,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #edh  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #be1 #bjai,mr4
 ,portman 7= himself & ,ms4 ,cantwell7  
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to reau?orize !    
,money ,foll[s ! ,p]son ,demon/ration   
,program4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,ensur+ ,m$icaid ,provides 
,opportunities = ,widespread ,equity1   
,res\rces1 & ,c>e ,act or ! ,,emp[] ,c>e
 ,act4  #b4 ,ext5sion ( ,money ,foll[s !
 ,p]son ,rebalanc+ demon/ration  7a7    
,fund+ ,section #fjga7;h7 ( ! ,deficit  
,r$uction ,act ( #bjje 7#db ,u4,s4,c4   
#acif;a note7 is am5d$--  7#a7 9        
p>agraph 7#a7-- 7,a7 9 subp>agraph 7,e71
 by /rik+ & aft] ! semicolon2  7,b7 9   
subp>agraph 7,f7-- 7i7 by /rik+ subject 
to subp>agraph 7#c71 #aab1jjj1jjj &     
ins]t+ #dej1jjj1jjj2 &  7ii7 by /rik+ ! 
p]iod at ! end & ins]t+ 2 &2 &  7,c7 by 
add+ at ! end ! foll[+ new subp>agraph3 
7,g7 #dej1jjj1jjj = ea* ( fiscal ye>s   

#bjbj ?r\gh #bjbc4  2  7#b7 9 p>agraph  
7#b7--  7,a7 by /rik+ ,subject to       
p>agraph 7#c71 am\nts & ins]t+ ,am\nts2 
&  7,b7 by /rik+ #bjba & ins]t+ #bjbc2 &
  7#c7 by /rik+ p>agraph 7#c74  7b7     
,rese>* & evaluation ,section #fjga7;g7 
( ! ,deficit ,r$uction ,act ( #bjje 7#db
 ,u4,s4,c4 #acif;a note7 is am5d$--     
7#a7 9 p>agraph 7#b71 by /rik+ #bjaf &  
ins]t+ #bjbc2 &  7#b7 9 p>agraph 7#c71  
by ins]t+ & = ea* ( fiscal ye>s #bjai   
?r\gh #bjbc1 aft] #bjaf14  #c4 ,*anges  
to in/itutional resid5cy p]iod          
requirem5t  7a7 ,9 g5]al ,section       
#fjga7;b77#b7 ( ! ,deficit ,r$uction    
,act ( #bjje 7#db ,u4,s4,c4 #acif;a     
note7 is am5d$-- 7#a7 9 subp>agraph     
7,a77i71 by /rik+ #ij & ins]t+ #fj2 &   
7#b7 by /rik+ ! flu% s5t5ce aft]        
subp>agraph 7,b74  7b7 ,effective date  
,! am5dm5ts made by subsection 7a7 %all 
take effect on ! date t is #cj days aft]
 ! date ( enactm5t ( ?is ,act4  #d4     
,updates to ,/ate application           
requirem5ts ,section #fjga7;c7 ( !      

,deficit ,r$uction ,act ( #bjje 7#db    
,u4,s4,c4 #acif;a note7 is am5d$-- 7#a7 
9 p>agraph 7#c71 by /rik+ 1 :i* %all    
include & all t foll[s ?r\gh #bjjg2     
7#b7 9 p>agraph 7#g7-- 7,a7 9 ! p>agraph
 head+1 by /rik+ ,rebalanc+ & ins]t+    
,exp5ditures2 &  7,b7 9 subp>agraph     
7,b7-- 7i7 9 clause 7i71 by /rik+ & aft]
 ! semicolon2  7ii7 9 clause 7ii71 by   
/rik+ ! p]iod at ! end & ins]t+ a       
semicolon2 &  7iii7 by add+ at ! end !  
foll[+3  7iii7 include a "w plan t      
describes = ea* ,f$]al fiscal ye> t     
occurs dur+ ! propos$ ,,mfp demon/ration
 project--  7,i7 ! use ( grant funds =  
ea* propos$ initiative t is design$ to  
accompli% ! objective describ$ 9        
subsection 7a77#a71 includ+ a fund+     
s\rce = ea* activity t is "p ( ea* su*  
propos$ initiative2  7,,ii7 an          
evaluation plan t id5tifies expect$     
results = ea* su* propos$ initiative2 & 
7,,iii7 a su/a9ability plan = compon5ts 
( su* propos$ initiatives t are int5d$  
to improve transitions1 :i* %all be     

