HOME AND COMMUNITY BASED CARE DEMONSTRATION PROJECT.

SEC. 809. HOME AND COMMUNITY BASED CARE DEMONSTRATION PROJECT.Title VIII of the Act (as redesignated by subsections (a) and (b) of section 701 of this Act) is amended by adding at the end the following new section: “home- and community-based care demonstration project “Sec. 821. (a) The Secretary, acting through the Service, is authorized to enter into contracts with, or make grants to, Indian tribes or tribal organizations providing health care services pursuant to a contract entered into under the Indian Self-Determination Act, to establish demonstration projects for the delivery of home-and community-based services to functionally disabled Indians. “(b) (1) Funds provided for a demonstration project under this section shall be used only for the delivery of home- and community-based services (including transportation services) to functionally disabled Indians. “(2) Such funds may not be used— “(A) to make cash payments to functionally disabled Indians; “(B) to provide room and board for functionally disabled Indians; “(C) for the construction or renovation of facilities or the purchase of medical equipment; or “(D) for the provision of nursing facility services. “(c) Not later than 180 days after the date of the enactment of this section, the Secretary, after consultation with Indian tribes and tribal organizations, shall develop and issue criteria for the approval of applications submitted under this section. Such criteria shall ensure that demonstration projects established under this section promote the development of the capacity of tribes and tribal organizations to deliver, or arrange for the delivery of, high quality, culturally appropriate home- and community-based services to functionally disabled Indians; “(d) The Secretary shall provide such technical and other assistance as may be necessary to enable applicants to comply with the provisions of this section. “(e) At the discretion of the tribe or tribal organization, services provided under a demonstration project established under this section may be provided (on a cost basis) to persons otherwise ineligible for the health care benefits of the Service. 106 STAT. 4588 “(f) The Secretary shall establish not more than 24 demonstration projects under this section. The Secretary may not establish a greater number of demonstration projects under this section in one service area than in any other service area until there is an equal number of such demonstration projects established with respect to all service areas from which the Secretary receives applications during the application period (as determined by the Secretary) which meet the criteria issued pursuant to subsection (c). “(g) The Secretary shall submit to the President, for inclusion in the report which is required to be submitted under section 801 for fiscal year 1999, a report on the findings and conclusions derived from the demonstration projects conducted under this section, together with legislative recommendations. “(h) For the purposes of this section, the following definitions shall apply: “(1) The term ‘home- and community-based services’ means one or more of the following: “(A) Homemaker/home health aide services. “(B) Chore services. “(C) Personal care services. “(D) Nursing care services provided outside of a nursing facility by, or under the supervision of, a registered nurse. “(E) Respite care. “(F) Training for family members in managing a functionally disabled individual. “(G) Adult day care. “(H) Such other home- and community-based services as the Secretary may approve. “(2) The term ‘functionally disabled’ means an individual who is determined to require home- and community-based services based on an assessment that uses criteria (including, at the discretion of the tribe or tribal organization, activities of daily living) developed by the tribe or tribal organization. “(i) There are authorized to be appropriated for each of the fiscal years 1993, 1994, 1995, 1996, and 1997 such sums as may be necessary to carry out this section. Such sums shall remain available until expended.”.