US SB1989

Amends Section 1915(c) of the Social Security Act to allow states to obtain waivers providing home and community-based services (HCBS) to individuals with disabilities under the ADA or Rehabilitation Act who have not received a nursing facility level-of-care determination

Requires states seeking expanded waivers to demonstrate no material impact on wait times for individuals already determined eligible for HCBS, and to provide estimates of newly covered individuals and service differences

Mandates annual reporting to CMS, publicly available beginning January 1, 2028, on waitlist management practices, eligibility screening procedures, average wait times, and percentage of authorized service hours actually delivered

Requires disclosure of specific access metrics for homemaker, home health aide, and personal care services, including time from approval to service start and fulfillment rates of authorized care hours

Directs HHS to issue guidance by January 1, 2026, allowing states to provide up to 60 days of HCBS coverage under an interim care plan while a full written plan of care is being finalized