EMPOWER Care Act

I 116TH CONGRESS 1ST SESSION H. R. 1342 To reauthorize the Money Follows the Person Demonstration Program. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 25, 2019 Mrs. DINGELL (for herself and Mr. GUTHRIE) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To reauthorize the Money Follows the Person Demonstration Program. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Ensuring Medicaid 4 Provides Opportunities for Widespread Equity, Resources, 5 and Care Act’’ or the ‘‘EMPOWER Care Act’’. 6 SEC. 2. EXTENSION OF MONEY FOLLOWS THE PERSON RE- 7 BALANCING DEMONSTRATION. 8 (a) FUNDING.—Section 6071(h) of the Deficit Re- 9 duction Act of 2005 (42 U.S.C. 1396a note) is amended— 10 (1) in paragraph (1)— 11 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 2 •HR 1342 IH (A) in subparagraph (E), by striking 1 ‘‘and’’ after the semicolon; 2 (B) in subparagraph (F)— 3 (i) by striking ‘‘subject to subpara- 4 graph (3), $112,000,000’’ and inserting 5 ‘‘$450,000,000’’; and 6 (ii) by striking the period at the end 7 and inserting ‘‘; and’’; and 8 (C) by adding at the end the following new 9 subparagraph: 10 ‘‘(G) $450,000,000 for each of fiscal years 11 2020 through 2023.’’; 12 (2) in paragraph (2)— 13 (A) by striking ‘‘Subject to paragraph (3), 14 amounts’’ and inserting ‘‘Amounts’’; and 15 (B) by striking ‘‘2021’’ and inserting 16 ‘‘2023’’; and 17 (3) by striking paragraph (3). 18 (b) RESEARCH AND EVALUATION.—Section 6071(g) 19 of the Deficit Reduction Act of 2005 (42 U.S.C. 1396a 20 note) is amended— 21 (1) in paragraph (2), by striking ‘‘2016’’ and 22 inserting ‘‘2023’’; and 23 (2) in paragraph (3), by inserting ‘‘and for each 24 of fiscal years 2019 through 2023,’’ after ‘‘2016,’’. 25 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 3 •HR 1342 IH SEC. 3. CHANGES TO INSTITUTIONAL RESIDENCY PERIOD 1 REQUIREMENT. 2 (a) IN GENERAL.—Section 6071(b)(2) of the Deficit 3 Reduction Act of 2005 (42 U.S.C. 1396a note) is amend- 4 ed— 5 (1) in subparagraph (A)(i), by striking ‘‘90’’ 6 and inserting ‘‘60’’; and 7 (2) by striking the flush sentence after subpara- 8 graph (B). 9 (b) EFFECTIVE DATE.—The amendments made by 10 subsection (a) shall take effect on the date that is 30 days 11 after the date of enactment of this Act. 12 SEC. 4. UPDATES TO STATE APPLICATION REQUIREMENTS. 13 Section 6071(c) of the Deficit Reduction Act of 2005 14 (42 U.S.C. 1396a note) is amended— 15 (1) in paragraph (3), by striking ‘‘, which shall 16 include’’ and all that follows through ‘‘2007’’; 17 (2) in paragraph (7)— 18 (A) in the paragraph heading, by striking 19 ‘‘REBALANCING’’ and inserting ‘‘EXPENDI- 20 TURES’’; and 21 (B) in subparagraph (B)— 22 (i) in clause (i), by striking ‘‘and’’ 23 after the semicolon; 24 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 4 •HR 1342 IH (ii) in clause (ii), by striking the pe- 1 riod at the end and inserting a semicolon; 2 and 3 (iii) by adding at the end the fol- 4 lowing: 5 ‘‘(iii) include a work plan that describes 6 for each Federal fiscal year that occurs during 7 the proposed MFP demonstration project— 8 ‘‘(I) the use of grant funds for each 9 proposed initiative that is designed to ac- 10 complish the objective described in sub- 11 section (a)(1), including a funding source 12 for each activity that is part of each such 13 proposed initiative; 14 ‘‘(II) an evaluation plan that identi- 15 fies expected results for each such pro- 16 posed initiative; and 17 ‘‘(III) a sustainability plan for compo- 18 nents of such proposed initiatives that are 19 intended to improve transitions, which 20 shall be updated with actual expenditure 21 information for each Federal fiscal year 22 that occurs during the MFP demonstration 23 project; and 24 