updat$ ) actual exp5diture in=mation =  
ea* ,f$]al fiscal ye> t occurs dur+ !   
,,mfp demon/ration project2 &  7iv7     
conta9 assurances t grant funds us$ to  
accompli% ! objective describ$ 9        
subsection 7a77#a7 %all be obligat$ n   
lat] ?an #bd mon?s aft] ! date on :i* ! 
funds are aw>d$ & %all be exp5d$ n lat] 
?an #fj mon?s aft] ! date on :i* ! funds
 are aw>d$ 7unless ! ,secret>y approves 
a waiv] ( ei!r su* requirem5t74  2 &    
7#c7 9 p>agraph 7#ac7-- 7,a7 9          
subp>agraph 7,a71 by /rik+ 2 & & ins]t+ 
1 & 9 su* mann] z w meet ! report+      
requirem5ts set =? = ! ,trans=m$        
,m$icaid ,/ati/ical ,managem5t          
,in=mation ,sy/em 7,t-,,msis722  7,b7 by
 r$esignat+ subp>agraph 7,b7 z          
subp>agraph 7,d72 &  7,c7 by ins]t+ aft]
 subp>agraph 7,a7 ! foll[+3  7,b7 !     
,/ate %all report on a qu>t]ly basis on 
! use ( grant funds by di/9ct activity1 
z describ$ 9 ! approv$ "w plan1 & by    
specific population z t>get$ by ! ,/ate2
  7,c7 if ! ,/ate fails to report !     

in=mation requir$ "u subp>agraph 7,b71  
fails to report su* in=mation on a      
qu>t]ly basis1 or fails to make progress
 "u ! approv$ "w plan1 ! ,/ate %all     
implem5t a corrective action plan & any 
lack ( progress "u ! approv$ "w plan may
 result 9 )hold+ ( grant funds made     
available to ! ,/ate2 &  4  #e4 ,fund+ =
 quality assurance & improvem5t2        
te*nical assi/ance2 ov]sight ,section   
#fjga7;f7 ( ! ,deficit ,r$uction ,act ( 
#bjje 7#db ,u4,s4,c4 #acif;a note7 is   
am5d$ by /rik+ p>agraph 7#b7 & ins]t+ ! 
foll[+3  7#b7 ,fund+ ,f ! am\nts        
appropriat$ "u subsection 7h77#a7 = ea* 
( fiscal ye>s #bjai ?r\gh #bjbc1        
#a1jjj1jjj %all be available to !       
,secret>y = ea* su* fiscal ye> to c>ry  
out ?is subsection4  4  #f4 ,be/        
practices evaluation ,section #fjga ( ! 
,deficit ,r$uction ,act ( #bjje 7#db    
,u4,s4,c4 #acif;a note7 is am5d$ by add+
 at ! end ! foll[+3  7i7 ,be/ practices 
7#a7 ,report ,! ,secret>y1 directly or  
?r\gh grant or contract1 %all submit a  

report to ! ,presid5t & ,congress n lat]
 ?an ,septemb] #cj1 #bjbj1 t conta9s    
f9d+s & conclusions on be/ practices f !
 ,/ate ,,mfp demon/ration projects c>ri$
 out ) grants made "u ?is section4 ,!   
report %all include in=mation & analyses
 ) respect to ! foll[+3  7,a7 ,! mo/    
effective ,/ate /rategies = transition+ 
b5efici>ies f in/itutional to qualifi$  
community sett+s c>ri$ out "u ! ,/ate   
,,mfp demon/ration projects & h[ su*    
/rategies may v>y = diff]5t types (     
b5efici>ies1 su* z b5efici>ies :o are   
ag$1 physically disabl$1 intellectually 
or developm5tally disabl$1 or           
individuals ) s]i\s m5tal illnesses1 &  
o!r t>get$ waiv] b5efici>y populations4 
7,b7 ,! mo/ common & ! mo/ effective    
,/ate uses ( grant funds c>ri$ out "u ! 
,/ate ,,mfp demon/ration projects =     
transition+ b5efici>ies f in/itutional  
to qualifi$ community sett+s & improv+  
heal? outcomes1 includ+ diff]5tiat+     
fund+ = curr5t initiatives t are design$
 = su* purpose & fund+ = propos$        

