,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #didc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #a1 #bjbj,mr4 
,k+ introduc$ ! foll[+ bill2 :i* 0 read 
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to provide  
enhanc$ ,f$]al mat*+ paym5ts = direct   
support work] tra9+ programs1 & = o!r   
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,direct ,support ,work]    
,tra9+ ,reimbursem5t ,act4  #b4 ,m$icaid
 fund+ = direct support work] tra9+     
programs ,section #aijc ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #acif;b7  
is am5d$-- 7#a7 9 subsection 7a77#b71 by
 add+ at ! end ! foll[+ new subp>agraph3
  7,f7 = cal5d> qu>t]s beg9n+ on or aft]
 ,janu>y #a1 #bjba1 an am\nt equal to   
#ge p]c5t ( s mu* ( ! sums exp5d$ dur+  
su* qu>t] = direct support work] tra9+  
programs describ$ 9 subsection 7bb7     
7includ+ ! co/s = eligible direct       
support work]s 7z def9$ 9 su*           
subsection7 to complete su* programs72  

plus  2 &  7#b7 by add+ at ! end !      
foll[+ new subsection3  7bb7 ,direct    
support work] tra9+ programs  7#a7 ,9   
g5]al ,a direct support work] tra9+     
program describ$ 9 ?is subsection is a  
program approv$ by ! ,/ate "u :i*       
eligible homec>e work]s are provid$ )-- 
7,a7 tra9+ 9 ! core tra9+ compet5cies = 
p]sonal or home c>e aides describ$ 9    
section #bjjh7;b77#c77;,a72 &  7,b7     
opportunities = education1 tra9+1 & c>e]
 advancem5t4  7#b7 ,eligible direct     
support work] ,! t]m eligible direct    
support work] means a p]sonal or home   
c>e aide 7z su* t]m is def9$ 9 section  
#bjjh7;b77#f77;,c771 a direct support   
work]1 a home heal? aide1 a nurs+       
assi/ant1 or a direct support           
pr(essional :o-- 7,a7 has at lea/ #cj   
p]c5t ( ! work]'s direct support cli5t  
volume 7z e/imat$ 9 accordance ) a      
me?odology e/abli%$ by ! ,secret>y7     
attributable to individuals :o are      
receiv+ m$ical assi/ance "u ?is title2  
or  7,b7 is employ$ by an ag5cy t is a  

provid] ( direct support s]vices t has  
at lea/ #cj p]c5t ( ! ag5cy's direct    
support cli5t volume 7z s e/imat$7      
attributable to su* individuals4  4