,i #aadth ,,congress #b;d ,session ,h4 ,r4 #eijb ,,in ,,the ,,house ,,of ,,representatives ,july #ad1 #bjaf,mr4 ,tonko 7for himself1 ,mr4 ,stivers1 ,mr4 ,langevin1 and ,mr4 ,harper7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to provide a temporary higher ,federal medical assistance percentage for ,federal expenditures under the ,medicaid program that are associated with the cost of compliance with certain ,federal regulations with respect to services furnished in certain intermediate care facilities or home and community-based services furnished to individuals with intellectual and developmental disabilities4 #a4 ,short title ,this ,act may be cited as the ,disability ,community ,act of #bjaf4 #b4 ,higher ,,fmap for certain ,medicaid expenditures associated with certain regulation compliance 7a7 ,in general ,section #aijc7;a77#e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77#e77 is amended-- 7#a7 by striking an amount equal to and inserting 7,a7 an amount equal to2 7#b7 by striking supplies2 and inserting supplies2 and2 and 7#c7 by adding at the end the following3 7,b7 an amount equal to #ij percent of the sum of the amounts expended during a quarter in #bjag1 #bjah1 or #bjai1 for items and services furnished in an intermediate care facility for the mentally retarded or for home and community-based services furnished to individuals with intellectual and developmental disabilities1 as the ,secretary determines are attributable to compliance with any of the regulations specified in-- 7i7 part #eia of title #bi1 ,code of ,federal ,regulations2 7ii7 part #eeb of title #bi1 ,code of ,federal ,regulations2 or 7iii7 part #dcj1 #dca1 #dce1 #dcf1 #ddj1 #dda1 or #ddg of title #db1 ,code of ,federal ,regulations2 4 7b7 ,conforming terminology for intermediate care facilities ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended-- 7#a7 by striking intermediate care facility for the mentally retarded each time such term appears 7including in headings7 and inserting intermediate care facility for individuals with intellectual and developmental disabilities2 7#b7 by striking intermediate care facilities for the mentally retarded each time such term appears 7including in headings7 and inserting intermediate care facilities for individuals with intellectual and developmental disabilities2 7#c7 by striking ,state mental retardation or developmental disability authority each time such term appears and inserting ,state intellectual or developmental disability authority2 7#d7 in section #aije7;d7-- 7,a7 in the matter before paragraph 7#a71 by striking thereof7 for the mentally retarded or persons and inserting thereof7 for individuals with intellectual or developmental disabilities or2 7,b7 in paragraph 7#a71 by striking mentally retarded individuals and inserting individuals with intellectual or developmental disabilities2 and 7,c7 in paragraph 7#b71 by striking the mentally retarded individual and inserting the individual with an intellectual or developmental disability2 7#e7 in section #aiae7;c77#g77;,c71 by striking mental retardation and inserting intellectual or developmental disabilities2 7#f7 in section #aiai7;b7-- 7,a7 in paragraph 7#c7-- 7i7 in subparagraph 7,e71 by striking mentally retarded and inserting has intellectual or developmental disabilities2 and 7ii7 in subparagraph 7,f7-- 7,i7 in the heading1 by striking and mentally retarded individuals and inserting individuals and individuals with intellectual or developmental disabilities2 and 7,,ii7 in clause 7ii7-- 7aa7 by striking is mentally retarded and inserting has an intellectual or developmental disability2 and 7bb7 by striking for mental retardation and inserting for intellectual or developmental disabilities2 7,b7 in paragraph 7#d7-- 7i7 in subparagraph 7,a77vii71 by striking mentally ill and mentally retarded residents and inserting residents who are mentally ill or who have intellectual or developmental disabilities2 and 7ii7 in subparagraph 7,c77ii77,,iv71 by striking the mentally retarded and inserting individuals with intellectual or developmental disabilities2 and 7#g7 in section #aiai7;e7-- 7,a7 in paragraph 7#g7-- 7i7 in subparagraph 7,a77i71 by striking mentally ill and mentally retarded individuals and inserting individuals who are mentally ill or who have intellectual or developmental disabilities2 7ii7 in subparagraph 7,b7-- 7,i7 by striking mental retardation each place such term appears and inserting intellectual or developmental disability2 7,,ii7 in clause 7ii7-- 7aa7 in the heading1 by striking mentally retarded residents and inserting residents with intellectual or developmental disabilities2 and 7bb7 in