,,ii  #aadth ,,congress  #ast ,session  
,s4 #bcch  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #a1  
#bjae,ms4 ,hirono introduced the        
following bill2 which was read twice and
 referred to the ,committee on ,health1 
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to award grants to ,states for 
the development of innovative long-term 
services and supports programs4  #a4    
,short title ,this ,act may be cited as 
the ,living ,independently for ,extended
 ,time ,act or the ,,lifetime ,act4  #b4
 ,findings ,congress finds the          
following3 7#a7 ,the number of          
,americans over age #fe or living with a
 disability is growing1 and over #gj    
percent of these individuals will need  
some form of long-term services and     
supports1 with a majority of individuals
 preferring home and community-based    
care4  7#b7 ,this is a major demographic
 shift and provides an opportunity for  
innovative solutions in long-term       
services and supports4  7#c7 ,developing

 programs to facilitate high-quality    
independent community-based living1     
create and improve jobs1 and address and
 improve upon gaps in existing systems  
will be essential to providing necessary
 services and supports to these         
individuals and families4  7#d7 ,it is  
imperative that ,congress act to address
 the looming long-term services and     
supports crisis4  #c4 ,purpose ,it is   
the purpose of this ,act to establish a 
grant program to provide incentives to  
,states for the development of solutions
 to the increased need of individuals   
for long-term services and supports and 
to increase ,state support and systems  
in long-term care4  #d4 ,establishment  
of long-term services and supports      
innovation grant program  7a7 ,state    
planning grants  7#a7 ,in general ,not  
later than #ij days after the date on   
which grant announcements are made under
 subsection 7d71 the ,secretary of      
,health and ,human ,services 7referred  
to in this ,act as the ,secretary7 shall

 award grants to eligible ,states to    
enable such ,states to develop          
innovative programs to meet the unique  
need for long-term services and supports
 in the ,state4  7#b7 ,eligibility ,to  
be eligible to receive a grant under    
paragraph 7#a71 a ,state shall-- 7,a7   
submit to the ,secretary an application1
 at such time1 in such manner1 and      
containing such information as the      
,secretary may require2  7,b7           
demonstrate to the ,secretary that the  
,state will work in conjunction with    
both public and private long-term       
services and supports stakeholder groups
 described in paragraph 7#c7 to develop 
a coordinated statewide long-term       
services and supports program for the   
,state that is not duplicative of other 
programs providing such services and    
supports in the ,state2 and  7,c7       
provide assurances that the ,state will1
 not later than #a year after the date  
on which the grant is awarded1 submit to
 the ,secretary a comprehensive plan for

 the implementation of innovative       
long-term services and supports program 
in the ,state1 which shall include the  
utilization of existing ,state or local 
frameworks4  7#c7 ,stakeholder groups   
,stakeholder groups described in this   
paragraph shall be groups that-- 7,a7   
represent the interests of--  7i7       
consumers of long-term services and     
supports and related insurance products1
 as well as their representatives2  7ii7
 older adults2  7iii7 individuals with  
cognitive or functional limitations2    
7iv7 family caregivers for individuals  
described in clause 7i71 7ii71 or 7iii72
  7v7 the health care workforce who     
directly provide long-term services and 
supports2  7vi7 private long-term       
services and supports insurance         
providers2  7vii7 employers2  7viii7    
,state insurance departments2  7ix7 area
 agency on aging or ,state agency on    
aging2  7x7 direct care workforce2 and  
7xi7 ,state ,medicaid agencies2  7,b7   
have demonstrated experience in dealing 

with issues related to long-term        
services and supports1 health care      
policy1 and public and private          
insurance2 and  7,c7 represent the      
health care interests and needs of a    
variety of geographic areas and         
demographic groups4  7b7 ,state         
implementation grants  7#a7 ,in general 
,the ,secretary shall award grants to   
eligible ,states to enable such ,states 
to implement the comprehensive plans    
submitted under subsection 7a77#b77;,c7 
to meet the long-term services and      
supports needs of such ,states4  7#b7   
,eligibility ,to be eligible to receive 
a grant under paragraph 7#a71 a ,state  
shall-- 7,a7 submit to the ,secretary an
 application1 at such time1 in such     
manner1 and containing such information 
as the ,secretary may require2  7,b7    
have submitted a comprehensive plan     
under subsection 7a77#b77;,c7 that has  
been approved by the ,secretary or1 if  
the ,state has not applied for a grant  
under subsection 7a71 submit a plan     

