(4) MONTHLY GRANT PAYMENT AMOUNTS.— 
(A) IN GENERAL.—Subject to paragraph 
(5), the Secretary shall pay to each State that 
is awarded a grant under this section, for each 
month during the State’s grant period (as de-
fined in subparagraph (C)), an amount equal to 
15 percent of the amount determined for the 
State under subparagraph (B). 
(B) AVERAGE MONTHLY HCBS EXPENDI-
TURES.—The amount determined for a State 
under this subparagraph is the amount equal 
to— 
(i) the sum of— 
(I) the average annual amount of 
State expenditures under title XIX of 
the Social Security Act (42 U.S.C. 
1396 et seq.) that are attributable to 
providing medical assistance for home 
and community-based services for the 
3 most recent fiscal years for which 
data is available; and 
(II) the average annual amount, 
if any, received by the State pursuant 
to an MFP demonstration project 
conducted under section 6071 of the 
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Deficit Reduction Act of 2005 (42 
U.S.C. 1396a note) for the 3 most re-
cent fiscal years for which data is 
available; divided by 
(ii) 12. 
(C) GRANT
PERIOD
DEFINED.—In this 
paragraph, the term ‘‘grant period’’ means, 
with respect to a State, the period of months— 
(i) beginning with the month in which 
the Secretary approves the State’s applica-
tion for a grant under this section; and 
(ii) ending with the 12th month that 
begins after the end of the COVID–19 
public health emergency period. 
(5) GRANTS TO INDIAN TRIBES.— 
(A) IN GENERAL.—During the COVID–19 
public health emergency period, the Secretary 
may award grants to an Indian tribe in the 
same manner, and subject to the same require-
ments, as apply to a State, except as otherwise 
provided in this paragraph. 
(B) APPLICATION.—Any Indian tribe seek-
ing a grant under this section shall submit to 
the Secretary an application that includes (in 
addition to any other information the Secretary 
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shall require) an identification of the population 
and service area or areas to be served by the 
activities and programs that will be funded by 
the grant. 
(C) 
MONTHLY
GRANT
PAYMENT 
AMOUNTS.— 
(i) IN GENERAL.—The Secretary shall 
pay to each Indian tribe that is awarded a 
grant under this section, for each month 
during the tribe’s grant period (as defined 
in clause (iii)), an amount equal to 15 per-
cent of the amount determined for the 
tribe under clause (ii). 
(ii) TRIBAL
SHARE
OF
MONTHLY 
HCBS EXPENDITURES.—The amount deter-
mined for an Indian tribe under this clause 
is equal to the— 
(I) the total of the average an-
nual amount of State expenditures 
made by a State or States under title 
XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) that are attrib-
utable to providing medical assistance 
for home and community-based serv-
ices to eligible individuals who reside 
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in the service area or areas identified 
by the tribe pursuant to subparagraph 
(B) for the 3 most recent fiscal years 
for which data is available; divided by 
(II) 12. 
(iii) 
GRANT
PERIOD.—The 
term 
‘‘grant period’’ has the same meaning with 
respect to an Indian tribe as the term has 
with respect to a State under paragraph 
(4)(C). 
(D) 
REDUCTION
OF
STATE
GRANT 
AMOUNTS.—If any State in which lies a service 
area or areas identified by an Indian tribe in a 
successful grant application pursuant to sub-
paragraph (B) is also awarded a grant under 
this section, the Secretary shall reduce the 
amount payable to such State each month 
under paragraph (4) by the portion of the 
amount payable to the Indian tribe under this 
paragraph that is attributable to expenditures 
by the State. 
(d) PERMISSIBLE USES OF FUNDS.— 
(1) IN GENERAL.—A State to which a grant is 
made under this section may use grant funds— 
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(A) to work with community partners such 
as Area Agencies on Aging, Independent Living 
Centers, non-profit home and community-based 
service providers, and other entities providing 
home and community-based services; 
(B) during the COVID–19 public health 
emergency period, for the purposes described in 
paragraph (2); and 
(C) after the end of such period, for the 
purposes described in paragraph (3). 
