Press Releases

CMS Provides Critical Tools to Help Improve Access for Millions who Receive Medicaid Home- and Community-based Services

New guidance outlines how states can establish important tools to connect individuals needing care with those qualified to provide it.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today took another critical step to improve access to home- and community-based services (HCBS) by reminding states of tools to better connect direct support workers to individuals receiving Medicaid-covered HCBS, such as individuals with disabilities and older adults. The agency’s new guidance focuses on building and maintaining worker registries — worker management platforms that make qualified health workers easier to find — so more individuals receiving Medicaid-covered services can receive care in a setting of their choice. The guidance also notes significant federal funding available to help states build these registries thanks to President Biden’s American Rescue Plan (ARP).

“For too long, American families have struggled to find and afford reliable high-quality care that enables their loved ones to live independently. Some people are forced to forgo their careers and stay home to care for a family member, and many caregivers struggle to make living wages. Thanks to President Biden and the American Rescue Plan, that changes today,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration has distributed $37 billion from the American Rescue Plan across all 50 states for home- and community-based services. Additionally, we are delivering new guidance to states about how direct worker registries can help ensure more individuals receiving Medicaid-covered services can receive care in a setting of their choice.” 

“It’s critical that people, particularly older Americans and people with disabilities, are able to receive care in the setting of their choice,” said CMS Administrator Chiquita Brooks-LaSure. “To achieve that vision, communities need clear links to the qualified professionals best trained provide that care. Helping states build and maintain worker registries will enable more people to find and receive high-quality, affordable, and person-centered care at home and in the community.”

Even before the COVID-19 public health emergency, shortages of direct support workers meant that many people were left with limited care choices, which sometimes lead individuals to receive care unnecessarily in institutional settings like nursing homes. One way to address this challenge is by leveraging worker registries to help Medicaid recipients answer two critical questions: Who is qualified to provide HCBS in my state, and how can I find them?

In addition to highlighting the value and mechanics of building worker registries, CMS’ guidance reiterates that states can access enhanced federal funding, including through the ARP, to develop and publicly post these lists of workers. Doing so can help with recruiting and retaining workers already in short supply. By better facilitating access to a robust pool of direct support workers, states can help more people find qualified professionals for their needs. This can improve quality of care and allow more individuals to remain in the community while strengthening the direct care workforce in states.

CMS also released data today on how enhanced funding for HCBS provided through the ARP has been invested to strengthen access to HCBS across the country. 

This guidance marks another step towards supporting access to quality HCBS so older adults and individuals with disabilities can live safely and independently in their homes and communities. These efforts include enhanced Medicaid funding for HCBS provided through the ARP; proposed rulemaking, including to improve access to care, care quality, and health outcomes, as well as better address health equity issues in the Medicaid program; and work with partners across government, including at the Department of Labor, to improve the type of data available on this workforce. It also helps implement President Biden’s executive order to increase access to high-quality care and support caregivers, millions of whom could leverage HCBS to reduce caregiver burden and burnout as more people seek care at home or in the community.

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