ADvancing States Releases Updated Analysis of State HCBS Spending Plans

The American Rescue Plan Act (ARPA) included a 10% FMAP increase to Medicaid-funded HCBS. CMS requires states to submit semi-annual spending plan updates outlining changes to previously approved activities using ARPA HCBS funding.

ADvancing States released an analysis of states’ initial spending plan submissions in September 2021, grouping activities into tables focusing on ten areas.  Each table provides information on a specific category of activities, including:

  • Service Expansions
  • Eligibility and Enrollment Activities
  • Provider Payment Increases
  • Direct Care Worker Recruitment, Retention, and Training
  • Technology for Providers
  • Technology for State Agencies
  • Capital/Structural Improvements
  • Quality Initiatives
  • Strengthening State Administration
  • Other Activities (not captured elsewhere)

We have updated these tables using the states’ most recent spending plan updates to CMS (either October 2022 or January 2023). We indicate removal of an initiative in a table by striking through the X, and new initiatives by a new X in green.  Notes indicating more nuanced changes can be found in the ‘other’ column.

This analysis reflects moment-in-time activity since states are able to update and modify initiatives in each spending plan. Although these public tables are high-level, ADvancing States has compiled more detailed information that is available to state agencies upon request. For more information about this document, or to request assistance with any ARPA related initiative, please contact Camille Dobson at

Click here to access the March 2023 analysis. 

Alert date: 
Monday, March 27, 2023