1044 
of subsections (a), (b)(4), and (b)(5) by striking ‘‘2021’’ 
and inserting ‘‘2022’’. 
SEC. 407. COURT IMPROVEMENT PROGRAM. 
(a) RESERVATION
OF FUNDS.—Of the additional 
amounts made available by reason of section 406 of this 
title, the Secretary shall reserve $10,000,000 for grants 
under subsection (b) of this section, which shall be consid-
ered to be made under section 438 of the Social Security 
Act. 
(b) DISTRIBUTION OF FUNDS.— 
(1) IN GENERAL.—From the amounts reserved 
under subsection (a) of this section, the Secretary 
shall— 
(A) reserve not more than $500,000 for 
Tribal court improvement activities; and 
(B) from the amount remaining after the 
application of subparagraph (A), make a grant 
to each highest State court that is approved to 
receive a grant under section 438 of the Social 
Security Act for the purpose described in sec-
tion 438(a)(3) of such Act, for fiscal year 2020. 
(2) AMOUNT.—The amount of the grant award-
ed to a highest State court under this subsection 
shall be the sum of— 
(A) $85,000; and 
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(B) the amount that bears the same ratio 
to the amount reserved under subsection (a) 
that remains after the application of paragraph 
(1)(A) and subparagraph (A) of this paragraph, 
as the number of individuals in the State in 
which the court is located who have not at-
tained 21 years of age bears to the total num-
ber of such individuals in all States the highest 
courts of which were awarded a grant under 
this subsection (based on the most recent year 
for which data are available from the Bureau of 
the Census). 
(3) OTHER RULES.— 
(A) IN GENERAL.—The grants awarded to 
the highest State courts under this subsection 
shall be in addition to any grants made to the 
courts under section 438 of the Social Security 
Act for any fiscal year. 
(B) NO
ADDITIONAL
APPLICATION.—The 
Secretary shall award grants to the highest 
State courts under this subsection without re-
quiring the courts to submit an additional ap-
plication. 
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(C) REPORTS.—The Secretary may estab-
lish reporting criteria specific to the grants 
awarded under this subsection. 
(D) REDISTRIBUTION
OF
FUNDS.—If a 
highest State court does not accept a grant 
awarded under this subsection, or does not 
agree to comply with any reporting require-
ments imposed under subparagraph (C) or the 
use of funds requirements specified in sub-
section (c), the Secretary shall redistribute the 
grant funds that would have been awarded to 
that court under this subsection among the 
other highest State courts that are awarded 
grants under this subsection and agree to com-
ply with the reporting and use of funds require-
ments. 
(E) NO
MATCHING
REQUIREMENT.—The 
limitation on the use of funds specified in sec-
tion 438(d) of such Act shall not apply to the 
grants awarded under this section. 
(c) USE OF FUNDS.—A highest State court awarded 
a grant under subsection (b) shall use the grant funds to 
address needs stemming from the COVID–19 public 
health emergency, which may include any of the following: 
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(1) Technology investments to facilitate the 
transition to remote hearings for dependency courts 
when necessary as a direct result of the COVID–19 
public health emergency. 
(2) Training for judges, attorneys, and case-
workers on facilitating and participating in remote 
hearings that comply with due process and all appli-
cable law, ensure child safety and well-being, and 
help inform judicial decision-making. 
(3) Programs to help families address aspects 
of the case plan to avoid delays in legal proceedings 
that would occur as a direct result of the COVID– 
19 public health emergency. 
(4) Other purposes to assist courts, court per-
sonnel, or related staff related to the COVID–19 
public health emergency. 
(d) CONFORMING AMENDMENTS.—Section 438 of the 
Social Security Act (42 U.S.C. 629h) is amended in each 
of subsections (c)(1) and (d) by striking ‘‘2021’’ and in-
serting ‘‘2022’’. 
SEC. 408. KINSHIP NAVIGATOR PROGRAMS PANDEMIC 
FLEXIBILITY. 
(a) INAPPLICABILITY
OF MATCHING FUNDS RE-
QUIREMENTS.—During the COVID–19 public health 
emergency period, the percentage specified in section 
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474(a)(7) of the Social Security Act is deemed to be 100 
percent. 