the matter preceding subclause 7,i71 by striking is mentally retarded and inserting has an intellectual or developmental disability2 and 7,,iii7 in clause 7iii71 by striking mentally ill or mentally retarded resident and inserting resident who is mentally ill or who has an intellectual or developmental disability2 7iii7 in subparagraph 7,c71 by striking mental retardation each place such term appears and inserting intellectual or developmental disability2 7iv7 in subparagraph 7,e7-- 7,i7 by striking are mentally retarded or and inserting have intellectual or developmental disabilities or are2 and 7,,ii7 by striking mental retardation and inserting intellectual or developmental disability2 and 7v7 in subparagraph 7,g77ii7-- 7,i7 by striking be mentally retarded and inserting have an intellectual or developmental disability2 and 7,,ii7 by striking is mentally retarded or a person with and inserting has an intellectual or developmental disability or4 #c4 ,electronic visit verification system required for personal care services and home health care services under medicaid 7a7 ,in general ,section #aijc of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7 is amended by inserting after subsection 7k7 the following new subsection3 7l7 7#a7 ,subject to paragraphs 7#c7 and 7#d71 with respect to any amount expended for personal care services or home health care services requiring an in-home visit by a provider that are provided under a ,state plan under this title 7or under a waiver of the plan7 and furnished in a calendar quarter beginning on or after ,january #a1 #bjai 7or1 in the case of home health care services1 on or after ,january #a1 #bjbc71 unless a ,state requires the use of an electronic visit verification system for such services furnished in such quarter under the plan or such waiver1 the ,federal medical assistance percentage shall be reduced-- 7,a7 in the case of personal care services-- 7i7 for calendar quarters in #bjai and #bjbj1 by 4#be percentage points2 7ii7 for calendar quarters in #bjba1 by 4#e percentage points2 7iii7 for calendar quarters in #bjbb1 by 4#ge percentage points2 and 7iv7 for calendar quarters in #bjbc and each year thereafter1 by #a percentage point2 and 7,b7 in the case of home health care services-- 7i7 for calendar quarters in #bjbc and #bjbd1 by 4#be percentage points2 7ii7 for calendar quarters in #bjbe1 by 4#e percentage points2 7iii7 for calendar quarters in #bjbf1 by 4#ge percentage points2 and 7iv7 for calendar quarters in #bjbg and each year thereafter1 by #a percentage point4 7#b7 ,subject to paragraphs 7#c7 and 7#d71 in implementing the requirement for the use of an electronic visit verification system under paragraph 7#a71 a ,state shall-- 7,a7 consult with agencies and entities that provide personal care services1 home health care services1 or both under the ,state plan 7or under a waiver of the plan7 to ensure that such system-- 7i7 is minimally burdensome2 7ii7 takes into account existing best practices and electronic visit verification systems in use in the ,state2 and 7iii7 is conducted in accordance with the requirements of ,,hipaa privacy and security law 7as defined in section #cjji of the ,public ,health ,service ,act72 7,b7 take into account a stakeholder process that includes input from beneficiaries1 family caregivers1 personal care or home health care services workers1 and other stakeholders1 as determined by the ,state in accordance with guidance from the ,secretary2 and 7,c7 ensure that individuals who furnish personal care services1 home health care services1 or both under the ,state plan 7or under a waiver of the plan7 are provided the opportunity for training on the use of such system4 7#c7 ,paragraphs 7#a7 and 7#b7 shall not apply in the case of a ,state that1 as of the date of the enactment of this subsection1 requires the use of any system for the electronic verification of visits conducted as part of both personal care services and home health care services4 7#d7 7,a7 ,in the case of a ,state described in subparagraph 7,b71 the reduction under paragraph 7#a7 shall not apply-- 7i7 in the case of personal care services1 for calendar quarters in #bjai2 and 7ii7 in the case of home health care services1 for calendar quarters in #bjbc4 7,b7 ,for purposes of subparagraph 7,a71 a ,state described in this subparagraph is a ,state that demonstrates to the ,secretary that the ,state-- 7i7 has made a good faith effort to comply with the requirements of paragraphs 7#a7 and 7#b7 7including by taking steps to adopt the technology used for an electronic visit verification system72 or 7ii7 in implementing such a system1 has encountered unavoidable