Page:United States Statutes at Large Volume 100 Part 1.djvu/239

 PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 203

"(B) includes (except as provided in subparagraph (C)) prevocational, educational, and supported employment services; but "(C) does not include— "(i) special education and related services (as defined in section 602(16) and (17) of the Education of the Handicapped Act (20 U.S.C. 1401(16), (17)) which otherwise are available to the individual through a local educational agency; and "(ii) vocational rehabilitation services which otherwise are available to the individual through a program funded under section 110 of the Rehabilitation Act of 1973 (29 U.S.C. 730).". (b) PERMITTING HOSPITAL LEVEL OF CARE FOR CERTAIN PARTICI-

PANTS.—(1) Section 1915(c)(1) of such Act (42 U.S.C 1396n(c)(l)) is State and local amended by inserting "or but for the provision of such services the governments. individuals would continue to receive inpatient hospital services, skilled nursing facility services, or intermediate care facility services because they are dependent on ventilator support the cost of which is reimbursed under the State plan" before the period at the end thereof. (2) Section 1915(c)(2)(C) of such Act (42 U.S.C. 1396n(cK2XC)) is amended— (A) by inserting "hospital or" after "provided in a"; and (B) by inserting "inpatient hospital services or" after "the provision of. (c) PROHIBITING IMPOSITION OF CERTAIN REGULATORY LIMITS.—

Section 1915(c) of such Act (42 U.S.C. 1396n(c)) as amended by subsection (a), is further amended— (1) in paragraph (2)(D), by inserting "100 percent o f after "does not exceed; and (2) by adding at the end thereof the following new paragraph: "(6) The Secretary may not require, as a condition of approval of a waiver under this section under paragraph (2)(D), that the actual total expenditures for home and community-based services under the waiver (and a claim for Federal financial participation in expenditures for the services) cannot exceed the approved estimates for these services. The Secretary may not deny Federal financial State and local payment with respect to services under such a waiver on the ground governments. that, in order to comply with paragraph (2)(D), a State has failed to comply with such a requirement.". (d) COMPUTATION OF EXPENDITURES FOR CERTAIN DISABLED PA-

TIENTS.—Section 1915(c) of such Act (42 U.S.C. 1396n(c)), as amended by subsection (c), is further amended by adding at the end thereof the following new paragraph: "(7) In making estimates under paragraph (2)(D) in the case of a State and local waiver which applies only to physically disabled individuals who are governments. inpatients in skilled nursing or intermediate care facilities, the State may determine the average per capita expenditure which would have been made in a fiscal year for those individuals under the State plan separately from the expenditure for other individuals who are inpatients of those facilities.'. (e) PERMITTING FLEXIBILITY IN ESTABLISHING INCOME STANDARDS.—Section 1915(c)(3) of such

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Act (42 U.S.C. 1396n(c)(3)) is amended by adding at the end the following new sentence: "A waiver may provide, with respect to post-eligibility treatment of income of all individuals receiving services under that waiver, that the maximum amount of the individual's income which

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