Latonya Reeves Freedom Act of 2023

II 118TH CONGRESS 1ST SESSION S. 1193 To prohibit discrimination against individuals with disabilities who need long- term services and supports, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 19, 2023 Mr. BENNET (for himself, Mr. BOOKER, Mr. MARKEY, Mr. WHITEHOUSE, Mr. SCHUMER, Ms. STABENOW, Mr. REED, Mr. HEINRICH, Ms. WARREN, Ms. CORTEZ MASTO, Mr. HICKENLOOPER, Ms. KLOBUCHAR, Ms. BALDWIN, Mrs. GILLIBRAND, Mr. CARPER, Ms. HIRONO, and Mr. VAN HOLLEN) in- troduced the following bill; which was read twice and referred to the Com- mittee on Health, Education, Labor, and Pensions A BILL To prohibit discrimination against individuals with disabil- ities who need long-term services and supports, and for other purposes. 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 ‘‘Latonya Reeves Free- 4 dom Act of 2023’’. 5 SEC. 2. PURPOSES. 6 The purposes of this Act are— 7 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1193 IS (1) to clarify and strengthen the integration 1 mandate of the Americans with Disabilities Act of 2 1990, held by the Supreme Court in Olmstead v. 3 L.C., 527 U.S. 581 (1999) in a manner that acceler- 4 ates and improves State compliance; 5 (2) to affirm that every individual who is eligi- 6 ble for long-term services and supports has a feder- 7 ally protected right to be meaningfully integrated 8 into that individual’s community and receive commu- 9 nity-based long-term services and supports; 10 (3) to ensure that States provide long-term 11 services and supports to individuals with disabilities 12 in a manner that allows individuals with disabilities 13 to live in the most integrated setting, including the 14 individual’s own home, have maximum control over 15 their services and supports, and ensure that long- 16 term services and supports are provided in a manner 17 that allows individuals with disabilities to lead an 18 independent life; 19 (4) to establish a comprehensive State planning 20 requirement that includes enforceable, measurable 21 objectives that are designed to transition individuals 22 with all types of disabilities at all ages out of institu- 23 tions and into the most integrated setting, if they 24 choose that transition; and 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1193 IS (5) to identify and address disparities in the 1 provision of community-based long-term services and 2 supports. 3 SEC. 3. DEFINITIONS AND RULE. 4 (a) DEFINITIONS.—In this Act: 5 (1) ACTIVITIES OF DAILY LIVING.—The term 6 ‘‘activities of daily living’’ has the meaning given the 7 term in section 441.505 of title 42, Code of Federal 8 Regulations (or a successor regulation). 9 (2) ADMINISTRATOR.—The term ‘‘Adminis- 10 trator’’ means— 11 (A) the Administrator of the Administra- 12 tion for Community Living; or 13 (B) another designee of the Secretary of 14 Health and Human Services. 15 (3) COMMUNITY-BASED; SERVICES OR SUP- 16 PORTS.—The term ‘‘community-based’’, when used 17 in reference to services or supports, means services 18 or supports that are provided to an individual with 19 an LTSS disability to enable that individual to live 20 in the community and lead an independent life, and 21 that are delivered in whichever setting the individual 22 with an LTSS disability has chosen out of the fol- 23 lowing settings with the following qualities: 24 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1193 IS (A) In the case of a dwelling or a nonresi- 1 dential setting (such as a setting in which an 2 individual with an LTSS disability receives day 3 services and supported employment), a dwelling 4 or setting— 5 (i) that, as a matter of infrastructure, 6 environment, amenities, location, services, 7 and features, is integrated into the greater 8 community and supports, for each indi- 9 vidual with an LTSS disability who re- 10 ceives services or supports at the setting— 11 (I) full access to the greater com- 12 munity (including access to opportuni- 13 ties to seek employment and work in 14 competitive integrated settings, en- 15 gage in community life, control per- 16 sonal resources, and receive services 17 in the community); and 18 (II) access to the greater commu- 19 nity to the same extent as access to 20 the community is enjoyed by an indi- 21 vidual who is not receiving long-term 22 services or supports; 23 (ii) that the individual has selected as 24 a meaningful choice from among nonresi- 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1193 IS dential setting