,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #dieg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,decemb] #c1 #bjbj,mr4 
,casey 7= himself1 ,mr4 ,book]1 ,mr4    
,van ,holl51 ,mr4 ,blum5?al1 ,mr4       
,m55dez1 ,ms4 ,smi?1 ,ms4 ,duckwor?1    
,ms4 ,w>r51 ,ms4 ,/ab5[1 ,mr4 ,br[n1    
,mrs4 ,%ahe51 ,mr4 ,m]kley1 ,mr4 ,pet]s1
 ,mrs4 ,gillibr&1 ,mr4 ,re$1 ,mr4       
,m>key1 ,ms4 ,baldw91 ,ms4 ,klobu*>1 &  
,mr4 ,s&]s7 introduc$ ! foll[+ bill2 :i*
 0 read twice & ref]r$ to ! ,committee  
on ,f9ance  ,a ,,bill  ,to provide = an 
em]g5cy increase 9 ,f$]al fund+ to ,/ate
 ,m$icaid programs = exp5ditures on home
 & community-bas$ s]vices4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,,covid 
,,hcbs ,relief ,act ( #bjbj4  #b4       
,additional support = ,m$icaid home &   
community-bas$ s]vices dur+ !           
,,covid-#ai em]g5cy p]iod  7a7 ,increas$
 ,,fmap  7#a7 ,9 g5]al ,not)/&+ section 
#aije7;b7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;d7b771 9 ! case (  
an ,,hcbs program ,/ate1 ! ,f$]al m$ical

 assi/ance p]c5tage det]m9$ = ! ,/ate "u
 section #aije7;b7 ( su* ,act &1 if     
applicable1 increas$ "u subsection 7y71 
7z71 or 7aa7 ( section #aije ( su* ,act 
7#db ,u4,s4,c4 #acif;d71 section        
#aiae7k7 ( su* ,act 7#db ,u4,s4,c4      
#acifn7k771 or section #fjjh7;a7 ( !    
,families ,fir/ ,coronavirus ,response  
,act 7,public ,law #aaf-abg71 %all be   
increas$ by #aj p]c5tage po9ts ) respect
 to exp5ditures ( ! ,/ate "u ! ,/ate    
,m$icaid program = home & community-bas$
 s]vices t are provid$ dur+ ! ,,hcbs    
program improvem5t p]iod4 ,9 no case may
 ! application ( ! previ\s s5t5ce result
 9 ! ,f$]al m$ical assi/ance p]c5tage   
det]m9$ = a ,/ate be+ m ?an #ie p]c5t4  
7#b7 ,def9itions ,9 ?is section3 7,a7   
,,hcbs program improvem5t p]iod ,! t]m  
,,hcbs program improvem5t p]iod means1 )
 respect to a ,/ate1 ! p]iod-- 7i7      
beg9n+ on ,octob] #a1 #bjbj2 &  7ii7    
end+ on ,septemb] #cj1 #bjbb4  7,b7     
,,hcbs program ,/ate ,! t]m ,,hcbs      
program ,/ate means a ,/ate t meets !   

condition describ$ 9 subsection 7b7 by  
submitt+ an application describ$ 9 su*  
subsection1 :i* is approv$ by !         
,secret>y pursuant to subsection 7c74   
7,c7 ,home & community-bas$ s]vices ,!  
t]m home & community-bas$ s]vices means 
home heal? c>e s]vices au?oriz$ "u      
p>agraph 7#g7 ( section #aije7;a7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7a771 behavioral heal? s]vices   
au?oriz$ "u p>agraph 7#ac7 ( su*        
section1 p]sonal c>e s]vices au?oriz$ "u
 p>agraph 7#bd7 ( su* section1 ,,pace   
s]vices au?oriz$ "u p>agraph 7#bf7 ( su*
 section1 s]vices au?oriz$ "u           
subsections 7b71 7c71 7i71 7j71 & 7k7 ( 
section #aiae ( su* ,act 7#db ,u4,s4,c4 
#acifn71 su* s]vices au?oriz$ "u a waiv]
 "u section #aaae ( su* ,act 7#db       
,u4,s4,c4 #acae71 & su* o!r s]vices     
specifi$ by ! ,secret>y4  7b7 ,condition
 ,! condition describ$ 9 ?is subsection1
 ) respect to a ,/ate1 is t ! ,/ate     
submits an application to ! ,secret>y1  
at su* "t & 9 su* mann] z specifi$ by ! 

