Title II, SEC. 2601. DEMONSTRATION ON ACUTE AND LONG-TERM CARE INTEGRATION. (a) Program Authorized. The Secretary of Health and Human Services shall conduct a demonstration program to test the effectiveness of various approaches to financing and providing integrated acute and long-term care services described in subsection (b) for the chronically ill and disabled who meet eligibility criteria under subsection (c). (b) Services and Benefits. (1) In general. Except as provided in paragraph (2), the following services and benefits shall be provided under each demonstration approved under this section: (A) Comprehensive benefit package. All benefits included in the comprehensive benefit package under title I of this Act. (B) Transitional benefits. Specialized benefits relating to the transition from acute to long-term care, including (i) assessment and consultation, (ii) inpatient transitional care, (iii) medical rehabilitation, (iv) home health care and home care, (v) caregiver support, and (vi) self-help technology. (C) Long-term care benefits. Long-term care benefits, including (i) adult day care, (ii) personal assistance services, (iii) homemaker services and chore services; (iv) home-delivered meals; (v) respite services; (vi) nursing facility services in specialized care units; (vii) services in other residential settings including community supported living arrangements and assisted living facilities; and (viii) assistive devices and environmental modifications. (D) Habilitation services. Specialized habilitation services for participants with developmental disabilities. (2) Variations in minimum benefits. (A) In general. Subject to the requirement of subparagraph (B), demonstrations may omit specified services listed under subparagraphs (C) and (D) of paragraph (1), or provide additional services, as found appropriate by the Secretary in the case of a particular demonstration, taking into consideration factors such as (i) the needs of a specialized group of eligible beneficiaries; (ii) the availability of the omitted benefits under other programs in the service area; and (iii) the geographic availability of service providers. (B) Breadth requirement. In approving variant demonstrations pursuant to subparagraph (A), the Secretary shall ensure that demonstrations under this section, taken as a group, adequately test financing and delivery models covering the entire array of services and benefits described in paragraph (1). (c) Eligibility Criteria. The Secretary shall establish eligibility criteria for individuals who may receive services under demonstrations under this section. Under such criteria, any of the following may be found to be eligible populations for such demonstrations: (1) Individuals with disabilities who are entitled to services and benefits under a State program under part 1 of this subtitle. (2) Individuals who are entitled to benefits under parts A and B of title XVIII of the Social Security Act. (3) Individuals who are entitled to medical assistance under a State plan under title XIX of the Social Security Act, and are also (A) individuals described in paragraph (2), or (B) individuals eligible for supplemental security income under title XVI of that Act. (d) Application. (1) In general. Each entity seeking to participate in a demonstration under this section shall submit an application, in such format and containing such information as the Secretary may require, including the information specified in this subsection. (2) Service delivery. The application shall state the services to be provided under the demonstration (either directly by the applicant or under other arrangements approved by the Secretary), which shall include services specified pursuant to subsection (b) and (A) enrollment services; (B) client assessment and care planning; (C) simplified access to needed services; (D) integrated management of acute and chronic care, including measures to ensure continuity of care across settings and services; (E) quality assurance, grievance, and appeals mechanisms; and (F) such other services as the Secretary may require. (3) Consumer protection and participation. The applicant shall provide evidence of consumer participation (A) in the planning of the demonstration (including a showing of support from community agencies or consumer interest groups); and (B) in the conduct of the demonstration, including descriptions of methods and procedures to be used (i) to make available to individuals enrolled in the demonstration information on self-help, health promotion and disability prevention practices, and enrollees' contributions to the costs of care; (ii) to ensure participation by such enrollees (or their designated representatives, where appropriate) in care planning and in decisions concerning treatment; (iii) to handle and resolve client grievances and appeals; (iv) to take enrollee views into account in quality assurance and provider contracting procedures; and (v) to evaluate enrollee satisfaction with the program. (4) Applicant qualifications. Applicants for grants under this section shall meet eligibility criteria established by the Secretary, including requirements relating to (A) adequate financial controls to monitor administrative and service costs, (B) demonstrated commitment of the Board of Directors or comparable governing body to the goals of demonstration, (C) information systems adequate to pay service providers, to collect required utilization and cost data, and to provide data adequate to permit evaluation of program performance, and (D) compliance with applicable State laws. (e) Payments to Participants. An entity conducting a demonstration under this section shall be entitled to receive, with respect to each enrollee, for the period during which it is providing to such enrollee services under a demonstration under this section, such amounts as the Secretary shall provide, which amounts (1) may include risk-based payments and non-risk based payments by governmental programs, by third parties, or by project enrollees, or any combination of such payments, and (2) may vary by project and by enrollee. (f) Number and Duration of Demonstration Projects. (1) Request for applications. The Secretary shall publish a request for applications under this section not later than one year after enactment of this Act. (2) Number and duration. The Secretary shall authorize not more than 25 demonstrations under this section, each of which shall run for 7 years from the date of the award. (g) Evaluation and Reports. The Secretary shall evaluate the demonstration projects under this section, and shall submit to the Congress (1) an interim report, by three years after enactment, describing the status of the demonstration and characteristics of the approved projects; and (2) a final report, by one year after completion of such demonstration projects, evaluating their effectiveness (including cost-effectiveness), and discussing the advisability of including some or all of the integrated models tested in the demonstration as a benefit under the comprehensive benefit package under title I of this Act, or under the programs under title XVIII of the Social Security Act. (h) Authorization of Appropriations. (1) For secretarial responsibilities. (A) In general. There are authorized to be appropriated $7,000,000 for fiscal year 1996, and $4,500,000 for each of the 6 succeeding fiscal years, for payment of costs of the Secretary in carrying out this section (including costs for technical assistance to potential service providers, and research and evaluation), which amounts shall remain available until expended. (B) Set-aside for feasibility studies. Of the total amount authorized to be appropriated under subparagraph (A), not less than $1,000,000 shall be available for studies of the feasibility of systems to provide integrated care for nonaged populations (including physically disabled children and adults, the chronically mentally ill, and individuals with disabilities, and combinations of these groups). (2) For covered benefits. There are authorized to be appropriated $50,000,000 for the first fiscal year for which grants are awarded under this section, and for each of the four succeeding fiscal years, for payment of costs of benefits for which no public or private program or entity is legally obligated to pay.