The Centers for Medicare and Medicaid Services (CMS) has issued this bulletin to the states on the workforce crisis.

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SUBJECT: Suggested Approaches for Strengthening and Stabilizing the Medicaid Home Care Workforce


This informational bulletin highlights steps available to states, providers, and others to strengthen the home care workforce, the term used in this document to encompass individuals furnishing HCBS, consistent with advancing goals of beneficiary autonomy and self-direction of needed services.

CMS and states are taking important steps to support increased access to high-quality home and community based care. These steps are helping to remedy a longstanding imbalance between institutional and home and community-based care: data for fiscal year 2014 showed that 53 percent of total Medicaid long-term services and supports (LTSS) expenditures were spent on home and community-based services (HCBS), a marked change from 2009 when only 45 percent of LTSS expenditures were on HCBS1. To continue this progress, CMS and states have moved forward with implementing recent regulations requiring greater community integration, adopting key improvements to managed LTSS, and soliciting public comment on how best to measure access to HCBS. A stable workforce, engaged in the delivery of services and supports that address the needs and preferences of beneficiaries, is a critical element to achieving continued progress.


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Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)