New York State Department of Health

1 HCBS Spending Plan For Implementation of American Rescue Plan ActAll Figures are in MillionsFFY Quarter 2 2022 Update (Gross)Projection in Q1 Spending PlaneFMAP Projection in Q1 Spending PlanSee tables below for Federal/Non-Federal Share SplitShared with CMS in October 2021 ProgramFFY21Q3 04/01/21-06/30/21 FFY21Q4 07/01/21-09/30/21 FFY22Q1 10/01/21-12/31/21 FFY22Q2 01/01/22-03/31/22 TOTALQ1 ProjectionDollar Difference% DifferenceFFY Q2 UpdateTotal Projection(~10% eFMAP)Q1 Projection(10% eFMAP)Dollar Difference% DifferenceHCBS (Managed Care)*$3,683$4,050$3,780$4,018$15,531$13 ,715$1, $1,526$1,372$ (All 1915c Waivers)**$1,819$1,742$1,976$1,895$7,433 $7,027$ $743$703$ Care Services $179$178$182$183$723$728($5) $72$73($1) Health Services $149$134$137$139$559$612($53) $56$61($5) E $87$90$86$93$355$355$ $36$35$ Management $8$9$9$9$35$41($6) $4$4($1) (in millions)$5,925$6,203$6,171$6,337$24,636 $22,478$2, $2,437$2,248$ denoted in blue text and subject to retrospective update upon future submissions.

2 Footnotes* Includes Managed Care & Managed Long Term Care (MLTC) HCBS spend; excluding PACE which is lined out separately below.** Includes DOH & non-DOH/Other State Agency (OSA) Fee-for-Service (FFS) spend and actuals pulled from the CMS 64 report spanning 4/1/21 through 09/30/21. These are FFS programs and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 09/30/21. This is an MLTC Managed Care program and actual spending is pulled from the CMS 64 report spanning 4/1/21 through 09/31 : The actual expenditure values for FFY21Q3 & FFY21Q4 in the summary table above are estimates based on a draft methodology not yet approved by estimate of funds attributable to the increase in FMAP that the State has claimed and/or anticipates claiming between April 1, 2021, and March 31, 2022.

3 All dollar figures are in based on proposed spend plan total projections Note: The expenditure values in the summary table above do not include anticipated HCBS spend resulting from re-investment of funding on HCBS eFMAP spending plan with CMS in October 2021 CategoryProposal NameLead AgencyExpenditureSFE Funding (Estimate @ completion)FFPG rossEstimate to Completion (SFE)Total Spend to-Date (SFE)FFY21Q2 (SFE)01/01/21 - 03/31/21 FFY21Q2 (Gross)01/01/21 - 03/31/21 FFY21Q3 (SFE)04/01/21 - 06/30/21 FFY21Q3 (Gross)04/01/21 - 06/30/21 FFY21Q4 (SFE) 07/01/21 - 09/30/21 FFY21Q4 (Gross) 07/01/21 - 09/30/21 FFY22Q1 (SFE)

4 10/01/21 - 12/31/21 FFY22Q1 (Gross) 10/01/21 - 12/31/21 FFY22Q2 (SFE) 01/01/22 - 03/31/22 FFY22Q2 (Gross) 01/01/22 - 03/31/22 FFY22Q3 (SFE)04/01/22- 06/30/22 FFY22Q3 (Gross)04/01/22- 06/30/22 FFY22Q4 (SFE)07/01/22- 09/30/22 FFY22Q4 (Gross)07/01/22- 09/30/22 FFY23Q1 (SFE) 10/01/22 - 12/31/22 FFY23Q1 (Gross) 10/01/22 - 12/31/22 FFY23Q2 (SFE)01/01/23 - 03/31/23 FFY23Q2 (Gross)01/01/23 - 03/31/23 FFY23Q3 (SFE)04/01/23 - 06/30/23 FFY23Q3 (Gross)04/01/23 - 06/30/23 FFY23Q4 (SFE)07/01/23 - 09/30/23 FFY23Q4 (Gross)07/01/23 - 09/30/23 FFY24Q1 (SFE) 10/01/23 - 12/31/23 FFY24Q1 (Gross) 10/01/23 - 12/31/23 FFY24Q2 (SFE)01/01/24 - 03/31/24 FFY24Q2 (Gross)01/01/24 - 03/31/24 FFY24Q3 (SFE)04/01/24 - 06/30/24 FFY24Q3 (Gross)04/01/24 - 06/30/24 FFY24Q4 (SFE)07/01/24 - 09/30/24 FFY24Q4 (Gross)

