October 6, 2021

PUBLIC NOTICE
Department of Health

Pursuant to 42 CFR Section 447.205, the Department of Health hereby gives public notice of the following:

The Department of Health proposes to amend the Title XIX (Medicaid) State Plan for non-institutional services to enhance, and increase access to, Home and Community Based Services (HCBS) in accordance with the federal statutory provisions of Section 9817 of the American Rescue Plan Act of 2021 (ARP) which, subject to approval of the State’s initial spending plan and narrative (Spending Plan) by the Centers for Medicare and Medicaid Services (CMS), provides a ten percent increase in Federal Medical Assistance Percentage (FMAP) to state Medicaid programs from April 1, 2021 to March 31, 2022 to supplement existing state expenditures on HCBS. The following changes are proposed:

Non-Institutional Services

Contingent upon CMS approval of the Spending Plan submitted by the State, effective on or after October 7, 2021, this notice proposes to increase reimbursement rates, as follows:

1) Rates for state-plan approved Assertive Community Treatment (ACT) Services will be increased by 5.0 percent, effective October 7, 2021. However, to allow for the full disbursement of funds available April 1, 2021 – March 31, 2022, the rate increase for the period October 7, 2021 – March 31, 2022 will be an additional 5.0 percent, for a total increase of 10.0 percent. Rates will then be reduced 5.0 percent effective April 1, 2022. This enhancement will allow providers to supplement the implementation of one or more activities to enhance, expand or strengthen HCBS under the Medicaid program, including strengthening the response to the COVID-19 Public Health Emergency, assisting providers in meeting the challenges of serving the highest need individuals including but not limited to, dually diagnosed individuals, homeless individuals and those receiving court ordered treatment.

The estimated annual net aggregate increase in gross Medicaid expenditures as a result of the proposed increase for ACT Services is $6,100,000.

2) Rates for state-plan approved ACT Services will be increased by an additional 8.2 percent for the period October 7, 2021 – March 31, 2022. This enhancement will allow providers to increase recruitment and retention of experienced and dedicated direct care and other staff through measures including, but not limited to, targeted loan forgiveness, tuition reimbursement, hiring and signing bonuses, longevity payments, expanded student placements, shift differential pay and retirement contributions.

The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for ACT Services $4,700,000.

3) Rates for state-plan approved ACT Services provided by 10 newly-licensed ACT teams serving individuals up to age 21 will be increased by an additional 50.0 percent, effective October 7, 2021 through March 31, 2022. This enhancement will allow for implementation of ten new Youth Assertive Community Treatment teams through start-up, training, and monitoring funds, and pre-discharge

Residential Treatment Facility (RTF) transitional services. As part of the Office of Mental Health’s mission to reduce reliance on out of home care, Youth ACT Services are an important model that is being implemented across the State to serve children and families with high needs who may not have the supports to successfully engage in more traditional outpatient services, and to divert them from long-term stays in higher levels of care.

The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for ACT Services is $2,300,000.

4) Rates for state-plan approved ACT Services will be increased by an additional 50.0 percent, effective October 7, 2021 through March 31, 2022 for certain ACT programs identified as serving young adults through start-up, training, monitoring funds, and pre-discharge.

The estimated annual net aggregate increase in gross Medicaid expenditures as a result of this proposed increase for ACT Services is $319,000.

The public is invited to review and comment on this proposed State Plan Amendment, a copy of which will be available for public review on the Department’s website at http://www.health.ny.gov/regulations/ state_plans/status. Individuals without Internet access may view the State Plan Amendments at any local (county) social services district.

For the New York City district, copies will be available at the following places:

New York County
250 Church Street
New York, New York 10018

Queens County, Queens Center
3220 Northern Boulevard
Long Island City, New York 11101

Kings County, Fulton Center
114 Willoughby Street
Brooklyn, New York 11201

Bronx County, Tremont Center
1916 Monterey Avenue
Bronx, New York 10457

Richmond County, Richmond Center
95 Central Avenue, St. George
Staten Island, New York 10301

For further information and to review and comment, please contact:
Department of Health, Division of Finance and Rate Setting, 99 Washington Ave., One Commerce Plaza, Suite 1432, Albany, NY 12210, spa_inquiries@health.ny.gov