,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #djbi  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #ag1 #bjbe ,mrs4
 ,d+ell introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce  ,a ,,bill  ,to provide = an   
em]g5cy increase 9 ,f$]al fund+ to ,/ate
 ,m$icaid programs = exp5ditures on home
 & community-bas$ s]vices4  #b4         
,additional support = ,m$icaid home &   
community-bas$ s]vices  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 or section     
#aiae7k7 ( su* ,act 7#db ,u4,s4,c4      
#acifn7k771 %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+ fiscal ye>s #bjbf & #bjbg4 
,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 ,/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,b7 ,home &        
community-bas$ s]vices ,! t]m home &    
community-bas$ s]vices means--  7i7 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;d7a772  7ii7 behavioral heal?     
s]vices au?oriz$ "u p>agraph 7#ac7 ( su*
 section2  7iii7 p]sonal c>e s]vices    
au?oriz$ "u p>agraph 7#bd7 ( su*        
section2  7iv7 ,,pace s]vices au?oriz$  
"u p>agraph 7#bf7 ( su* section2  7v7   
s]vices au?oriz$ "u subsections 7b71    
7c71 7i71 7j71 & 7k7 ( section #aiae (  

su* ,act 7#db ,u4,s4,c4 #acifn72  7vi7  
su* s]vices au?oriz$ "u a waiv] "u      
section #aaae ( su* ,act 7#db ,u4,s4,c4 
#acae72 &  7vii7 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 all      
,f$]al funds attributable to ! increase 
"u subsection 7a7 w be--  7,a7 exp5d$ by
 ! ,/ate 9 accordance ) ?is section n   
lat] ?an ,septemb] #cj1 #bjbi2 &  7,b7  
us$--  7i7 to implem5t ! activities     
describ$ 9 subsection 7d72  7ii7 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 &  7iii7 to     
increase reimbursem5t rates = home &    
community-bas$ s]vices to a level t w   
support recruitm5t & ret5tion ( a       
suffici5t work=ce to provide home &     
community-bas$ s]vices to eligible      
individuals2 &  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 !   
purposes describ$ 9 p>agraph 7#b74  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$ical leave = home heal? work]s &      
direct support pr(essionals4  7,c7 ,to  
provide haz>d pay1 ov]time pay1 & %ift  
diff]5tial pay = home heal? work]s &    
direct support pr(essionals4  7,d7 ,to  
improve /ability ( home heal? work] &   
direct support pr(essional jobs1 includ+
 consi/5t h\rs1 s*$ul+1 pay1 & b5efit   

eligibility4  7,e7 ,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,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$$ supplies1 equipm5t1 &
 s]vices1 :i* may include su* items z   
family c>egiv] pay & respite s]vices4   
7,j7 ,to pay = tra9+ = home heal? work]s
 & direct support pr(essionals4  7,k7   
,to pay = assi/ive te*nologies1 /aff+1 &

 tra9+ to facilitate eligible           
individuals' communication1 & o!r co/s  
incurr$ 9 ord] to facilitate community  
integration & ensure an individual's    
p]son-c5t]$ s]vice plan cont9ues to be  
fully implem5t$4  7,l7 ,to prep>e       
in=mation & public heal? & educational  
mat]ials 9 accessible =mats 7includ+    
=mats accessible to p ) l[ lit]acy or   
intellectual disabilities7 ab\t         
prev5tion1 treatm5t1 recov]y & o!r      
aspects ( communicable diseases & ?reats
 to ! heal? ( eligible individuals1 _!  
families1 & ! g5]al community s]v$ by   
ag5cies describ$ 9 subp>agraph 7,a74    
7,m7 ,to protect ! heal? & safety ( home
 heal? work]s & direct support          
pr(essionals dur+ public heal? em]g5cies
 & natural disa/]s4  7,n7 ,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 communicable diseases & o!r public 
heal? ?reats4  7,o7 ,to all[ day s]vices
 provid]s to provide home &             

community-bas$ s]vices4  7,p7 ,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,q7 ,to assi/ eligible         
individuals :o _h to relocate to a nurs+
 facility or in/itutional sett+ f _!    
homes 9--  7i7 mov+ back to _! homes    
7includ+ by pay+ = mov+ co/s1 fir/      
mon?'s r5t1 & o!r "o-"t exp5ses & />t-up
 co/s72  7ii7 resum+ home &             
community-bas$ s]vices2  7iii7 receiv+  
m5tal heal? s]vices & necess>y          
rehabilitative s]vice to rega9 skills   
lo/ :ile relocat$2 &  7iv7 :ile funds   
attributable to ! increas$ ,,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+ ! em]g5cy p]iod        
describ$ 9 section #aace7;g77#a77;,b7 ( 
! ,social ,security ,act 7#db ,u4,s4,c4 

#acbj;b-#e7;g77#a77;,b774  7e7 ,report+ 
requirem5ts  7#a7 ,/ate report+         
requirem5ts ,n lat] ?an ,decemb] #ca1   
#bjbi1 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 ! ,pap]work ,r$uction ,act ( #aiie71  
%all n apply to ! provisions ( ?is      
subsection4  7f7 ,additional def9itions 
,9 ?is section3  7#a7 ,eligible         
individual ,! t]m eligible individual   
means an individual :o is eligible = or 
enroll$ = m$ical assi/ance "u a ,/ate   
,m$icaid program4  7#b7 ,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#c7 ,secret>y ,! t]m ,secret>y means ! 
,secret>y ( ,heal? & ,human ,s]vices4   
7#d7 ,/ate ,! t]m ,/ate has ! mean+ giv5
 su* t]m = purposes ( title ,,xix ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq474