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Sustainability

Figuring out how to pay for services and program development is an ongoing struggle.  While the Deficit Reduction Act and other legislation has broadened the potential authorities states may use to fund services, each of these new authorities has its own limitations and requirements.   

HCBS Strategies can assist in developing sustainable programs in the following ways:

Finding the Best Fit for Drawing Down Federal Financial Participation (FFP): 

We have done detailed comparisons of all of the Medicaid funding authorities including administrative match, 1915(a)/(b)/(c)/(g) /(i)/(j), and 1115.  We used this analysis to crosswalk what services and for whom a state wished to draw down FFP with the most appropriate funding opportunity.  Our experience participating in federal and state panels reviewing State Plan Amendments and Waiver applications helps us to provide practical advice regarding which is the most reasonable approach.

Writing waiver applications:

We have written 1915(c) Waiver applications (including using the Waiver application 3.5 formats) and 1115 Demonstrations. 

Grant Writing: 

We have written successful competitive grant applications to federal agencies including CMS and the Administration on Aging.  Our staff also have extensive experience participating in and overseeing federal grant solicitations.

Fiscal Impact Statements: 

States typically need to develop a fiscal impact statement to justify the adoption or expansion of a program.  We have experience developing microsimulation models that can be used to develop these estimates.

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