On March 11, 2021, the American Rescue Plan Act (ARPA) was signed. It includes Section 9817, which gives qualifying states a temporary 10% increase in federal medical assistance percentage (FMAP) for specific Medicaid expenditures related to HCBS programs from April 1, 2021, to March 31, 2022. States must use these extra federal funds to enhance their existing state funds for Medicaid HCBS that were in place as of April 1, 2021.

 

Furthermore, states are required to allocate state funds matching the increased federal funds from the enhanced FMAP for activities that improve, broaden, or reinforce Home and Community-Based Services (HCBS) within the Medicaid program. These funds with the increased FMAP can be utilized until March 31, 2024, for activities aligned with ARPA Section 9817 goals, as specified in the Centers for Medicare and Medicaid Services (CMS) guidance. ARPA allows states to implement various activities, such as improving HCBS services, eligibility, infrastructure, and reimbursement methods, to enhance, expand, or strengthen Medicaid HCBS.

ARPA Projects

Remote Monitoring Grant

Starting October 1, 2022, Iowa Medicaid will take applications from eligible providers for the ARPA HCBS Remote Monitoring Grant. This grant aims to aid qualified Home and Community-Based Services (HCBS) providers by providing funds for remote support services that use technology. These services involve real-time assistance from direct support professionals in distant locations. The grant funds are meant to cover expenses associated with implementing technology-enabled services to enhance and expand the capacity of providers to serve HCBS waiver and HCBS habilitation participants.

Health Information Technology (IT) and Infrastructure Grant

Beginning October 1, 2022, Iowa Medicaid will accept applications from eligible providers to receive funds from the ARPA HCBS Health IT and Infrastructure Grant.

Grants will serve the purpose of assisting qualified HCBS providers with funding projects that improve, enhance, and/or expand HCBS, including but not limited to those that allow providers to implement meaningful use of certified electronic health records (EHR) systems; to fully comply with the HCBS settings rule or electronic visit verification (EVV) requirements; or to otherwise expand their capacity to serve HCBS waiver or HCBS habilitation participants.

Health IT and Infrastructure Grant Funds

Agency providers enrolled under multiple national provider identifiers (NPIs) for eligible HCBS should list those NPIs and their corresponding tax ID number and pay-to-legacy numbers on the application. Providers should submit only one application per organization. Duplicate applications will be rejected.

Agency providers may apply for the Health IT and Infrastructure Grant funds beginning October 1, 2022. The application period will remain open until the funds allocated for this project have been expended. Providers may request grant funds by completing the online application and attestation and uploading the required documents and minority impact statement. The department will only accept complete applications which include the submission of the required documents listed below.

Proposals from entities that have multiple locations may be awarded for only one location or all locations at the department’s discretion. Entities should indicate the location(s) in their proposal application. Entities can submit proposals for multiple projects (if applicable, submit one proposal application with all projects listed).

HCBS Employee Training and Scholarship Grant

Beginning October 1, 2022, Iowa Medicaid will accept applications from eligible providers to receive funds from the ARPA HCBS Employee Training and Scholarship Grant.

Grants will serve the purpose of assisting qualified HCBS providers with funding employee training and scholarships for education and training in nursing, behavioral health, and other healthcare fields. Grant funds must be used to cover costs related to training and education that will enhance the quality of direct services provided and/or cover the costs related to a course of study that is expected to lead to career advancement with the provider or in the HCBS field.

Iowa Medicaid ARPA HCBS Spending Plan and Narrative 2023

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Iowa Medicaid ARPA HCBS Spending Plan and Narrative FFY 2023 Q3

Iowa Medicaid ARPA HCBS Spending Plan FFY 2022

ARPA Information and Resources

ARPA 2021

Centers for Medicare and Medicaid Services (CMS) Letter to State Medicaid Directors

CMS LTSS Rebalancing Toolkit

PUBLIC NOTICE: Feedback Requested for Iowa Medicaid's American Rescue Plan Act Funds