Sec. 307. Application to domestic workers who provide Medicaid-funded services

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Not later than 1 year after the date of enactment of this Act, the Secretary and the Secretary of Health and Human Services jointly shall develop and issue the following regulations: Regulations regarding the application of the protections and rights afforded to domestic workers including personal or home care aides who provide services described in subsection

(b)that are funded under the State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) or under a waiver of such plan including through a contract or other arrangement with a managed care entity (as defined in section 1932(a)(1)(B) of the Social Security Act ( 42 U.S.C. 1396u–2(a)(1)(B) )), to individuals enrolled in such plan or waiver. The regulations issued under this paragraph shall recognize the role of self-directed care for individuals with disabilities and shall— protect, stabilize, and expand the domestic worker and personal or home care aide workforce; recognize the role of self-directed care for individuals with disabilities; prohibit States from requiring individuals with disabilities who self-direct their care to use their direct service budget to pay for costs resulting from the application of such protections and rights to domestic workers (such as paid sick time, penalties, or overtime pay) except to the extent that such costs are directly related to the provision of services described in subsection

(b)to such individuals; and facilitate Federal and State compliance with section 504 of the Rehabilitation Act of 1973 ( 29 U.S.C. 794 ), the Americans with Disabilities Act of 1990 ( 42 U.S.C. 12101 et seq.), and the holdings of the Supreme Court in Olmstead v. L.C., 527 U.S. 581 (1999), and companion cases. Regulations regarding— mechanisms for States to use to pay for the costs described in paragraph (1)(C), including, to the extent the Secretaries determine appropriate, through the establishment of a dedicated State fund, using funds appropriated to a State agency, and using fiscal intermediaries; and how States may use funds provided as a result of the increased Federal medical assistance percentage for services provided by domestic workers under section 1905(ff) of such Act ( 42 U.S.C. 196d(ff) ) (as added by section 401) for such costs. The services described in this subsection are the following: Home or community-based services provided under a waiver approved under subsection

(c)or

(d)of section 1915 of the Social Security Act ( 42 U.S.C. 1396n ). Home and community-based services provided under a State plan amendment under section 1915(i) of such Act ( 42 U.S.C. 1396n(i) ). Self-directed personal assistance services provided under section 1915(j) of such Act ( 42 U.S.C. 1396n(j) ). Home and community-based attendant services and supports provided under section 1915(k) of such Act ( 42 U.S.C. 1396n(k) ). Home health care services provided under section 1905(a)(7) of such Act ( 42 U.S.C. 1396d(a)(7) ). Rehabilitative services provided under section 1905(a)(13) of such Act ( 42 U.S.C. 1396d(a)(13) ). Personal care services provided under section 1905(a)(24) of such Act ( 42 U.S.C. 1396d(a)(24) ). Home and community care for functionally disabled elderly individuals under section 1929 of such Act ( 42 U.S.C. 1396t ). Community supported living arrangements services under section 1930 of such Act ( 42 U.S.C. 1396u ). Any services described in this subsection provided under a PACE program agreement in accordance with section 1934 of such Act ( 42 U.S.C. 1396u–4 ). Any services described in this subsection provided under a waiver approved under section 1115 of the Social Security Act ( 42 U.S.C. 1315 ). Any other services provided by a domestic worker who is a personal or home care aide that are funded under a State plan under title XIX of such Act or under a waiver of such plan, as the Secretary and the Secretary of Health and Human Services may determine.

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