7that is similar to the plans required  
under subsection 7a77#b77;,c77 to the   
,secretary for the implementation of    
new1 or continued operation of existing1
 long-term services and supports        
activities2  7,c7 provide assurances    
that the ,state will provide long-term  
services and supports under the grant to
 individuals who demonstrate a need for 
such services regardless of age2  7,d7  
provide assurances that the ,state will 
provide matching funds in accordance    
with paragraph 7#c72 and  7,e7 submit to
 the ,secretary progress and outcomes   
reports containing uniform data as      
determined appropriate by the           
,secretary4  7#c7 ,matching requirement 
,to be eligible to receive a grant under
 paragraph 7#a71 a ,state shall agree1  
with respect to the costs to be incurred
 by the ,state in implementing the      
comprehensive plan under subsection     
7a77#b77;,c71 to make available         
non-,federal contributions 7in cash or  
in-kind7 toward such costs in an amount 

equal to not less than #a for each #d of
 ,federal funds provided under the      
grant4 ,such contributions may be made  
directly or through donations from      
public or private entities4  7#d7       
,preference ,in awarding grants under   
paragraph 7#a71 the ,secretary shall    
give preference to ,states that         
demonstrate--  7,a7 the activities to be
 carried out under the grant will       
enhances access to quality1 affordable  
long-term services and supports for     
consumers2 and  7,b7 the sustainability 
and scalability of the program to be    
carried out under the grant beyond the  
grant period4  7#e7 ,limitation ,a      
,state shall not use in excess of #e    
percent of the amount awarded under a   
grant under paragraph 7#a7 for the      
administrative expenses associated with 
carrying out activities under the grant4
  7c7 ,technical assistance and outcomes
 data ,the ,secretary may use not to    
exceed #e percent of the amount         
appropriated for each fiscal year under 

subsection 7f7 to--  7#a7 provide       
technical assistance to ,states in      
carrying out programs under this        
section2 and  7#b7 collect and          
disseminate data1 including from the    
reports submitted by the ,states under  
subsection 7b77#b77;,d71 on improvements
 to long-term services and supports     
provided in the ,states and the effect  
that grants under this section had on   
the availability of such services and   
supports4  7d7 ,grant announcements ,not
 later than #a year after the date of   
enactment of this ,act1 the ,secretary  
shall announce the opportunity to apply 
for the initial series of grants under  
this section4 ,not later than #b years  
after such date1 the ,secretary shall   
announce the opportunity to apply for   
the remaining grants under this section4
  7e7 ,report ,not later than #a year   
after the date on which grants are      
awarded under subsection 7b71 and       
annually thereafter1 the ,secretary     
shall submit to ,congress a report on   

the activities carried out under grants 
under this section1 including a         
description of improvements to long-term
 services and supports provided in the  
,states and the effect that grants under
 this section had on the availability of
 such services and supports4  7f7       
,appropriations  7#a7 ,in general ,there
 is authorized to be appropriated-- 7,a7
 to award grants under subsection 7a71  
#ej1jjj1jjj1 to be used during the first
 fiscal year for which such grants are  
awarded2 and  7,b7 to award grants under
 subsection 7b71 #bej1jjj1jjj1 to be    
available until expended4  7#b7         
,additional amounts ,in addition to     
amounts appropriated under paragraph    
7#a77;,b7 for a fiscal year1 the        
,secretary may use any amounts          
appropriated under paragraph 7#a77;,a7  
and remaining unexpended after fiscal   
year #bjae to award grants under        
subsection 7b74  7g7 ,definition ,in    
this ,act1 the term long-term services  
and supports means the services and     

supports described in section #cba7;a7  
of the ,older ,americans ,act of 7#db   
,u4,s4,c4 #cjcj;d7a7 et seq474