,,ii #aafth ,,congress #ast ,session ,s4 #edh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #be1 #bjai,mr4 ,portman 7for himself and ,ms4 ,cantwell7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to reauthorize the ,money ,follows the ,person ,demonstration ,program4 #a4 ,short title ,this ,act may be cited as the ,ensuring ,medicaid ,provides ,opportunities for ,widespread ,equity1 ,resources1 and ,care ,act or the ,,empower ,care ,act4 #b4 ,extension of ,money ,follows the ,person ,rebalancing demonstration 7a7 ,funding ,section #fjga7;h7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 in subparagraph 7,e71 by striking and after the semicolon2 7,b7 in subparagraph 7,f7-- 7i7 by striking subject to subparagraph 7#c71 #aab1jjj1jjj and inserting #dej1jjj1jjj2 and 7ii7 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,g7 #dej1jjj1jjj for each of fiscal years #bjbj through #bjbc4 2 7#b7 in paragraph 7#b7-- 7,a7 by striking ,subject to paragraph 7#c71 amounts and inserting ,amounts2 and 7,b7 by striking #bjba and inserting #bjbc2 and 7#c7 by striking paragraph 7#c74 7b7 ,research and evaluation ,section #fjga7;g7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in paragraph 7#b71 by striking #bjaf and inserting #bjbc2 and 7#b7 in paragraph 7#c71 by inserting and for each of fiscal years #bjai through #bjbc1 after #bjaf14 #c4 ,changes to institutional residency period requirement 7a7 ,in general ,section #fjga7;b77#b7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in subparagraph 7,a77i71 by striking #ij and inserting #fj2 and 7#b7 by striking the flush sentence after subparagraph 7,b74 7b7 ,effective date ,the amendments made by subsection 7a7 shall take effect on the date that is #cj days after the date of enactment of this ,act4 #d4 ,updates to ,state application requirements ,section #fjga7;c7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended-- 7#a7 in paragraph 7#c71 by striking 1 which shall include and all that follows through #bjjg2 7#b7 in paragraph 7#g7-- 7,a7 in the paragraph heading1 by striking ,rebalancing and inserting ,expenditures2 and 7,b7 in subparagraph 7,b7-- 7i7 in clause 7i71 by striking and after the semicolon2 7ii7 in clause 7ii71 by striking the period at the end and inserting a semicolon2 and 7iii7 by adding at the end the following3 7iii7 include a work plan that describes for each ,federal fiscal year that occurs during the proposed ,,mfp demonstration project-- 7,i7 the use of grant funds for each proposed initiative that is designed to accomplish the objective described in subsection 7a77#a71 including a funding source for each activity that is part of each such proposed initiative2 7,,ii7 an evaluation plan that identifies expected results for each such proposed initiative2 and 7,,iii7 a sustainability plan for components of such proposed initiatives that are intended to improve transitions1 which shall be updated with actual expenditure information for each ,federal fiscal year that occurs during the ,,mfp demonstration project2 and 7iv7 contain assurances that grant funds used to accomplish the objective described in subsection 7a77#a7 shall be obligated not later than #bd months after the date on which the funds are awarded and shall be expended not later than #fj months after the date on which the funds are awarded 7unless the ,secretary approves a waiver of either such requirement74 2 and 7#c7 in paragraph 7#ac7-- 7,a7 in subparagraph 7,a71 by striking 2 and and inserting 1 and in such manner as will meet the reporting requirements set forth for the ,transformed ,medicaid ,statistical ,management ,information ,system 7,t-,,msis722 7,b7 by redesignating subparagraph 7,b7 as subparagraph 7,d72 and 7,c7 by inserting after subparagraph 7,a7 the following3 7,b7 the ,state shall report on a quarterly basis on the use of grant funds by distinct activity1 as described in the approved work plan1 and by specific population as targeted by the ,state2 7,c7 if the ,state fails to report the information required under subparagraph 7,b71 fails to report such information on a quarterly basis1 or fails to make progress under the approved work plan1 the ,state shall implement a corrective action plan and any lack of progress under the approved work plan may result in withholding of grant funds made available to the ,state2 and 4 #e4 ,funding for quality assurance and improvement2 technical assistance2 oversight ,section #fjga7;f7 of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended by striking paragraph 7#b7 and inserting the following3 7#b7 ,funding ,from the amounts appropriated under subsection 7h77#a7 for each of fiscal years #bjai through #bjbc1 #a1jjj1jjj shall be available to the ,secretary for each such fiscal year to carry out this