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