Page:United States Statutes at Large Volume 101 Part 2.djvu/994

 101 STAT. 1330-200 Contracts.

PUBLIC LAW 100-203—DEC. 22, 1987 "(E) PERMITTING ALTERNATIVE DISPOSITION PLANS.—With

respect to residents of a nursing facility who are mentally retarded or mentally ill and who are determined under subparagraph (B) not to require the level of services of such a facility, but who require active treatment for mental illness or mental retardation, a State and the nursing facility shall be considered to be in compliance with the requirement of this paragraph if, before October 1, 1988, the State and the Secretary have entered into an agreement relating to the disposition of such residents of the facility and the State is in compliance with such agreement. Such an agreement may provide for the disposition of the residents after the date specified in subparagraph (C). "(F) APPEALS PROCEDURES.—Each State, as a condition of approval of its plan under this title, effective January 1, ^ 1989, must have in effect an appeals process for individuals adversely affected by determinations under subparagraph (A) or (B). "(G) DEFINITIONS.—In this paragraph and in subsection (b)(3)(F): ^ "(i) An individual is considered toT)e 'mentally ill' if the individual has a primary or secondary diagnosis of mental disorder (as defined in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition) and does not have a primary diagnosis of dementia (including Alzheimer's disease or a related disorder), "(ii) An individual is considered to be 'mentally retarded' if the individual is mentally retarded or a person with a related condition (as described in section 1905(d)). ^ / "(iii) The term 'active treatment' has the meaning '. given such term by the Secretary in regulations, but does not include, in the case of a resident of a nursing "' » facility, services within the scope of services which the facility must provide or arrange for its residents under subsection (b)(4). (f) RESPONSIBIUTIES OF SECRETARY RELATING TO NURSING FACILITY REQUIREMENTS.— "(1) GENERAL RESPONSIBILITY.—It is the duty and responsibil-

ity of the Secretary to assure that requirements which govern the provision of care in nursing facilities under State plans approved under this title, and the enforcement of such requirements, are adequate to protect the health, safety, welfare, and rights of residents and to promote the effective and efficient use of public moneys. (2) REQUIREMENTS FOR NURSE AIDE TRAINING AND COMPETENCY EVALUATION PROGRAMS AND FOR NURSE AIDE COMPETENCY EVALUATION PROGRAMS.—

"(A) IN GENERAL.—For purposes of subsections (b)(5) and (e)(l)(A), the Secretary shall establish, by not later than July 1, 1988— "(i) requirements for the approval of nurse aide training and competency evaluation programs, including requirements relating to (I) the areas to be covered in such a program (including at least basic nursing skills, personal care skills, cognitive, behavioral and social care, basic restorative services, and residents'

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