subsection4 4 #f4 ,best practices evaluation ,section #fjga of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 is amended by adding at the end the following3 7i7 ,best practices 7#a7 ,report ,the ,secretary1 directly or through grant or contract1 shall submit a report to the ,president and ,congress not later than ,september #cj1 #bjbj1 that contains findings and conclusions on best practices from the ,state ,,mfp demonstration projects carried out with grants made under this section4 ,the report shall include information and analyses with respect to the following3 7,a7 ,the most effective ,state strategies for transitioning beneficiaries from institutional to qualified community settings carried out under the ,state ,,mfp demonstration projects and how such strategies may vary for different types of beneficiaries1 such as beneficiaries who are aged1 physically disabled1 intellectually or developmentally disabled1 or individuals with serious mental illnesses1 and other targeted waiver beneficiary populations4 7,b7 ,the most common and the most effective ,state uses of grant funds carried out under the ,state ,,mfp demonstration projects for transitioning beneficiaries from institutional to qualified community settings and improving health outcomes1 including differentiating funding for current initiatives that are designed for such purpose and funding for proposed initiatives that are designed for such purpose4 7,c7 ,the most effective ,state approaches carried out under ,state ,,mfp demonstration projects for improving person-centered care and planning4 7,d7 ,identification of program1 financing1 and other flexibilities available under the ,state ,,mfp demonstration projects1 that are not available under the traditional ,medicaid program1 and which directly contributed to successful transitions and improved health outcomes under the ,state ,,mfp demonstration projects4 7,e7 ,state strategies and financing mechanisms for effective coordination of housing financed or supported under ,state ,,mfp demonstration projects with local housing authorities and other resources4 7,f7 ,effective ,state approaches for delivering ,money ,follows the ,person transition services through managed care entities4 7,g7 ,other best practices and effective transition strategies demonstrated by ,states with approved ,,mfp demonstration projects1 as determined by the ,secretary4 7,h7 ,identification and analyses of opportunities and challenges to integrating effective ,money ,follows the ,person practices and ,state strategies into the traditional ,medicaid program4 7#b7 ,collaboration ,in preparing the report required under this subsection1 the ,secretary shall collect and incorporate information from ,states with approved ,,mfp demonstration projects and beneficiaries participating in such projects1 and providers participating in such projects4 7#c7 ,funding ,from the amounts appropriated under subsection 7h77#a7 for each of fiscal years #bjai through #bjbj1 not more than #cjj1jjj shall be available to the ,secretary for each such fiscal year to carry out this subsection4 4 #g4 ,,macpac report on qualified settings criteria ,section #fjga of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note71 as amended by section #f1 is amended by adding at the end the following3 7j7 ,,macpac report ,prior to the final implementation date established by the ,secretary for the criteria established for home and community-based settings in section #dda4cja7;c77#d7 of title #db1 ,code of ,federal ,regulations1 as part of final implementation of the ,home and ,community ,based ,services 7,,hcbs7 ,final ,rule published on ,january #af1 #bjad 7#gi ,fed4 ,reg4 #bidg7 7referred to in this subsection as the ,,hcbs final rule71 the ,medicaid and ,,chip ,payment and ,access ,commission 7,,macpac7 shall submit to ,congress a report that-- 7#a7 identifies the types of home and community-based settings and associated services that are available to eligible individuals in both the ,,mfp demonstration program and sites in compliance with the ,,hcbs final rule2 and 7#b7 if determined appropriate by the ,commission1 recommends policies to align the criteria for a qualified residence under subsection 7b77#f7 7as in effect on ,october #a1 #bjag7 with the criteria in the ,,hcbs final rule4 4 #h4 ,application to current projects ,not later than #a year after the date of enactment of this ,act1 any ,state with an approved ,,mfp demonstration project under section #fjga of the ,deficit ,reduction ,act of #bjje 7#db ,u4,s4,c4 #acif;a note7 on the date of enactment of this ,act shall submit a revised application to the ,secretary that contains the same information and assurances as are required for any new ,state applicant under the amendments made by this ,act4