,,ii  #aai? ,,congress  #b;d ,session   
,s4 #ebgj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,augu/ #e1 #bjbf,mr4   
,kim introduc$ ! foll[+ bill2 :i* 0 read
 twice & ref]r$ to ! ,committee on      
,f9ance  ,a ,,bill  ,to am5d title      
,,xviii ( ! ,social ,security ,act to   
e/abli% a ,m$ic>e home c>e b5efit1 & =  
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,m$ic>e at ,home ,act4 
#b4 ,f9d+s ,congress f9ds ! foll[+3 7#a7
 ,m ?an #aj1jjj1jjj ,m$ic>e b5efici>ies 
ne$ assi/ance ) "o or m activities (    
daily liv+1 & curr5t ,m$ic>e law does n 
cov] long-t]m1 p]sonal c>e 9 ! home4    
7#b7 ,! abs5ce ( a home c>e b5efit =ces 
b5efici>ies & families to pay out (     
pocket1 sp5d d[n into ,m$icaid1 or =go  
ne$$ c>e1 (t5 at great] co/ to ! heal?  
c>e sy/em ?r\gh avoidable               
hospitalizations & in/itutionalization4 
,pay+ out ( pocket = home c>e co/s m ?an
 #fj1jjj annually4  7#c7 ,! va/ majority
 ( p want to live & age ) dignity 9 _!  
homes :5 !y ne$ c>e1 includ+ #id p]c5t (

 old] adults1 #ij p]c5t ( p )           
disabilities1 & #hi p]c5t ( adults      
ov]all4  7#d7 ,am]icans ov]:elm+ly &    
/rongly believe ,m$ic>e %\ld cov] home  
c>e s]vices1 ) #ic p]c5t ( adults       
agree+4 ,! majority ( curr5t ,m$ic>e    
b5efici>ies ei!r believe x already does 
or d n "k if x does or n4  7#e7 ,a      
mode/1 capp$ home c>e b5efit "u ,m$ic>e 
w\ld all[ old] adults & p ) disabilities
 to rema9 safely 9 _! homes &           
communities4 ,x w\ld also take !        
pressure (f ( unpaid family c>egiv]s :o 
n[ provide ov] #a1jjj1jjj1jjj1jjj 9     
unpaid c>e to ! economy fill+ 9 gaps 9 !
 sy/ems4  #c4 ,e/abli%m5t ( ,m$ic>e home
 c>e b5efit  7a7 ,9 g5]al ,section #ahfa
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7 is am5d$ by add+ at ! 
end ! foll[+ new subsection3  7ooo7     
,home c>e s]vices  7#a7 ,9 g5]al ,! t]m 
home c>e s]vices means ! foll[+ s]vices 
furni%$ to an individual 9 !            
individual's home by a home c>e work] "u
 a plan e/abli%$ "u p>agraph 7#c73 7,a7 

,assi/ance ) activities ( daily liv+1   
includ+ ba?+1 dress+1 toilet+1          
transf]r+1 & eat+4  7,b7 ,assi/ance )   
in/rum5tal activities ( daily liv+1     
includ+ meal prep>ation1 m$ication      
rem9d]s1 & light h\sekeep+ directly     
relat$ to ! heal? & safety ( !          
individual4  7#b7 ,limitations ,home c>e
 s]vices furni%$ "u ?is subsection--    
7,a7 %all n exce$ #bj h\rs p] week p]   
individual2 &  7,b7 d n include1 & are  
sep>ate f1 home heal? s]vices describ$ 9
 subsection 7m74  7#c7 ,plan ( c>e ,home
 c>e s]vices %all be furni%$ pursuant to
 a plan ( c>e e/abli%$ & p]iodically    
review$ by a physician 7or o!r          
practition] au?oriz$ "u ?is title to    
e/abli% a plan ( c>e71 :i* %all c]tify t
 ! individual requires assi/ance ) n    
few] ?an #b activities ( daily liv+1 #b 
in/rum5tal activities ( daily liv+1 or  
#a activity ( daily liv+ & #a in/rum5tal
 activity ( daily liv+ describ$ 9       
p>agraph 7#a77;,a74  4  7b7 ,cov]age "u 
"p ,b ,section #ahcb7;a77#b7 ( ! ,social

