[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 5321 Introduced in Senate (IS)]

<DOC>






119th CONGRESS
  2d Session
                                S. 5321

 To amend title XIX of the Social Security Act to require coverage of, 
   and expand access to, home and community-based services under the 
    Medicaid program to award grants for the creation, recruitment, 
 training and education, retention, and advancement of the direct care 
  workforce and to award grants to support family caregivers and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             August 6, 2026

  Mr. Lujan (for himself, Mr. Kaine, Ms. Baldwin, Ms. Duckworth, Mrs. 
 Gillibrand, Ms. Hassan, Mr. Blumenthal, Mr. Merkley, Mr. Sanders, Ms. 
Warren, Mr. Reed, Mr. Markey, Mrs. Shaheen, Mr. Fetterman, Mr. Kim, and 
 Mrs. Murray) 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 require coverage of, 
   and expand access to, home and community-based services under the 
    Medicaid program to award grants for the creation, recruitment, 
 training and education, retention, and advancement of the direct care 
  workforce and to award grants to support family caregivers 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``HCBS Access Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
TITLE I--REQUIRING AND EXPANDING ACCESS TO HCBS COVERAGE UNDER MEDICAID

Sec. 101. Purpose.
Sec. 102. Requiring coverage of home and community-based services under 
                            the Medicaid program.
Sec. 103. Medicaid eligibility modifications.
Sec. 104. Home and community-based services implementation plan.
Sec. 105. Quality of services.
Sec. 106. Reports; technical assistance; other administrative 
                            requirements.
Sec. 107. Quality measurement and improvement.
Sec. 108. Making permanent the extended protection under medicaid for 
                            recipients of home and community-based 
                            services against spousal impoverishment.
Sec. 109. Permanent extension of money follows the person rebalancing 
                            demonstration.
Sec. 110. Liens, adjustments, and recoveries for medical assistance.
Sec. 111. HCBS provider tax.
Sec. 112. Medicare amendment.
     TITLE II--RECOGNIZING THE ROLE OF DIRECT SUPPORT PROFESSIONALS

Sec. 201. Findings.
Sec. 202. Revision of standard occupational classification system.
            TITLE III--SUPPORT FOR THE DIRECT CARE WORKFORCE

Sec. 301. Definitions.
Sec. 302. Authority to establish a technical assistance center for 
                            building the direct care workforce.
Sec. 303. Authority to award grants.
Sec. 304. Project plans.
Sec. 305. Evaluations and reports; technical assistance.
Sec. 306. Authorization of appropriations.
                          TITLE IV--EVALUATION

Sec. 401. Evaluation of impact on access to HCBS.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Demographics.--The term ``demographics'' means 
        information relating to the races, ethnicities, genders, sexual 
        orientations, gender identities, geographic locations, incomes, 
        primary languages, types of service setting, and disability 
        types represented within a particular group of individuals.
            (2) Secretary.--Except as otherwise provided, the term 
        ``Secretary'' means the Secretary of Health and Human Services.

TITLE I--REQUIRING AND EXPANDING ACCESS TO HCBS COVERAGE UNDER MEDICAID

SEC. 101. PURPOSE.