system delays4 7#e7 ,in this subsection3 7,a7 ,the term electronic visit verification system means1 with respect to personal care services or home health care services1 a system under which visits conducted as part of such services are electronically verified with respect to-- 7i7 the type of service performed2 7ii7 the individual receiving the service2 7iii7 the date of the service2 7iv7 the location of service delivery2 7v7 the individual providing the service2 and 7vi7 the time the service begins and ends4 7,b7 ,the term home health care services means services described in section #aije7;a77#g7 provided under a ,state plan under this title 7or under a waiver of the plan74 7,c7 ,the term personal care services means personal care services provided under a ,state plan under this title 7or under a waiver of the plan71 including services provided under section #aije7;a77#bd71 #aiae7;c71 #aiae7;i71 #aiae7;j71 or #aiae7k7 or under a wavier under section #aaae4 7#f7 7,a7 ,in the case in which a ,state requires personal care service and home health care service providers to utilize an electronic visit verification system operated by the ,state or a contractor on behalf of the ,state1 the ,secretary shall pay to the ,state1 for each quarter1 an amount equal to #ij per centum of so much of the sums expended during such quarter as are attributable to the design1 development1 or installation of such system1 and #ge per centum of so much of the sums for the operation and maintenance of such system4 7,b7 ,subparagraph 7,a7 shall not apply in the case in which a ,state requires personal care service and home health care service providers to utilize an electronic visit verification system that is not operated by the ,state or a contractor on behalf of the ,state4 4 7b7 ,collection and dissemination of best practices ,not later than ,january #a1 #bjah1 the ,secretary of ,health and ,human ,services shall1 with respect to electronic visit verification systems 7as defined in subsection 7l77#e7 of section #aijc of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b71 as inserted by subsection 7a771 collect and disseminate best practices to ,state ,medicaid ,directors with respect to-- 7#a7 training individuals who furnish personal care services1 home health care services1 or both under the ,state plan under title ,,xix of such ,act 7or under a waiver of the plan7 on such systems and the operation of such systems and the prevention of fraud with respect to the provision of personal care services or home health care services 7as defined in such subsection 7l77#e772 and 7#b7 the provision of notice and educational materials to family caregivers and beneficiaries with respect to the use of such electronic visit verification systems and other means to prevent such fraud4 7c7 ,rules of construction 7#a7 ,no employer-employee relationship established ,nothing in the amendment made by this section may be construed as establishing an employer-employee relationship between the agency or entity that provides for personal care services or home health care services and the individuals who1 under a contract with such an agency or entity1 furnish such services for purposes of part #eeb of title #bi1 ,code of ,federal ,regulations 7or any successor regulations74 7#b7 ,no particular or uniform electronic visit verification system required ,nothing in the amendment made by this section shall be construed to require the use of a particular or uniform electronic visit verification system 7as defined in subsection 7l77#e7 of section #aijc of the ,social ,security ,act1 as inserted by subsection 7a77 by all agencies or entities that provide personal care services or home health care under a ,state plan under title ,,xix of the ,social ,security ,act 7or under a waiver of the plan7 7#db ,u4,s4,c4 #acif et seq474 7#c7 ,no limits on provision of care ,nothing in the amendment made by this section may be construed to limit1 with respect to personal care services or home health care services provided under a ,state plan under title ,,xix of the ,social ,security ,act 7or under a waiver of the plan7 7#db ,u4,s4,c4 #acif et seq471 provider selection1 constrain beneficiaries' selection of a caregiver1 or impede the manner in which care is delivered4 7#d7 ,no prohibition on state quality measures requirements ,nothing in the amendment made by this section shall be construed as prohibiting a ,state1 in implementing an electronic visit verification system 7as defined in subsection 7l77#e7 of section #aijc of the ,social ,security ,act1 as inserted by subsection 7a771 from establishing requirements related to quality measures for such system4