,,ii #aafth ,,congress #b;d ,session ,s4 #dieg ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #c1 #bjbj,mr4 ,casey 7for himself1 ,mr4 ,booker1 ,mr4 ,van ,hollen1 ,mr4 ,blumenthal1 ,mr4 ,menendez1 ,ms4 ,smith1 ,ms4 ,duckworth1 ,ms4 ,warren1 ,ms4 ,stabenow1 ,mr4 ,brown1 ,mrs4 ,shaheen1 ,mr4 ,merkley1 ,mr4 ,peters1 ,mrs4 ,gillibrand1 ,mr4 ,reed1 ,mr4 ,markey1 ,ms4 ,baldwin1 ,ms4 ,klobuchar1 and ,mr4 ,sanders7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to provide for an emergency increase in ,federal funding to ,state ,medicaid programs for expenditures on home and community-based services4 #a4 ,short title ,this ,act may be cited as the ,,covid ,,hcbs ,relief ,act of #bjbj4 #b4 ,additional support for ,medicaid home and community-based services during the ,,covid-#ai emergency period 7a7 ,increased ,,fmap 7#a7 ,in general ,notwithstanding section #aije7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7b771 in the case of an ,,hcbs program ,state1 the ,federal medical assistance percentage determined for the ,state under section #aije7;b7 of such ,act and1 if applicable1 increased under subsection 7y71 7z71 or 7aa7 of section #aije of such ,act 7#db ,u4,s4,c4 #acif;d71 section #aiae7k7 of such ,act 7#db ,u4,s4,c4 #acifn7k771 or section #fjjh7;a7 of the ,families ,first ,coronavirus ,response ,act 7,public ,law #aaf-abg71 shall be increased by #aj percentage points with respect to expenditures of the ,state under the ,state ,medicaid program for home and community-based services that are provided during the ,,hcbs program improvement period4 ,in no case may the application of the previous sentence result in the ,federal medical assistance percentage determined for a ,state being more than #ie percent4 7#b7 ,definitions ,in this section3 7,a7 ,,hcbs program improvement period ,the term ,,hcbs program improvement period means1 with respect to a ,state1 the period-- 7i7 beginning on ,october #a1 #bjbj2 and 7ii7 ending on ,september #cj1 #bjbb4 7,b7 ,,hcbs program ,state ,the term ,,hcbs program ,state means a ,state that meets the condition described in subsection 7b7 by submitting an application described in such subsection1 which is approved by the ,secretary pursuant to subsection 7c74 7,c7 ,home and community-based services ,the term home and community-based services means home health care services authorized under paragraph 7#g7 of section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a771 behavioral health services authorized under paragraph 7#ac7 of such section1 personal care services authorized under paragraph 7#bd7 of such section1 ,,pace services authorized under paragraph 7#bf7 of such section1 services authorized under subsections 7b71 7c71 7i71 7j71 and 7k7 of section #aiae of such ,act 7#db ,u4,s4,c4 #acifn71 such services authorized under a waiver under section #aaae of such ,act 7#db ,u4,s4,c4 #acae71 and such other services specified by the ,secretary4 7b7 ,condition ,the condition described in this subsection1 with respect to a ,state1 is that the ,state submits an application to the ,secretary1 at such time and in such manner as specified by the ,secretary1 that includes1 in addition to such other information as the ,secretary shall require-- 7#a7 a description of which activities described in subsection 7d7 that a ,state plans to implement and a description of how it plans to implement such activities2 7#b7 assurances that the ,federal funds attributable to the increase under subsection 7a7 will be used-- 7,a7 to implement the activities described in subsection 7d72 and 7,b7 to supplement1 and not supplant1 the level of ,state funds expended for home and community-based services for eligible individuals through programs in effect as of the date of the enactment of this section2 and 7#c7 assurances that the ,state will conduct adequate oversight and ensure the validity of such data as may be required by the ,secretary4 7c7 ,approval of application ,not later than #ij days after the date of submission of an application of a ,state under subsection 7b71 the ,secretary shall certify if the application is complete4 ,upon certification that an application of a ,state is complete1 the application shall be deemed to be approved for purposes of this section4 7d7 ,activities ,to improve the delivery of ,,hcbs 7#a7 ,in general ,a ,state shall work with community partners1 such as ,area ,agencies on ,aging1 ,centers for ,independent ,living1 non-profit home and community-based services providers1 and other entities providing home and community-based services1 to implement-- 7,a7 the purposes described in paragraph 7#b7 during the ,,covid-#ai public health emergency period2 and 7,b7 the purposes described in paragraph 7#c7 after the end of such emergency period4 7#b7 ,focused areas of ,,hcbs improvement ,the purposes described in this paragraph1 with respect to a ,state1 are the following3 7,a7 ,to increase rates for home health agencies and agencies that employ direct support professionals 7including independent providers in a self-directed or consumer-directed model7 to provide home and community-based services under the ,state ,medicaid program1 provided that any agency or individual that receives payment under such an increased rate increases the compensation it pays its home health workers or direct support professionals4 7,b7 ,to provide paid sick leave1 paid family leave1 and paid medical leave for home health workers and direct support professionals4 7,c7 ,to provide hazard pay1 overtime pay1 and shift differential pay for home health workers and direct support professionals4 7,d7 ,to provide home and community-based services to eligible individuals who are on waiting lists for programs approved under sections #aaae or #aiae of the ,social ,security ,act 7#db ,u4,s4,c4 #acae1 #acifn74 7,e7 ,to expand home and community-based services to facilitate reducing the census of nursing facilities1 intermediate care facilities1 psychiatric facilities1 and other institutional or congregate settings so that safety measures can be effectively implemented within these settings4 7,f7 ,to purchase emergency supplies and equipment1 which may include items not typically covered under the ,medicaid program1 such as personal protective equipment1 necessary to enhance access to services and to protect the health and well-being of home health workers and direct support professionals4 7,g7 ,to pay for the travel of home health workers and direct support professionals