(b) WAIVER OF EVIDENCE STANDARD.—During the 
COVID–19 public health emergency period, the require-
ment in section 474(a)(7) of the Social Security Act that 
the Secretary determine that a kinship navigator program 
be operated in accordance with promising, supported, or 
well-supported practices that meet the applicable criteria 
specified for the practices in section 471(e)(4)(C) of such 
Act shall have no force or effect. 
(c) OTHER ALLOWABLE USES OF FUNDS.—A State 
may use funds provided to carry out a kinship navigator 
program— 
(1) for evaluations, independent systematic re-
view, and related activities; 
(2) to provide short-term support to kinship 
families for direct services or assistance during the 
COVID–19 public health emergency period; and 
(3) to ensure that kinship caregivers have the 
information and resources to allow kinship families 
to function at their full potential, including— 
(A) ensuring that those who are at risk of 
contracting COVID–19 have access to informa-
tion and resources for necessities, including 
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food, safety supplies, and testing and treatment 
for COVID–19; 
(B) access to technology and technological 
supports needed for remote learning or other 
activities that must be carried out virtually due 
to the COVID–19 public health emergency; 
(C) health care and other assistance, in-
cluding legal assistance and assistance with 
making alternative care plans for the children 
in their care if the caregivers were to become 
unable to continue caring for the children; 
(D) services to kinship families, including 
kinship families raising children outside of the 
foster care system; and 
(E) assistance to allow children to continue 
safely living with kin. 
(d) 
TERRITORY
CAP
EXEMPTION.—Section 
1108(a)(1) of the Social Security Act shall be applied 
without regard to any amount paid to a territory pursuant 
to this section that would not have been paid to the terri-
tory in the absence of this section. 
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SEC. 409. ADJUSTMENT OF FUNDING CERTAINTY BASE-
LINES FOR FAMILY FIRST TRANSITION ACT 
FUNDING CERTAINTY GRANTS. 
Section 602(c)(2) of division N of the Further Con-
solidated Appropriations Act, 2020 (Public Law 116–94) 
is amended— 
(1) in subparagraph (C), in the matter pre-
ceding clause (i), by striking ‘‘The calculation’’ and 
inserting ‘‘Except as provided in subparagraph (G), 
the calculation’’; and 
(2) by adding at the end the following: 
‘‘(G) ADJUSTMENT
OF
FUNDING
CER-
TAINTY BASELINES.— 
‘‘(i) HOLD
HARMLESS
FOR
TEM-
PORARY INCREASE IN FMAP.—For each fis-
cal year specified in subparagraph (B), the 
Secretary shall increase the maximum 
capped allocation for fiscal year 2019 or 
the final cost neutrality limit for fiscal year 
2018 for a State or sub-State jurisdiction 
referred to in subparagraph (A)(i), by the 
amount equal to the difference between— 
‘‘(I) the amount of the foster 
care maintenance payments portion of 
such maximum capped allocation or 
final cost neutrality limit; and 
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‘‘(II) the amount that the foster 
care maintenance payments portion of 
such maximum capped allocation or 
final cost neutrality limit would be if 
the Federal medical assistance per-
centage applicable to the State under 
clause (ii) for the fiscal year so speci-
fied were used to determine the 
amount of such portion. 
‘‘(ii) APPLICABLE FEDERAL MEDICAL 
ASSISTANCE PERCENTAGE.—For purposes 
of clause (i)(II), the Federal medical as-
sistance percentage applicable to a State 
for a fiscal year specified in subparagraph 
(B) is the average of the values of the Fed-
eral medical assistance percentage applica-
ble to the State in each quarter of such fis-
cal year under section 474(a)(1) of the So-
cial Security Act (42 U.S.C. 674(a)(1)) 
after application of any temporary increase 
in the Federal medical assistance percent-
age for the State and quarter under sec-
tion 
6008 
of 
the 
Families 
First 
Coronavirus Response Act (42 U.S.C. 
1396d note) and any other Federal legisla-
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tion enacted during the period that begins 
on July 1, 2020, and ends on September 
30, 2021.’’. 
