying newly hired nurses to participate in on-the-job training and shadowing experiences. Pennsylvania is also planning to use these funds to develop a worker registry that allows participants to locate, review and contact direct care workers who will best meet their care needs. Additionally, Pennsylvania is investing in recruiting and retaining thousands of home care workers in the state – from behavioral health workers to non-emergency medical transportation drivers who take home care beneficiaries to doctors' appointments. Pennsylvania is also investing ARP State and Local Fiscal Recovery Funds in the next generation of Pennsylvania nurses working in the state's hospitals, funding up to $7,500 in student debt relief for nearly 7,000 nurses who practice in the state for three years.
  • Supporting care and family support for people with Intellectual and Developmental Disabilities (IDDs) – with 41 states making investments in services for individuals with an IDD. For example, North Carolina is using ARP funds to provide research-based behavioral health options for individuals with autism who are over 21, an investment the state will continue supporting beyond its ARP investment.
  • Supporting Family Caregivers: 29 states are investing in efforts to offer family caregivers training, respite, new training websites, counseling support groups, and other services. For example, Delaware is funding a respite program for family caregivers of children with complex medical conditions, severe emotional disorders, and dual diagnoses of mental health and intellectual or developmental disabilities, and plans to continue this program even after it finishes its ARP investment.
  • Expanding access to community-based care by addressing waitlists – with 21 states reducing or eliminating their waiting lists for key services (many by thousands): 21 states are eliminating or reducing Home and Community Based Services waiting lists by opening additional waiver slots and providing supports for those waiting for services – expanding services for tens of thousands of people.
  • Addressing key structural gaps and addressing social determinants of health such as housing: For example, 24 States are providing housing-related services and supports to address social determinants of health. New Jersey is funding the development of subsidized and accessible rental units – "Healthy Homes" that will support better health outcomes for individuals at risk of homelessness or institutionalization. Colorado is investing in a pilot program to provide supportive housing services for 500 HCBS participants – with a focus on providing housing to individuals who have serious mental illnesses and have a history of experiencing homelessness and emergency care.

50-State Data: Planned Funding for Home and Community Based Services through the American Rescue Plan

State Millions of Dollars
Alaska 25
Alabama 702
Arkansas 152
Arizona 1617
California 4434
Colorado 510
Connecticut 462
Delaware 53
Florida 1209
Georgia 565
Hawaii 52
Iowa 365
Idaho 302
Illinois 630
Indiana 798
Kansas 84
Kentucky 309
Louisiana 458
Massachusetts 1101
Maryland 560
Maine 241
Michigan 274
Minnesota 1222
Missouri 1050
Mississippi 401
Montana 70
North Carolina 1484
North Dakota 45
Nebraska 88
New Hampshire 155
New Jersey 840
New Mexico 1200
Nevada 126
New York 5213
Ohio 1075
Oklahoma 283
Oregon 743
Pennsylvania 2586
Rhode Island 158
South Carolina 80
South Dakota 71
Tennessee 440
Texas 964
Utah 158
Virginia 620
Vermont 155
Washington 1453
Wisconsin 696
West Virginia 356
Wyoming 33
Washington, D.C. 168


Source: 50 State Plans Submitted to CMS

Kamala Harris, FACT SHEET: Vice President Harris Announces that American Rescue Plan Investments in Home and Community-Based Care Services for Millions of Seniors and Americans with Disabilities Reach About $37 billion across all 50 States Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/368481

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