,secret>y1 t includes1 9 addition to su*
 o!r in=mation z ! ,secret>y %all       
require-- 7#a7 a description ( :i*      
activities describ$ 9 subsection 7d7 t a
 ,/ate plans to implem5t & a description
 ( h[ x plans to implem5t su*           
activities2  7#b7 assurances t ! ,f$]al 
funds attributable to ! increase "u     
subsection 7a7 w be us$-- 7,a7 to       
implem5t ! activities describ$ 9        
subsection 7d72 &  7,b7 to supplem5t1 & 
n supplant1 ! level ( ,/ate funds exp5d$
 = home & community-bas$ s]vices =      
eligible individuals ?r\gh programs 9   
effect z ( ! date ( ! enactm5t ( ?is    
section2 &  7#c7 assurances t ! ,/ate w 
conduct adequate ov]sight & ensure !    
validity ( su* data z may be requir$ by 
! ,secret>y4  7c7 ,approval (           
application ,n lat] ?an #ij days aft] ! 
date ( submission ( an application ( a  
,/ate "u subsection 7b71 ! ,secret>y    
%all c]tify if ! application is         
complete4 ,^u c]tification t an         
application ( a ,/ate is complete1 !    

application %all be deem$ to be approv$ 
= purposes ( ?is section4  7d7          
,activities ,to improve ! deliv]y (     
,,hcbs  7#a7 ,9 g5]al ,a ,/ate %all "w )
 community p>tn]s1 su* z ,area ,ag5cies 
on ,ag+1 ,c5t]s = ,indep5d5t ,liv+1     
non-pr(it home & community-bas$ s]vices 
provid]s1 & o!r entities provid+ home & 
community-bas$ s]vices1 to implem5t--   
7,a7 ! purposes describ$ 9 p>agraph 7#b7
 dur+ ! ,,covid-#ai public heal? em]g5cy
 p]iod2 &  7,b7 ! purposes describ$ 9   
p>agraph 7#c7 aft] ! end ( su* em]g5cy  
p]iod4  7#b7 ,focus$ areas ( ,,hcbs     
improvem5t ,! purposes describ$ 9 ?is   
p>agraph1 ) respect to a ,/ate1 are !   
foll[+3 7,a7 ,to increase rates = home  
heal? ag5cies & ag5cies t employ direct 
support pr(essionals 7includ+ indep5d5t 
provid]s 9 a self-direct$ or            
consum]-direct$ model7 to provide home &
 community-bas$ s]vices "u ! ,/ate      
,m$icaid program1 provid$ t any ag5cy or
 individual t receives paym5t "u su* an 
increas$ rate increases ! comp5sation x 

pays its home heal? work]s or direct    
support pr(essionals4  7,b7 ,to provide 
paid sick leave1 paid family leave1 &   
paid m$ical leave = home heal? work]s & 
direct support pr(essionals4  7,c7 ,to  
provide haz>d pay1 ov]time pay1 & %ift  
diff]5tial pay = home heal? work]s &    
direct support pr(essionals4  7,d7 ,to  
provide home & community-bas$ s]vices to
 eligible individuals :o are on wait+   
li/s = programs approv$ "u sections     
#aaae or #aiae ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acae1 #acifn74     
7,e7 ,to exp& home & community-bas$     
s]vices to facilitate r$uc+ ! c5sus (   
nurs+ facilities1 int]m$iate c>e        
facilities1 psy*iatric facilities1 & o!r
 in/itutional or congregate sett+s s t  
safety measures c be effectively        
implem5t$ )9 ^! sett+s4  7,f7 ,to       
pur*ase em]g5cy supplies & equipm5t1 :i*
 may include items n typically cov]$ "u 
! ,m$icaid program1 su* z p]sonal       
protective equipm5t1 necess>y to enhance
 access to s]vices & to protect ! heal? 