 ,security ,act 7#db ,u4,s4,c4          
#aciek7a77#b77 is am5d$-- 7#a7 9        
subp>agraph 7,i71 by /rik+ & at ! end2  
7#b7 9 subp>agraph 7,j71 by /rik+ !     
p]iod at ! end & ins]t+ 2 &2 &  7#c7 by 
add+ at ! end ! foll[+ new subp>agraph3 
7,k7 home c>e s]vices 7z def9$ 9 section
 #ahfa7ooo774  4  7c7 ,paym5t ,section  
#ahcc ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #aciel7 is am5d$ by add+ at ! 
end ! foll[+ new subsection3  7ee7      
,paym5t = home c>e s]vices ,! ,secret>y 
%all e/abli% a paym5t me?odology = home 
c>e s]vices 7z def9$ 9 section          
#ahfa7ooo77 furni%$ by ag5cies or       
individuals enroll$ "u ?is title1 :i*   
%all reflect a reasonable wage floor =  
home c>e work]s furni%+ su* s]vices4  4 
#d4 ,eligibility ,an individual is      
eligible = home c>e s]vices "u ?is ,act 
if ! individual-- 7#a7 is entitl$ to    
b5efits "u "p ,a1 or enroll$ "u "p ,b1 (
 title ,,xviii ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acie et seq472     
7#b7 has be5 c]tifi$1 9 accordance )    

section #ahfa7ooo77#c7 ( su* ,act 7z    
add$ by section #c71 z requir+ assi/ance
 ) n few] ?an #b activities ( daily     
liv+1 #b in/rum5tal activities ( daily  
liv+1 or #a activity ( daily liv+ & #a  
in/rum5tal activity ( daily liv+2 &     
7#c7 is n1 at ! "t ,m$ic>e home c>e     
s]vices are furni%$1 receiv+ long-t]m   
s]vices & supports ?r\gh a ,/ate plan   
7or waiv] ( su* plan7 "u title ,,xix ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acif et seq47 t duplicate ! s]vices    
describ$ 9 section #ahfa7ooo74  #e4     
,b5efit am\nt ,home c>e s]vices furni%$ 
"u ?is ,act may n exce$ #bj h\rs p] week
 p] eligible individual1 z set =? 9     
section #ahfa7ooo77#b77;,a7 ( ! ,social 
,security ,act 7z add$ by section #c74  
#f4 ,f9anc+  7a7 ,"p ,b premium ,!      
,secret>y %all adju/ ! mon?ly premium "u
 section #ahci ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acier7 to reflect !
 additional actu>ial co/ ( ! b5efit     
e/abli%$ "u ?is ,act1 subject to ! /&>d 
subsidy s*$ule "u su* section4  7b7     

,actu>ial report ,n lat] ?an #ahj days  
aft] ! date ( enactm5t ( ?is ,act1 !    
,*ief ,actu>y ( ! ,c5t]s = ,m$ic>e      
,m$icaid ,s]vices %all submit to        
,congress an e/imate ( ! p]-b5efici>y   
premium impact ( ! b5efit e/abli%$ "u   
?is ,act4  #g4 ,adm9i/ration  7a7       
,regulations ,n lat] ?an #a ye> aft] !  
date ( enactm5t ( ?is ,act1 ! ,secret>y 
( ,heal? & ,human ,s]vices %all         
promulgate regulations necess>y to c>ry 
out ?is ,act & ! am5dm5ts made by ?is   
,act1 includ+ /&>ds = home c>e work]    
qualifications & ag5cy enrollm5t4  7b7  
,effective date ,! am5dm5ts made by ?is 
,act %all apply to home c>e s]vices     
furni%$ on or aft] ! fir/ day ( ! fir/  
plan ye> beg9n+ m ?an #b ye>s aft] !    
date ( enactm5t ( ?is ,act4