Last week, the Florida Agency for Health Care Administration (AHCA) unveiled its plan to distribute more than $1.1 billion to Medicaid home- and community-based services (HCBS) providers, including home health agencies.

Section 9817 of the American Rescue Plan (ARP) provides enhanced federal funding through a one-year, 10% increase to the share of state Medicaid spending that is paid for by the federal government. The Federal Medical Assistance Percentage (FMAP) increase begins retroactively on April 1, 2021, and ends March 31, 2022. Under the ARP, the funds must be used to increase access to HCBS for Medicaid recipients and must be expended by March 31, 2024.

The federal Centers for Medicare & Medicaid Services (CMS) issued program guidance in May 2021 and initially provided states 60 days to submit a proposed program plan for consideration. As required by CMS, state plans must work to enhance, expand, or strengthen HCBS services, not supplant services that were already in place before the funding was authorized by the ARP.

CMS received proposed plans from all 50 states and the District of Columbia. As of October 29, CMS has conditionally approved just seven state plans to draw down and distribute the funds, including Florida's proposal that was approved on September 28. AHCA Chief of Staff Cody Farrill presented the state's plan to Florida lawmakers on November 3, and the plan was approved by the Legislative Budget Commission on November 4.

Specific to home health agencies that provide Medicaid HCBS, AHCA will distribute over $670 million to agencies — 56% of the total funds drawn down — to support program activities (“one-time provider stipend”) as well as individual workers (“one-time provider retention payments”). Florida has proposed spending funds by June 1, 2023.

One-Time Provider Stipend

AHCA will distribute $403,702,090 for a one-time stipend to HCBS waiver providers to support program activities. AHCA anticipates that it will make available an online application in December, though a specific date and what the application will consist of remain unclear at this time. Once approved by AHCA, agencies can expect to receive funds by February 2022.

One-Time Provider Retention Payments

AHCA will distribute $266,604,000 for one-time direct payments to all HCBS workers for capacity building and workforce development. We hope these direct payments will bolster the workforce during these challenging times and reinforce the value of the critical services they provide.

AHCA has not clarified how it will ensure that workers do not receive multiple disbursements if they work for multiple agencies, though HCAF has recommended the use of the Electronic Visit Verification (EVV) system as an option. Similar to the provider stipend process, AHCA anticipates that it will make available an online application in December, though a specific date and what the application will consist of remain unclear at this time. Once approved by AHCA, workers can expect to receive funds by February 2022.

HCAF Working for YOU!

HCAF has been a driving force in advocating for AHCA to draw down these funds since the ARP was signed into law on March 11, 2021. On April 7, HCAF and the Partnership for Quality Home Healthcare sent a letter to then-Medicaid Deputy Secretary Beth Kidder requesting immediate action, which was followed up with multiple meetings with Medicaid Director Tom Wallace and legislative leaders to offer recommendations for how to utilize the funding and ensure integrity in the distribution process. We are hopeful that these funds give some much-needed financial relief for agencies and home care workers after all they have endured over the past 20 months of the COVID-19 pandemic.

HCAF will continue to engage with AHCA leadership to provide recommendations and assistance as the process unfolds, and will keep our valued members informed along the way. Our year-round advocacy is are essential to ensuring victories like this one for all providers. Just imagine what we could achieve if we had the support of every home health agency as a member? If your agency is not a member, please help us continue to move the ball forward for all providers by joining today.

Please stay tuned for more information and, as always, thank you for your support for HCAF!