Capitol Correspondence - 10.09.18

GAO Issues Report Reviewing Medicaid HCBS Program Structures and Challenges Providing Services

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GAO Issues Report Reviewing Medicaid HCBS Program Structures and Challenges Providing Services

The Government Accountability Office (GAO) issued a report reviewing challenges states face with their Home and Community Based Services (HCBS) programs, citing the increase demand for these programs as a motivation for understanding the approaches states use to provide HCBS coverage. The report looked at 26 programs in five states:  Arizona, Florida, Mississippi, Montana, and Oregon.  Notably, GAO noted the workforce crisis as one of the key challenges and themes surrounding this programs.

As summarized on its report page, GAO found that:

“State and MCO officials identified several challenges providing HCBS and described their efforts to respond to them:

HCBS workforce: Officials cited challenges recruiting and retaining HCBS providers, particularly given the low wages these providers typically receive. To respond to this, officials from Mississippi, Montana, and two of the MCOs reported offering providers higher payment rates.

Complex needs: Officials described challenges serving beneficiaries with complex medical and behavioral health needs, including individuals who display aggressive or other challenging behaviors. Officials from Montana and one MCO reported responding to this challenge by providing behavioral health training for providers.

HCBS funding: State officials reported that limitations on overall HCBS funding levels posed a challenge, which they responded to by providing their state legislatures with information on the projected need for HCBS to inform future funding decisions, and leveraging other available resources, such as federal grants.

The Department of Health and Human Services provided technical comments on a draft of this report, which GAO incorporated as appropriate.”

ANCOR encourages its members to use this important report to highlight the challenges in the Medicaid program – and the successes even in light of the challenges – in the federal, state, and local advocacy of your services.