& well-be+ ( home heal? work]s & direct 
support pr(essionals4  7,g7 ,to pay = ! 
travel ( home heal? work]s & direct     
support pr(essionals to conduct home &  
community-bas$ s]vices4  7,h7 ,to       
recruit new home heal? work]s & direct  
support pr(essionals4  7,i7 ,to support 
family c>e provid]s ( eligible          
individuals ) ne$$ supplies & equipm5t1 
:i* may include items n typically cov]$ 
"u ! ,m$icaid program1 su* z p]sonal    
protective equipm5t1 & pay4  7,j7 ,to   
pay = tra9+ = home heal? work]s & direct
 support pr(essionals t is specific to !
 ,,covid-#ai public heal? em]g5cy4  7,k7
 ,to pay = assi/ive te*nologies1 /aff+1 
& o!r co/s incurr$ dur+ ! ,,covid-#ai   
public heal? em]g5cy p]iod 9 ord] to    
facilitate community integration &      
ensure an individual's p]son-c5t]$      
s]vice plan cont9ues to be fully        
implem5t$4  7,l7 ,to prep>e in=mation & 
public heal? & educational mat]ials 9   
accessible =mats 7includ+ =mats         
accessible to p ) l[ lit]acy or         

intellectual disabilities7 ab\t         
prev5tion1 treatm5t1 recov]y1 & o!r     
aspects ( ,,covid-#ai = eligible        
individuals1 _! families1 & ! g5]al     
community s]v$ by ag5cies describ$ 9    
subp>agraph 7,a74  7,m7 ,to pay =       
int]pret]s to assi/ 9 provid+ home &    
community-bas$ s]vices to eligible      
individuals & to in=m ! g5]al public    
ab\t ,,covid-#ai4  7,n7 ,to all[ day    
s]vices provid]s to provide home &      
community-bas$ s]vices4  7,o7 ,to pay = 
o!r exp5ses deem$ appropriate by !      
,secret>y to enhance1 exp&1 or /r5g!n   
,home & ,community-,bas$ ,s]vices1      
includ+ reta9] paym5ts1 & exp5ses :i*   
meet ! crit]ia ( ! home & community-bas$
 sett+s rule publi%$ on ,janu>y #af1    
#bjad4  7#c7 ,p]missible uses aft] !    
em]g5cy p]iod ,! purpose describ$ 9 ?is 
p>agraph1 ) respect to a ,/ate1 is to   
assi/ eligible individuals :o _h to     
relocate to a nurs+ facility or         
in/itutional sett+ f _! homes dur+ !    
,,covid-#ai public heal? em]g5cy p]iod  

9-- 7,a7 mov+ back to _! homes 7includ+ 
by pay+ = mov+ co/s1 fir/ mon?'s r5t1 & 
o!r "o-"t exp5ses & />t-up co/s72  7,b7 
resum+ home & community-bas$ s]vices2   
7,c7 receiv+ m5tal heal? s]vices &      
necess>y rehabilitative s]vice to rega9 
skills lo/ :ile relocat$ dur+ ! public  
heal? em]g5cy p]iod2 &  7,d7 :ile funds 
attributable to ! increas$ ,,fmap "u ?is
 section rema9 available1 cont9u+ home &
 community-bas$ s]vices = eligible      
individuals :o 7 s]v$ f a wait+ li/ =   
su* s]vices dur+ ! public heal? em]g5cy 
p]iod4  7e7 ,report+ requirem5ts  7#a7  
,/ate report+ requirem5ts ,n lat] ?an   
,decemb] #ca1 #bjbc1 any ,/ate ) respect
 to :i* an application is approv$ by !  
,secret>y pursuant to subsection 7c7    
%all submit a report to ! ,secret>y t   
conta9s ! foll[+ in=mation3 7,a7        
,activities & programs t 7 fund$ us+    
,f$]al funds attributable to su*        
increase4  7,b7 ,! numb] ( eligible     
individuals :o 7 s]v$ by su* activities 
& programs4  7,c7 ,! numb] ( eligible   

