Home and community-based services implementation plan

(a) In general Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended— (1) in subsection (a)— (A) in paragraph (88), by striking and at the end; (B) in paragraph (89), by striking the period and inserting; and; and (C) by inserting after paragraph (89) the following new paragraph: (90) provide that, prior to the beginning of the first calendar quarter beginning on or after the date that is 5 years after the date of the enactment of this paragraph, the State shall submit to the Secretary the implementation plan described in subsection (yy).; and (2) by adding at the end the following new subsection: (yy) Implementation plan For purposes of subsection (a)(90), an implementation plan described in this subsection is a plan developed by a State that includes the following: (1) An explanation of how the State will operationalize the definition of an eligible individual under section 1905(ll), including the process for determinations specified in paragraph (3)(A)(i) of such section. (2) A description of the characteristics of the State’s direct care workforce that provides home- and community-based services, including the number of workers, the average and range of direct care worker wages or service payments, the health and other workplace benefits provided to workers, turnover and vacancy rates, and an explanation of the State’s plan to ensure a stable and high quality workforce and how the State plans to ensure that compensation for individuals furnishing home and community-based services is sufficient to ensure a sufficient supply of workers to provide services to all eligible individuals and plans to identify and address any additional workforce issues. (3) A list of any home and community-based services provided under the State Medicaid plan (including any waiver of such plan) as of the date of enactment of this subsection, including a breakdown of use of such services by demographics (as defined in section 2 of the HCBS Access Act), compared to such services that are required under the amendments made by section 102 of such Act, and a description of numerical goals to increase access to such services that have barriers to access for populations in need of such services. (4) A description of how the State will incorporate existing State disability and aging agencies into the new unified provision of home and community-based services and how such State will ensure that such services address all functional impairments. (5) A plan for carrying out outreach and education activities with respect to the availability of such services through appropriate entities, including a program that ensures that an individual is not denied such services based on the fact that the individual contacts the wrong entity (commonly referred to as a No Wrong Door Program). (6) A plan for how such services will be coordinated with other relevant State agencies, such as housing, transportation, child welfare, food and income security, and employment agencies. (7) A State with federally-recognized Indian tribes, Indian health programs, and/or urban Indian health organizations shall include a process to consult with the Indian tribes, and seek advice from Indian Health programs and urban Indian health organizations in the State. (8) A description of how the State will build capacity prior to the implementation of the requirement described in subsection (a) to ensure that such services are available to every eligible individual under the Medicaid program, how the State will ensure an adequate provider network to provide access to and choice of provider, and how the State will ensure that such services are provided in a setting that meets the requirements specified in paragraph (1) of section 1905(ll), as added by section 102 of the HCBS Access Act. (9) A plan for how the State will prioritize individuals who have already met eligibility requirements but are on waiting lists to receive HCBS and ensure those individuals do not experience an increase in the amount of time they will wait to receive services. (10) In the case of a State that utilizes an alternative benefit plan, a description of how the State will ensure that all individuals who are eligible individuals (as defined in such section) are appropriately identified as medically frail and exempted from such plan. (11) How the State will coordinate eligibility for such services with other disability eligibility programs, such as disability buy-in programs. (12) Data and milestone requirements to ensure community integration, including such requirements with respect to utilization of such services by demographics (as defined in section 2 of the HCBS Access Act). (13) A description of how the State will evaluate and address disparities based on age, disability, race, ethnicity, sexual orientation, gender identity, and geographic equity.. (b) FMAP increase Section 1903(a) of the Social Security Act (42 U.S.C. 1396b(a)) is amended— (1) in paragraph (6), by striking plus at the end; (2) by redesignating paragraph (7) as paragraph (8); and (3) by inserting after paragraph (6) the following new paragraph: (7) an amount equal to 100 percent of the sums expended during the quarter which are attributable to the costs of developing the implementation plan described in section 1902(yy); plus.