; and . 108. Making permanent the State option to extend protection under Medicaid for recipients of home and community-based services against spousal impoverishment (a) In general Section 1924(h)(1)(A) of the Social Security Act ( 42 U.S.C. 1396r–5(h)(1)(A) ) is amended by striking is described in section 1902(a)(10)(A)(ii)(VI) and inserting the following: is an eligible individual (as defined in section 1905(jj)(3)) . (b) Conforming amendment Section 2404 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 1396r–5 note) is amended by striking September 30, 2027 and inserting the date of enactment of the HCBS Access Act . 109. Permanent extension of Money Follows the Person Rebalancing demonstration Subparagraph (L) of section 6071(h)(1) of the Deficit Reduction Act of 2005 ( 42 U.S.C. 1396a note) is amended by striking each of fiscal years 2024 through 2027 and inserting each fiscal year after 2023 . II Recognizing the role of direct support professionals 201. Findings Congress finds the following: (1) Direct support professionals play a critical role in the care provided to children and adults with intellectual and developmental disabilities. (2) Providers of home and community-based services are experiencing difficulty hiring and retaining direct support professionals, with a national turnover rate of 45 percent as identified in a 2016 study by the National Core Indicators. (3) High turnover rates can lead to instability for individuals receiving services, and this may result in individuals not receiving enough personalized care to help them reach their goals for independent living. (4) A discrete occupational category for direct support professionals will help States and the Federal Government— (A) better interpret the shortage in the labor market of direct support professionals