I 
111TH CONGRESS 
1ST SESSION H. R. 2852 
To amend the Social Security Act to build on the aging network to establish 
long-term services and supports through single-entry point systems, evi-
dence-based disease prevention and health promotion programs, and en-
hanced nursing home diversion programs. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 12, 2009 
Mr. BRALEY of Iowa (for himself and Mr. SARBANES) introduced the following 
bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Social Security Act to build on the aging 
network to establish long-term services and supports 
through single-entry point systems, evidence-based dis-
ease prevention and health promotion programs, and en-
hanced nursing home diversion programs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Project 2020: Building 
on the Promise of Home and Community-Based Services 
Act of 2009’’. 
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SEC. 2. LONG-TERM SERVICES AND SUPPORTS. 
The Social Security Act (42 U.S.C. 301 et seq.) is 
amended by adding at the end the following: 
‘‘TITLE XXII—LONG-TERM 
SERVICES AND SUPPORTS 
‘‘SEC. 2201. DEFINITIONS. 
‘‘Except as otherwise provided, the terms used in this 
title have the meanings given the terms in section 102 of 
the Older Americans Act of 1965 (42 U.S.C. 3002). 
‘‘Subtitle A—Single-Entry Point 
System Program 
‘‘SEC. 2211. STATE SINGLE-ENTRY POINT SYSTEMS. 
‘‘(a) DEFINITIONS.—In this title: 
‘‘(1) LONG-TERM SERVICES AND SUPPORTS.— 
The term ‘long-term services and supports’ means 
any service (including a disease prevention and 
health promotion service, an in-home service, or a 
case management service), care, or item (including 
an assistive device) that is— 
‘‘(A) intended to assist individuals in cop-
ing with, and, to the extent practicable, com-
pensating for, functional impairment in car-
rying out activities of daily living; 
‘‘(B) furnished at home, in a community 
care setting, including a small community care 
setting (as defined in section 1929(g)(1)) and a 
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large community care setting (as defined in sec-
tion 1929(h)(1)), or in a long-term care facility; 
and 
‘‘(C) not furnished to diagnose, treat, or 
cure a medical disease or condition. 
‘‘(2) SINGLE-ENTRY POINT SYSTEM.—The term 
‘single-entry point system’ means any coordinated 
system for providing— 
‘‘(A) comprehensive information to con-
sumers and caregivers on the full range of 
available public and private long-term services 
and supports, options, service providers, and re-
sources, including information on the avail-
ability of integrated long-term care, including 
consumer directed care options; 
‘‘(B) personal counseling to assist individ-
uals in assessing their existing or anticipated 
long-term care needs, and developing and imple-
menting a plan for long-term care designed to 
meet their specific needs and circumstances; 
and 
‘‘(C) consumers and caregivers access to 
the range of publicly supported and privately 
supported long-term services and supports that 
are available. 
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‘‘(b) PROGRAM.—The Secretary shall establish and 
carry out a single-entry point system program. In carrying 
out the program, the Secretary shall make grants to 
States, from allotments described in subsection (c), to pay 
for the Federal share of the cost of establishing State sin-
gle-entry point systems. 
‘‘(c) ALLOTMENTS.— 
‘‘(1) ALLOTMENTS
TO
INDIAN
TRIBES
AND 
TERRITORIES.— 
‘‘(A) RESERVATION.—The Secretary shall 
reserve from the funds made available under 
subsection (g)— 
‘‘(i) for fiscal year 2010, $1,962,456; 
and 
‘‘(ii) for each subsequent fiscal year, 
$1,962,456, increased by the percentage 
increase in the Consumer Price Index for 
All Urban Consumers, between October of 
the fiscal year preceding the subsequent 
fiscal year and October 2007. 
‘‘(B) ALLOTMENTS.—The Secretary shall 
use the funds reserved under subparagraph (A) 
to make allotments to— 
‘‘(i) Indian tribes; and 
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‘‘(ii) Guam, American Samoa, the 
Commonwealth of the Northern Mariana 
Islands, the Commonwealth of Puerto 
Rico, and the United States Virgin Islands. 
‘‘(2) ALLOTMENTS TO STATES.— 
‘‘(A) IN GENERAL.— 
‘‘(i) AMOUNT.—The Secretary shall 
allot to each eligible State for a fiscal year 
the sum of the fixed amount determined 
under subparagraph (B), and the alloca-
tion determined under subparagraph (C), 
for the State. 
