II 

115TH CONGRESS 

1ST SESSION S. 2227 

To reauthorize the Money Follows the Person Demonstration Program. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 13, 2017 

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 DEMONSTRATION. 

8 (a) FUNDING.—Section 6071(h) of the Deficit Re9 duction Act of 2005 (42 U.S.C. 1396a note) is amended— 

10 (1) in paragraph (1)— 


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

2 ‘‘and’’ after the semicolon; 

3 (B) in subparagraph (E), by striking the 

4 period at the end and inserting ‘‘; and’’; and 

5 (C) by adding at the end the following: 

6 ‘‘(F) $450,000,000 for each of fiscal years 

7 2018 through 2022.’’; and 

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

9 inserting ‘‘2022’’. 

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

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

12 note) is amended— 

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

14 inserting ‘‘2022’’; and 

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

16 of fiscal years 2018 through 2022,’’ after ‘‘2016,’’. 

17 SEC. 3. CHANGES TO INSTITUTIONAL RESIDENCY PERIOD 

18 REQUIREMENT. 

19 Section 6071(b)(2) of the Deficit Reduction Act of 

20 2005 (42 U.S.C. 1396a note) is amended— 

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

22 and inserting ‘‘60’’; and 

23 (2) by striking the flush sentence after subpara24 graph (B). 


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1 SEC. 4. UPDATES TO STATE APPLICATION REQUIREMENTS. 

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

3 (42 U.S.C. 1396a note) is amended— 

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

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

6 (2) in paragraph (7)— 

7 (A) in the paragraph heading, by striking 

8 ‘‘REBALANCING’’ and inserting ‘‘EXPENDI9 TURES’’; and 

10 (B) in subparagraph (B)— 

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

12 after the semicolon; 

13 (ii) in clause (ii), by striking the pe14 riod at the end and inserting a semicolon; 

15 and 

16 (iii) by adding at the end the fol17 lowing: 

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

19 for each Federal fiscal year that occurs during 

20 the proposed MFP demonstration project— 

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

22 proposed initiative that is designed to ac23 complish the objective described in sub24 section (a)(1), including a funding source 

25 for each activity that is part of each such 

26 proposed initiative; 


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1 ‘‘(II) an evaluation plan that identi2 fies expected results for each such pro3 posed initiative; and 

4 ‘‘(III) a sustainability plan for compo5 nents of such proposed initiatives that are 

6 intended to improve transitions, which 

7 shall be updated with actual expenditure 

8 information for each Federal fiscal year 

9 that occurs during the MFP demonstration 

10 project; and 

11 ‘‘(iv) contain assurances that grant funds 

12 used to accomplish the objective described in 

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

14 than 24 months after the date on which the 

15 funds are awarded and shall be expended not 

16 later than 60 months after the date on which 

17 the funds are awarded (unless the Secretary ap18 proves a waiver of either such requirement).’’; 

19 and 

20 (3) in paragraph (13)— 

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

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

23 will meet the reporting requirements set forth 

24 for the Transformed Medicaid Statistical Man25 agement Information System (T-MSIS);’’; 


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1 (B) by redesignating subparagraph (B) as 

2 subparagraph (D); and 

3 (C) by inserting after subparagraph (A) 

4 the following: 

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

6 basis on the use of grant funds by distinct ac7 tivity, as described in the approved work plan, 

8 and by specific population as targeted by the 

9 State; 

10 ‘‘(C) if the State fails to report the infor11 mation required under subparagraph (B), fails 

12 to report such information on a quarterly basis, 

13 or fails to make progress under the approved 

14 work plan, the State shall implement a correc15 tive action plan and any lack of progress under 

16 the approved work plan may result in with17 holding of grant funds made available to the 

18 State; and’’. 

19 SEC. 5. FUNDING FOR QUALITY ASSURANCE AND IMPROVE20 MENT; TECHNICAL ASSISTANCE; OVERSIGHT. 

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

22 (42 U.S.C. 1396a note) is amended by striking paragraph 

23 (2) and inserting the following: 

24 ‘‘(2) FUNDING.—From the amounts appro25 priated under subsection (h)(1)(F) for each of fiscal 


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1 years 2018 through 2022, $1,000,000 shall be avail2 able to the Secretary for each such fiscal year to 

3 carry out this subsection.’’. 

4 SEC. 6. BEST PRACTICES EVALUATION. 

5 Section 6071 of the Deficit Reduction Act of 2005 

6 (42 U.S.C. 1396a note) is amended by adding at the end 

7 the following: 

8 ‘‘(i) BEST PRACTICES.— 

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

10 through grant or contract, shall submit a report to 

11 the President and Congress not later than Sep12 tember 30, 2020, that contains findings and conclu13 sions on best practices from the State MFP dem14 onstration projects carried out with grants made 

15 under this section. The report shall include informa16 tion and analyses with respect to the following: 

17 ‘‘(A) The most effective State strategies 

18 for transitioning beneficiaries from institutional 

19 to qualified community settings carried out 

20 under the State MFP demonstration projects 

21 and how such strategies may vary for different 

22 types of beneficiaries, such as beneficiaries who 

23 are aged, physically disabled, intellectually or 

24 developmentally disabled, or individuals with seVerDate Sep 11 2014 20:28 Dec 18, 2017 Jkt 079200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2227.IS S2227

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1 rious mental illnesses, and other targeted waiv2 er beneficiary populations. 

