Page:United States Statutes at Large Volume 101 Part 2.djvu/938

 101 STAT. 1330-144

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PUBLIC LAW 100-203—DEC. 22, 1987

natives to the provision of skilled nursing facility or intermediate care facility services, which such individuals may choose if available under the waiver. Each State with a waiver under this subsection shall provide to the Secretary annually, consistent with a reasonable data collection plan designed by the Secretary, information on the impact of the waiver granted under this subsection on the type and amount of medical assistance provided under the State plan and on the health and welfare of recipients. "(3) A waiver granted under this subsection may include a waiver of the requirements of section 1902(a)(l) (relating to statewideness), section 1902(a)(10XB) (relating to comparability), and section 1902(a)(10XCXiXni) (relating to income and resource rules applicable in the community). Subject to a termination by the State (with notice to the Secretary) at any time, a waiver under this subsection shall be for an initial term of 3 years and, upon the request of a State, shall be extended for additional 5-year periods unless the Secretary determines that for the previous waiver period the assurances provided under paragraph (2) have not been met. A waiver may provide, with respect to post-eligibility treatment of income of all individuals receiving services under the waiver, that the maximum amount of the individual's income which may be disregarded for any month is equal to the amount that may be allowed for that purpose under a waiver under subsection (c). "(4) A waiver under this subsection may, consistent with paragraph (2), provide medical Eissistance to individuals for case management services, homemaker/home health aide services and personal care services, adult day health services, respite care, and other medical and social services that can contribute to the health and well-being of individuals and their ability to reside in a communitybased care setting. "(5)(A) In the case of a State having a waiver approved under this subsection, notwithstanding any other provision of section 1903 to the contrary, the total amount expended by the State for medical assistance with respect to skilled nursing facility services, intermediate care facility services, and home and community-based services under the State plan for individuals 65 years of age or older during a waiver year under this subsection may not exceed the projected amount determined under subparagraph (B). "(B) For purposes of subparagraph (A), the projected amount under this subparagraph is the sum of the following: "(i) The aggregate amount of the State's medical assistance under this title for skilled nursing facility services and intermediate care facility services furnished to individuals who have attained the age of 65 for the base year increased by a percentage which is equal to the lesser of 7 percent times the number of years beginning after the base year and ending before the waiver year involved or the sum of— (I) the percentage increase (based on an appropriate market-basket index representing the costs of elements of ^"* such services) between the base year and the waiver year involved, plus "(II) the percentage increase between the base year and the W£dver year involved in the number of residents in the '^^ ^ State who have attained the age of 65, plus "(III) 2 percent for each year beginning after the base year and ending before the waiver year.

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