(B) in subclause (IX)(dd), by striking the 
semicolon at the end and inserting ‘‘; or’’; and 
(C) by inserting after subclause (IX) the 
following new subclause: 
‘‘(X) beginning with the first cal-
endar quarter that begins on or after 
the date that is 5 years after the date 
of enactment of this subclause (or 
such earlier date as the State may 
elect), who are eligible individuals de-
scribed in subsection (jj)(3)(A) and 
are not described in a previous sub-
clause of this clause and whose in-
come does not exceed the greater of— 
‘‘(aa) 150 percent of the 
poverty line (as defined in section 
2110(c)(5)) applicable to a family 
of the size involved; and 
‘‘(bb) 300 percent of the 
supplemental 
security 
income 
benefit rate established by section 
1611(b)(1);’’; and 
(2) in subparagraph (A)(ii)— 
(A) in subclause (XXII), by striking ‘‘; or’’ 
and inserting a semicolon; 
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(B) in subclause (XXIII), by striking the 
semicolon at the end and inserting ‘‘; or’’; and 
(C) by adding at the end the following new 
subclause: 
‘‘(XXIV) who are eligible individ-
uals who would be described in clause 
(i)(X) but for the fact that their in-
come exceeds the income levels estab-
lished under such clause but is less 
than such income level as the State 
may establish for purposes of this 
subclause;’’. 
SEC. 104. HOME AND COMMUNITY-BASED SERVICES IMPLE-
MENTATION PLAN GRANT PROGRAM. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary shall 
award to each State a grant for purposes of enabling such 
State to implement the requirement to provide home and 
community-based services under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.). 
(b) USE OF FUNDS.—A grant awarded under sub-
section (a) shall be used by a State to develop an imple-
mentation plan described in subsection (c) to be submitted 
to the Secretary for approval. 
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(c) IMPLEMENTATION PLAN.—An implementation 
plan described in this subsection is a plan developed by 
a State that includes the following: 
(1) An explanation of how the State will 
operationalize the definition of an eligible individual 
under section 1905(jj) of the Social Security Act, in-
cluding the process for determinations specified in 
paragraph (3)(A)(i) of such section. 
(2) A description of the State’s plan to ensure 
a stable and high quality workforce and how the 
State plans to ensure a living wage for individuals 
furnishing home and community-based services and 
identify and address any additional workforce issues. 
(3) A list of any home and community-based 
services provided under the State Medicaid plan (in-
cluding any waiver of such plan) as of the date of 
enactment of this Act, including a breakdown of use 
of such services by demographics (as defined in sec-
tion 2), compared to such services that are required 
under the amendments made by section 102, and a 
description of numerical goals to increase access to 
such services that have barriers to access for popu-
lations in need of such services. 
(4) A description of how the State will incor-
porate existing State disability agencies into the new 
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unified provision of home and community-based 
services and how such State will ensure that such 
services address all functional impairments. 
(5) An explanation of how the State will ensure 
access to such services. 
(6) A plan for carrying out outreach and edu-
cation activities with respect to the availability of 
such services through Aging and Disability Resource 
Centers and other similar entities (such as entities 
receiving funds from the Administration for Commu-
nity Living or the Substance Abuse and Mental 
Health Services Administration), including a pro-
gram that ensures that an individual is not denied 
such services based on the fact that the individual 
contacts the wrong entity (commonly referred to as 
a ‘‘No Wrong Door Program’’). 
(7) A plan for how such services will be coordi-
nated with other relevant State agencies, such as 
housing, transportation, child welfare, food and in-
come security, and employment agencies. 
(8) A description of how the State will build ca-
pacity prior to the implementation of the require-
ment described in subsection (a) to ensure that such 
services are available to every eligible individual 
under the Medicaid program and how the State will 
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ensure that such services are provided in a setting 
that meets the requirements specified in paragraph 
(1) of section 1905(jj) of the Social Security Act, as 
added by section 102. 
(9) In the case of a State that utilizes an alter-
native benefit plan, a description of how the State 
will ensure that all individuals who are eligible indi-
viduals (as defined in such section) are appropriately 
identified as medically frail and exempted from such 
plan. 
(10) How the State will coordinate eligibility for 
such services with other disability eligibility pro-
grams, such as disability buy-in programs. 
(11) Data and milestone requirements to ensure 
community integration, including such requirements 
with respect to utilization of such services by demo-
graphics (as defined in section 2). 
(d) STATE PLAN REQUIREMENT.—Section 1902(a) 
of the Social Security Act (42 U.S.C. 1396a(a)) is amend-
ed— 
(1) in paragraph (86), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (87), by striking the period at 
the end and inserting ‘‘; and’’; and 
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