,i #aad? ,,congress #b;d ,session ,h4 ,r4 #eijc ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,july #ad1 #bjaf,mr4 ,van ,holl5 7= himself1 ,mrs4 ,mc,morris ,rodg]s1 ,mr4 ,fo/]1 ,mr4 ,cr5%aw1 ,mr4 ,langev91 ,mr4 ,sessions1 & ,mr4 ,bey]7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce ,a ,,bill ,to e/abli% ! ,transition to ,indep5d5ce demon/ration program4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,transition to ,indep5d5ce ,act ( #bjaf4 #b4 ,transition to ,indep5d5ce ,demon/ration ,program 7a7 ,e/abli%m5t ,! ,secret>y %all e/abli% a demon/ration program "u :i* a ,/ate t is a ,m$icaid ,buy-,9 ,/ate & meets c]ta9 crit]ia may receive bonus paym5ts = meet+ specific measurable b5*m>ks 9 exp&+ individual integrat$ employm5t & r$uc+ subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation placem5ts = work+-age individuals ) a disability receiv+ ,m$icaid-fund$ home or community-bas$ s]vices & = tak+ o!r actions conducive to exp&+ employm5t opportunities = individuals ) disabilities )9 ! ,/ate4 7b7 ,requirem5ts = ! ,transition to ,indep5d5ce demon/ration program 7#a7 ,m9imum /&>ds ,! ,secret>y %all e/abli% m9imum /&>ds = ,m$icaid ,buy-,9 ,/ates p>ticipat+ 9 ! demon/ration program to comply ) 9 e/abli%+ eligibility requirem5ts = individual p>ticipants1 b5efits1 & adm9i/rative requirem5ts = ! ,transition to ,indep5d5ce ,m$icaid ,buy-,9 ,option (f]$ "u ! demon/ration program4 7#b7 ,pref]5ce giv5 to c]ta9 ,/ates = demon/ration p>ticipation ,! ,secret>y %all give pref]5ce 9 select+ ,/ates to p>ticipate 9 ! demon/ration program to ,/ates t h ,m$icaid ,buy-,9 programs t-- 7,a7 e/abli% an assets or res\rces te/ = p>ticipation by an individual 9 ! ,m$icaid ,buy-,9 ,option t is n less ?an #bj1jjj2 7,b7 e/abli% an income requirem5t = p>ticipation by an individual 9 ! ,m$icaid ,buy-,9 ,option t is at lea/ up to #djj p]c5t ( ! pov]ty l9e2 7,c7 (f] home & community-bas$ s]vices1 includ+ employm5t-bas$ s]vices & supports1 9 ! ,m$icaid ,buy ,9 ,option2 & 7,d7 e/abli% su* o!r requirem5ts = an individual's p>ticipation 9 ! ,m$icaid ,buy-,9 ,option z ! ,secret>y %all specify4 7#c7 ,"w inc5tives coord9ator ,! m9imum /&>ds %all require a ,m$icaid ,buy-,9 ,/ate p>ticipat+ 9 ! demon/ration program to provide "w inc5tives coord9ators :o h be5 tra9$ z "w inc5tive speciali/s "u a community-bas$ "w inc5tives plann+ & assi/ance program e/abli%$ "u section #aadi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#bj7 to assi/ ! individuals :o elect to p>ticipate 9 ! ,m$icaid ,buy-,9 ,option 9 ord] to ensure ! individuals are provid$ ) appropriate items & s]vices4 7c7 ,application & selection requirem5ts 7#a7 ,9 g5]al ,n lat] ?an ,june #cj1 #bjag1 ! ,secret>y %all solicit applications f ,m$icaid ,buy-,9 ,/ates & select #ae ,m$icaid ,buy-,9 ,/ates to p>ticipate 9 ! demon/ration program4 7#b7 ,application requirem5ts ,an application to p>ticipate 9 ! demon/ration program %all include ! foll[+3 7,a7 ,data & in=mation reg>d+ ! numb]s ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices 9 ! ,m$icaid ,buy-,9 ,/ate :o are 9 individual integrat$ employm5t1 subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation or day treatm5t1 respectively4 7,b7 ,data & in=mation v]ify+ t ! ,m$icaid ,buy-,9 ,/ate is prep>$ to meet ! m9imum /&>ds e/abli%$ by ! ,secret>y = ! ,m$icaid ,buy-,9 ,option4 7,c7 ,a plan = promot+ ! ,m$icaid ,buy-,9 ,option to pot5tially eligible individuals t includes-- 7i7 cle> & easy-to-und]/&1 multi-m$ia in=mation on h[ to enroll 9 ! ,m$icaid ,buy-,9 ,option on ! ,web sites = ! ,m$icaid ,buy-,9 ,/ate's ,m$icaid & ,disability ,det]m9ation ,s]vices ,ag5cies2 & 7ii7 a no-wrong door policy "u :i* individuals :o apply = a det]m9ation ( eligibility = ! ,m$icaid ,buy-,9 ,option are also det]m9$ if !y are eligible = an applicable ,/ate heal? subsidy program 9 accordance ) section #adac ( ! ,pati5t ,protection & ,af=dable ,c>e ,act 7#db ,u4,s4,c4 #ahjhc7 7includ+ ! ,/ate ,m$icaid program "u ano!r eligibility pa?way71 in=m$ ( ! results ( su* det]m9ations &1 dep5d+ on _! eligibility1 provid$ ) ! option to volunt>ily elect to p>ticipate 9 ! ,m$icaid ,buy-,9 ,option or an applicable ,/ate heal? subsidy program4 7,d7 7i7 ,an assurance t ! ,/ate w e/abli% & build capacity = an eligibility process to make eligibility det]m9ations = ! ,m$icaid ,buy-,9 program4 ,su* process %all provide = a det]m9ation ( eligibility n lat] ?an #ij days aft] ! date t an application to p>ticipate 9 ! program is fil$1 includ+ = individuals :o are n receiv+ disability insurance b5efits "u title ,,ii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #dja et seq47 or supplem5tal security income b5efits "u title ,,xvi ( su* ,act 7#db ,u4,s4,c4 #acha et seq474 7ii7 ,a description ( ! eligibility crit]ia ! ,/ate w use1 ! process x w use to det]m9e eligibility1 = individuals :o d n qualify = su* title ,,ii or ,,ssi b5efits & ! /aff :o w be responsible = mak+ ^? det]m9ations4 ,?is eligibility process %all n use ! disability det]m9ation process us$ by ! ,social ,security ,adm9i/ration = su* title ,,ii & ,,ssi b5efits4 7,e7 ,v]ification t ! ,m$icaid ,buy-,9 ,/ate %all e/abli% a ,/akehold] ,advisory ,committee t meets ! requirem5ts ( p>agraph 7#c7 & %all consult ) & consid] recomm5dations ( ! ,committee :ile conduct+ ! demon/ration program4 7,f7 ,a description ( ! p]son-c5t]$ plann+ process t ! ,/ate int5ds to use = p>ticipants 9 ! demon/ration program4 7,g7 ,su* o!r in=mation z ! ,secret>y may require relat+ to ! demon/ration program4 7#c7 ,/akehold] ,advisory ,committee requirem5ts 7,a7 ,memb]%ip ,9 e/abli%+ ! ,/akehold] ,advisory ,committee requir$ = ! demon/ration program1 ! ,m$icaid ,buy-,9 ,/ate %all ensure t-- 7i7 at lea/ #ej p]c5t ( ! memb]s ( ! ,/akehold] ,advisory ,committee are individuals ) disabilities2 & 7ii7 at lea/ #a memb] ( ! ,committee is a provid] ( s]vices to individuals ) disabilities4 7,b7 ,duties ,! ,/akehold] ,advisory ,committee %all-- 7i7 analyze outcomes data & o!r in=mation relat$ to ! conduct ( ! demon/ration program2 & 7ii7 regul>ly submit recomm5dations1 includ+ = specific actions by ! ,m$icaid ,buy-,9 ,/ate p>ticipat+ 9 ! demon/ration program1 t ! ,committee det]m9es appropriate ) respect to ! conduct ( ! demon/ration program by ! ,/ate4 7d7 ,requirem5t = select+ ,/ates ,9 select+ ,m$icaid ,buy-,9 ,/ates to p>ticipate 9 ! demon/ration program1 ! ,secret>y %all ensure t ! ,m$icaid ,buy-,9 ,/ates select$ include ,m$icaid ,buy-,9 ,/ates ) l[1 m$ium1 & high numb]s ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices & are 9 individual integrat$ employm5t1 subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation or day treatm5t1 respectively4 