‘‘(17) Section 1847. 
‘‘(18) Section 1851. 
‘‘(19) Section 1852. 
‘‘(20) Section 1855. 
‘‘(21) Section 1856. 
‘‘(22) Section 1857. 
‘‘(23) Section 1858. 
‘‘(24) Section 1861. 
‘‘(25) Section 1863. 
‘‘(26) Section 1864. 
‘‘(27) Section 1866B. 
‘‘(28) Section 1866C. 
‘‘(29) Section 1866E. 
‘‘(30) Section 1867. 
‘‘(31) Section 1868. 
‘‘(32) Section 1869. 
‘‘(33) Section 1871. 
‘‘(34) Section 1874A. 
‘‘(35) Section 1880. 
‘‘(36) Section 1881. 
‘‘(37) Section 1881A. 
‘‘(38) Section 1891. 
‘‘(39) Section 1894. 
‘‘(40) Section 1895. 
‘‘(41) Section 1896. 
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‘‘PART B—HOME- AND COMMUNITY-BASED LONG- 
TERM SERVICES AND SUPPORTS 
‘‘SEC. 2231. HOME- AND COMMUNITY-BASED LONG-TERM 
SERVICES AND SUPPORTS BENEFIT. 
‘‘All individuals enrolled under Medicare for America 
under this title shall have coverage for home- and commu-
nity-based long-term services and supports benefits. Noth-
ing in this part shall be construed to limit an enrollee’s 
entitlement to any other benefit that is covered pursuant 
to section 2203, including nursing facility benefits. 
‘‘SEC. 2232. ELIGIBILITY. 
‘‘(a) ELIGIBLE INDIVIDUALS.—An individual who is 
eligible for home- and community-based long-term services 
and supports benefits under this part is an individual who 
satisfies each of the following: 
‘‘(1) The individual is eligible for Medicare for 
America. 
‘‘(2) The individual is determined by a licensed 
health care practitioner to be unable to perform, 
without substantial assistance, at least one Activity 
of 
Daily 
Living 
as 
described 
in 
section 
7702B(c)(2)(B) of the Internal Revenue Code of 
1986, or to require substantial assistance with one 
or more of the following areas: 
‘‘(A) Communication. 
‘‘(B) Social interaction. 
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‘‘(C) Learning. 
‘‘(D) Self-care. 
‘‘(E) Self-management. 
‘‘(F) Impairments that affect the person’s 
capacity for social or economic participation. 
‘‘(b) CLARIFICATION.—Under this part, in the case 
of an individual described in subsection (a) who experi-
ences periods in which their functional capacity changes 
or improves, such individual shall continue to have access 
to benefits under this part as needed. If such an individ-
ual’s functional capacity improves to a point in which the 
individual no longer requires home- and community-based 
long-term services and supports, or requires fewer serv-
ices, the individual shall be able to immediately and 
seamlessly resume receiving all needed services if and 
when their functional needs recur. Eligibility for services 
shall be maintained if, without the services, the individual 
would have reduced functional capacity. When assessing 
functional impairment, the individual will be assessed 
without regard to any current services or the ameliorative 
effects of other mitigating measures described in section 
3(4)(E)(i)(I) of the Americans With Disabilities Act of 
1990. 
‘‘(c) BENEFITS.— 
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‘‘(1) DEFINITION.—For purposes of this title, 
the term ‘home- and community-based long-term 
services and supports benefit’ means the daily living 
supports needed by eligible individuals in order to 
live, work, and participate in their communities, and 
includes all home- and community-based services 
and supports coverable as of the date of the enact-
ment of this title, under any State plan or waiver 
under title XIX, including— 
‘‘(A) home health aides and homemakers; 
‘‘(B) direct support professionals and per-
sonal attendant care services; 
‘‘(C) hospice; 
‘‘(D) nursing care; 
‘‘(E) medical social services; 
‘‘(F) care coordination, including case 
management, fiscal intermediary, and support 
brokerage services; 
‘‘(G) short-term inpatient care, including 
respite care and care for pain control; 
‘‘(H) behavioral health home- and commu-
nity-based long-term services and supports, in-
cluding assertive community treatment; peer 
support services; intensive care coordination, in-
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cluding case management; supported employ-
ment; and supported housing wraparound; 
‘‘(I) private-duty nursing; 
‘‘(J) respite services provided in the indi-
vidual’s home or broader community; and 
‘‘(K) transitional services to support an in-
dividual’s transition from an institutional set-
ting to the community. 
‘‘(2) NON-APPLICATION.—The provisions of sec-
tions 424.22(a)(1)(i) and 424.22(a)(1)(ii) of title 42 
of the Code of Federal Regulations does not apply 
in the case of the benefit described in paragraph 
(1)(A). 
‘‘(d) HOME- AND COMMUNITY-BASED LONG-TERM 
SERVICES
AND
SUPPORTS
WORKFORCE
DEVELOP-
MENT.— 
‘‘(1) IN GENERAL.—The Secretary shall ensure 
that the number of individuals in the home- and 
community-based long-term services and supports 
workforce is adequate to ensure community integra-
tion for all beneficiaries under Medicare for Amer-
ica. In so doing, the Secretary may consider a wide 
range of factors, including payment rates for direct 
care workers, career pipelines and credentialing, 
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