options, including nondis- 1 ability-specific settings; 2 (iii) in which an individual has rights 3 to privacy, dignity, and respect, and free- 4 dom from coercion and restraint; 5 (iv) that, as a matter of infrastruc- 6 ture, environment, amenities, location, 7 services, and features, optimizes, but does 8 not regiment, individual initiative, auton- 9 omy, and independence in making life 10 choices, including choices about daily ac- 11 tivities, physical environment, and persons 12 with whom the individual interacts; and 13 (v) that, as a matter of infrastructure, 14 environment, amenities, location, services, 15 and features, facilitates individual choice 16 regarding the provision of services and 17 supports, and who provides those services 18 and supports. 19 (B) In the case of a dwelling, a dwelling— 20 (i) that is owned by an individual with 21 an LTSS disability or the individual’s fam- 22 ily member; 23 (ii) that is leased to the individual 24 with an LTSS disability under an indi- 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1193 IS vidual lease, that has lockable access and 1 egress, and that includes living, sleeping, 2 bathing, and cooking areas over which an 3 individual with an LTSS disability or the 4 individual’s family member has domain 5 and control; or 6 (iii) that is a group or shared resi- 7 dence— 8 (I) in which no more than 4 un- 9 related individuals with an LTSS dis- 10 ability reside; 11 (II) for which each individual 12 with an LTSS disability living at the 13 residence owns, rents, or occupies the 14 residence under a legally enforceable 15 agreement under which the individual 16 has, at a minimum, the same respon- 17 sibilities and protections as tenants 18 have under applicable landlord-tenant 19 law; 20 (III) in which each individual 21 with an LTSS disability living at the 22 residence— 23 (aa) has privacy in the indi- 24 vidual’s sleeping unit, including a 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1193 IS lockable entrance door controlled 1 by the individual; 2 (bb) shares a sleeping unit 3 only if such individual and the 4 individual sharing the unit choose 5 to do so, and if individuals in the 6 residence so choose, they also 7 have a choice of roommates with- 8 in the residence; 9 (cc) has the freedom to fur- 10 nish and decorate the individual’s 11 sleeping or living unit as per- 12 mitted under the lease or other 13 agreement; 14 (dd) has the freedom and 15 support to control the individ- 16 ual’s own schedules and activi- 17 ties; and 18 (ee) is able to have visitors 19 of the individual’s choosing at 20 any time; and 21 (IV) that is physically accessible 22 to the individual with an LTSS dis- 23 ability living at the residence. 24 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1193 IS (4) COMMUNITY-BASED; SETTING.—The term 1 ‘‘community-based’’, when used in reference to a set- 2 ting, means a setting described in subparagraph (A) 3 or (B) of paragraph (3). 4 (5) DWELLING.—The term ‘‘dwelling’’ has the 5 meaning given the term in section 802 of the Fair 6 Housing Act (42 U.S.C. 3602). 7 (6) HEALTH-RELATED TASKS.—The term 8 ‘‘health-related tasks’’ means specific nonacute 9 tasks, typically regulated by States as medical or 10 nursing tasks that an individual with a disability 11 may require to live in the community, including— 12 (A) administration of medication; 13 (B) assistance with use, operation, and 14 maintenance of a ventilator; and 15 (C) maintenance and use of a gastrostomy 16 tube, a catheter, or a stable ostomy. 17 (7) INDIVIDUAL WITH A DISABILITY.—The term 18 ‘‘individual with a disability’’ means an individual 19 who is a person with a disability, as defined in sec- 20 tion 3 of the Americans with Disabilities Act of 21 1990 (42 U.S.C. 12102). 22 (8) INDIVIDUAL WITH AN LTSS DISABILITY.— 23 The term ‘‘individual with an LTSS disability’’ 24 means an individual with a disability who— 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1193 IS (A) in order to live in the community and 1 lead an independent life requires assistance in 2 accomplishing— 3 (i) activities of daily living; 4 (ii) instrumental activities of daily liv- 5 ing; 6 (iii) health-related tasks; or 7 (iv) other functions, tasks, or activi- 8 ties related to an activity or task described 9 in clause (i), (ii), or (iii); and 10 (B)(i) is currently in an institutional place- 11 ment; or 12 (ii) is at risk of institutionalization if the 13 individual does not receive community-based 14 long-term services and supports. 