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Office of Community Living outlines LTSS spending surge and proposes utilization limits, rate alignments and DD‑waiver enrollment changes
Summary
HCPF’s Office of Community Living told the committee LTSS spending has grown rapidly and that utilization and recent wage‑driven rate increases together explain most of the trend. OCL proposed a package of measures (soft yearly HCBS caps, 56‑hour weekly provider limits, caps on legally responsible persons' homemaker hours, rate alignment for certain residential settings, PEDI for residential services, and DD waiver enrollment changes) intended to slow growth while preserving community care.
Bonnie Silva, director of HCPF’s Office of Community Living, told the Joint Budget Committee the state faces unsustainable LTSS cost growth and presented a multi‑part proposal to slow trends while preserving access to community services.
Silva said LTSS spending is driven primarily by utilization (roughly 46% of recent trend), rate increases tied to workforce wage investments (about 43% of trend) and enrollment changes. The agency cited a net OCL budget of just over $5 billion total funds with about 50% federal match and said projected LTSS spending will rise another $2.17 billion in FY26‑27 absent corrective action.
To reduce growth, HCPF proposed targeted measures in the…
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