SEC. 410. TECHNICAL CORRECTION TO TEMPORARY IN-
CREASE OF MEDICAID FMAP. 
Section 6008 of the Families First Coronavirus Re-
sponse Act (Public Law 116–127) is amended by adding 
at the end the following: 
‘‘(e) APPLICATION TO TITLE IV–E PAYMENTS.—If 
the District of Columbia receives the increase described 
in subsection (a) in the Federal medical assistance per-
centage for the District of Columbia with respect to a 
quarter, the Federal medical assistance percentage for the 
District of Columbia, as so increased, shall apply to pay-
ments made to the District of Columbia under part E of 
title IV of the Social Security Act (42 U.S.C. 670 et seq.) 
for that quarter, and the payments under such part shall 
be deemed to be made on the basis of the Federal medical 
assistance percentage applied with respect to such District 
for purposes of title XIX of such Act (42 U.S.C. 1396 
et seq.) and as increased under subsection (a).’’. 
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TITLE V—PANDEMIC STATE 
FLEXIBILITIES 
SEC. 501. EMERGENCY FLEXIBILITY FOR STATE TANF PRO-
GRAMS. 
(a) STATE PROGRAMS.—Sections 407(a), 407(e)(1), 
and 408(a)(7)(A) of the Social Security Act shall have no 
force or effect during the applicable period, and para-
graphs (3), (9), (14), and (15) of section 409(a) of such 
Act shall not apply with respect to conduct engaged in 
during the period. 
(b) TRIBAL PROGRAMS.—The minimum work partici-
pation requirements and time limits established under sec-
tion 412(c) of the Social Security Act shall have no force 
or effect during the applicable period, and the penalties 
established under such section shall not apply with respect 
to conduct engaged in during the period. 
(c) PENALTY FOR NONCOMPLIANCE.— 
(1) IN GENERAL.—If the Secretary of Health 
and Human Services finds that a State or an Indian 
tribe has imposed a work requirement as a condition 
of receiving assistance, or a time limit on the provi-
sion of assistance, under a program funded under 
part A of title IV of the Social Security Act or any 
program funded with qualified State expenditures 
(as defined in section 409(a)(7)(B)(i) of such Act) 
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during the applicable period, or has imposed a pen-
alty for failure to comply with a work requirement 
during the period, the Secretary shall reduce the 
grant payable to the State under section 403(a)(1) 
of such Act or the grant payable to the tribe under 
section 412(a)(1) of such Act, as the case may be, 
for fiscal year 2021 by an amount equal to 5 percent 
of the State or tribal family assistance grant, as the 
case may be. 
(2) APPLICABILITY OF CERTAIN PROVISIONS.— 
For purposes of section 409(d) of the Social Secu-
rity Act, paragraph (1) of this subsection shall be 
considered to be included in section 409(a) of such 
Act. 
(d) DEFINITIONS.—In this section: 
(1) APPLICABLE PERIOD.—The term ‘‘applica-
ble period’’ means the period that begins on March 
1, 2020, and ends January 31, 2021. 
(2) WORK REQUIREMENT.—The term ‘‘work re-
quirement’’ means a requirement to engage in a 
work activity (as defined in section 407(d) of the So-
cial Security Act) or other work-related activity as 
defined by a State or tribal program funded under 
part A of title IV of such Act. 
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(3) OTHER TERMS.—Each other term has the 
meaning given the term in section 419 of the Social 
Security Act. 
SEC. 502. EMERGENCY FLEXIBILITY FOR CHILD SUPPORT 
PROGRAMS. 
(a) IN GENERAL.—With respect to the period that 
begins on March 1, 2020, and ends January 31, 2021: 
(1) 
Sections 
408(a)(2), 
409(a)(5), 
and 
409(a)(8) of the Social Security Act shall have no 
force or effect. 
(2) Notwithstanding section 466(d) of such Act, 
the Secretary of Health and Human Services (in this 
subsection referred to as the ‘‘Secretary’’) may ex-
empt a State from any requirement of section 466 
of such Act to respond to the COVID–19 pandemic, 
except that the Secretary may not exempt a State 
from any requirement to— 
(A) provide a parent with notice of a right 
to request a review and, if appropriate, adjust-
ment of a support order; or 
(B) afford a parent the opportunity to 
make such a request. 
