Sec. 202. Authority to award Medicaid HCBS grants to respond to the COVID–19 public health emergency
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The Secretary is authorized to award grants to States in accordance with this section to enhance access to home and community-based services during the COVID–19 public health emergency period. In this section: The term COVID–19 public health emergency period means the portion of the emergency period defined in paragraph (1)(B) of section 1135(g) of the Social Security Act ( 42 U.S.C. 1320b–5(g) ) beginning on or after the date of the enactment of this Act. The term eligible individual means an individual who is eligible for or enrolled for medical assistance under a State Medicaid program.
The term home and community-based services means, with respect to a State Medicaid program, home and community-based services (including home health and personal care services) that are provided under the State's qualified HCBS program or that could be provided under such a program but are otherwise provided under the Medicaid program. The term Indian tribe means an Indian tribe, a tribal organization, or an urban Indian organization (as such terms are defined in section 4 of the Indian Health Care Improvement Act ( 25 U.S.C. 1603 )), and includes a tribal consortium of Indian tribes or tribal organizations (as so defined).
The term Medicaid program means, with respect to a State, the State program under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) (including any waiver or demonstration under such title or under section 1115 of such Act ( 42 U.S.C. 1315 ) relating to such title). The term Secretary means the Secretary of Health and Human Services. The term State has the meaning given such term for purposes of title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.). The term qualified HCBS program means a program providing home and community-based services operating under a State Medicaid program, whether or not operating under waiver authority.
During the COVID–19 public health emergency period, the Secretary may award grants to States with applications meeting the requirements of paragraph (2). A State seeking a grant under this section shall submit an application to the Secretary at such time, in such form and manner, and containing such information as the Secretary shall require. The Secretary shall not award any grants under this section with respect to a State that submits an application after the date that is 60 days after the end of the COVID–19 public health emergency period.
A State to which a grant is made under this section shall only use grant funds in accordance with subsection (d). Federal funds paid to a State pursuant to this section must be used to supplement, but not supplant, the level of State funds expended for home and community-based services for eligible individuals programs in effect for such individuals at the time the grant is awarded under this section. Subject to paragraph (5), the Secretary shall pay to each State that is awarded a grant under this section, for each month during the State's grant period (as defined in subparagraph (C)), an amount equal to 15 percent of the amount determined for the State under subparagraph (B).
The amount determined for a State under this subparagraph is the amount equal to— the sum of— the average annual amount of State expenditures under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) that are attributable to providing medical assistance for home and community-based services for the 3 most recent fiscal years for which data is available; and the average annual amount, if any, received by the State pursuant to an MFP demonstration project conducted under section 6071 of the Deficit Reduction Act of 2005 ( 42 U.S.C. 1396a note) for the 3 most recent fiscal years for which data is available; divided by 12.
In this paragraph, the term grant period means, with respect to a State, the period of months— beginning with the month in which the Secretary approves the State's application for a grant under this section; and ending with the twelfth month that begins after the end of the COVID–19 public health emergency period. During the COVID–19 public health emergency period, the Secretary may award grants to an Indian tribe in the same manner, and subject to the same requirements, as apply to a State, except as otherwise provided in this paragraph.
Any Indian tribe seeking a grant under this section shall submit to the Secretary an application that includes (in addition to any other information the Secretary shall require) an identification of the population and service area or areas to be served by the activities and programs that will be funded by the grant. The Secretary shall pay to each Indian tribe that is awarded a grant under this section, for each month during the tribe's grant period (as defined in clause (iii)), an amount equal to 15 percent of the amount determined for the tribe under clause (ii).