initiatives t are design$ = su* purpose4
  7,c7 ,! mo/ effective ,/ate approa*es 
c>ri$ out "u ,/ate ,,mfp demon/ration   
projects = improv+ p]son-c5t]$ c>e &    
plann+4  7,d7 ,id5tification ( program1 
f9anc+1 & o!r flexibilities available "u
 ! ,/ate ,,mfp demon/ration projects1 t 
are n available "u ! traditional        
,m$icaid program1 & :i* directly        
contribut$ to successful transitions &  
improv$ heal? outcomes "u ! ,/ate ,,mfp 
demon/ration projects4  7,e7 ,/ate      
/rategies & f9anc+ me*anisms = effective
 coord9ation ( h\s+ f9anc$ or support$  
"u ,/ate ,,mfp demon/ration projects )  
local h\s+ au?orities & o!r res\rces4   
7,f7 ,effective ,/ate approa*es =       
deliv]+ ,money ,foll[s ! ,p]son         
transition s]vices ?r\gh manag$ c>e     
entities4  7,g7 ,o!r be/ practices &    
effective transition /rategies          
demon/rat$ by ,/ates ) approv$ ,,mfp    
demon/ration projects1 z det]m9$ by !   
,secret>y4  7,h7 ,id5tification &       
analyses ( opportunities & *all5ges to  

integrat+ effective ,money ,foll[s !    
,p]son practices & ,/ate /rategies into 
! traditional ,m$icaid program4  7#b7   
,collaboration ,9 prep>+ ! report       
requir$ "u ?is subsection1 ! ,secret>y  
%all collect & incorporate in=mation f  
,/ates ) approv$ ,,mfp demon/ration     
projects & b5efici>ies p>ticipat+ 9 su* 
projects1 & provid]s p>ticipat+ 9 su*   
projects4  7#c7 ,fund+ ,f ! am\nts      
appropriat$ "u subsection 7h77#a7 = ea* 
( fiscal ye>s #bjai ?r\gh #bjbj1 n m ?an
 #cjj1jjj %all be available to !        
,secret>y = ea* su* fiscal ye> to c>ry  
out ?is subsection4  4  #g4 ,,macpac    
report on qualifi$ sett+s crit]ia       
,section #fjga ( ! ,deficit ,r$uction   
,act ( #bjje 7#db ,u4,s4,c4 #acif;a     
note71 z am5d$ by section #f1 is am5d$  
by add+ at ! end ! foll[+3  7j7 ,,macpac
 report ,prior to ! f9al implem5tation  
date e/abli%$ by ! ,secret>y = ! crit]ia
 e/abli%$ = home & community-bas$ sett+s
 9 section #dda4cja7;c77#d7 ( title #db1
 ,code ( ,f$]al ,regulations1 z "p (    

f9al implem5tation ( ! ,home &          
,community ,bas$ ,s]vices 7,,hcbs7 ,f9al
 ,rule publi%$ on ,janu>y #af1 #bjad    
7#gi ,f$4 ,reg4 #bidg7 7ref]r$ to 9 ?is 
subsection z ! ,,hcbs f9al rule71 !     
,m$icaid & ,,*ip ,paym5t & ,access      
,commission 7,,macpac7 %all submit to   
,congress a report t--  7#a7 id5tifies !
 types ( home & community-bas$ sett+s & 
associat$ s]vices t are available to    
eligible individuals 9 bo? ! ,,mfp      
demon/ration program & sites 9          
compliance ) ! ,,hcbs f9al rule2 &  7#b7
 if det]m9$ appropriate by !            
,commission1 recomm5ds policies to align
 ! crit]ia = a qualifi$ resid5ce "u     
subsection 7b77#f7 7z 9 effect on       
,octob] #a1 #bjag7 ) ! crit]ia 9 !      
,,hcbs f9al rule4  4  #h4 ,application  
to curr5t projects ,n lat] ?an #a ye>   
aft] ! date ( enactm5t ( ?is ,act1 any  
,/ate ) an approv$ ,,mfp demon/ration   
project "u section #fjga ( ! ,deficit   
,r$uction ,act ( #bjje 7#db ,u4,s4,c4   
#acif;a note7 on ! date ( enactm5t ( ?is

 ,act %all submit a revis$ application  
to ! ,secret>y t conta9s ! same         
in=mation & assurances z are requir$ =  
any new ,/ate applicant "u ! am5dm5ts   
made by ?is ,act4