124 STAT. 297 PUBLIC LAW 111–148—MAR. 23, 2010 Subtitle E—New Options for States to Provide Long-Term Services and Supports SEC. 2401. COMMUNITY FIRST CHOICE OPTION. Section 1915 of the Social Security Act (42 U.S.C. 1396n) is amended by adding at the end the following: ‘‘(k) STATE PLAN OPTION TO PROVIDE HOME AND COMMUNITY- BASED ATTENDANT SERVICES AND SUPPORTS.— ‘‘(1) IN GENERAL.—Subject to the succeeding provisions of this subsection, beginning October 1, 2010, a State may provide through a State plan amendment for the provision of medical assistance for home and community-based attendant services and supports for individuals who are eligible for medical assist- ance under the State plan whose income does not exceed 150 percent of the poverty line (as defined in section 2110(c)(5)) or, if greater, the income level applicable for an individual who has been determined to require an institutional level of care to be eligible for nursing facility services under the State plan and with respect to whom there has been a determination that, but for the provision of such services, the individuals would require the level of care provided in a hospital, a nursing facility, an intermediate care facility for the mentally retarded, or an institution for mental diseases, the cost of which could be reimbursed under the State plan, but only if the individual chooses to receive such home and community-based attendant services and supports, and only if the State meets the following requirements: ‘‘(A) AVAILABILITY.—The State shall make available home and community-based attendant services and sup- ports to eligible individuals, as needed, to assist in accom- plishing activities of daily living, instrumental activities of daily living, and health-related tasks through hands- on assistance, supervision, or cueing— ‘‘(i) under a person-centered plan of services and supports that is based on an assessment of functional need and that is agreed to in writing by the individual or, as appropriate, the individual’s representative; ‘‘(ii) in a home or community setting, which does not include a nursing facility, institution for mental diseases, or an intermediate care facility for the men- tally retarded; ‘‘(iii) under an agency-provider model or other model (as defined in paragraph (6)(C )); and ‘‘(iv) the furnishing of which— ‘‘(I) is selected, managed, and dismissed by the individual, or, as appropriate, with assistance from the individual’s representative; ‘‘(II) is controlled, to the maximum extent pos- sible, by the individual or where appropriate, the individual’s representative, regardless of who may act as the employer of record; and ‘‘(III) provided by an individual who is quali- fied to provide such services, including family members (as defined by the Secretary). ‘‘(B) INCLUDED SERVICES AND SUPPORTS.—In addition to assistance in accomplishing activities of daily living, Contracts. Effective date.
