A federal proposal to make Home and Community-Based Services (HCBS) a mandatory Medicaid benefit is back in play.

The HCBS Access Act, first introduced in the summer of 2021, is a “companion” bill to Better Care Better Job Acts, a proposal that would give states a 10 percentage point increase in federal Medicaid matching funds for services. That bill was reintroduced in January.

Backers say the Access Act would “eliminate waiting lists for community-based services over time by increasing funding for the program, providing grants to states to make Home and Community-Based Services a mandatory Medicaid benefit,” reports Disability Scoop.

Currently, only institutional care is automatically covered by Medicaid. People with developmental disabilities need waivers to access these services, and waitlists can be long.

More challenging, once a waiver has been approved, waitlists for the services themselves are notoriously long as well. There are more than 650,000 people nationwide still stuck on waiting lists who are not getting the services they need, according to the Arc of the U.S. In 2021, people on waiting lists waited an average of 45 months to receive HCBS waiver services, according to the Kaiser Family Foundation. People with intellectual developmental disabilities, it noted, waited the longest for services, 67 months on average.

In New York, the waiver is administered by OPWDD. It’s OPWDD’s primary funding mechanism for supporting individuals in the community by providing a variety of services and supports individualized to meet each person’s needs, such as habilitation services, respite care and service coordination.

Congresswoman Debbie Dingell (MI-06), Senator Bob Casey (D-PA), and Congressman Jamaal Bowman Ed.D. (NY-16) introduced the HCBS Access Act.


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