S. 5321
Introduced in Senate · August 12, 2026August 6, 2026
Mr. Luján (for himself, Mr. Kaine, Ms. Baldwin, Ms. Duckworth, Mrs. Gillibrand, Ms. Hassan, Mr. Blumenthal, Mr. Merkley, Mr. Sanders, Ms. Warren, Mr. Reed, Mr. Markey, Mrs. Shaheen, Mr. Fetterman, Mr. Kim, and Mrs. Murray) introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XIX of the Social Security Act to require coverage of, and expand access to, home and community-based services under the Medicaid program to award grants for the creation, recruitment, training and education, retention, and advancement of the direct care workforce and to award grants to support family caregivers and for other purposes.
1. Short title; table of contents; 2. Definitions; TITLE I—REQUIRING AND EXPANDING ACCESS TO HCBS COVERAGE UNDER MEDICAID; 101. Purpose; 102. Requiring coverage of home and community-based services under the Medicaid program; 103. Medicaid eligibility modifications; 104. Home and community-based services implementation plan; 105. Quality of services; 106. Reports; technical assistance; other administrative requirements; 107. Quality measurement and improvement; 108. Making permanent the extended protection under medicaid for recipients of home and community-based services against spousal impoverishment; 109. Permanent extension of money follows the person rebalancing demonstration; 110. Liens, adjustments, and recoveries for medical assistance; 111. HCBS provider tax; 112. Medicare amendment; TITLE II—RECOGNIZING THE ROLE OF DIRECT SUPPORT PROFESSIONALS; 201. Findings; 202. Revision of standard occupational classification system; TITLE III—SUPPORT FOR THE DIRECT CARE WORKFORCE; 301. Definitions; 302. Authority to establish a technical assistance center for building the direct care workforce; 303. Authority to award grants; 304. Project plans; 305. Evaluations and reports; technical assistance; 306. Authorization of appropriations; TITLE IV—EVALUATION; 401. Evaluation of impact on access to HCBS