,,ii  #aaith ,,congress  #b;d ,session  
,s4 #ddgi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,april #cj1    
#bjbf,mr4 ,marshall introduced the      
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to provide assisted living  
assistance through ,medicaid and the    
low-income housing tax credit4  #a4     
,short title ,this ,act may be cited as 
the ,assisted ,living ,affordability1   
,choice1 ,community1 ,empowerment1      
,savings1 and ,support ,act or the      
,,access ,act4  #b4 ,coverage of        
services in an assisted living residence
 under ,medicaid  7a7 ,definition of    
medical assistance ,section #aije7;a7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acif;d7a77 is amended-- 7#a7 
in paragraph 7#ca71 by striking and     
after the semicolon2  7#b7 by           
redesignating paragraph 7#cb7 as        
paragraph 7#cc72 and  7#c7 by inserting 
after paragraph 7#ca71 the following new
 paragraph3  7#cb7 services provided in 

an assisted living residence consistent 
with ,state law permitting such         
services1 including to individuals who  
would require the level of care provided
 in a hospital or nursing facility1 the 
cost of which could be reimbursed under 
the ,state plan 7or a waiver of such    
plan71 and who meet the ,state's income 
and resources requirements adopted under
 section #aijb7;a77#aj77;,a77i77,v7 and 
for whom the estimated annual average   
per capita total ,medicaid cost for all 
services for individuals receiving      
services in an assisted living residence
 would be no greater than the estimated 
annual average per capita total         
,medicaid cost for all services that    
would have been incurred had those      
individuals received services in a      
hospital or nursing facility2 and  4    
7b7 ,mandatory benefit ,section         
#aijb7;a77#aj77;,a7 of such ,act 7#db   
,u4,s4,c4 #acif;a7a77#aj77;,a77 is      
amended in the matter preceding clause  
7i71 by striking and 7#cj7 and inserting

 7#cj71 and 7#cb74  7c7 ,effective date 
7#a7 ,in general ,except as provided in 
paragraph 7#b71 the amendments made by  
this section shall take effect on       
,january #a1 #bjbg4  7#b7 ,delay        
permitted if state legislation required 
,in the case of a ,state plan approved  
under title ,,xix of the ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq47 which the ,secretary of ,health   
and ,human ,services determines requires
 ,state legislation 7other than         
legislation appropriating funds7 in     
order for the plan to meet the          
additional requirements imposed by the  
amendments made by this section1 the    
,state plan shall not be regarded as    
failing to comply with the requirements 
of such title ,,xix solely on the basis 
of the failure of the plan to meet such 
additional requirements before the first
 day of the first calendar quarter      
beginning after the close of the first  
regular session of the ,state           
legislature that ends after the #a-year 

period beginning with the date of the   
enactment of this section4 ,for purposes
 of the preceding sentence1 in the case 
of a ,state that has a #b-year          
legislative session1 each year of the   
session is deemed to be a separate      
regular session of the ,state           
legislature4  #c4 ,selection criteria   
for qualified allocation plan under the 
low-income housing tax credit  7a7 ,in  
general ,subparagraph 7,c7 of section   
#db7m77#a7 of the ,internal ,revenue    
,code of #aihf is amended by striking   
and at the end of clause 7ix71 by       
striking the period at the end of clause
 7x7 and inserting 1 and1 and by adding 
at the end the following new clause3    
7xi7 projects which reduce the medical  
assistance costs of long-term services  
and supports for the elderly by         
providing such services and supports in 
a non-institutional setting4  4  7b7    
,effective date ,the amendments made by 
this section shall apply to allocations 
made after ,january #a1 #bjbg4