Page:United States Statutes at Large Volume 104 Part 2.djvu/594

 104 STAT. 1388-186 PUBLIC LAW 101-508—NOV. 5, 1990 "(4) No PREVENTION OF MORE STRINGENT REQUIREMENTS BY STATES.—Nothing in this section shall be construed as preventing States from imposing requirements that are more stringent than the requirements published or developed by the Secretary under this subsection. "(1) WAIVER OF STATEWIDENESS.—States may waive the requirement of section 1902(a)(1) (related to State wideness)'*'^ for a program of home and community care under this section. "(m) LIMITATION ON AMOUNT OF EXPENDITURES AS MEDICAL ASSIST- ANCE. — . "(1) LIMITATION ON AMOUNT.— The amount of funds that may be expended as medical assistance to carry out the purposes of this section shall be for fiscal year 1991, $40,000,000, for fiscal year 1992, $70,000,000, for fiscal year 1993, $130,000,000, for fiscal year 1994, $160,000,000, and for fiscal year 1995, $180,000,000. "(2) ASSURANCE OF ENTITLEMENT TO SERVICE. —A State which receives Federal medical assistance for expenditures for home and community care under this section must provide home and community care specified under the Individual Community Care Plan under subsection (d) to individuals described in subsection (b) for the duration of the election period, without regard to the amount of funds available to the State under paragraph (1). For purposes of this paragraph, an election period is the period of 4 or more calendar quarters elected by the State, and approved by the Secretary, for the provision of home and community care under this section, "(3) LIMITATION ON ELIGIBILITY. — The State may limit eligibility for home and community care under this section during an election period under paragraph (2) to reasonable classifications (based on age, degree of functional disability, and need for services). "(4) ALLOCATION OF MEDICAL ASSISTANCE.— The Secretary shall establish a limitation on the amount of Federal medical assistance available to any State during the State's election period under paragraph (2). The limitation under this paragraph shall take into account the limitation under paragraph (1) and the number of elderly individuals age 65 or over residing in such State in relation to the number of such elderly individuals in the United States during 1990. For purposes of the previous sentence, elderly individuals shall, to the maximum extent practicable, be low-income elderly individuals.". (c) PAYMENT FOR HOME AND COMMUNITY CARE.— (1) REASONABLE AND ADEQUATE PAYMENT RATES. — Section 1902 (42 U.S.C. 1396a) is amended— (A) in subsection (a)(13)— (i) by striking "and" at the end of subparagraph (D), (ii) by inserting "and" at the end of subparagraph (E), and (iii) by adding at the end the following new subparagraph: "(F) for payment for home and community care (as defined in section 1929(a) and provided under such section) through rates which are reasonable and adequate to meet the costs of providing care, efficiently and economically, in conformity with applicable State and Federal laws, regulations, and quality and safety standards;"; and
 * '' So in original. Probably should be "Statewideness)".

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