3 ‘‘(B) The most common and the most ef4 fective State uses of grant funds carried out 

5 under the State MFP demonstration projects 

6 for transitioning beneficiaries from institutional 

7 to qualified community settings and improving 

8 health outcomes, including differentiating fund9 ing for current initiatives that are designed for 

10 such purpose and funding for proposed initia11 tives that are designed for such purpose. 

12 ‘‘(C) The most effective State approaches 

13 carried out under State MFP demonstration 

14 projects for improving person-centered care and 

15 planning. 

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

17 and other flexibilities available under the State 

18 MFP demonstration projects, that are not 

19 available under the traditional Medicaid pro20 gram, and which directly contributed to suc21 cessful transitions and improved health out22 comes under the State MFP demonstration 

23 projects. 

24 ‘‘(E) State strategies and financing mecha25 nisms for effective coordination of housing fiVerDate Sep 11 2014 20:28 Dec 18, 2017 Jkt 079200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2227.IS S2227

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1 nanced or supported under State MFP dem2 onstration projects with local housing authori3 ties and other resources. 

4 ‘‘(F) Effective State approaches for deliv5 ering Money Follows the Person transition serv6 ices through managed care entities. 

7 ‘‘(G) Other best practices and effective 

8 transition strategies demonstrated by States 

9 with approved MFP demonstration projects, as 

10 determined by the Secretary. 

11 ‘‘(H) Identification and analyses of oppor12 tunities and challenges to integrating effective 

13 Money Follows the Person practices and State 

14 strategies into the traditional Medicaid pro15 gram. 

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

17 required under this subsection, the Secretary shall 

18 collect and incorporate information from States with 

19 approved MFP demonstration projects and bene20 ficiaries participating in such projects, and providers 

21 participating in such projects. 

22 ‘‘(3) FUNDING.—From the amounts appro23 priated under subsection (h)(1) for each of fiscal 

24 years 2017 through 2019, not more than $300,000 


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1 shall be available to the Secretary for each such fis2 cal year to carry out this subsection.’’. 

3 SEC. 7. MACPAC REPORT ON QUALIFIED SETTINGS CRI4 TERIA. 

5 Section 6071 of the Deficit Reduction Act of 2005 

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

7 amended by adding at the end the following: 

8 ‘‘(j) MACPAC REPORT.—Prior to the final imple9 mentation date established by the Secretary for the cri10 teria established for home and community-based settings 

11 in section 441.301(c)(4) of title 42, Code of Federal Regu12 lations, as part of final implementation of the Home and 

13 Community Based Services (HCBS) Final Rule published 

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

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

16 and CHIP Payment and Access Commission (MACPAC) 

17 shall submit to Congress a report that— 

18 ‘‘(1) identifies the types of home and commu19 nity-based settings and associated services that are 

20 available to eligible individuals in both the MFP 

21 demonstration program and sites in compliance with 

22 the HCBS final rule, including regional variation in 

23 the type and accessibility of such settings; and 

24 ‘‘(2) recommends policies to align the criteria 

25 for a qualified residence under subsection (b)(6) (as 


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1 in effect on October 1, 2017) with the criteria in the 

2 HCBS final rule.’’. 

3 SEC. 8. TECHNICAL AMENDMENT. 

4 Section 6071(b) of the Deficit Reduction Act of 2005 

5 (42 U.S.C. 1396a note) is amended by adding at the end 

6 the following: 

7 ‘‘(10) SECRETARY.—The term ‘Secretary’ 

8 means the Secretary of Health and Human Serv9 ices.’’. 

10 SEC. 9. EFFECTIVE DATES; APPLICATION TO CURRENT 

11 PROJECTS. 

12 (a) EFFECTIVE DATES.— 

13 (1) IN GENERAL.—Except as provided in para14 graph (2), the amendments made by this Act shall 

15 take effect as if enacted on October 1, 2017. 

16 (2) CHANGES TO INSTITUTIONAL RESIDENCY

17 PERIOD REQUIREMENT.—The amendments made by 

18 section 3 shall take effect on the date that is 30 

19 days after the date of enactment of this Act. 

20 (b) APPLICATION TO CURRENT PROJECTS.—Not 

21 later than 1 year after the date of enactment of this Act, 

22 any State with an approved MFP demonstration project 

23 under section 6071 of the Deficit Reduction Act of 2005 

24 (42 U.S.C. 1396a note) on the date of enactment of this 

25 Act shall submit a revised application to the Secretary 


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1 that contains the same information and assurances as are 

2 required for any new State applicant under the amend3 ments made by this Act. 

Æ 


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