7e7 ,l5g? ( demon/ration program ,! demon/ration program %all be conduct$ = a p]iod ( #e fiscal ye>s1 beg9n+ ) fiscal ye> #bjah4 7f7 ,p]=mance bonus paym5ts 7#a7 ,9 g5]al ,= ea* fiscal ye> 9 :i* ! demon/ration program is conduct$1 a ,m$icaid ,buy-,9 ,/ate p>ticipat+ 9 ! demon/ration program dur+ t fiscal ye> may qualify = a p]=mance bonus paym5t4 7#b7 ,/ate-specifi$ crit]ia & p]=mance plans ,9 ord] to p>ticipate 9 ! demon/ration program1 a ,m$icaid ,buy-,9 ,/ate %all submit crit]ia & a plan = a*iev+ ea* ( ! m&atory b5*m>ks describ$ 9 p>agraph 7#c7 & a selection ( ! additional b5*m>ks describ$ 9 p>agraph 7#d7 z det]m9$ by ! ,secret>y4 ,! ,secret>y %all e/abli% a me?odology = assess+ ,/ate p]=mance ) respect to ! ,/ate-specifi$ crit]ia = ! m&atory & additional b5*m>ks4 7#c7 ,m&atory b5*m>ks ,! m&atory b5*m>ks describ$ 9 ?is p>agraph are ! foll[+3 7,a7 ,r$uc$ p>ticipation 9 segregat$ programs & increas$ p>ticipation 9 individual integrat$ employm5t 7i7 ,r$uc$ population c5sus ( segregat$ programs 7,i7 ,9 g5]al ,a*iev+ a r$uction 9 ! population 9 ! ,/ate ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices or :o are receiv+ s]vices ?r\gh an ,int]m$iate ,c>e ,facility = ,p]sons ) ,developm5tal ,disabilities 7,,icf-,,dd71 a nurs+ facility1 an in/itution = individuals ) m5tal illness1 or o!r congregate facilities & are 9 subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation or day treatm5t4 7,,ii7 ,m9imum p]c5t r$uctions2 bonus bas$ on a*ievem5t ( diff]+ ti]s ,9 ord] to receive a bonus paym5t = a fiscal ye> "u ?is clause1 a ,m$icaid ,buy-,9 ,/ate %all a*ieve a r$uction ( ! population describ$ 9 subclause 7,i7 ( at lea/ #aj p]c5t bel[ ! ,/ate's mo/ rec5t prior fiscal ye>'s c5sus ( ! eligible population 9 subm9imum wage "w1 congregate sett+ "w1 or facility bas$ day habilitation or day treatm5t4 ,subject to p>agraph 7#e77;,b71 ! ,secret>y %all aw>d an increas$ bonus paym5t = a fiscal ye> to a ,m$icaid ,buy-,9 ,/ate t a*ieves a p]c5tage r$uction ( #bj1 #cj1 #dj or m ) respect to ! prior fiscal ye>'s c5sus ( su* population4 7,,iii7 ,requirem5ts = meet+ b5*m>k ,a work+-age individual ) a disability %all be deem$ z c\nt+ t[>ds a p]c5tage r$uction = purposes ( ?is clause if ! individual is-- 7aa7 employ$ 9 a competitive1 integrat$ employm5t sett+ = at lea/ #aj h\rs a week on av]age ov] a #abj-;day p]iod dur+ ! ye> involv$2 7bb7 receiv+ integrat$ day s]vices t rea* ! level ( c>e requir$ 9 ! individual's p]son-c5t]$ plan2 or 7cc7 a comb9ation ( items 7aa7 & 7bb71 enabl+ ! individual to a*ieve1 if desir$1 a comp>able level ( b5efit z be=e ! *ange 9 placem5t4 ,! ,/ate mu/ report aggregate data to ! ,secret>y on ! outcome ( all individuals transition+ out ( congregate sett+s be+ c\nt$ t[>ds fulfillm5t ( ?is b5*m>k4 7ii7 ,increas$ population c5sus ( individual integrat$ employm5t 7,i7 ,9 g5]al ,a*iev+ an increase 9 ! population 9 ! ,/ate ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices & are 9 individual integrat$ employm5t4 7,,ii7 ,m9imum p]c5t increases2 bonus bas$ on a*ievem5t ( c]ta9 ti]s ,9 ord] to receive a bonus paym5t = a fiscal ye> "u ?is clause1 a ,m$icaid ,buy-,9 ,/ate %all a*ieve an increase 9 ! population describ$ 9 subclause 7,i7 ( at lea/ #aj p]c5t above ! ,/ate's mo/ rec5t prior fiscal ye>'s c5sus ( ! eligible population 9 individual integrat$ employm5t4 ,subject to p>agraph 7#e77;,b71 ! ,secret>y %all aw>d an increas$ bonus paym5t = a fiscal ye> to a ,m$icaid ,buy-,9 ,/ate t a*ieves a p]c5tage increase ( #bj1 #cj1 #dj or m ) respect to ! prior fiscal ye>'s c5sus ( su* population4 7,,iii7 ,requirem5ts = meet+ b5*m>k ,a work+-age individual ) a disability %all be deem$ z c\nt+ t[>ds a p]c5tage increase = purposes ( ?is clause if ! individual is employ$ 9 an integrat$ individual employm5t sett+ = at lea/ #aj h\rs a week on av]age ov] a #abj-;day p]iod dur+ ! fiscal ye> involv$4 7,b7 ,meet+ ! ,m$icaid buy-9 /&>ds ,meet+ ! m9imum /&>ds e/abli%$ by ! ,secret>y = ! ,m$icaid ,buy-,9 ,option4 7#d7 ,additional b5*m>ks ,! additional b5*m>ks describ$ 9 ?is p>agraph are ! foll[+3 7,a7 ,elim9ation ( new placem5t approvals ,elim9at+ new approvals = placem5t 9 ! ,/ate ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices 9 subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation or day treatm5t1 9 accordance ) crit]ia e/abli%$ by ! ,secret>y4 7,b7 ,demon/ration ( int]-ag5cy collaboration ,demon/rat+ int]-ag5cy collaboration betwe5 ! ,/ate ag5cies responsible = adm9i/]+ ,m$icaid1 vocational rehabilitation1 & education 7&1 if ! ,/ate is p>ticipat+ ! ,promot+ ,read9ess ( ,m9ors 9 ,supplem5tal ,security ,income initiative 7,,promise71 includ+ coord9ation ) t initiative71 9 det]m9+ pay] ( la/ resort rules & rules = provid+ individuals ) a seamless transition ( s]vices provid$ "u su* ag5cies1 9 accordance ) crit]ia e/abli%$ by ! ,secret>y4 7,c7 ,t]m9ation ( vocational rehabilitation fund+ ,end+ ! use ( vocational rehabilitation fund+ = subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation or day treatm5t1 9 accordance ) crit]ia e/abli%$ by ! ,secret>y4 7,d7 ,work=ce developm5t ,demon/rat+ 9 accordance ) crit]ia e/abli%$ by ! ,secret>y satisfaction ( at lea/ two ( ! foll[+ /rategies to promote work=ce developm5t3 7i7 ,increas+ ,m$icaid paym5ts = support$ employm5t provid]s = individuals ) disabilities by an am\nt necess>y to ensure an adequately support$ employm5t network1 z det]m9$ by ! ,secret>y4 7ii7 ,adopt+ employm5t /rategies t result 9 work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices be+ recruit$1 hir$1 & reta9$ z full-"t employees ( ,/ate gov]nm5t or by contractors ( ,/ate gov]nm5t4 7iii7 ,develop+ a ,/ate equival5t ( section #ejc ( ! ,rehabilitation ,act ( #aigc 7#bi ,u4,s4,c4 #gic7 to recruit1 hire1 promote1 & reta9 work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices ) a utilization goal ( at lea/ #g p]c5t ( ! ,/ate gov]nm5t work=ce4 7iv7 ,develop+ a special hir+ au?ority me*anism ak9 to ! ,s*$ule ,a appo9t+ au?ority "u section #bac4cajb7u7 ( title #e ( ! ,code ( ,f$]al ,regulations 7commonly ref]r$ to z ! ,s*$ule ,a ,hir+ ,au?ority7 to assi/ 9 eas+ ! hir+ ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices )9 ! ,/ate gov]nm5t ) an accompany+ plan submitt$ to ! ,secret>y outl9+ t>get$ implem5tation goals = ! am\nt ( individuals ) disabilities )9 ,/ate gov]nm5t4 7v7 ,increas+ ! hir+ ( work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices 9 employm5t = :i* ! individual is comp5sat$ at or above ! m9imum wage1 ?r\gh collaboration ) ! ,/ate vocational rehabilitation & work=ce developm5t programs & ,f$]al contractors4 7vi7 ,provid+ ,/ate tax cr$its to employ]s = hir+ new work]s :o