H.R. 1493

HCBS Access Act

This bill expands coverage of home- and community-based services (HCBS) under Medicaid. It also establishes programs and requirements to support providers who furnish HCBS.

Specifically, the bill requires state Medicaid programs to cover HCBS for individuals who (1) are determined to have a functional impairment that affects daily living and that is expected to last at least 90 days, (2) during the five-year period after the bill is enacted, are already receiving HCBS through Medicaid under a demonstration waiver or other state option, or (3) are under the age of 21 and are otherwise eligible. Covered services include home health care services, private nursing services, homemaking assistance, non-emergency and non-medical transportation, and caregiver support.

The bill also requires the Office of Management and Budget to revise the Standard Occupational Classification system so that the occupation of direct support professional (i.e., a professional who provides services for individuals with disabilities) is classified under a separate code as a healthcare support occupation. Additionally, the Administration for Community Living must establish a technical assistance center and award grants to government, nonprofit, educational entities, and relevant employers to support training, recruitment, and retention of direct support professionals.

The Centers for Medicare & Medicaid Services must study the effects of the bill's implementation on HCBS beneficiaries and the direct care workforce.