to conduct home and community-based services4 7,h7 ,to recruit new home health workers and direct support professionals4 7,i7 ,to support family care providers of eligible individuals with needed supplies and equipment1 which may include items not typically covered under the ,medicaid program1 such as personal protective equipment1 and pay4 7,j7 ,to pay for training for home health workers and direct support professionals that is specific to the ,,covid-#ai public health emergency4 7,k7 ,to pay for assistive technologies1 staffing1 and other costs incurred during the ,,covid-#ai public health emergency period in order to facilitate community integration and ensure an individual's person-centered service plan continues to be fully implemented4 7,l7 ,to prepare information and public health and educational materials in accessible formats 7including formats accessible to people with low literacy or intellectual disabilities7 about prevention1 treatment1 recovery1 and other aspects of ,,covid-#ai for eligible individuals1 their families1 and the general community served by agencies described in subparagraph 7,a74 7,m7 ,to pay for interpreters to assist in providing home and community-based services to eligible individuals and to inform the general public about ,,covid-#ai4 7,n7 ,to allow day services providers to provide home and community-based services4 7,o7 ,to pay for other expenses deemed appropriate by the ,secretary to enhance1 expand1 or strengthen ,home and ,community-,based ,services1 including retainer payments1 and expenses which meet the criteria of the home and community-based settings rule published on ,january #af1 #bjad4 7#c7 ,permissible uses after the emergency period ,the purpose described in this paragraph1 with respect to a ,state1 is to assist eligible individuals who had to relocate to a nursing facility or institutional setting from their homes during the ,,covid-#ai public health emergency period in-- 7,a7 moving back to their homes 7including by paying for moving costs1 first month's rent1 and other one-time expenses and start-up costs72 7,b7 resuming home and community-based services2 7,c7 receiving mental health services and necessary rehabilitative service to regain skills lost while relocated during the public health emergency period2 and 7,d7 while funds attributable to the increased ,,fmap under this section remain available1 continuing home and community-based services for eligible individuals who were served from a waiting list for such services during the public health emergency period4 7e7 ,reporting requirements 7#a7 ,state reporting requirements ,not later than ,december #ca1 #bjbc1 any ,state with respect to which an application is approved by the ,secretary pursuant to subsection 7c7 shall submit a report to the ,secretary that contains the following information3 7,a7 ,activities and programs that were funded using ,federal funds attributable to such increase4 7,b7 ,the number of eligible individuals who were served by such activities and programs4 7,c7 ,the number of eligible individuals who were able to resume home and community-based services as a result of such activities and programs4 7#b7 ,,hhs evaluation 7,a7 ,in general ,the ,secretary shall evaluate the implementation and outcomes of this section in the aggregate using an external evaluator with experience evaluating home and community-based services1 disability programs1 and older adult programs4 7,b7 ,evaluation criteria ,for purposes of subparagraph 7,a71 the external evaluator shall-- 7i7 document and evaluate changes in access1 availability1 and quality of home and community-based services in each ,,hcbs program ,state2 7ii7 document and evaluate aggregate changes in access1 availability1 and quality of home and community-based services across all such ,states2 and 7iii7 evaluate the implementation and outcomes of this section based on-- 7,i7 the impact of this section on increasing funding for home and community-based services2 7,,ii7 the impact of this section on achieving targeted access1 availability1 and quality of home and community-based services2 and 7,,iii7 promising practices identified by activities conducted pursuant to subsection 7d7 that increase access to1 availability of1 and quality of home and community-based services4 7,c7 ,dissemination of evaluation findings ,the ,secretary shall-- 7i7 disseminate the findings from the evaluations conducted under this paragraph to-- 7,i7 all ,state ,medicaid directors2 and 7,,ii7 the ,committee on ,energy and ,commerce of the ,house of ,representatives1 the ,committee on ,finance of the ,senate1 and the ,special ,committee on ,aging of the ,senate2 and 7ii7 make all evaluation findings publicly available in an accessible electronic format and any other accessible format determined appropriate by the ,secretary4 7,d7 ,oversight ,each ,state with respect to which an application is approved by the ,secretary pursuant to subsection 7c7 shall ensure adequate oversight of the expenditure of ,federal funds pursuant to such increase in accordance with the ,medicaid regulations1 including section #aaae and #aiae waiver regulations and special terms and conditions for any relevant waiver or grant program4 7#c7 ,non-,application ,of ,the ,paperwork ,reduction ,act ,chapter #ce of title #dd1 ,united ,states ,code 7commonly referred to as the 8,paperwork ,reduction ,act of #aiie071 shall not apply to the provisions of this subsection4 7f7 ,additional definitions ,in this section3 7#a7 ,,covid-#ai public health emergency period ,the term ,,covid-#ai public health emergency period means the portion of the emergency period described in paragraph 7#a77;,b7 of section #aace7;g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77 beginning on or after the date of the enactment of this ,act4 7#b7 ,eligible individual ,the term eligible individual means an individual who is eligible for or enrolled for medical assistance under a ,state ,medicaid program4 7#c7 ,medicaid program ,the term ,medicaid program means1 with respect to a ,state1 the ,state program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 7including any waiver or demonstration under such title or under section #aaae of such ,act 7#db ,u4,s4,c4 #acae7 relating to such title74 7#d7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#e7 ,state ,the term ,state has the meaning given such term for purposes of title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474