The amount determined for an Indian tribe under this clause is equal to— the total of the average annual amount of State expenditures made by a State or States under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) that are attributable to providing medical assistance for home and community-based services to eligible individuals who reside in the service area or areas identified by the tribe pursuant to subparagraph
(B)for the 3 most recent fiscal years for which data is available; divided by 12. The term grant period has the same meaning with respect to an Indian tribe as the term has with respect to a State under paragraph (4)(C). If any State in which lies a service area or areas identified by an Indian tribe in a successful grant application pursuant to subparagraph
(B)is also awarded a grant under this section, the Secretary shall reduce the amount payable to such State each month under paragraph
(4)by the portion of the amount payable to the Indian tribe under this paragraph that is attributable to expenditures by the State. A State to which a grant is made under this section may use grant funds— to work with community partners such as Area Agencies on Aging, Independent Living Centers, nonprofit home and community based service providers, and other entities providing home and community-based services; during the COVID–19 public health emergency period, for the purposes described in paragraph (2); and after the end of such period, for the purposes described in paragraph (3). The purposes described in this paragraph for which a State may use grant funds awarded under this section are the following: To increase rates for home health and direct service worker agencies to provide home and community-based services under the State Medicaid program, provided that any agency or individual that receives payment under such an increased rate increases the compensation it pays its home health or direct service workers. To provide paid sick leave, paid family leave, and paid medical leave for home health workers and direct service workers. To provide hazard pay, overtime pay, and shift differential pay for home health workers and direct service workers. To provide home and community-based services to eligible individuals who are on waiting lists for programs approved under sections 1115 or 1915 of the Social Security Act ( 42 U.S.C. 1315 , 1396n). To purchase emergency supplies and equipment necessary to enhance access to services and to protect the health and well-being of home health workers and direct service workers. To pay for home health worker and direct service worker travel to conduct home and community-based services. To recruit new direct service workers and home health workers. To support family care providers of eligible individuals with needed supplies and equipment and pay. To pay for training for direct service workers and home health workers that is specific to the COVID–19 public health emergency. To pay for assistive technologies, staffing, and other costs incurred during the public health emergency in order to facility community integration and ensure an individual’s person-centered service plan continue to be fully implemented. To support direct service workers and home health workers going to nursing facilities, hospitals, institutions, and quarantine settings to provide services to eligible individuals who usually receive home and community-based services and have chosen to temporarily move to a more restrictive setting. To prepare information and public health and educational materials in accessible formats about prevention, treatment, recovery and other aspects of COVID–19 for eligible individuals, their families, and the general community served by home health and direct service agencies, including formats accessible to people with low literacy or intellectual disabilities. To pay for American sign language interpreters to assist in providing home and community-based services to eligible individuals and to inform the general public about COVID–19. To allow for day service providers to shift to providing home-based services. To pay for COVID–19 testing in home settings. To pay for other expenses deemed appropriate by the Secretary and which meet the criteria of the home and community-based settings rule. The purpose described in this paragraph for which a State may use grant funds awarded under this section is to assist eligible individuals who had to relocate to a nursing facility or institutional setting from their homes during the COVID–19 public health emergency period in— moving back to their homes (including by paying for moving costs); resuming home and community-based services; receiving mental health services and necessary rehabilitative service to regain skills lost while relocated during the public health emergency period; and continuing home and community-based services for eligible individuals who were served from a waiting list for such services during the public health emergency period. Not later than 18 months after the end of the COVID–19 public health emergency period, any State that received a grant under this section shall submit a report to the Secretary that contains the following information: Activities and programs that were funded using grant amounts. The number of eligible individuals who were served by such activities and programs. The number of eligible individuals who were able to resume home and community-based services as a result of such activities and programs. Not later than 18 months after the end of the COVID–19 public health emergency period, the Secretary shall issue a public summary of the grants awarded under this section. Subject to paragraph (2), there are appropriated for fiscal year 2020 from any funds in the Treasury not otherwise appropriated such sums as are necessary to carry out this section, to remain available until expended. Amounts made available under paragraph
(1)shall not be available for the awarding of grants to States that do not submit an application for such a grant before the date described in subsection (c)(3)(A). A State that receives a grant under this section shall return to the Secretary any portion of such grant that is unused as of the date that is 1 year after the last day of the COVID–19 public health emergency period, and such returned portion shall revert to the Treasury.
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- 42 USC 1320b–5(g)
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Sec. 202
Authority to award Medicaid HCBS grants to respond to the COVID–19 public health emergency
Cite42 USC 1320b–5(g)
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