(3) The Secretary may not impose a penalty or 
take any other adverse action against a State pursu-
ant to section 452(g)(1) of such Act for failure to 
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(7) To the extent that a preceding provision of 
this section applies with respect to a provision of law 
applicable to a program operated by an Indian tribe 
or tribal organization (as defined in subsections (e) 
and (l) of section 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 450b)), 
that preceding provision shall apply with respect to 
the Indian tribe or tribal organization. 
(b) CLARIFICATION OF PERFORMANCE INCENTIVE 
PAYMENT
CALCULATION.—Notwithstanding paragraph 
(3) of section 458(b) of the Social Security Act, the State 
incentive payment share for each of fiscal years 2020 and 
2021 for purposes of such section shall be the State incen-
tive payment share determined under such section for fis-
cal year 2019. 
(c) STATE DEFINED.—In subsection (a), the term 
‘‘State’’ has the meaning given the term in section 
1101(a) of the Social Security Act for purposes of title 
IV of such Act. 
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DIVISION K—HEALTH 
PROVISIONS 
SEC. 100. SHORT TITLE. 
This division may be cited as the ‘‘Investing in Amer-
ica’s Health Care During the COVID–19 Pandemic Act’’. 
TITLE I—MEDICAID PROVISIONS 
SEC. 101. COVID–19-RELATED TEMPORARY INCREASE OF 
MEDICAID FMAP. 
(a) IN GENERAL.—Section 6008 of the Families 
First Coronavirus Response Act (42 U.S.C. 1396d note) 
is amended— 
(1) in subsection (a)— 
(A) by inserting ‘‘(or, if later, September 
30, 2021)’’ after ‘‘last day of such emergency 
period occurs’’; and 
(B) by striking ‘‘6.2 percentage points.’’ 
and inserting ‘‘the percentage points specified 
in subsection (e). In no case may the applica-
tion of this section result in the Federal medical 
assistance percentage determined for a State 
being more than 95 percent.’’; and 
(2) by adding at the end the following new sub-
sections: 
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‘‘(f) SPECIFIED PERCENTAGE POINTS.—For pur-
poses of subsection (a), the percentage points specified in 
this subsection are— 
‘‘(1) for each calendar quarter occurring during 
the period beginning on the first day of the emer-
gency period described in paragraph (1)(B) of sec-
tion 1135(g) of the Social Security Act (42 U.S.C. 
1320b-5(g)) and ending on September 30, 2020, 6.2 
percentage points; 
‘‘(2) for each calendar quarter occurring during 
the period beginning on October 1, 2020, and ending 
on September 30, 2021, 14 percentage points; and 
‘‘(3) for each calendar quarter, if any, occurring 
during the period beginning on October 1, 2021, and 
ending on the last day of the calendar quarter in 
which the last day of such emergency period occurs, 
6.2 percentage points. 
‘‘(g) CLARIFICATIONS.— 
‘‘(1) In the case of a State that treats an indi-
vidual described in subsection (b)(3) as eligible for 
the benefits described in such subsection, for the pe-
riod described in subsection (a), expenditures for 
medical assistance and administrative costs attrib-
utable to such individual that would not otherwise be 
included as expenditures under section 1903 of the 
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Social Security Act shall be regarded as expendi-
tures under the State plan approved under title XIX 
of the Social Security Act or for administration of 
such State plan. 
‘‘(2) The limitations on payment under sub-
sections (f) and (g) of section 1108 of the Social Se-
curity Act (42 U.S.C. 1308) shall not apply to Fed-
eral payments made under section 1903(a)(1) of the 
Social Security Act (42 U.S.C. 1396b(a)(1)) attrib-
utable to the increase in the Federal medical assist-
ance percentage under this section. 
‘‘(3) Expenditures attributable to the increased 
Federal medical assistance percentage under this 
section shall not be counted for purposes of the limi-
tations under section 2104(b)(4) of such Act (42 
U.S.C. 1397dd(b)(4)). 
