Page:United States Statutes at Large Volume 85.djvu/839

 85 STAT. ]

809

PUBLIC LAW 92-223-DEC. 28, 1971

striking out "referred to the Secretary by such agency under such section 402(a) (15)" and inserting in lieu thereof "certified to the Secretary by such agency under section 402(a) (19)(G) ". (c) The amendments made by this section shall, except as otherwise specified herein, take effect on July 1, 1972.

Ante, p. 804. Effective date.

INCLUSION UNDER MEDICAID OF CARE I N INTERMEDIATE CARE FACILITIES

SEC. 4. (a)(1) Section 1905(a) of the Social Security Act as amended— (A) by striking out "and" at the end of clause (14), (B) by striking out the semicolon at the end of clause (15) and inserting in lieu thereof "; and", and (C) by inserting after clause (15) the following new clause: "(16) intermediate care facility services (other than such services in an institution for tuberculosis or mental diseases) for individuals who are determined, in accordance with section 1902(a) (31)(A), to be in need of such care;". (2) Section 1905 of such Act is amended by adding at the end thereof the following new subsections: "(c) For purposes of this title the term 'intermediate care facility' means an institution which (1) is licensed under State law to provide, on a regular basis, health-related care and services to individuals who do not require the decree of care and treatment which a hospital or skilled nursing home is designed to provide, but who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, (2) meets such standards prescribed by the Secretary as he finds appropriate for the proper provision of such care, and (3) meets such standards of safety and sanitation as are established under regulation of the Secretary in addition to those applicable to nursing homes under State law. The term 'intermediate care facility' also includes any skilled nursing home or hospit-al which meets the requirements of the preceding sentence. The term 'intermediate care facility' also includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts, but only with respect to institutional services deemed appropriate by the State. With respect to services furnished to individuals under age 65, the term 'intermediate care facility' shall not include, except as provided in subsection (d), any public institution or distinct part thereof for mental diseases or mental defects. " (d) The term 'intermediate care facility services' may include services in a public institution (or distinct part thereof) for the mentally retarded or persons with related conditions if— "(1) the primary purpose of such institution (or distinct part thereof) is to provide health or rehabilitative services for mentally retarded individuals and which meet such standards as may be prescribed by the Secretary; "(2) the mentally retarded individual with respect to whom a request for payment is made under a plan approved under this title is receiving active treatment under such a program; and " (3) the State or political subdivision responsible for the operation of such institution has agreed that the non-Federal expenditures with respect to patients in such institution (or distinct part thereof) will not be reduced because of payments made under this title." (b) Section 1902(a) of such Act is amended— (1) by striking out "and" at the end of paragraph (29); (2) by striking out the period at the end of paragraph (30) and inserting in lieu thereof "; and"; and

79 Stat. 351. 42 USC 1396d.

Infra,

"Intermediate care facility."

"Intermediate care facility services."

79 Stat. 344; 51 Stat. 911. 42 USC 1396a.

