,,ii  #aai? ,,congress  #a/ ,session    
,s4 #aihi  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #i1 #bjbe ,mr4   
,s*mitt introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on  
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to increase 
transp>5cy & exp& cov]age options )     
respect to home & community-bas$        
s]vices1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,help+  
,communities ) ,bett] ,support ,act4    
#b4 ,increas+ transp>5cy & exp&+ ,,hcbs 
cov]age options  7a7 ,9 g5]al ,section  
#aiae7;c7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acifn7c77 is am5d$--    
7#a7 9 p>agraph 7#b77;,e7-- 7,a7 by     
ins]t+ 1 n less frequ5tly ?an be=e      
annually2 &  7,b7 by ins]t+ 7includ+1 ) 
respect to su* in=mation provid$ on or  
aft] ,janu>y #a1 #bjbh1 ! in=mation     
specifi$ 9 p>agraph 7#ab77 be=e ! p]iod 
at ! end2 &  7#b7 by add+ at ! end !    
foll[+ new p>agraphs3  7#aa7  7,a7      
,not)/&+ p>agraph 7#a71 ! ,secret>y may 

approve a waiv] "u ?is subsection = a   
,/ate to include z m$ical assi/ance "u !
 ,/ate plan ( su* ,/ate paym5t = "p or  
all ( ! co/ ( home or community-bas$    
s]vices 7o!r ?an room & bo>d 7z describ$
 9 su* p>agraph77 approv$ by ! ,secret>y
 :i* are provid$ pursuant to a writt5   
plan ( c>e to individuals o!r ?an       
individuals describ$ 9 su* p>agraph if  
su* ,/ate meets ! requirem5ts specifi$ 9
 subp>agraph 7,b74  7,b7 ,= purposes (  
subp>agraph 7,a71 ! requirem5ts specifi$
 9 ?is subp>agraph are1 ) respect to a  
,/ate1 ! foll[+3  7i7 ,z ( ! date t su* 
,/ate reque/s a waiv] "u ?is p>agraph to
 provide home or community-bas$ s]vices 
to individuals-- 7,i7 ) respect to :om  
!re has n be5 a det]m9ation describ$ 9  
p>agraph 7#a7 made2 &  7,,ii7 :o meet ! 
def9ition ( disability "u section #c ( !
 ,am]icans ) ,disabilities ,act ( #aiij 
7#db ,u4,s4,c4 #abajb7 or section #ejd (
 ! ,rehabilitation ,act ( #aigc 7#bi    
,u4,s4,c4 #gid71 all o!r waiv]s 7if any7
 grant$ "u ?is subsection ) respect to !

 ,/ate plan meet ! requirem5ts ( ?is    
subsection4  7ii7 ,! ,/ate demon/rates  
to ! ,secret>y t approval ( a waiv] "u  
?is subsection ) respect to individuals 
describ$ 9 clause 7i7 w h no mat]ial    
impact on ! av]age am\nt ( "t t         
individuals ) respect to :om a          
det]m9ation describ$ 9 p>agraph 7#a7 has
 be5 made w ne$ to wait to receive home 
or community-bas$ s]vices "u any waiv]  
grant$ "u ?is subsection4  7iii7 ,!     
,/ate provides to ! ,secret>y-- 7,i7 an 
e/imate ( ! numb] ( individuals describ$
 9 clause 7i7 t ! ,/ate w make su*      
s]vices available to "u a waiv] "u ?is  
subsection2 &  7,,ii7 a description ( h[
 ! types & quantities ( su* s]vices     
furni%$ to su* individuals "u su* a     
waiv] may diff] f ! types & quantities (
 su* s]vices furni%$ to individuals n   
describ$ 9 clause 7i7 "u su* a waiv]4   
7#ab7 ,= purposes ( p>agraph 7#b77;,e71 
! in=mation specifi$ 9 ?is p>agraph     
7:i*1 beg9n+ on ,janu>y #a1 #bjbh1 %all 
be made publicly available on ! website 

