119-s1989

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 1989 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 1989

To amend title XIX of the Social Security Act to increase transparency 
 and expand coverage options with respect to home and community-based 
 services, and for other purposes.

_______________________________________________________________________

 IN THE SENATE OF THE UNITED STATES

 June 9, 2025

 Mr. Schmitt introduced the following bill; which was read twice and 
 referred to the Committee on Finance

_______________________________________________________________________

 A BILL

To amend title XIX of the Social Security Act to increase transparency 
 and expand coverage options with respect to home and community-based 
 services, and for other purposes.

 Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

 This Act may be cited as the ``Helping Communities with Better 
Support Act''.

SEC. 2. INCREASING TRANSPARENCY AND EXPANDING HCBS COVERAGE OPTIONS.

    (a) In General.--

Section 1915
            (c) of the Social Security Act (42 
U.S.C. 1396n
            (c) ) is amended--

    (1) in paragraph

    (2)
        (E) --
        (A) by inserting ``, not less frequently than'' 
 before ``annually''; and
        (B) by inserting ``(including, with respect to such 
 information provided on or after January 1, 2028, the 
 information specified in paragraph

    (12) )'' before the 
 period at the end; and

    (2) by adding at the end the following new paragraphs:
 ``

    (11)
        (A) Notwithstanding paragraph

    (1) , the Secretary may approve 
a waiver under this subsection for a State to include as `medical 
assistance' under the State plan of such State payment for part or all 
of the cost of home or community-based services (other than room and 
board (as described in such paragraph)) approved by the Secretary which 
are provided pursuant to a written plan of care to individuals other 
than individuals described in such paragraph if such State meets the 
requirements specified in subparagraph
        (B) .
 ``
        (B) For purposes of subparagraph
        (A) , the requirements specified 
in this subparagraph are, with respect to a State, the following:
 ``
            (i) As of the date that such State requests a waiver 
 under this paragraph to provide home or community-based 
 services to individuals--
 ``
            (I) with respect to whom there has not been a 
 determination described in paragraph

    (1) made; and
 ``
            (II) who meet the definition of disability under 
 

section 3 of the Americans with Disabilities Act of 
 1990 (42 U.S.C. 12102) or 

section 504 of the 
 Rehabilitation Act of 1973 (29 U.S.C. 794), all other 
 waivers (if any) granted under this subsection with 
 respect to the State plan meet the requirements of this 
 subsection.
 ``
            (ii) The State demonstrates to the Secretary that 
 approval of a waiver under this subsection with respect to 
 individuals described in clause
            (i) will have no material 
 impact on the average amount of time that individuals with 
 respect to whom a determination described in paragraph

    (1) has 
 been made will need to wait to receive home or community-based 
 services under any waiver granted under this subsection.
 ``
            (iii) The State provides to the Secretary--
 ``
            (I) an estimate of the number of individuals 
 described in clause
            (i) that the State will make such 
 services available to under a waiver under this 
 subsection; and
 ``
            (II) a description of how the types and 
 quantities of such services furnished to such 
 individuals under such a waiver may differ from the 
 types and quantities of such services furnished to 
 individuals not described in clause
            (i) under such a 
 waiver.
 ``

    (12) For purposes of paragraph

    (2)
        (E) , the information specified 
in this paragraph (which, beginning on January 1, 2028, shall be made 
publicly available on the website of the Centers for Medicare & 
Medicaid Services) is the following:
 ``
        (A) In the case of a State that limits the number of 
 individuals who may be provided home or community-based 
 services under a waiver granted under this subsection--
 ``
            (i) a description of how the State maintains its 
 list of individuals who have applied to receive such 
 services under such waiver but who, due to such limit, 
 have not yet been approved to receive such services;
 ``
            (ii) information on whether the State screens 
 individuals on such list to determine whether such 
 individuals are eligible to receive such services under 
 such waiver;
 ``
            (iii) information on whether (and, if applicable, 
 how often) the State periodically re-screens such 
 individuals to determine whether such individuals are 
 so eligible; and
 ``
            (iv) the average amount of time that individuals 
 approved to receive such services were on such list.
 ``
        (B) A description of the types of services furnished 
 under a waiver under this subsection, including--
 ``
            (i) the average amount of time from when such 
 services are initially approved for an individual to 
 when such individual begins receiving such services; 
 and
 ``
            (ii) with respect to the most recent 1-year 
 period ending on the date that such information is 
 provided to the Secretary for which data is available 
 (or such other period as may be specified by the 
 Secretary), the average percentage of hours of home or 
 community-based services authorized under written plans 
 of care for individuals receiving such services under a 
 waiver granted under this subsection that are actually 
 furnished to such individual.
 ``
            (C) Information regarding access to homemaker services, 
 home health aide services, and personal care services under a 
 waiver under this subsection, including--
 ``
            (i) with respect to the most recent 1-year period 
 ending on the date that such information is provided to 
 the Secretary for which data is available, the average 
 amount of time from when homemaker services, home 
 health aide services, or personal care services are 
 initially approved to be furnished to individuals under 
 such a waiver to when services began; and
 ``
            (ii) with respect to the period described in 
 clause
            (i) , the average percentage of hours of 
 homemaker services, home health aide services, and 
 personal care services authorized under written plans 
 of care for individuals receiving such services under a 
 waiver granted under this subsection that are actually 
 furnished to such individual.''.

    (b) Guidance.--Not later than January 1, 2026, the Secretary of 
Health and Human Services shall issue guidance to States to clarify how 
a State with a waiver in effect under 

section 1915
            (c) of the Social 
Security Act (42 U.S.C. 1396n
            (c) ) may provide, with respect to an 
individual who is eligible for home and community-based services (as 
such term is described in such section) under such waiver, up to 60 
days of coverage for such services under an interim care plan for the 
period beginning on the date such eligibility is determined and ending 
on the date that a written plan of care (as such term is described in 
such section) with respect to such individual is finalized.
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