June 24, 1997

Mr. GINGRICH introduced the following bill; which was referred to the Committee on Commerce

To amend title XIX of the Social Security Act to provide for coverage of community attendant services under the Medicaid program.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Medicaid Community Attendant Services Act of 1997'.

SEC. 2. COVERAGE OF COMMUNITY-BASED ATTENDANT SERVICES UNDER THE MEDICAID PROGRAM.

(a) REQUIRING COVERAGE FOR INDIVIDUALS ENTITLED TO NURSING FACILITY SERVICES OR INTERMEDIATE CARE FACILITY SERVICES FOR THE MENTALLY RETARDED- Section 1902(a)(10)(D) of the Social Security Act (42 U.S.C. 1396a(a)(10)(D)) is amended--

(1) by inserting `(i)' after `(D)', and

(2) by adding at the end the following:

`(ii) subject to section 1932(b), for the inclusion of qualified community-based attendant services for any individual who, under the State plan, is entitled to nursing facility services or intermediate care facility services for the mentally retarded and who requires such services based on functional need (and without regard to age or disability);'.

(b) MEDICAID COVERAGE OF COMMUNITY-BASED ATTENDANT SERVICES-

(1) IN GENERAL- Title XIX of the Social Security Act, as amended by section 114(a) of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, is amended--

(A) by redesignating section 1932 as section 1933, and

(B) by inserting after section 1931 the following new section:

`COVERAGE OF QUALIFIED COMMUNITY-BASED ATTENDANT SERVICES

`SEC. 1932. (a) QUALIFIED COMMUNITY-BASED ATTENDANT SERVICES DEFINED-

`(1) IN GENERAL- In this title, the term `qualified community-based attendant services' means attendant services (as defined by the Secretary) furnished to an individual--

`(A) on an as-needed basis under a plan of service that is based on an assessment of functional need and that is agreed to by the individual;

`(B) in a home or community-based setting, which may include a school, workplace, or recreation or religious facility, but does not include a nursing facility, an intermediate care facility for the mentally retarded, or other institutional facility;

`(C) under either an agency-provider model or other model (as defined in subsection (c)); and

`(D) the furnishing of which is selected, managed, controlled by the individual (as defined by the Secretary).

`(2) SERVICES INCLUDED- Such term includes--

`(A) backup and emergency attendant services;

`(B) voluntary training on how to select, manage, and dismiss attendants; and

`(C) health-related tasks (as defined by the Secretary) that are assigned to, delegated to, or performed by, unlicensed personal attendants.

`(3) EXCLUDED SERVICES- Subject to paragraph (4), such term does not include--

`(A) provision of room and board, and

`(B) prevocational, vocational, and supported employment.

`(4) FLEXIBILITY IN TRANSITION TO HOME SETTING- Under regulations of the Secretary, such term may include expenditures for transitional costs, such as rent and utility deposits, first months's rent and utilities, bedding, basic kitchen supplies, and other necessities required for an individual to make the transition from a nursing facility or intermediate care facility for the mentally retarded to a home setting.