‘‘(4) Notwithstanding the first sentence of sec-
tion 2105(b) of the Social Security Act (42 U.S.C. 
1397ee(b)), the application of the increase under 
this section may result in the enhanced FMAP of a 
State for a fiscal year under such section exceeding 
85 percent, but in no case may the application of 
such increase before application of the second sen-
tence of such section result in the enhanced FMAP 
of the State exceeding 95 percent. 
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‘‘(h) SCOPE OF APPLICATION.—An increase in the 
Federal medical assistance percentage for a State under 
this section shall not be taken into account for purposes 
of payments under part D of title IV of the Social Security 
Act (42 U.S.C. 651 et seq.).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect and apply as if included 
in the enactment of section 6008 of the Families First 
Coronavirus Response Act (Public Law 116–127). 
SEC. 102. ADDITIONAL SUPPORT FOR MEDICAID HOME AND 
COMMUNITY-BASED SERVICES DURING THE 
COVID–19 EMERGENCY PERIOD. 
(a) INCREASED FMAP.— 
(1) IN
GENERAL.—Notwithstanding section 
1905(b) of the Social Security Act (42 U.S.C. 
1396d(b)), in the case of an HCBS program State, 
the Federal medical assistance percentage deter-
mined for the State under section 1905(b) of such 
Act and, if applicable, increased under subsection 
(y), (z), or (aa) of section 1905 of such Act (42 
U.S.C. 1396d), section 1915(k) of such Act (42 
U.S.C. 1396n(k)), or section 6008(a) of the Fami-
lies First Coronavirus Response Act (Public Law 
116–127), shall be increased by 10 percentage 
points with respect to expenditures of the State 
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under the State Medicaid program for home and 
community-based services that are provided during 
the HCBS program improvement period. In no case 
may the application of the previous sentence result 
in the Federal medical assistance percentage deter-
mined for a State being more than 95 percent. 
(2) DEFINITIONS.—In this section: 
(A) HCBS PROGRAM
IMPROVEMENT
PE-
RIOD.—The term ‘‘HCBS program improve-
ment period’’ means, with respect to a State, 
the period— 
(i) beginning on October 1, 2020; and 
(ii) ending on September 30, 2021. 
(B) HCBS PROGRAM
STATE.—The term 
‘‘HCBS program State’’ means a State that 
meets the condition described in subsection (b) 
by submitting an application described in such 
subsection, which is approved by the Secretary 
pursuant to subsection (c). 
(C) HOME AND COMMUNITY-BASED SERV-
ICES.—The term ‘‘home and community-based 
services’’ means home health care services au-
thorized under paragraph (7) of section 1905(a) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396d(a)), personal care services authorized 
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under paragraph (24) of such section, PACE 
services authorized under paragraph (26) of 
such section, services authorized under sub-
sections (b), (c), (i), (j), and (k) of section 1915 
of such Act (42 U.S.C. 1396n), such services 
authorized under a waiver under section 1115 
of such Act (42 U.S.C. 1315), and such other 
services specified by the Secretary. 
(b) CONDITION.—The condition described in this sub-
section, with respect to a State, is that the State submits 
an application to the Secretary, at such time and in such 
manner as specified by the Secretary, that includes, in ad-
dition to such other information as the Secretary shall re-
quire— 
(1) a description of which activities described in 
subsection (d) that a state plans to implement and 
a description of how it plans to implement such ac-
tivities; 
(2) assurances that the Federal funds attrib-
utable to the increase under subsection (a) will be 
used— 
(A) to implement the activities described in 
subsection (d); and 
(B) to supplement, and not supplant, the 
level of State funds expended for home and 
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community-based services for eligible individ-
uals through programs in effect as of the date 
of the enactment of this section; and 
(3) assurances that the State will conduct ade-
quate oversight and ensure the validity of such data 
as may be required by the Secretary. 
(c) APPROVAL OF APPLICATION.—Not later than 90 
days after the date of submission of an application of a 
State under subsection (b), the Secretary shall certify if 
the application is complete. Upon certification that an ap-
plication of a State is complete, the application shall be 
deemed to be approved for purposes of this section. 
(d) ACTIVITIES
TO IMPROVE
THE DELIVERY
OF 
HCBS.— 
(1) IN
GENERAL.—A State shall work with 
community partners, such as Area Agencies on 
Aging, Centers for Independent Living, non-profit 
home and community-based services providers, and 
other entities providing home and community-based 
services, to implement— 
(A) the purposes described in paragraph 
(2) during the COVID–19 public health emer-
gency period; and 
(B) the purposes described in paragraph 
(3) after the end of such emergency period. 
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(2) FOCUSED
AREAS
OF
HCBS
IMPROVE-
MENT.—The purposes described in this paragraph, 
with respect to a State, are the following: 
(A) To increase rates for home health 
agencies and agencies that employ direct sup-
port professionals (including independent pro-
viders in a self-directed or consumer-directed 
model) to provide home and community-based 
services under the State Medicaid program, 
provided that any agency or individual that re-
ceives payment under such an increased rate in-
creases the compensation it pays its home 
health workers or direct support professionals. 
(B) To provide paid sick leave, paid family 
leave, and paid medical leave for home health 
workers and direct support professionals. 
(C) To provide hazard pay, overtime pay, 
and shift differential pay for home health work-
ers and direct support professionals. 
(D) To provide home and community- 
based services to eligible individuals who are on 
waiting lists for programs approved under sec-
tions 1115 or 1915 of the Social Security Act 
(42 U.S.C. 1315, 1396n). 
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(E) To purchase emergency supplies and 
equipment, which may include items not typi-
cally covered under the Medicaid program, such 
as personal protective equipment, necessary to 
enhance access to services and to protect the 
health and well-being of home health workers 
and direct support professionals. 
(F) To pay for the travel of home health 
workers and direct support professionals to con-
duct home and community-based services. 
(G) To recruit new home health workers 
and direct support professionals. 
(H) To support family care providers of el-
igible individuals with needed supplies and 
equipment, which may include items not typi-
cally covered under the Medicaid program, such 
as personal protective equipment, and pay. 
(I) To pay for training for home health 
workers and direct support professionals that is 
specific to the COVID–19 public health emer-
gency. 
(J) To pay for assistive technologies, staff-
ing, and other costs incurred during the 
COVID–19 public health emergency period in 
order to facilitate community integration and 
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ensure an individual’s person-centered service 
plan continues to be fully implemented. 
(K) To prepare information and public 
health and educational materials in accessible 
formats (including formats accessible to people 
with low literacy or intellectual disabilities) 
about prevention, treatment, recovery and other 
aspects of COVID–19 for eligible individuals, 
their families, and the general community 
served by agencies described in subparagraph 
(A). 
(L) To pay for American sign language in-
terpreters to assist in providing home and com-
munity-based services to eligible individuals and 
to inform the general public about COVID–19. 
(M) To allow day services providers to pro-
vide home and community-based services. 
(N) To pay for other expenses deemed ap-
propriate by the Secretary to enhance, expand, 
or strengthen Home and Community-Based 
Services, including retainer payments, and ex-
penses which meet the criteria of the home and 
community-based settings rule published on 
January 16, 2014. 
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(3) PERMISSIBLE
USES
AFTER
THE
EMER-
GENCY
PERIOD.—The purpose described in this 
paragraph, with respect to a State, is to assist eligi-
ble individuals who had to relocate to a nursing fa-
cility or institutional setting from their homes dur-
ing the COVID–19 public health emergency period 
in— 
(A) moving back to their homes (including 
by paying for moving costs, first month’s rent, 
and other one-time expenses and start-up 
costs); 
(B) resuming home and community-based 
services; 
(C) receiving mental health services and 
necessary rehabilitative service to regain skills 
lost while relocated during the public health 
emergency period; and 
(D) while funds attributable to the in-
creased FMAP under this section remain avail-
able, continuing home and community-based 
services for eligible individuals who were served 
from a waiting list for such services during the 
public health emergency period. 
(e) REPORTING REQUIREMENTS.— 
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