are work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices4 7#e7 ,paym5t to /ates 7,a7 ,9 g5]al ,subject to ! succe$+ provisions ( ?is p>agraph1 ! ,secret>y %all make a p]=mance bonus paym5t to ea* ,m$icaid ,buy-,9 ,/ate p>ticipat+ 9 ! demon/ration program t qualifies = su* a paym5t ) respect to a fiscal ye> z a s+le paym5t n lat] ?an ! la/ day ( ! fir/ cal5d> qu>t] ( ! fiscal ye> foll[+ ! fiscal ye> to :i* ! p]=mance bonus paym5ts applies4 ,paym5ts to ,/ates made "u ?is p>agraph %all be consid]$ to h be5 made "u1 & are subject to ! requirem5ts (1 section #aijc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;b74 7,b7 ,det]m9ation ( paym5t ,! p]=mance bonus paym5t = a ,m$icaid ,buy-,9 ,/ate %all consi/ ( ! additional am\nt t ! ,/ate w\ld h be5 paid = provid+ m$ical assi/ance to individuals enroll$ 9 ! ,/ate's ,m$icaid ,buy-,9 ,option dur+ ! prec$+ fiscal ye> if ! regul> ,,fmap applicable to su* assi/ance 7 increas$ 7subject to subp>agraph 7,c77 z foll[s3 7i7 ,two p]c5tage po9ts = a*iev+ ! m9imum #aj p]c5t r$uction 9 ! m&atory b5*m>k describ$ 9 p>agraph 7#c77;,a7 dur+ ! prec$+ fiscal ye> 7or #b4d p]c5tage po9ts = a*iev+ a r$uction ( at lea/ #bj p]c5t 7b n m ?an #cj p]c5t71 #b4f p]c5tage po9ts = a*iev+ a r$uction ( at lea/ #cj p]c5t 7b n m ?an #dj p]c5t71 & #b4h p]c5tage po9ts = a*iev+ a r$uction ( at lea/ #dj p]c5t74 7ii7 ,two p]c5tage po9ts = a*iev+ ! m9imum #aj p]c5t increase 9 ! m&atory b5*m>k describ$ 9 p>agraph 7#c77;,b7 dur+ ! prec$+ fiscal ye> 7or #b4d p]c5tage po9ts = a*iev+ an increase ( at lea/ #bj p]c5t 7b n m ?an #cj p]c5t71 #b4f p]c5tage po9ts = a*iev+ an increase ( at lea/ #cj p]c5t 7b n m ?an #dj p]c5t71 & #b4h p]c5tage po9ts = a*iev+ an increase ( at lea/ #dj p]c5t74 7iii7 ,"o-half p]c5tage po9ts = ea* additional b5*m>k describ$ 9 p>agraph 7#d7 t ! ,/ate a*ieves dur+ ! prec$+ fiscal ye>4 7,c7 ,limitations ,9 no case may-- 7i7 ! increase 9 ! regul> ,,fmap result+ f ! application ( subp>agraph 7,b7 = any ,m$icaid ,buy-,9 ,/ate exce$ #ajj p]c5t ( ! co/s = provid+ m$ical assi/ance to individuals enroll$ 9 ! ,m$icaid ,buy-,9 ,option ) respect to ea* fiscal ye> ( ! #e-;fiscal-ye> p]iod 9 :i* ! demon/ration project is conduct$2 or 7ii7 paym5ts be made to a ,m$icaid ,buy-,9 ,/ate "u ?is p>agraph aft] ,decemb] #ca1 #bjba4 7,d7 ,use ( paym5ts ,a ,m$icaid ,buy-,9 ,/ate receiv+ a p]=mance bonus paym5t "u ?is p>agraph %all use ! paym5t only to exp& individual integrat$ employm5t & community integration = work+-age individuals ) disabilities :o are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices4 7g7 ,reports2 recomm5dations 7#a7 ,annual ,/ate reports 7,a7 ,9 g5]al ,ea* ,m$icaid ,buy-,9 ,/ate p>ticipat+ 9 ! demon/ration program annually %all submit a detail$ report to ! ,secret>y reg>d+ ! ,/ate's conduct ( ! demon/ration program4 7,b7 ,in=mation to be includ$ ,su* annual reports %all include1 9 addition to data & in=mation reg>d+ ,/ate p]=mance ) respect ! m&atory & additional b5*m>ks describ$ 9 p>agraphs 7#c7 & 7#d7 ( subsection 7f7 & su* o!r in=mation z ! ,secret>y may require1 data & in=mation reg>d+ ! ext5t to :i*1 s9ce ! />t ( ! demon/ration program-- 7i7 ! ,/ate has r$uc$ ! ,/ate population ( individuals ) disabilities :o h atta9$ age #ah b h n atta9$ age #ca1 are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices or s]vices ?r\gh an ,int]m$iate ,c>e ,facility = ,p]sons ) ,developm5tal ,disabilities 7,,icf-,,dd71 a nurs+ facility1 an in/itution = individuals ) m5tal illness1 or o!r congregate facilities1 & 7 9 subm9imum wage "w1 congregate sett+ "w1 or facility-bas$ day habilitation or day treatm5t2 & 7ii7 ! ,/ate has increas$ ! ,/ate population ( individuals ) disabilities :o h atta9$ age #ah b h n atta9$ age #ca1 are receiv+ ,m$icaid-fund$ home or community-bas$ s]vices1 & are engag$ 9 individual integrat$ employm5t4 7,c7 ,additional in=mation on transition+ individuals to integrat$ employm5t ,ea* su* annual report %all include in=mation reg>d+-- 7i7 ! ,/ate's ef=ts to transition individuals ) disabilities :o are p>ticipat+ 9 ! demon/ration program to individual integrat$ employm5t dur+ ! prec$+ fiscal ye>2 7ii7 ! full spectrum ( employm5t outcomes = su* individuals2 7iii7 be/ practices = successfully a*iev+ su* transitions2 & 7iv7 lessons le>n$4 7,d7 ,promot+ public p>ticipation ,to promote transp>5cy ) respect to su* annual reports1 ea* ,m$icaid ,buy-,9 ,/ate %all-- 7i7 provide1 be=e submission ( ea* su* report-- 7,i7 = po/+ ( a draft ( ! report = review by ! public on a publicly accessible ,web site ( ! ,/ate2 7,,ii7 = provid+ a p]iod ( n less ?an #cj days = ! receipt ( public comm5ts on ! draft report2 & 7,,iii7 = at lea/ two public he>+s reg>d+ ! draft report2 & 7ii7 include 9 ! report s submitt$ a response to public comm5ts receiv$ dur+ su* p]iod 7along ) a description ( :e!r *anges h be5 made 9 ! report 9 response to su* comm5ts74 ,) respect to ea* su* ,/ate report submitt$1 ! ,secret>y1 at ! ,f$]al level1 %all provide = ano!r #cj-;day public comm5t p]iod to receive comm5ts on su* report4 7,e7 ,po/+ ( reports on publicly accessible ,web site ,! ,secret>y %all po/ ea* ( ! annual reports submitt$ "u ?is p>agraph1 ) a summ>y ( ! comm5ts receiv$ "u subp>agraph 7,d71 on a publicly accessible ,web site4 7#b7 ,reports & recomm5dations to ,congress 7,a7 ,9 g5]al ,n lat] ?an ,janu>y #a1 #bjah1 & ,janu>y #a ( ea* ( ! #f ye>s !reaft]1 ! ,secret>y %all submit to ,congress a report on ! demon/ration program4 ,ea* su* report %all include data & in=mation reg>d+ ,/ate p]=mance ) respect to ea* ( ! m&atory & additional b5*m>ks describ$ 9 p>agraphs 7#c7 & 7#d7 ( subsection 7f7 & o!r data & in=mation report$ by ,/ates "u p>agraph 7#a7 & an assessm5t ( ! ext5t to :i* ! demon/ration program is successful 9 transition+ work+-age individuals ) disabilities to indep5d5t liv+ & "w 9 _! communities4 7,b7 ,recomm5dations ,n lat] ?an ,decemb] #ca1 #bjai1 ! ,secret>y %all submit to ,congress recomm5dations reg>d+ :e!r ! demon/ration program %\ld be cont9u$1 exp&$1 modifi$1 or t]m9at$4 7#c7 ,rese>* & evaluation 7,a7 ,9 g5]al ,! ,secret>y1 act+ ?r\gh ! ,adm9i/ration on ,community ,liv+1 directly or ?r\gh grant or contract1 %all provide = rese>* on1 & a national evaluation (1 ! demon/ration program1 includ+ assi/ance to ! ,secret>y 9 prep>+ ! f9al report requir$ "u subp>agraph 7,c74 7,b7 ,cont5ts ( evaluation ,su* national evaluation %all include an analysis ( ! *>act]i/ics & outcomes ( ! individuals p>ticipat+ 9 ! demon/ration program & ! be/ practices develop$ to a*ieve ! goals ( ! demon/ration program4 7,c7 ,f9al report ,n lat] ?an ,june #cj1 #bjbj1 ! ,secret>y %all submit to ! ,presid5t & ,congress a f9al report t reflects ! evaluation "u subp>agraph 7,a71 t provides f9d+s & conclusions on ! conduct & effectiv5ess ( demon/ration program1 & t includes a summ>y ( ! public comm5ts receiv$ "u p>agraph 7#a77;,d74 7h7 ,def9itions ,9 ?is section3 7#a7 ,congregate sett+ "w ,! t]m congregate sett+ "w means a nonpr(it1 =-pr(it1 or ,/ate ag5cy entity t employs a majority ( individuals ) disabilities & receives ,m$icaid or o!r ,/ate funds = ! purpose ( provid+ employm5t s]vices1 or a facility or sub-unit ( any su* ag5cy t meets su* crit]ia4 7#b7 ,demon/ration program ,! t]m demon/ration program means ! ,transition to ,indep5d5ce ,demon/ration ,program e/abli%$ "u ?is section4 7#c7 ,facility-bas$ day habilitation or day treatm5t ,! t]m facility-bas$ day habilitation or day treatm5t has ! mean+ e/abli%$ by ! ,secret>y = t t]m = purposes ( ! demon/ration program & %all include non-resid5tial day s]vices :i* take place pr$om9antly or 9 l>ge "p at a s+le site1 fix$ site1 or c5t]-bas$ program = individuals ) disabilities4 ,9 e/abli%+ ! mean+ ( su* t]m1 ! ,secret>y %all provide cle> in/ructions di/+ui%+ facility-bas$ day habilitation or day treatm5t f integrat$ day habilitation or day treatm5t programs tak+ place 9 sett+s )9 ! broad] community & :i* d n isolate individuals p>ticipat+ 9 su* integrat$ day habilitation or day treatm5t programs f ma9/ream life4 7#d7 ,individual integrat$ employm5t 7,a7 ,9 g5]al ,! t]m individual integrat$ employm5t means ! ongo+ supports to an individual :o1 because ( ! individual's disabilities1 ne$s int5sive on-go+ supports to obta9 & ma9ta9 an individual job 9 competitive or cu/omiz$ employm5t1 self-employm5t1 or 9 an integrat$ work+ sett+ 9 ! g5]al work=ce = :i* ! individual is comp5sat$ at or above ! m9imum wage1 b n less ?an ! cu/om>y wage & level ( b5efits paid by ! employ] = ! same or simil> "w p]=m$ by an individual )\t a disability4 7,b7 ,cu/omiz$ employm5t s]vices includ$ ,su* t]m includes cu/omiz$ employm5t s]vices 9 :i* an individual receives support to craft a job description ar\nd _! /r5g?s & *all5ges4 7,c7 ,exclusions ,su* t]m does n include segregat$ enclaves1 segregat$ mobile "w crews1 or o!r employm5t sc5>ios :]e an individual is plac$ solely bas$ on ! individual's disability4 ,9 ?is subp>agraph1 ! t]m segregat$ means1 ) respect to a sett+ or "w crew1 a sett+ or "w crew 9 :i* individuals ) disabilities are sep>at$ 79 place or 9 rates ( pay7 f individuals )\t disabilities4 7#e7 ,integrat$ day habilitation s]vices ,! t]m integrat$ day habilitation s]vices means s]vices t are provid$ outside ( disability specific programs or facilities1 9 a sett+ t supports ! full access ( individuals ) disabilities to ! great] community to ! same degree z individuals n receiv+ s]vices1 & consi/5t ) ! foll[+3 7,a7 ,ea* individual receiv+ su* s]vices has an individually tailor$ s*$ule t is directly relat$ to & reflects ! individual's specific int]e/s & goals4 7,b7 ,activities take place on an individual basis or 9 small gr\ps ( individuals :o *oose to be s]v$ toge!r4 7,c7 ,! majority ( "t sp5t receiv+ su* s]vices takes place )9 ! broad] community r ?an )9 a s+le-site1 fix$ site1 or c5t]-bas$ program = individuals ) disabilities1 reg>dless ( ! program size4 7,d7 ,! s]vices are provid$ consi/5t ) ! requirem5ts ( section #dda4gaj ( title #db1 ,code ( ,f$]al ,regulations4 7#f7 ,m$icaid ,! t]m ,m$icaid means ! program = m$ical assi/ance e/abli%$ "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#g7 ,m$icaid ,buy-,9 ,/ate ,! t]m ,m$icaid ,buy-,9 ,/ate means a ,/ate t1 "u subclause 7,,xiii71 7,,xv71 or 7,,xvi7 ( section #aijb7;a77#aj77;,a77ii7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77ii771 a waiv] approv$ "u section #aaae or #aiae ( su* ,act 7#db ,u4,s4,c4 #acae1 #acifn71 or o!r au?ority1 has a program "u :i* individuals ) disabilities ) e>n+s & assets t w\ld o!rwise make !m ineligible = m$ical assi/ance "u ! ,/ate's ,m$icaid program are able to ma9ta9 _! eligibility = su* assi/ance4 7#h7 ,nurs+ facility ,! t]m nurs+ facility has ! mean+ giv5 t t]m 9 section #aiai7;a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acifr7a774 7#i7 ,pov]ty l9e ,! t]m pov]ty l9e has ! mean+ giv5 t t]m 9 section #baaj7;c77#e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;jj7c77#e774 7#aj7 ,regul> ,,fmap ,! t]m regul> ,,fmap means ! ,f$]al m$ical assi/ance p]c5tage applicable to ! ,/ate 7z det]m9$ "u section #aije7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7b777 )\t reg>d to any increases 9 t p]c5tage applicable "u subsections 7y71 7z71 7aa71 or 7dd7 ( section #aije ( su* ,act or "u any o!r provision ( law4 7#aa7 ,secret>y ,! t]m ,secret>y means ! ,secret>y ( ,heal? & ,human ,s]vices4 7#ab7 ,subm9imum wage "w ,! t]m subm9imum wage "w means any sett+ 9 :i* individuals ) disabilities are paid less ?an m9imum wage "u a c]tificate issu$ 9 accordance ) section #ad7;c7 ( ! ,fair ,labor ,/&>ds ,act ( #aich 7#bi ,u4,s4,c4 #bad7;c774 7#ac7 ,support$ employm5t ,! t]m support$ employm5t has ! mean+ giv5 t t]m 9 section #g ( ! ,rehabilitation ,act ( #aigc 7#bi ,u4,s4,c4 #gje74 7#ad7 ,/ate ,! t]m ,/ate has ! mean+ giv5 su* t]m = purposes ( title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#ae7 ,title ii disability b5efici>y ,! t]m title ,,ii disability b5efici>y means an individual entitl$ to disability insurance b5efits "u section #bbc ( ! ,social ,security ,act 7#db ,u4,s4,c4 #dbc7 or to mon?ly insurance b5efits "u section #bjb ( su* ,act 7#db ,u4,s4,c4 #djb7 bas$ on su* individual's disability 7z def9$ 9 section #bbc7;d7 ( su* ,act 7#db ,u4,s4,c4 #dbc7;d7774 7#af7 ,title xvi disability b5efici>y ,! t]m title ,,xvi disability b5efici>y means an individual eligible = supplem5tal security income b5efits "u title ,,xvi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acha et seq47 on ! basis ( bl9dness 7)9 ! mean+ ( section #afad7;a77#b7 ( su* ,act 7#db ,u4,s4,c4 #achb;c7a77#b777 or disability 7)9 ! mean+ ( section #afad7;a77#c7 ( su* ,act 7#db ,u4,s4,c4 #achb;c7a77#c7774 7#ag7 ,work+-age individual ) a disability receiv+ ,m$icaid-fund$ home or community-bas$ s]vices ,! t]m work+-age individual ) a disability receiv+ ,m$icaid-fund$ home or community-bas$ s]vices means a title ,,ii disability b5efici>y or a title ,,xvi disability b5efici>y :o has atta9$ age #ah1 b has n atta9$ age #fe1 & is receiv+ home or community-bas$ s]vices-- 7,a7 "u a waiv] approv$ "u subsection 7c7 or 7d7 ( section #aiae ! ,social ,security ,act 7#db ,u4,s4,c4 #acifn72 7,b7 "u ! ,/ate ,m$icaid plan 9 accordance ) subsection 7i71 7j71 or 7k7 ( su* section2 or 7,c7 "u a ,m$icaid waiv] approv$ und] section #aaae ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae74