II 

116TH CONGRESS 

1ST SESSION S. 548 

To reauthorize the Money Follows the Person Demonstration Program. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 25, 2019 

Mr. PORTMAN (for himself and Ms. CANTWELL) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To reauthorize the Money Follows the Person Demonstration 

Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Ensuring Medicaid 

5 Provides Opportunities for Widespread Equity, Resources, 

6 and Care Act’’ or the ‘‘EMPOWER Care Act’’. 

7 SEC. 2. EXTENSION OF MONEY FOLLOWS THE PERSON RE8 BALANCING DEMONSTRATION. 

9 (a) FUNDING.—Section 6071(h) of the Deficit Re10 duction Act of 2005 (42 U.S.C. 1396a note) is amended— 

11 (1) in paragraph (1)— 


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1 (A) in subparagraph (E), by striking 

2 ‘‘and’’ after the semicolon; 

3 (B) in subparagraph (F)— 

4 (i) by striking ‘‘subject to subpara5 graph (3), $112,000,000’’ and inserting 

6 ‘‘$450,000,000’’; and 

7 (ii) by striking the period at the end 

8 and inserting ‘‘; and’’; and 

9 (C) by adding at the end the following new 

10 subparagraph: 

11 ‘‘(G) $450,000,000 for each of fiscal years 

12 2020 through 2023.’’; 

13 (2) in paragraph (2)— 

14 (A) by striking ‘‘Subject to paragraph (3), 

15 amounts’’ and inserting ‘‘Amounts’’; and 

16 (B) by striking ‘‘2021’’ and inserting 

17 ‘‘2023’’; and 

18 (3) by striking paragraph (3). 

19 (b) RESEARCH AND EVALUATION.—Section 6071(g) 

20 of the Deficit Reduction Act of 2005 (42 U.S.C. 1396a 

21 note) is amended— 

22 (1) in paragraph (2), by striking ‘‘2016’’ and 

23 inserting ‘‘2023’’; and 

24 (2) in paragraph (3), by inserting ‘‘and for each 

25 of fiscal years 2019 through 2023,’’ after ‘‘2016,’’. 


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1 SEC. 3. CHANGES TO INSTITUTIONAL RESIDENCY PERIOD 

2 REQUIREMENT. 

3 (a) IN GENERAL.—Section 6071(b)(2) of the Deficit 

4 Reduction Act of 2005 (42 U.S.C. 1396a note) is amend5 ed— 

6 (1) in subparagraph (A)(i), by striking ‘‘90’’ 

7 and inserting ‘‘60’’; and 

8 (2) by striking the flush sentence after subpara9 graph (B). 

10 (b) EFFECTIVE DATE.—The amendments made by 

11 subsection (a) shall take effect on the date that is 30 days 

12 after the date of enactment of this Act. 

13 SEC. 4. UPDATES TO STATE APPLICATION REQUIREMENTS. 

14 Section 6071(c) of the Deficit Reduction Act of 2005 

15 (42 U.S.C. 1396a note) is amended— 

16 (1) in paragraph (3), by striking ‘‘, which shall 

17 include’’ and all that follows through ‘‘2007’’; 

18 (2) in paragraph (7)— 

19 (A) in the paragraph heading, by striking 

20 ‘‘REBALANCING’’ and inserting ‘‘EXPENDI21 TURES’’; and 

22 (B) in subparagraph (B)— 

23 (i) in clause (i), by striking ‘‘and’’ 

24 after the semicolon; 


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1 (ii) in clause (ii), by striking the pe2 riod at the end and inserting a semicolon; 

3 and 

4 (iii) by adding at the end the fol5 lowing: 

6 ‘‘(iii) include a work plan that describes 

7 for each Federal fiscal year that occurs during 

8 the proposed MFP demonstration project— 

9 ‘‘(I) the use of grant funds for each 

10 proposed initiative that is designed to ac11 complish the objective described in sub12 section (a)(1), including a funding source 

13 for each activity that is part of each such 

14 proposed initiative; 

15 ‘‘(II) an evaluation plan that identi16 fies expected results for each such pro17 posed initiative; and 

18 ‘‘(III) a sustainability plan for compo19 nents of such proposed initiatives that are 

20 intended to improve transitions, which 

21 shall be updated with actual expenditure 

22 information for each Federal fiscal year 

23 that occurs during the MFP demonstration 

24 project; and 


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1 ‘‘(iv) contain assurances that grant funds 

2 used to accomplish the objective described in 

3 subsection (a)(1) shall be obligated not later 

4 than 24 months after the date on which the 

5 funds are awarded and shall be expended not 

6 later than 60 months after the date on which 

7 the funds are awarded (unless the Secretary ap8 proves a waiver of either such requirement).’’; 

9 and 

10 (3) in paragraph (13)— 

11 (A) in subparagraph (A), by striking ‘‘; 

12 and’’ and inserting ‘‘, and in such manner as 

13 will meet the reporting requirements set forth 

14 for the Transformed Medicaid Statistical Man15 agement Information System (T–MSIS);’’; 

16 (B) by redesignating subparagraph (B) as 

17 subparagraph (D); and 

18 (C) by inserting after subparagraph (A) 

19 the following: 

20 ‘‘(B) the State shall report on a quarterly 

21 basis on the use of grant funds by distinct ac22 tivity, as described in the approved work plan, 

23 and by specific population as targeted by the 

24 State; 


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1 ‘‘(C) if the State fails to report the infor2 mation required under subparagraph (B), fails 

3 to report such information on a quarterly basis, 

4 or fails to make progress under the approved 

5 work plan, the State shall implement a correc6 tive action plan and any lack of progress under 

7 the approved work plan may result in with8 holding of grant funds made available to the 

9 State; and’’. 

10 SEC. 5. FUNDING FOR QUALITY ASSURANCE AND IMPROVE11 MENT; TECHNICAL ASSISTANCE; OVERSIGHT. 

12 Section 6071(f) of the Deficit Reduction Act of 2005 

13 (42 U.S.C. 1396a note) is amended by striking paragraph 

14 (2) and inserting the following: 

15 ‘‘(2) FUNDING.—From the amounts appro16 priated under subsection (h)(1) for each of fiscal 

17 years 2019 through 2023, $1,000,000 shall be avail18 able to the Secretary for each such fiscal year to 

19 carry out this subsection.’’. 

20 SEC. 6. BEST PRACTICES EVALUATION. 

21 Section 6071 of the Deficit Reduction Act of 2005 

22 (42 U.S.C. 1396a note) is amended by adding at the end 

23 the following: 

24 ‘‘(i) BEST PRACTICES.— 


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1 ‘‘(1) REPORT.—The Secretary, directly or 

2 through grant or contract, shall submit a report to 

3 the President and Congress not later than Sep4 tember 30, 2020, that contains findings and conclu5 sions on best practices from the State MFP dem6 onstration projects carried out with grants made 

7 under this section. The report shall include informa8 tion and analyses with respect to the following: 

9 ‘‘(A) The most effective State strategies 

10 for transitioning beneficiaries from institutional 

11 to qualified community settings carried out 

12 under the State MFP demonstration projects 

13 and how such strategies may vary for different 

14 types of beneficiaries, such as beneficiaries who 

15 are aged, physically disabled, intellectually or 

16 developmentally disabled, or individuals with se17 rious mental illnesses, and other targeted waiv18 er beneficiary populations. 

19 ‘‘(B) The most common and the most ef20 fective State uses of grant funds carried out 

21 under the State MFP demonstration projects 

22 for transitioning beneficiaries from institutional 

23 to qualified community settings and improving 

24 health outcomes, including differentiating fund25 ing for current initiatives that are designed for 


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1 such purpose and funding for proposed initia2 tives that are designed for such purpose. 

3 ‘‘(C) The most effective State approaches 

4 carried out under State MFP demonstration 

5 projects for improving person-centered care and 

6 planning. 

7 ‘‘(D) Identification of program, financing, 

8 and other flexibilities available under the State 

9 MFP demonstration projects, that are not 

10 available under the traditional Medicaid pro11 gram, and which directly contributed to suc12 cessful transitions and improved health out13 comes under the State MFP demonstration 

14 projects. 

15 ‘‘(E) State strategies and financing mecha16 nisms for effective coordination of housing fi17 nanced or supported under State MFP dem18 onstration projects with local housing authori19 ties and other resources. 

20 ‘‘(F) Effective State approaches for deliv21 ering Money Follows the Person transition serv22 ices through managed care entities. 

23 ‘‘(G) Other best practices and effective 

24 transition strategies demonstrated by States 


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1 with approved MFP demonstration projects, as 

2 determined by the Secretary. 

3 ‘‘(H) Identification and analyses of oppor4 tunities and challenges to integrating effective 

5 Money Follows the Person practices and State 

6 strategies into the traditional Medicaid pro7 gram. 

8 ‘‘(2) COLLABORATION.—In preparing the report 

9 required under this subsection, the Secretary shall 

10 collect and incorporate information from States with 

11 approved MFP demonstration projects and bene12 ficiaries participating in such projects, and providers 

13 participating in such projects. 

14 ‘‘(3) FUNDING.—From the amounts appro15 priated under subsection (h)(1) for each of fiscal 

16 years 2019 through 2020, not more than $300,000 

17 shall be available to the Secretary for each such fis18 cal year to carry out this subsection.’’. 

19 SEC. 7. MACPAC REPORT ON QUALIFIED SETTINGS CRI20 TERIA. 

21 Section 6071 of the Deficit Reduction Act of 2005 

22 (42 U.S.C. 1396a note), as amended by section 6, is 

23 amended by adding at the end the following: 

24 ‘‘(j) MACPAC REPORT.—Prior to the final imple25 mentation date established by the Secretary for the criVerDate Sep 11 2014 02:14 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S548.IS S548

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1 teria established for home and community-based settings 

2 in section 441.301(c)(4) of title 42, Code of Federal Regu3 lations, as part of final implementation of the Home and 

4 Community Based Services (HCBS) Final Rule published 

5 on January 16, 2014 (79 Fed. Reg. 2947) (referred to 

6 in this subsection as the ‘HCBS final rule’), the Medicaid 

7 and CHIP Payment and Access Commission (MACPAC) 

8 shall submit to Congress a report that— 

9 ‘‘(1) identifies the types of home and commu10 nity-based settings and associated services that are 

11 available to eligible individuals in both the MFP 

12 demonstration program and sites in compliance with 

13 the HCBS final rule; and 

14 ‘‘(2) if determined appropriate by the Commis15 sion, recommends policies to align the criteria for a 

16 qualified residence under subsection (b)(6) (as in ef17 fect on October 1, 2017) with the criteria in the 

18 HCBS final rule.’’. 

19 SEC. 8. APPLICATION TO CURRENT PROJECTS. 

20 Not later than 1 year after the date of enactment 

21 of this Act, any State with an approved MFP demonstra22 tion project under section 6071 of the Deficit Reduction 

23 Act of 2005 (42 U.S.C. 1396a note) on the date of enact24 ment of this Act shall submit a revised application to the 

25 Secretary that contains the same information and assurVerDate Sep 11 2014 02:14 Mar 01, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S548.IS S548

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1 ances as are required for any new State applicant under 

2 the amendments made by this Act. 

Æ 


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