,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #gadi  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,novemb] #af1         
#bjah,mrs4 ,d+ell 7= h]self & ,mr4      
,upton7 introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to am5d title     
,,xix ( ! ,social ,security ,act to     
remove an in/itutional bias by mak+     
p]man5t ! protection = recipi5ts ( home 
& community-bas$ s]vices aga9/ sp\sal   
impov]i%m5t4  #a4 ,%ort title ,?is ,act 
may be cit$ z ! ,protect+ ,m>ri$ ,s5iors
 f ,impov]i%m5t ,act4  #b4 ,mak+ p]man5t
 ! protection "u ,m$icaid = recipi5ts ( 
home & community-bas$ s]vices aga9/     
sp\sal impov]i%m5t  7a7 ,9 g5]al        
,section #aibd7;h77#a77;,a7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acifr-#e7;h77#a77;,a77 is am5d$ by     
/rik+ 7at ! option ( ! ,/ate7 is        
describ$ 9 section                      
#aijb7;a77#aj77;,a77ii77,,vi7 & ins]t+ !
 foll[+3 be=e ,janu>y #a1 #bjai1 at !   
option ( ! ,/ate1 is describ$ 9 section 

#aijb7;a77#aj77;,a77ii77,,vi71 or1      
beg9n+ ,janu>y #a1 #bjai1 is eligible = 
m$ical assi/ance = home & community-bas$
 s]vices provid$ "u subsection 7c71 7d71
 or 7i7 ( section #aiae1 "u a waiv]     
approv$ "u section #aaae1 or :o is      
eligible = su* m$ical assi/ance by      
reason ( be+ det]m9$ eligible "u section
 #aijb7;a77#aj77;,c7 or by reason (     
section #aijb7;f7 or o!rwise on ! basis 
( a r$uction ( income bas$ on co/s      
incurr$ = m$ical or o!r rem$ial c>e1 or 
:o is eligible = m$ical assi/ance = home
 & community-bas$ att5dant s]vices &    
supports "u section #aiae7k74  7b7      
,con/ruction  7#a7 ,protect+ ,/ate      
sp\sal income & asset disreg>d          
flexibility "u waiv]s & plan am5dm5ts   
,no?+ 9 section #bdjd ( ,public ,law    
#aaa-adh 7#db ,u4,s4,c4 #acier-#e7 or   
section #aibd ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acifr-#e7 %all be      
con/ru$ z prohibit+ a ,/ate f disreg>d+ 
an individual's sp\sal income & assets  
"u a ,/ate waiv] or plan am5dm5t        

describ$ 9 p>agraph 7#b7 = purposes (   
mak+ det]m9ations ( eligibility = home &
 community-bas$ s]vices or home &       
community-bas$ att5dant s]vices &       
supports "u su* waiv] or plan am5dm5t4  
7#b7 ,/ate waiv] or plan am5dm5t        
describ$ ,a ,/ate waiv] or plan am5dm5t 
describ$ 9 ?is p>agraph is any ( !      
foll[+3 7,a7 ,a waiv] or plan am5dm5t to
 provide m$ical assi/ance = home &      
community-bas$ s]vices "u a waiv] or    
plan am5dm5t "u subsection 7c71 7d71 or 
7i7 ( section #aiae ( ! ,social         
,security ,act 7#db ,u4,s4,c4 #acifn7 or
 "u section #aaae ( su* ,act 7#db       
,u4,s4,c4 #acae74  7,b7 ,a plan am5dm5t 
to provide m$ical assi/ance = home &    
community-bas$ s]vices = individuals by 
reason ( be+ det]m9$ eligible "u section
 #aijb7;a77#aj77;,c7 ( su* ,act 7#db    
,u4,s4,c4 #acif;a7a77#aj77;,c77 or by   
reason ( section #aijb7;f7 ( su* ,act   
7#db ,u4,s4,c4 #acif;a7f77 or o!rwise on
 ! basis ( a r$uction ( income bas$ on  
co/s incurr$ = m$ical or o!r rem$ial c>e

 "u :i* ! ,/ate disreg>d$ ! income &    
assets ( ! individual's sp\se 9 det]m9+ 
! initial & ongo+ f9ancial eligibility (
 an individual = su* s]vices 9 place ( !
 sp\sal impov]i%m5t provisions appli$ "u
 section #aibd ( su* ,act 7#db ,u4,s4,c4
 #acifr-#e74  7,c7 ,a plan am5dm5t to   
provide m$ical assi/ance = home &       
community-bas$ att5dant s]vices &       
supports "u section #aiae7k7 ( su* ,act 
7#db ,u4,s4,c4 #acifn7k774