Title IV, SEC. 4213. NEW STATE LONG-TERM CARE INTEGRATION OPTION. Title XIX, as amended by section 4201(a), is amended by redesignating section 1932 as section 1933 and by inserting after section 1931 the following new section: ``state long-term care option ``Sec. 1932. (a) In General. A State under this title may make an election under and subject to the succeeding provisions of this section. Under such an election instead of being entitled to receive payment under section 1903(a) for medical assistance for nursing facility services and intermediate care facilities for the mentally retarded, for one or more defined populations, the State is entitled to receive, subject to subsection (e), payment under section 1903(a) for long-term care services described in subsection (b)(2) for such populations under this section. ``(b) Plan Amendment Required. A State making an election under subsection (a) shall submit a State plan amendment describing ``(1) the category (or categories) of defined populations (otherwise eligible for medical assistance with respect to nursing facility services or home and community-based services or described in subsection (d)) with respect to whom this section shall apply; ``(2) the long-term care services (within the range of services described in subsection (c)(1)) for which medical assistance is available under the State plan for eligible individuals within each such category of individuals; ``(3) how the provision of such services, and expenditures under this section, will be coordinated with the provision of services and expenditures under part 1 of subtitle B of title II of the Health Security Act (relating to State programs for home and community-based services for individuals with disabilities); and ``(4) such other information as the Secretary determines as necessary to carry out this section. ``(c) Care and Services. ``(1) Continuum of care required. The services described in this paragraph shall represent a continuum of long-term care, and shall include (as appropriate based upon a plan of care described in paragraph (2)) ``(A) nursing facility services and other services described in section 1905(a), ``(B) home and community-based services described in section 1915(c) or 1915(d), ``(C) home and community care for functionally disabled elderly individuals described in section 1929, and ``(D) community supported living arrangements services (as defined in section 1930(a)). ``(2) Plan of care and service evaluation. A plan of care described in this paragraph shall ``(A) be developed in consultation with the individual or, in the case of an individual incapable of participating in the development of the plan of care, the individual's family members or guardian; ``(C) be based on a comprehensive assessment of the individual's need for the continuum of services described in paragraph (1), and ``(D) be periodically updated based upon the individual's needs (but in no event less frequently than every 6 months). ``(3) Intake and assessment process. A State shall use an intake and assessment process meeting standards established by the Secretary to develop the plan of care required under paragraph (2). ``(4) Dissemination of information. The State shall provide information about the availability of services under this section, and how to obtain them, in a manner that ensures that such information is widely disseminated to all eligible providers, agencies, and organizations providing services to the population of individuals receiving assistance under this section. ``(d) Additional Eligible Populations. ``(1) In general. A State may provide medical assistance under this section, in addition to individuals otherwise eligible for medical assistance, to individuals who would be so eligible but for ``(A) failure to meet the disability criteria otherwise applicable, or ``(B) subject to paragraph (2), failure to meet income or resource requirements otherwise applicable. ``(2) Limitation on income. A State may not provide under this subsection medical assistance to an individual whose income (as determined under section 1612 for purposes of the supplemental security income program) exceeds the greater of ``(A) the income official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981), or ``(B) the maximum level of State supplementary payment under section 1616 (or under section 212 of Public Law 93 66). ``(e) Rules Relating to Federal Financial Participation. ``(1) In general. With respect to medical assistance provided under this section for a category of individuals (specified under subsection (b)(1)) ``(A) the amount of medical assistance that may otherwise be taken into account in making payment under section 1903(a)(1) shall not exceed the amount specified in paragraph (2) for the category; ``(B) the amount of State expenditures (other than for medical assistance) that may otherwise be taken into account in making payment under section 1903(a) (other than paragraph (1)) shall not exceed the amount specified in paragraph (3) for the category; and ``(C) a State may include (as expenditures for medical assistance under the State plan) expenditures for room and board and other community-assisted residential services furnished in settings that meet standards established by the Secretary and that otherwise may not qualify as settings for which Federal financial participation is available under this title. ``(2) Limit on medical assistance. The amount specified in this paragraph (for a calendar quarter or other period) is as follows: ``(A) Base medical assistance. The total medical assistance provided under the State plan for the services described in subsection (c)(1) for the category of individuals in the base period (specified by the Secretary). ``(B) Update. The amount determined under subparagraph (A) shall be updated (to the calendar quarter or other period involved) ``(i) for periods through fiscal year 2002, by the rate of growth (estimated by the Secretary) in the medical assistance described in subparagraph (A) under the State plan if the election in subsection (a) had not been made, and ``(ii) beginning in fiscal year 2003, by a factor (for each such fiscal year) equivalent to the product of the factors described in subparagraph (A) and (B) of section 2109(a)(2) of the Health Security Act for the fiscal year. ``(3) Limit on administration. The amount specified in this paragraph is such amount as the State establishes, to the satisfaction of the Secretary, does not exceed the amount of expenditures that would have been made for administrative expenditures with respect to services covered under this section if the election in subsection (a) had not been made. ``(4) Effect on entitlement. In the case of a State that has made an election under subsection (a), notwithstanding any other provision of this title, no individual is entitled to medical assistance under the State plan for nursing facility services and intermediate care facilities for the mentally retarded except as the State provides under this section. ``(f) Other Requirements. ``(1) Safeguards. The State must establish necessary safeguards (including adequate standards for provider participation) have been taken to protect the health and welfare of individuals provided services under this section and to assure financial accountability of funds. Nothing in this section shall be construed as waiving requirements otherwise applicable under this title with respect to providers of covered services. ``(2) Financial coordination. The State must provide for the financial coordination of expenditures for medical assistance under this section with expenditures under any State program for home and community-based services for individuals with disabilities under part 1 of subtitle B of title II of the Health Security Act.''.