(2) PERMISSIBLE
USES
DURING
THE
EMER-
GENCY
PERIOD.—The purposes described in this 
paragraph for which a State may use grant funds 
awarded under this section are the following: 
(A) To increase rates for home health and 
direct service worker agencies to provide home 
and community-based services under the State 
Medicaid program, provided that any agency or 
individual that receives payment under such an 
increased rate increases the compensation it 
pays its home health or direct service workers. 
(B) To provide paid sick leave, paid family 
leave, and paid medical leave for home health 
workers and direct service workers. 
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(C) To provide hazard pay, overtime pay, 
and shift differential pay for home health work-
ers and direct service workers. 
(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). 
(E) To purchase emergency supplies and 
equipment necessary to enhance access to serv-
ices and to protect the health and well-being of 
home health workers and direct service workers. 
(F) To pay for home health worker and di-
rect service worker travel to conduct home and 
community-based services. 
(G) To recruit new direct service workers 
and home health workers. 
(H) To support family care providers of el-
igible individuals with needed supplies and 
equipment and pay. 
(I) To pay for training for direct service 
workers and home health workers that is spe-
cific to the COVID–19 public health emergency. 
(J) To pay for assistive technologies, staff-
ing, and other costs incurred during the public 
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health emergency in order to facility community 
integration and ensure an individual’s person- 
centered service plan continue to be fully imple-
mented. 
(K) To support direct service workers and 
home health workers going to nursing facilities, 
hospitals, institutions, and quarantine settings 
to provide services to eligible individuals who 
usually receive home and community-based 
services and have chosen to temporarily move to 
a more restrictive setting. 
(L) To prepare information and public 
health and educational materials in accessible 
formats about prevention, treatment, recovery 
and other aspects of COVID–19 for eligible in-
dividuals, their families, and the general com-
munity served by home health and direct service 
agencies, including formats accessible to people 
with low literacy or intellectual disabilities. 
(M) 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. 
(N) To allow for day service providers to 
shift to providing home-based services. 
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(O) To pay for COVID–19 testing in home 
settings. 
(P) To pay for other expenses deemed ap-
propriate by the Secretary and which meet the 
criteria of the home and community-based set-
tings rule. 
(3) PERMISSIBLE
USES
AFTER
THE
EMER-
GENCY
PERIOD.—The purpose described in this 
paragraph for which a State may use grant funds 
awarded under this section is to assist eligible indi-
viduals who had to relocate to a nursing facility or 
institutional setting from their homes during the 
COVID–19 public health emergency period in— 
(A) moving back to their homes (including 
by paying for moving 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) 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. 
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(e) REPORTING REQUIREMENTS.— 
(1) STATE
REPORTING
REQUIREMENTS.—Not 
later than 18 months after the end of the COVID– 
19 public health emergency period, any State that 
received a grant under this section shall submit a re-
port to the Secretary that contains the following in-
formation: 
(A) Activities and programs that were 
funded using grant amounts. 
(B) The number of eligible individuals who 
were served by such activities and programs. 
(C) The number of eligible individuals who 
were able to resume home and community- 
based services as a result of such activities and 
programs. 
(2) HHS REPORT.—Not later than 18 months 
after the end of the COVID–19 public health emer-
gency period, the Secretary shall issue a public sum-
mary of the grants awarded under this section. 
(f) APPROPRIATION.— 
(1) IN GENERAL.—Subject to paragraph (2), 
there are appropriated for fiscal year 2020 from any 
funds in the Treasury not otherwise appropriated 
such sums as are necessary to carry out this section, 
to remain available until expended. 
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(2) 
AVAILABILITY
OF
APPROPRIATIONS.— 
Amounts made available under paragraph (1) shall 
not be available for the awarding of grants to States 
that do not submit an application for such a grant 
before the date described in subsection (c)(3)(A). 
(3) UNUSED GRANT FUNDS.—A State that re-
ceives a grant under this section shall return to the 
Secretary any portion of such grant that is unused 
as of the date that is 1 year after the last day of 
the COVID–19 public health emergency period, and 
such returned portion shall revert to the Treasury. 
Æ 
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