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 5 •HR 1342 IH ‘‘(iv) contain assurances that grant funds 1 used to accomplish the objective described in 2 subsection (a)(1) shall be obligated not later 3 than 24 months after the date on which the 4 funds are awarded and shall be expended not 5 later than 60 months after the date on which 6 the funds are awarded (unless the Secretary ap- 7 proves a waiver of either such requirement).’’; 8 and 9 (3) in paragraph (13)— 10 (A) in subparagraph (A), by striking ‘‘; 11 and’’ and inserting ‘‘, and in such manner as 12 will meet the reporting requirements set forth 13 for the Transformed Medicaid Statistical Man- 14 agement Information System (T–MSIS);’’; 15 (B) by redesignating subparagraph (B) as 16 subparagraph (D); and 17 (C) by inserting after subparagraph (A) 18 the following: 19 ‘‘(B) the State shall report on a quarterly 20 basis on the use of grant funds by distinct ac- 21 tivity, as described in the approved work plan, 22 and by specific population as targeted by the 23 State; 24 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 6 •HR 1342 IH ‘‘(C) if the State fails to report the infor- 1 mation required under subparagraph (B), fails 2 to report such information on a quarterly basis, 3 or fails to make progress under the approved 4 work plan, the State shall implement a correc- 5 tive action plan and any lack of progress under 6 the approved work plan may result in with- 7 holding of grant funds made available to the 8 State; and’’. 9 SEC. 5. FUNDING FOR QUALITY ASSURANCE AND IMPROVE- 10 MENT; TECHNICAL ASSISTANCE; OVERSIGHT. 11 Section 6071(f) of the Deficit Reduction Act of 2005 12 (42 U.S.C. 1396a note) is amended by striking paragraph 13 (2) and inserting the following: 14 ‘‘(2) FUNDING.—From the amounts appro- 15 priated under subsection (h)(1) for each of fiscal 16 years 2019 through 2023, $1,000,000 shall be avail- 17 able to the Secretary for each such fiscal year to 18 carry out this subsection.’’. 19 SEC. 6. BEST PRACTICES EVALUATION. 20 Section 6071 of the Deficit Reduction Act of 2005 21 (42 U.S.C. 1396a note) is amended by adding at the end 22 the following: 23 ‘‘(i) BEST PRACTICES.— 24 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 7 •HR 1342 IH ‘‘(1) REPORT.—The Secretary, directly or 1 through grant or contract, shall submit a report to 2 the President and Congress not later than Sep- 3 tember 30, 2020, that contains findings and conclu- 4 sions on best practices from the State MFP dem- 5 onstration projects carried out with grants made 6 under this section. The report shall include informa- 7 tion and analyses with respect to the following: 8 ‘‘(A) The most effective State strategies 9 for transitioning beneficiaries from institutional 10 to qualified community settings carried out 11 under the State MFP demonstration projects 12 and how such strategies may vary for different 13 types of beneficiaries, such as beneficiaries who 14 are aged, physically disabled, intellectually or 15 developmentally disabled, or individuals with se- 16 rious mental illnesses, and other targeted waiv- 17 er beneficiary populations. 18 ‘‘(B) The most common and the most ef- 19 fective State uses of grant funds carried out 20 under the State MFP demonstration projects 21 for transitioning beneficiaries from institutional 22 to qualified community settings and improving 23 health outcomes, including differentiating fund- 24 ing for current initiatives that are designed for 25 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 8 •HR 1342 IH such purpose and funding for proposed initia- 1 tives that are designed for such purpose. 2 ‘‘(C) The most effective State approaches 3 carried out under State MFP demonstration 4 projects for improving person-centered care and 5 planning. 