Committee weighs HCBS soft caps, caregiver-hour limits and exception process

The joint committee spent extensive time on Home- and Community-Based Services (HCBS) proposals that would limit hours and change authorization processes.

Director Silva and OSPB staff said HCBS and family-caregiver payments have grown rapidly under Community First Choice and that a new set of proposals would control growth while preserving necessary access. Silva described a phased approach that would delay implementation and allow stair-step reductions to 56 hours per caregiver by November 1, 2026, with an appeals and exceptions process handled by case management agencies.

Committee members warned of consequences for single-parent caregivers in rural areas who may not be able to recruit substitute caregivers. Representative Taggart recounted a constituent's experience caring full time for a child with complex needs and asked how an exceptions process would prevent harm. Silva said exceptions would be available through case managers and that the department would provide temporary allowances where no alternative exists.

Members also focused on operational capacity: if a cap is in place, appeals must be processed quickly. Staff and the department asked for one term-limited FTE to manage appeals and exception reviews; the committee approved that request on a 4–2 vote with a requirement to revisit staffing after up to two fiscal years.

Committee direction: staff and the department will provide additional modeling on provider makeup, likely behavioral changes, expected appeals workload and more detailed member/family impact scenarios for figure setting.