    It is the purpose of this title to require coverage of home and 
community-based services (in this section referred to as ``HCBS'') 
under a State plan (or waiver of such plan) under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.) for the following reasons:
            (1) To eliminate waiting lists for HCBS, which delay access 
        to necessary services and deny access to the promise of 
        community inclusion guaranteed under the Americans with 
        Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) for 
        individuals with disabilities and older adults.
            (2) To build on decades of progress in serving individuals 
        with disabilities and older adults through access to HCBS.
            (3) To fulfill the purposes of the Medicaid program to 
        provide medical assistance for individuals whose income and 
        resources are insufficient to meet the costs of necessary 
        medical services, and to provide rehabilitation, long-term 
        services and supports, and other services to help such 
        individuals attain or retain capacity for independence or self-
        care.
            (4) To ensure that individuals with all kinds of 
        disabilities and with multiple disabilities, including 
        intellectual disabilities, cognitive disabilities, 
        developmental disabilities, behavioral health disabilities, 
        physical disabilities, and substance use disorders, and older 
        adults, receive the services they need to live in their 
        communities.
            (5) To streamline access to HCBS by eliminating the need 
        for States to repeatedly apply for waivers of their respective 
        State plans for medical assistance.
            (6) To continue to increase the capacity of community 
        services to ensure individuals with disabilities and older 
        adults have high-quality, safe, and meaningful options to 
        receive care in their community and are not at risk of 
        unnecessary institutionalization.
            (7) To act on the decades of research and practice that 
        show that everyone, including individuals with the most severe 
        disabilities, can live in the community with the right services 
        and supports.
            (8) To eliminate the race, gender, sexual orientation, and 
        gender identity disparities that exist in accessing information 
        and HCBS and to prevent the unnecessary impoverishment and 
        institutionalization of black and brown individuals with 
        disabilities and older adults.
            (9) To support over 63,000,000 unpaid family caregivers, 
        who are disproportionately women and often providing complex 
        services and supports to older adults and individuals with 
        disabilities because of a lack of affordable services, 
        workforce shortages, and other inefficiencies.
            (10) To improve direct care quality and ensure access to 
        services by improving workforce standards for the nearly 
        3,200,000 direct care workers, who are primarily women, people 
        of color, and immigrants facing heightened risks of 
        discrimination in employment, providing support to individuals 
        with disabilities and older adults in their homes and 
        communities.

SEC. 102. REQUIRING COVERAGE OF HOME AND COMMUNITY-BASED SERVICES UNDER 
              THE MEDICAID PROGRAM.

