1. Short title This Act may be cited as the HCBS Infrastructure Improvement Act . 2. Findings and purpose (a) Findings Congress finds the following: (1) States are prioritizing funding of their Medicaid programs for long-term services and supports (referred to in this section as LTSS ) to offer a wider range of options for home and community-based services (referred to in this section as HCBS ), but gaps in HCBS remain. (2) In fiscal year 2016, States were spending only 57 percent of their total LTSS budgets on HCBS, well short of the national goal of 69 percent set by the Centers for Medicare & Medicaid Services. (3) In 2017, more than 700,000 people with disabilities, older adults, and children were on waiting lists to receive HCBS through existing Medicaid waver programs. (4) According to projections by the Bureau of the Census, the number of adults over age 65 will reach 84,000,000 by mid-century, and the population of people 85 and older will be nearly 15 million by 2040. (5) Absent strategic planning and investment, States will experience greater difficulties as the needs of older adults increase demands on State home and community-based services HCBS capacity. (6) A one-time, targeted investment to strengthen State capacity to build out Medicaid infrastructure that supports multiple HCBS programs and connects to other Federal and State programs, including Medicare and the Older Americans Act, will improve the quality of health and daily living for the millions of older adults, people with disabilities and their families. (7) Home and community-based services HCBS play an outsized role in addressing the social determinants of health among older adults and people with disabilities, who require accessible housing and accessible transportation and access to reliable personal care to avert costly medical crises. (b) Purpose The purpose of this Act is to establish to a one-time infrastructure improvement initiative for States to strengthen their HCBS capacity in selected target areas, including housing and