5 07/01/24 - 09/30/24 Support & Strengthening the Direct Care WorkforceATransform the Long-Term Care Workforce and Achieve Value-Based PaymentDOHD irected Payment807,214,000$ 897,514,000$ 1,704,728,000$ 807,214,000$ -$ $0$0$0$0$0$0$0$0$180,600,000$451,500,000 $0$0$0$0$626,614,000$1,253,228,000$0$0$0 $0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceBCOVID Workforce Performance IncentivesOPWDD1915 (c) Waiver Amendment Appendix 582,726,568$ 552,726,568$ 1,135,453,136$ 582,726,568$ -$ $0$0$0$0$0$0$0$0$528,384,000**$1,056,768 ,000$24,342,568**$48,685,136$10,000,000$ 10,000,000$10,000,000$10,000,000$10,000, 000$10,000,000$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceCExpand Advanced Training Incentive (ATI)

6 Program for HCBS Transitions from Nursing HomeDOHS tate Plan Amendment69,100,000$ 69,100,000$ 138,200,000$ 69,100,000$ -$ $0$0$0$0$0$0$0$0$0$0$69,100,000$138,200, 000$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceDWorkforce Transportation IncentiveDOHN/A10,000,000$ -$ 10,000,000$ 10,000,000$ -$ $0$0$0$0$0$0$0$0$0$0$0$0$0$0$10,000,000$ 10,000,000$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceEImprove the OMH WorkforceOMHD irected Payment & State Plan Amendment39,166,796$ 50,325,145$ 89,491,941$ 39,166,796$ -$ $0$0$0$0$0$0$0$0$22,316,699$55,791,747$8 ,425,048$16,850,097$8,425,048$16,850.

7 097$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceFImprove the OASAS WorkforceOASASS tate Plan Amendment7,695,974$ 7,695,974$ 15,391,949$ 7,695,974$ -$ $0$0$0$0$0$0$0$0$0$0$7,695,974$15,391,94 9$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceGIncrease medicaid Rehabilitation Rates for OMH Community Residence ProgramsOMHS tate Plan Amendment7,000,000$ 7,200,000$ 14,200,000$ 7,000,000$ -$ $0$0$0$0$0$0$0$0$7,000,000$14,200,000$0$ 0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceHEnhance the Children's Services WorkforceDOHD irected Payment4,640,000$ 6,960,000$ 11,600,000$ 4,640.

8 000$ -$ $0$0$0$0$0$0$0$0$4,640,000$11,600,000$0$ 0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceIExpand Training and Implementation Support for Evidence Based Practices (EBPs)OMHN/A8,600,000$ -$ 8,600,000$ 8,600,000$ -$ $0$0$0$0$0$0$0$0$8,600,000$8,600,000$0$0 $0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceJExpand Recruitment and Retention of Culturally Competent, Culturally Responsive and Diverse PersonnelOMHN/A4,000,000$ -$ 4,000,000$ 4,000.

9 000$ -$ $0$0$0$0$0$0$0$0$4,000,000$4,000,000$0$0 $0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceKExpand Certified and Credentialed Peer CapacityOMHD irected Payment4,000,000$ -$ 4,000,000$ 4,000,000$ -$ $0$0$0$0$0$0$0$0$4,000,000$4,000,000$0$0 $0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceLHomecare Worker BonusDOHD irected Payment417,750,000$ 417,750,000$ 835,500,000$ 417,750,000$ -$ $0$0$0$0$0$0$0$0$0$0$104,050,000$208,100 ,000$104,500,000$209,000,000$104,500,000 $209,000,000$104,700,000$209,400,000$0$0 $0$0$0$0$0$0$0$0$0$0 Support & Strengthening the Direct Care WorkforceMImprove and Support the Assisted Living Program (ALP)

10 WorkforceDOHD irected Payment 20,000,000$ 20,000,000$ 40,000,000$ 20,000,000$ -$ $0$0$0$0$0$0$0$0$0$0$5,000,000$10,000,00 0$5,000,000$10,000,000$5,000,000$10,000, 00