    (a) Definition of Home and Community-Based Services.--
            (1) Inclusion as medical assistance.--Section 1905(a) of 
        the Social Security Act (42 U.S.C. 1396d(a)) is amended--
                    (A) in paragraph (31), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (32) as paragraph 
                (33); and
                    (C) by inserting after paragraph (31) the following 
                new paragraph:
            ``(32) home and community-based services (as defined in 
        subsection (ll)); and''.
            (2) Home and community-based services defined.--Section 
        1905 of the Social Security Act (42 U.S.C. 1396d) is amended by 
        adding at the end the following new subsection:
    ``(ll) Home and Community-Based Services.--
            ``(1) In general.--For purposes of this title, the term 
        `home and community-based services' means those services 
        specified in paragraph (2) furnished to an eligible individual 
        (as defined in paragraph (3)), based on an individualized 
        assessment (as described in paragraph (4)) and person-centered 
        service plan (as described in paragraph (4)(D)) for such 
        individual, in a setting that--
                    ``(A) meets the qualities specified in paragraph 
                (1) of section 441.710(a) of title 42, Code of Federal 
                Regulations (or a successor regulation);
                    ``(B) is not described in paragraph (2) of such 
                section (or a successor regulation); and
                    ``(C) meets such other qualities as the Secretary 
                determines appropriate in line with recommendations for 
                additional services made by the advisory panel 
                described in paragraph (2)(B) of this subsection.
            ``(2) Services specified.--
                    ``(A) In general.--For purposes of paragraph (1), 
                the services specified in this paragraph are services 
                described in any of paragraphs (7), (8), (13)(C), (19), 
                (20), (22), (24), (29), and (33) of subsection (a) of 
                this section or in any of subsections (c)(4)(B), 
                (c)(5), (k)(1)(A), (k)(1)(B), or (k)(1)(D) of section 
                1915, including the following:
                            ``(i) Supported employment and integrated 
                        day services.
                            ``(ii) Personal assistance, including 
                        personal care attendants, direct support 
                        professionals, home health aides, private duty 
                        nursing, homemakers and chore assistance, and 
                        companionship services.
                            ``(iii) Services that enhance independence, 
                        inclusion, and full participation in the 
                        broader community.
                            ``(iv) Non-emergency, non-medical 
                        transportation services to facilitate community 
                        integration.
                            ``(v) Respite services provided in the 
                        individual's home or broader community.
                            ``(vi) Caregiver and family support 
                        services.
                            ``(vii) Case management, including 
                        intensive case management, fiscal intermediary, 
                        and support brokerage services.
                            ``(viii) Services that support person-
                        centered planning and self-direction.
                            ``(ix) Direct support services during acute 
                        hospitalizations.
                            ``(x) Necessary medical and nursing 
                        services not otherwise covered that are 
                        necessary in order for the individual to remain 
                        in their home and community, including hospice 
                        services.
                            ``(xi) Home and community-based intensive 
                        behavioral health and crisis intervention 
                        services.
                            ``(xii) Peer support services.
                            ``(xiii) Housing support, including 
                        transitional housing or transitional support 
                        services for individuals who are unhoused, and 
                        wrap-around services.
                            ``(xiv) Necessary home modifications and 
                        assistive technology, including those that 
                        substitute for human assistance.
                            ``(xv) Transition services to support an 
                        individual who is transitioning from an 
                        institutional setting to the community, 
                        including appropriate services for individuals 
                        who are unhoused or at risk of becoming 
                        unhoused, and including such transition 
                        services provided while the individual resides 
                        in an institution.
                            ``(xvi) Nutrition services.
                            ``(xvii) Assisted living services.
                            ``(xviii) Any other service approved by the 
                        Secretary, pursuant to the recommendation of 
                        the advisory panel convened under subparagraph 
                        (B).
                    ``(B) Specification of recommended services.--
                            ``(i) In general.--Not later than 6 months 
                        after the date of the enactment of this 
                        subparagraph, and not less frequently than once 
                        every 5 years thereafter, the Secretary shall 
                        appoint an advisory panel for purposes of 
                        recommending additional services which may be 
                        included as home and community-based services 
                        under this paragraph.
                            ``(ii) Composition.--
                                    ``(I) Selection.--The advisory 
                                panel shall be comprised of not less 
                                than 50 members and include 
                                representatives of the following 
                                categories, with the majority of all 
                                members being selected from the 
                                categories described in items (aa), 
                                (bb), and (cc):
                                            ``(aa) Individuals with 
                                        disabilities receiving home and 
                                        community-based services under 
                                        this title and individuals with 
                                        disabilities in need of such 
                                        services, including those with 
                                        physical disabilities, 
                                        behavioral health disabilities, 
                                        or intellectual or 
                                        developmental disabilities, and 
                                        including older adults, that 
                                        are representative of multiple 
                                        States, geographical locations, 
                                        races, ethnicities, and other 
                                        demographic factors.
                                            ``(bb) Beneficiary-led 
                                        disability rights 
                                        organizations.
                                            ``(cc) Disability-led 
                                        organizations.
                                            ``(dd) Disabled veterans 
                                        organizations.
                                            ``(ee) Disability 
                                        organizations representing 
                                        families.
                                            ``(ff) Organizations 
                                        serving individuals with 
                                        disabilities, including 
                                        intellectual or developmental 
                                        disabilities.
                                            ``(gg) Organizations 
                                        serving older adults.
                                            ``(hh) Direct care workers 
                                        and the labor organizations 
                                        that represent such workers.
                                            ``(ii) The Protection and 
                                        Advocacy System.
                                            ``(jj) The Centers for 
                                        Independent Living.
                                            ``(kk) Health care 
                                        providers.
                                            ``(ll) The National 
                                        Association of Medicaid 
                                        Directors.
                                            ``(mm) The National 
                                        Association of State Directors 
                                        of Developmental Disabilities 
                                        Services.
                                            ``(nn) The National 
                                        Association of State Mental 
                                        Health Program Directors.
                                            ``(oo) Advancing States.
                                            ``(pp) The Centers for 
                                        Medicare & Medicaid Services.
                                            ``(qq) The Administration 
                                        for Community Living of the 
                                        Department of Health and Human 
                                        Services.
                                            ``(rr) Members of federally 
                                        recognized tribes and tribally 
                                        led organizations.
                                            ``(ss) Other relevant 
                                        Federal, State, and local home 
                                        and community-based service 
                                        systems, as determined by the 
                                        Secretary.
                                    ``(II) Requirement for 
                                proportionate representation.--The 
                                Secretary shall seek to ensure 
                                proportionate representation among each 
                                category described in items (dd) 
                                through (ss) of subclause (I) in 
                                convening the advisory panel.
                            ``(iii) Duties.--
                                    ``(I) In general.--Not later than 2 
                                years after an advisory panel is 
                                convened under clause (i), the advisory 
                                panel shall submit to the Secretary and 
                                to Congress a report recommending 
                                additional services which may be 
                                included as home and community-based 
                                services under this paragraph wi