Home and Community-Based (HCBS) Access Act
Topic:
Proposals are grouped into broad types, with specific topics within each category
Proposal Overview
Name: Home and Community-Based (HCBS) Access Act
Congress: 118th
Year: 2023
Sponsor and Co-Sponsors
Sponsor:
Representative Debbie Dingell (D-MI)
Co-Sponsors:
12 Democratic cosponsors
Companion Bill
S. 762: HCBS Access Act (2023)
Related Bills from Prior Congresses
None
Program Details
Overview: The bill makes Home and Community-Based Services (HCBS) a mandatory Medicaid benefit. It requires states to cover HCBS for individuals with functional impairment that is expected to last at least 90 days. It covers individuals already receiving HCBS through a Medicaid HCBS waiver or other state option, including those under the age of 21.
This bill includes a number of provisions related to HCBS, but this analysis focuses on provisions related only to family caregivers.
Covered Services
Covered services must include home health, private nursing services, homemaker services, transportation, and caregiver support.
Support for Direct Care Professionals
The bill requires the Office of Management and Budget (OMB) to revise the Standard Occupational Classification system to classify direct support professionals under a separate code as a health care support occupation.
Technical Assistance Center
The bill establishes a technical assistance center to strengthen the direct care workforce. It provides grants to government, nonprofit, educational entities, and relevant employers for workforce recruitment, retention, training, and advancement.
Grant Awards
The Technical Assistance Center can award grants to eligible entities to carry out the work described above.
Eligible Grant Categories
The two primary grant categories are: Direct Care Professionals and Managers. Grants for projects focused on recruitment, retention and advancement of direct care professionals, including self-directed care professionals, and their supervisors.
Family Caregiver Grants to support entities that offer training or other resources and support to paid or unpaid family caregivers.
At least 30% of the grants should focus specifically on professional development and advancement opportunities for direct care professionals.
Evaluation
Centers for Medicare & Medicaid Services (CMS) will study how the bill impacts HCBS beneficiaries and the direct care workforce.
Creating Permanent Programs within Medicaid HCBS
Makes spousal impoverishment protections and the Money Follows the Person demonstration program permanent.
Financing & Implementation
Program Administration
Office of Management and Budget, Centers for Medicare & Medicaid Services, Administration for Community Living
Revenue Source(s)
$2 million annually for each of fiscal years 2024 through 2028, for the technical assistance center. Authorizes $1 billion in workforce grants (FY 2024)
Program Cost Estimate
Not specified