individuals :o 7 able to resume home &  
community-bas$ s]vices z a result ( su* 
activities & programs4  7#b7 ,,hhs      
evaluation  7,a7 ,9 g5]al ,! ,secret>y  
%all evaluate ! implem5tation & outcomes
 ( ?is section 9 ! aggregate us+ an     
ext]nal evaluator ) exp]i5ce evaluat+   
home & community-bas$ s]vices1          
disability programs1 & old] adult       
programs4  7,b7 ,evaluation crit]ia ,=  
purposes ( subp>agraph 7,a71 ! ext]nal  
evaluator %all-- 7i7 docum5t & evaluate 
*anges 9 access1 availability1 & quality
 ( home & community-bas$ s]vices 9 ea*  
,,hcbs program ,/ate2  7ii7 docum5t &   
evaluate aggregate *anges 9 access1     
availability1 & quality ( home &        
community-bas$ s]vices across all su*   
,/ates2 &  7iii7 evaluate !             
implem5tation & outcomes ( ?is section  
bas$ on-- 7,i7 ! impact ( ?is section on
 increas+ fund+ = home & community-bas$ 
s]vices2  7,,ii7 ! impact ( ?is section 
on a*iev+ t>get$ access1 availability1 &
 quality ( home & community-bas$        

s]vices2 &  7,,iii7 promis+ practices   
id5tifi$ by activities conduct$ pursuant
 to subsection 7d7 t increase access to1
 availability (1 & quality ( home &     
community-bas$ s]vices4  7,c7           
,dissem9ation ( evaluation f9d+s ,!     
,secret>y %all-- 7i7 dissem9ate ! f9d+s 
f ! evaluations conduct$ "u ?is p>agraph
 to-- 7,i7 all ,/ate ,m$icaid directors2
 &  7,,ii7 ! ,committee on ,en]gy &     
,comm]ce ( ! ,h\se ( ,repres5tatives1 ! 
,committee on ,f9ance ( ! ,s5ate1 & !   
,special ,committee on ,ag+ ( ! ,s5ate2 
&  7ii7 make all evaluation f9d+s       
publicly available 9 an accessible      
electronic =mat & any o!r accessible    
=mat det]m9$ appropriate by ! ,secret>y4
  7,d7 ,ov]sight ,ea* ,/ate ) respect to
 :i* an application is approv$ by !     
,secret>y pursuant to subsection 7c7    
%all ensure adequate ov]sight ( !       
exp5diture ( ,f$]al funds pursuant to   
su* increase 9 accordance ) ! ,m$icaid  
regulations1 includ+ section #aaae &    
#aiae waiv] regulations & special t]ms &

 conditions = any relevant waiv] or     
grant program4  7#c7 ,non-,application  
,( ,! ,pap]work ,r$uction ,act ,*apt]   
#ce ( title #dd1 ,unit$ ,/ates ,code    
7commonly ref]r$ to z ! 8,pap]work      
,r$uction ,act ( #aiie071 %all n apply  
to ! provisions ( ?is subsection4  7f7  
,additional def9itions ,9 ?is section3  
7#a7 ,,covid-#ai public heal? em]g5cy   
p]iod ,! t]m ,,covid-#ai public heal?   
em]g5cy p]iod means ! portion ( !       
em]g5cy p]iod describ$ 9 p>agraph       
7#a77;,b7 ( section #aace7;g7 ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;b-#e7;g77 beg9n+ on or aft] ! date
 ( ! enactm5t ( ?is ,act4  7#b7         
,eligible individual ,! t]m eligible    
individual means an individual :o is    
eligible = or enroll$ = m$ical assi/ance
 "u a ,/ate ,m$icaid program4  7#c7     
,m$icaid program ,! t]m ,m$icaid program
 means1 ) respect to a ,/ate1 ! ,/ate   
program "u title ,,xix ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 7includ+ any waiv] or demon/ration

 "u su* title or "u section #aaae ( su* 
,act 7#db ,u4,s4,c4 #acae7 relat+ to su*
 title74  7#d7 ,secret>y ,! t]m         
,secret>y means ! ,secret>y ( ,heal? &  
,human ,s]vices4  7#e7 ,/ate ,! t]m     
,/ate has ! mean+ giv5 su* t]m =        
purposes ( title ,,xix ( ! ,social      
,security ,act 7#db ,u4,s4,c4 #acif et  
seq474