S. 1989 — Helping Communities with Better Support Act

This section amends Section 1915(c) of the Social Security Act, which authorizes Medicaid home and community-based services (HCBS) waivers that enable states to provide long-term services and supports in community settings (instead of institutions) to individuals determined to need an institutional level of care. Specifically, the section (1) requires states to provide information on their HCBS waivers not less frequently than annually (previously annually) and, for information submitted on or after January 1, 2028, to include additional details specified in new paragraph (12) that must be publicly posted on the CMS website; (2) authorizes the Secretary to approve an HCBS waiver for a state to cover part or all of the cost of services (excluding room and board) for individuals who meet the disability definition under Section 3 of the Americans with Disabilities Act (42 U.S.C. 12102) or Section 504 of the Rehabilitation Act (29 U.S.C. 794) but who lack a determination of needing institutional care, provided the state demonstrates compliance of its other waivers, no material impact on wait times for traditional HCBS waiver participants, and submits estimates and service descriptions; and (3) specifies new paragraph (12) reporting details, including for states with enrollment caps, waitlist maintenance and screening practices, average wait times to service approval and start, and average percentage of authorized HCBS hours (overall and for homemaker, home health aide, and personal care services) actually furnished. Additionally, this section directs the Secretary of Health and Human Services to issue guidance to states by January 1, 2026, clarifying how to provide up to 60 days of interim HCBS coverage under an existing waiver from the date eligibility is determined until a written plan of care is finalized.