Capitol Correspondence - 12.06.22

Kaiser Family Foundation Releases New Resources Evaluating HCBS Waiting Lists and the Impact of the Pandemic

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Last week the Kaiser Family Foundation (KFF) issued two new resources that shed light on the current state of Home and Community-Based Services (HCBS) across the country.

In A Look at Waiting Lists for Home and Community-Based Services from 2016 to 2021, KFF finds that the number of states with waiting lists reached a low in 2021, with 37 states maintaining waiting lists for HCBS. In 2021, the number of people waiting for HCBS across those states was approximately 656,000. Of those people on waiting lists, people with intellectual and developmental disabilities comprise 73%, or about 482,000.

KFF also released its report, the Ongoing Impacts of the Pandemic on Medicaid Home & Community-Based Services (HCBS) Programs: Findings from a 50-State Survey, which looks at the impact of the workforce crisis on availability of services. The survey findings mirror those of ANCOR’s direct support workforce survey, which found that the pandemic’s affect on the direct support workforce has been so extreme as to jeopardize access to services.

Key findings from KFF’s pandemic survey include:

  • All responding states (49 in total) indicated they were experiencing shortages of direct care workers in 2022.
  • 44 states reported a permanent closure of at least one Medicaid HCBS provider during the pandemic, up from 30 states in 2021.
  • 48 states reported that they responded to the workforce crisis by increasing HCBS provider payment rates, many through use of American Rescue Plan Act (ARPA) funding or emergency authorities authorized through the public health emergency.
  • More than half of states said they plan to continue rate increases even after temporary funding and authorities expire.
  • 35 states reported their use of ARPA funds was limited to temporary measures to avoid higher ongoing costs after enhanced federal funding ended.