15 (9) INSTITUTION; INSTITUTIONALIZATION.— 16 (A) INSTITUTION.—The term ‘‘institution’’ 17 means— 18 (i) a skilled nursing facility (as de- 19 fined in section 1819(a) of the Social Secu- 20 rity Act (42 U.S.C. 1395i–3(a))); 21 (ii) a nursing facility (as defined in 22 section 1919(a) of such Act (42 U.S.C. 23 1396r(a))); 24 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1193 IS (iii) a long-term care hospital (as de- 1 scribed in section 1886(d)(1)(B)(iv) of 2 such Act (42 U.S.C. 3 1395ww(d)(1)(B)(iv))); 4 (iv) a facility described in section 5 1905(d) of such Act (42 U.S.C. 1396d(d)); 6 (v) an institution which is a psy- 7 chiatric hospital (as defined in section 8 1861(f) of such Act (42 U.S.C. 1395x(f))) 9 or that provides in-patient psychiatric serv- 10 ices in a residential setting specified by the 11 Secretary; 12 (vi) an institution described in section 13 1905(i) of such Act (42 U.S.C. 1396d(i)); 14 and 15 (vii) any congregate setting that is not 16 community-based or that has the effect of 17 isolating individuals with disabilities from 18 the community. 19 (B) INSTITUTIONALIZATION.—The term 20 ‘‘institutionalization’’, used with respect to an 21 individual with an LTSS disability, refers to the 22 individual living or receiving services or sup- 23 ports in a setting that is not community-based. 24 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1193 IS (10) INSTRUMENTAL ACTIVITIES OF DAILY LIV- 1 ING.—The term ‘‘instrumental activities of daily liv- 2 ing’’ means one or more activities related to living 3 independently in the community, including activities 4 related to— 5 (A) nutrition, such as preparing meals or 6 special diets, monitoring to prevent choking or 7 aspiration, or assisting with special utensils; 8 (B) household chores and environmental 9 maintenance tasks; 10 (C) communication and interpersonal 11 skills, such as— 12 (i) using the telephone or other com- 13 munications devices; 14 (ii) forming and maintaining inter- 15 personal relationships; or 16 (iii) securing opportunities to partici- 17 pate in group support or peer-to-peer sup- 18 port arrangements; 19 (D) travel and community participation, 20 such as shopping, arranging appointments, or 21 moving around the community; 22 (E) care of others, such as raising chil- 23 dren, taking care of pets, or selecting care- 24 givers; or 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1193 IS (F) management of personal property and 1 personal safety, such as— 2 (i) taking medication; 3 (ii) handling or managing money; or 4 (iii) responding to emergent situations 5 or unscheduled needs requiring an imme- 6 diate response. 7 (11) LONG-TERM SERVICE OR SUPPORT.— 8 (A) IN GENERAL.—The terms ‘‘long-term 9 service or support’’ and ‘‘LTSS’’ mean the as- 10 sistance provided to an individual with a dis- 11 ability in accomplishing, acquiring the means or 12 ability to accomplish, maintaining, or enhanc- 13 ing— 14 (i) activities of daily living; 15 (ii) instrumental activities of daily liv- 16 ing; 17 (iii) health-related tasks; or 18 (iv) other functions, tasks, or activi- 19 ties related to an activity or task described 20 in clause (i), (ii), or (iii). 21 (B) ASSISTANCE.—In subparagraph (A), 22 the term ‘‘assistance’’ includes support provided 23 to an individual by another person due to con- 24 fusion, dementia, behavioral symptoms, or cog- 25 VerDate Sep 11 2014 22:42 Apr 21, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1193.IS S1193 kjohnson on DSK79L0C42PROD with BILLS 13 •S 1193 IS nitive, intellectual, mental, or emotional disabil- 1 ities, including support to— 2 (i) help the individual identify and set 3 goals, communicate needs, overcome fears, 4 and manage transitions; 5 (ii) help the individual with executive 6 functioning, decision making, self-expres- 7 sion, and problemsolving; 8 (iii) provide reassurance to the indi- 9 vidual; and 10 (iv) help the individual with orienta- 11 tion, memory, and other activities related 12 to independent living. 13 (12) LTSS INSURANCE PROVIDER.—The term 14 ‘‘LTSS insurance provider’’ means a public or pri- 15 vate entity that— 16 (A) provides funds for long-term services 17 and supports; and 18 (B) is engaged in commerce or in an in- 19 dustry or activity affecting commerce. 20 (13) PUBLIC ENTITY.— 21 (A) IN GENERAL.—The term ‘‘public enti- 22 ty’’ means an entity that— 23 VerDate Sep 11 2014 01:36 Ap [Text truncated for display. 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