( ! ,c5t]s = ,m$ic>e  ,m$icaid ,s]vices7
 is ! foll[+3  7,a7 ,9 ! case ( a ,/ate 
t limits ! numb] ( individuals :o may be
 provid$ home or community-bas$ s]vices 
"u a waiv] grant$ "u ?is subsection--   
7i7 a description ( h[ ! ,/ate ma9ta9s  
its li/ ( individuals :o h appli$ to    
receive su* s]vices "u su* waiv] b :o1  
due to su* limit1 h n yet be5 approv$ to
 receive su* s]vices2  7ii7 in=mation on
 :e!r ! ,/ate scre5s individuals on su* 
li/ to det]m9e :e!r su* individuals are 
eligible to receive su* s]vices "u su*  
waiv]2  7iii7 in=mation on :e!r 7&1 if  
applicable1 h[ (t57 ! ,/ate p]iodically 
re-scre5s su* individuals to det]m9e    
:e!r su* individuals are s eligible2 &  
7iv7 ! av]age am\nt ( "t t individuals  
approv$ to receive su* s]vices 7 on su* 
li/4  7,b7 ,a description ( ! types (   
s]vices furni%$ "u a waiv] "u ?is       
subsection1 includ+--  7i7 ! av]age     
am\nt ( "t f :5 su* s]vices are         
initially approv$ = an individual to :5 
su* individual beg9s receiv+ su*        

s]vices2 &  7ii7 ) respect to ! mo/     
rec5t #a-ye> p]iod end+ on ! date t su* 
in=mation is provid$ to ! ,secret>y =   
:i* data is available 7or su* o!r p]iod 
z may be specifi$ by ! ,secret>y71 !    
av]age p]c5tage ( h\rs ( home or        
community-bas$ s]vices au?oriz$ "u      
writt5 plans ( c>e = individuals receiv+
 su* s]vices "u a waiv] grant$ "u ?is   
subsection t are actually furni%$ to su*
 individual4  7,c7 ,in=mation reg>d+    
access to homemak] s]vices1 home heal?  
aide s]vices1 & p]sonal c>e s]vices "u a
 waiv] "u ?is subsection1 includ+-- 7i7 
) respect to ! mo/ rec5t #a-ye> p]iod   
end+ on ! date t su* in=mation is       
provid$ to ! ,secret>y = :i* data is    
available1 ! av]age am\nt ( "t f :5     
homemak] s]vices1 home heal? aide       
s]vices1 or p]sonal c>e s]vices are     
initially approv$ to be furni%$ to      
individuals "u su* a waiv] to :5 s]vices
 began2 &  7ii7 ) respect to ! p]iod    
describ$ 9 clause 7i71 ! av]age p]c5tage
 ( h\rs ( homemak] s]vices1 home heal?  

aide s]vices1 & p]sonal c>e s]vices     
au?oriz$ "u writt5 plans ( c>e =        
individuals receiv+ su* s]vices "u a    
waiv] grant$ "u ?is subsection t are    
actually furni%$ to su* individual4  4  
7b7 ,guidance ,n lat] ?an ,janu>y #a1   
#bjbf1 ! ,secret>y ( ,heal? & ,human    
,s]vices %all issue guidance to ,/ates  
to cl>ify h[ a ,/ate ) a waiv] 9 effect 
"u section #aiae7;c7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4 #acifn7c77
 may provide1 ) respect to an individual
 :o is eligible = home & community-bas$ 
s]vices 7z su* t]m is describ$ 9 su*    
section7 "u su* waiv]1 up to #fj days ( 
cov]age = su* s]vices "u an int]im c>e  
plan = ! p]iod beg9n+ on ! date su*     
eligibility is det]m9$ & end+ on ! date 
t a writt5 plan ( c>e 7z su* t]m is     
describ$ 9 su* section7 ) respect to su*
 individual is f9aliz$4