,,ii  #aad? ,,congress  #a/ ,session    
,s4 #bcch  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #a1 #bjae,ms4 
,hirono introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to aw>d grants to ,/ates = !
 developm5t ( innovative long-t]m       
s]vices & supports programs4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,liv+   
,indep5d5tly = ,ext5d$ ,"t ,act or !    
,,lifetime ,act4  #b4 ,f9d+s ,congress  
f9ds ! foll[+3 7#a7 ,! numb] ( ,am]icans
 ov] age #fe or liv+ ) a disability is  
gr[+1 & ov] #gj p]c5t ( ^! individuals w
 ne$ "s =m ( long-t]m s]vices &         
supports1 ) a majority ( individuals    
pref]r+ home & community-bas$ c>e4  7#b7
 ,?is is a major demographic %ift &     
provides an opportunity = innovative    
solutions 9 long-t]m s]vices & supports4
  7#c7 ,develop+ programs to facilitate 
high-quality indep5d5t community-bas$   
liv+1 create & improve jobs1 & address &
 improve ^u gaps 9 exi/+ sy/ems w be    

ess5tial to provid+ necess>y s]vices &  
supports to ^! individuals & families4  
7#d7 ,x is imp]ative t ,congress act to 
address ! loom+ long-t]m s]vices &      
supports crisis4  #c4 ,purpose ,x is !  
purpose ( ?is ,act to e/abli% a grant   
program to provide inc5tives to ,/ates =
 ! developm5t ( solutions to ! increas$ 
ne$ ( individuals = long-t]m s]vices &  
supports & to increase ,/ate support &  
sy/ems 9 long-t]m c>e4  #d4 ,e/abli%m5t 
( long-t]m s]vices & supports innovation
 grant program  7a7 ,/ate plann+ grants 
7#a7 ,9 g5]al ,n lat] ?an #ij days aft] 
! date on :i* grant ann\ncem5ts are made
 "u subsection 7d71 ! ,secret>y ( ,heal?
 & ,human ,s]vices 7ref]r$ to 9 ?is ,act
 z ! ,secret>y7 %all aw>d grants to     
eligible ,/ates to enable su* ,/ates to 
develop innovative programs to meet !   
unique ne$ = long-t]m s]vices & supports
 9 ! ,/ate4  7#b7 ,eligibility ,to be   
eligible to receive a grant "u p>agraph 
7#a71 a ,/ate %all-- 7,a7 submit to !   
,secret>y an application1 at su* "t1 9  

su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require2  7,b7 demon/rate 
to ! ,secret>y t ! ,/ate w "w 9         
conjunction ) bo? public & private      
long-t]m s]vices & supports /akehold]   
gr\ps describ$ 9 p>agraph 7#c7 to       
develop a coord9at$ /atewide long-t]m   
s]vices & supports program = ! ,/ate t  
is n duplicative ( o!r programs provid+ 
su* s]vices & supports 9 ! ,/ate2 &     
7,c7 provide assurances t ! ,/ate w1 n  
lat] ?an #a ye> aft] ! date on :i* !    
grant is aw>d$1 submit to ! ,secret>y a 
compreh5sive plan = ! implem5tation (   
innovative long-t]m s]vices & supports  
program 9 ! ,/ate1 :i* %all include !   
utilization ( exi/+ ,/ate or local      
frameworks4  7#c7 ,/akehold] gr\ps      
,/akehold] gr\ps describ$ 9 ?is p>agraph
 %all be gr\ps t-- 7,a7 repres5t !      
int]e/s (--  7i7 consum]s ( long-t]m    
s]vices & supports & relat$ insurance   
products1 z well z _! repres5tatives2   
7ii7 old] adults2  7iii7 individuals )  
cognitive or functional limitations2    

7iv7 family c>egiv]s = individuals      
describ$ 9 clause 7i71 7ii71 or 7iii72  
7v7 ! heal? c>e work=ce :o directly     
provide long-t]m s]vices & supports2    
7vi7 private long-t]m s]vices & supports
 insurance provid]s2  7vii7 employ]s2   
7viii7 ,/ate insurance dep>tm5ts2  7ix7 
area ag5cy on ag+ or ,/ate ag5cy on ag+2
  7x7 direct c>e work=ce2 &  7xi7 ,/ate 
,m$icaid ag5cies2  7,b7 h demon/rat$    
exp]i5ce 9 deal+ ) issues relat$ to     
long-t]m s]vices & supports1 heal? c>e  
policy1 & public & private insurance2 & 
7,c7 repres5t ! heal? c>e int]e/s & ne$s
 ( a v>iety ( geographic areas &        
demographic gr\ps4  7b7 ,/ate           
implem5tation grants  7#a7 ,9 g5]al ,!  
,secret>y %all aw>d grants to eligible  
,/ates to enable su* ,/ates to implem5t 
! compreh5sive plans submitt$ "u        
subsection 7a77#b77;,c7 to meet !       
long-t]m s]vices & supports ne$s ( su*  
,/ates4  7#b7 ,eligibility ,to be       
eligible to receive a grant "u p>agraph 
7#a71 a ,/ate %all-- 7,a7 submit to !   

,secret>y an application1 at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require2  7,b7 h submitt$ 
a compreh5sive plan "u subsection       
7a77#b77;,c7 t has be5 approv$ by !     
,secret>y or1 if ! ,/ate has n appli$ = 
a grant "u subsection 7a71 submit a plan
 7t is simil> to ! plans requir$ "u     
subsection 7a77#b77;,c77 to ! ,secret>y 
= ! implem5tation ( new1 or cont9u$     
op]ation ( exi/+1 long-t]m s]vices &    
supports activities2  7,c7 provide      
assurances t ! ,/ate w provide long-t]m 
s]vices & supports "u ! grant to        
individuals :o demon/rate a ne$ = su*   
s]vices reg>dless ( age2  7,d7 provide  
assurances t ! ,/ate w provide mat*+    
funds 9 accordance ) p>agraph 7#c72 &   
7,e7 submit to ! ,secret>y progress &   
outcomes reports conta9+ uni=m data z   
det]m9$ appropriate by ! ,secret>y4     
7#c7 ,mat*+ requirem5t ,to be eligible  
to receive a grant "u p>agraph 7#a71 a  
,/ate %all agree1 ) respect to ! co/s to
 be incurr$ by ! ,/ate 9 implem5t+ !    

compreh5sive plan "u subsection         
7a77#b77;,c71 to make available         
non-,f$]al contributions 79 ca% or      
9-k9d7 t[>d su* co/s 9 an am\nt equal to
 n less ?an #a = ea* #d ( ,f$]al funds  
provid$ "u ! grant4 ,su* contributions  
may be made directly or ?r\gh donations 
f public or private entities4  7#d7     
,pref]5ce ,9 aw>d+ grants "u p>agraph   
7#a71 ! ,secret>y %all give pref]5ce to 
,/ates t demon/rate--  7,a7 ! activities
 to be c>ri$ out "u ! grant w enhances  
access to quality1 af=dable long-t]m    
s]vices & supports = consum]s2 &  7,b7 !
 su/a9ability & scalability ( ! program 
to be c>ri$ out "u ! grant beyond !     
grant p]iod4  7#e7 ,limitation ,a ,/ate 
%all n use 9 excess ( #e p]c5t ( ! am\nt
 aw>d$ "u a grant "u p>agraph 7#a7 = !  
adm9i/rative exp5ses associat$ ) c>ry+  
out activities "u ! grant4  7c7         
,te*nical assi/ance & outcomes data ,!  
,secret>y may use n to exce$ #e p]c5t ( 
! am\nt appropriat$ = ea* fiscal ye> "u 
subsection 7f7 to--  7#a7 provide       

te*nical assi/ance to ,/ates 9 c>ry+ out
 programs "u ?is section2 &  7#b7       
collect & dissem9ate data1 includ+ f !  
reports submitt$ by ! ,/ates "u         
subsection 7b77#b77;,d71 on improvem5ts 
to long-t]m s]vices & supports provid$ 9
 ! ,/ates & ! effect t grants "u ?is    
section _h on ! availability ( su*      
s]vices & supports4  7d7 ,grant         
ann\ncem5ts ,n lat] ?an #a ye> aft] !   
date ( enactm5t ( ?is ,act1 ! ,secret>y 
%all ann\nce ! opportunity to apply = ! 
initial s]ies ( grants "u ?is section4  
,n lat] ?an #b ye>s aft] su* date1 !    
,secret>y %all ann\nce ! opportunity to 
apply = ! rema9+ grants "u ?is section4 
7e7 ,report ,n lat] ?an #a ye> aft] !   
date on :i* grants are aw>d$ "u         
subsection 7b71 & annually !reaft]1 !   
,secret>y %all submit to ,congress a    
report on ! activities c>ri$ out "u     
grants "u ?is section1 includ+ a        
description ( improvem5ts to long-t]m   
s]vices & supports provid$ 9 ! ,/ates & 
! effect t grants "u ?is section _h on !

 availability ( su* s]vices & supports4 
7f7 ,appropriations  7#a7 ,9 g5]al ,!re 
is au?oriz$ to be appropriat$-- 7,a7 to 
aw>d grants "u subsection 7a71          
#ej1jjj1jjj1 to be us$ dur+ ! fir/      
fiscal ye> = :i* su* grants are aw>d$2 &
  7,b7 to aw>d grants "u subsection 7b71
 #bej1jjj1jjj1 to be available until    
exp5d$4  7#b7 ,additional am\nts ,9     
addition to am\nts appropriat$ "u       
p>agraph 7#a77;,b7 = a fiscal ye>1 !    
,secret>y may use any am\nts appropriat$
 "u p>agraph 7#a77;,a7 & rema9+ unexp5d$
 aft] fiscal ye> #bjae to aw>d grants "u
 subsection 7b74  7g7 ,def9ition ,9 ?is 
,act1 ! t]m long-t]m s]vices & supports 
means ! s]vices & supports describ$ 9   
section #cba7;a7 ( ! ,old] ,am]icans    
,act ( 7#db ,u4,s4,c4 #cjcj;d7a7 et     
seq474