6 ‘‘(D) Identification of program, financing, 7 and other flexibilities available under the State 8 MFP demonstration projects, that are not 9 available under the traditional Medicaid pro- 10 gram, and which directly contributed to suc- 11 cessful transitions and improved health out- 12 comes under the State MFP demonstration 13 projects. 14 ‘‘(E) State strategies and financing mecha- 15 nisms for effective coordination of housing fi- 16 nanced or supported under State MFP dem- 17 onstration projects with local housing authori- 18 ties and other resources. 19 ‘‘(F) Effective State approaches for deliv- 20 ering Money Follows the Person transition serv- 21 ices through managed care entities. 22 ‘‘(G) Other best practices and effective 23 transition strategies demonstrated by States 24 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 9 •HR 1342 IH with approved MFP demonstration projects, as 1 determined by the Secretary. 2 ‘‘(H) Identification and analyses of oppor- 3 tunities and challenges to integrating effective 4 Money Follows the Person practices and State 5 strategies into the traditional Medicaid pro- 6 gram. 7 ‘‘(2) COLLABORATION.—In preparing the report 8 required under this subsection, the Secretary shall 9 collect and incorporate information from States with 10 approved MFP demonstration projects and bene- 11 ficiaries participating in such projects, and providers 12 participating in such projects. 13 ‘‘(3) FUNDING.—From the amounts appro- 14 priated under subsection (h)(1) for each of fiscal 15 years 2019 through 2020, not more than $300,000 16 shall be available to the Secretary for each such fis- 17 cal year to carry out this subsection.’’. 18 SEC. 7. MACPAC REPORT ON QUALIFIED SETTINGS CRI- 19 TERIA. 20 Section 6071 of the Deficit Reduction Act of 2005 21 (42 U.S.C. 1396a note), as amended by section 6, is 22 amended by adding at the end the following: 23 ‘‘(j) MACPAC REPORT.—Prior to the final imple- 24 mentation date established by the Secretary for the cri- 25 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 10 •HR 1342 IH teria established for home and community-based settings 1 in section 441.301(c)(4) of title 42, Code of Federal Regu- 2 lations, as part of final implementation of the Home and 3 Community Based Services (HCBS) Final Rule published 4 on January 16, 2014 (79 Fed. Reg. 2947) (referred to 5 in this subsection as the ‘HCBS final rule’), the Medicaid 6 and CHIP Payment and Access Commission (MACPAC) 7 shall submit to Congress a report that— 8 ‘‘(1) identifies the types of home and commu- 9 nity-based settings and associated services that are 10 available to eligible individuals in both the MFP 11 demonstration program and sites in compliance with 12 the HCBS final rule; and 13 ‘‘(2) if determined appropriate by the Commis- 14 sion, recommends policies to align the criteria for a 15 qualified residence under subsection (b)(6) (as in ef- 16 fect on October 1, 2017) with the criteria in the 17 HCBS final rule.’’. 18 SEC. 8. APPLICATION TO CURRENT PROJECTS. 19 Not later than 1 year after the date of enactment 20 of this Act, any State with an approved MFP demonstra- 21 tion project under section 6071 of the Deficit Reduction 22 Act of 2005 (42 U.S.C. 1396a note) on the date of enact- 23 ment of this Act shall submit a revised application to the 24 Secretary that contains the same information and assur- 25 VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS 11 •HR 1342 IH ances as are required for any new State applicant under 1 the amendments made by this Act. 2 Æ VerDate Sep 11 2014 02:27 Mar 02, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H1342.IH H1342 kjohnson on DSK79L0C42 with BILLS