This bill, known as the "Helping Communities with Better Support Act," seeks to amend Title XIX of the Social Security Act to significantly increase transparency and expand coverage options for home and community-based services (HCBS) under Medicaid. Its primary goals are to ensure greater accountability in HCBS delivery and to make these vital services accessible to a wider range of individuals with disabilities.

To enhance transparency, the legislation mandates that states annually report detailed information regarding their HCBS waiver programs. Beginning January 1, 2028, much of this data, including specifics on waitlist management, screening processes, and average wait times for services, must be made publicly available on the Centers for Medicare & Medicaid Services (CMS) website. States must also report the average time from service approval to commencement and the percentage of authorized HCBS hours that are actually furnished, including for homemaker, home health aide, and personal care services.

Furthermore, the bill expands HCBS coverage options by allowing the Secretary to approve waivers for states to provide these services to individuals who meet the disability definitions under the Americans with Disabilities Act or the Rehabilitation Act, even if they do not meet traditional institutional level of care criteria. States seeking this expansion must demonstrate that it will not negatively impact wait times for existing beneficiaries and must provide estimates of the number of new individuals to be served.

Finally, the Secretary of Health and Human Services is directed to issue guidance by January 1, 2026. This guidance will clarify how states can provide up to 60 days of interim HCBS coverage for eligible individuals under an interim care plan, bridging the gap between eligibility determination and the finalization of a comprehensive written plan of care.