‘‘(ii) SUBGRANTS TO AREA AGENCIES 
ON AGING.— 
‘‘(I) IN
GENERAL.—Each State 
agency receiving an allotment under 
clause (i) shall use such allotment to 
make subgrants to area agencies on 
aging that can demonstrate perform-
ance capacity to carry out activities 
described in this section whether such 
area agency on aging carries out the 
activities directly or through contract 
with an aging network or disability 
entity. An area agency on aging desir-
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ing a subgrant shall establish or des-
ignate a collaborative board to ensure 
meaningful 
involvement 
of 
stake-
holders in the development, planning, 
implementation, and evaluation of a 
single-entry point system consistent 
with the following: 
‘‘(aa) 
The 
collaborative 
board shall be composed of— 
‘‘(AA) individuals rep-
resenting 
all 
populations 
served by the agency’s sin-
gle-entry point system, in-
cluding older adults and in-
dividuals from diverse back-
grounds who have a dis-
ability or a chronic condition 
requiring long-term support; 
‘‘(BB) a representative 
from the local center for 
independent living (as de-
fined in section 702 of the 
Rehabilitation Act of 1973 
(29 U.S.C. 796a)), and rep-
resentatives from other or-
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ganizations 
that 
provide 
services to the individuals 
served by the system and 
those who advocate on be-
half of such individuals; and 
‘‘(CC) 
representatives 
of the government and non- 
governmental agencies that 
are affected by the system. 
‘‘(bb) The agency shall work 
in conjunction with the collabo-
rative board on— 
‘‘(AA) the design and 
operations of the single- 
entry point system; 
‘‘(BB) 
stakeholder 
input; and 
‘‘(CC) other program 
and 
policy 
development 
issues related to the single- 
entry point system. 
‘‘(cc) An advisory board es-
tablished under the Real Choice 
Systems Change Program or for 
an existing single-entry point sys-
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tem may be used to carry out the 
activities of a collaborative board 
under this subclause if such advi-
sory board meets the require-
ments under item (aa). 
‘‘(II) SUBGRANTS TO OTHER EN-
TITIES.—A State agency may make 
subgrants described in subclause (I) 
to other qualified aging network or 
disability entities only if the area 
agency on aging chooses not to apply 
for a subgrant or is not able to dem-
onstrate 
performance 
capacity 
to 
carry out the activities described in 
this section. 
‘‘(III) SUBGRANTEE
RECIPIENT 
SUBGRANTS.—An administrator of a 
single-entry point system established 
by a State receiving an allotment 
under clause (i) shall make any nec-
essary subgrants to key partners in-
volved in developing, planning, or im-
plementing the single-entry point sys-
tem. Such partners may include cen-
ters for independent living (as defined 
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in section 702 of the Rehabilitation 
Act of 1973 (29 U.S.C. 796a)). 
‘‘(B) FIXED AMOUNTS FOR STATES.— 
‘‘(i) RESERVATION.—The Secretary 
shall reserve from the funds made available 
under subsection (g)— 
‘‘(I) 
for 
fiscal 
year 
2010, 
$15,759,000; and 
‘‘(II) for each subsequent fiscal 
year, $15,759,000, increased by the 
percentage increase in the Consumer 
Price Index for All Urban Consumers, 
between October of the fiscal year 
preceding the subsequent fiscal year 
and October 2007. 
‘‘(ii) FIXED
AMOUNTS.—The Sec-
retary shall use the funds reserved under 
clause (i) to provide equal fixed amounts to 
the States. 
‘‘(C) ALLOCATION FOR STATES.—The Sec-
retary shall allocate to each eligible State for a 
fiscal year an amount that bears the same rela-
tionship to the funds made available under sub-
section (g) (and not reserved under paragraph 
(1) or subparagraph (B)) for that fiscal year as 
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the number of persons who are either older in-
dividuals or individuals with disabilities in that 
State bears to the number of such persons or 
individuals in all the States. 
‘‘(D) DETERMINATION
OF
NUMBER
OF 
PERSONS.— 
‘‘(i) OLDER INDIVIDUALS.—The num-
ber of older individuals in any State and in 
all States shall be determined by the Sec-
retary on the basis of the most recent data 
available from the Bureau of the Census, 
and other reliable demographic data satis-
factory to the Secretary. 
‘‘(ii) INDIVIDUALS
WITH
DISABIL-
ITIES.—The number of individuals with 
disabilities in any State and in all States 
shall be determined by the Secretary on 
the basis of the most recent data available 
from the American Community Survey, 
and other reliable demographic data satis-
factory to the Secretary, on individuals 
who have a sensory disability, physical dis-
ability, mental disability, self-care dis-
ability, go-outside-home disability, or em-
ployment disability. 
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‘‘(3) ELIGIBILITY.—In addition to the States 
determined by the Secretary to be eligible for a 
grant under this section, a State that receives a 
Federal grant for an aging and disability resource 
center is eligible for a grant under this section. 
‘‘(4) DEFINITION.—In this subsection, the term 
‘State’ shall not include any jurisdiction described in 
paragraph (1)(B)(ii). 
‘‘(d) APPLICATIONS.— 
‘‘(1) IN GENERAL.—To be eligible to receive an 
initial grant under this section, a State agency shall, 
after consulting and coordinating with consumers, 
other stakeholders, centers for independent living in 
the State, if any, and area agencies on aging in the 
State, if any, submit an application to the Secretary 
at such time, in such manner, and containing the 
following information: 
‘‘(A) Evidence of substantial involvement 
of stakeholders and agencies in the State that 
are administering programs that will be the 
subject of referrals. 
‘‘(B) The applicant’s plan for providing— 
‘‘(i) comprehensive information on the 
full range of available public and private 
long-term services and supports options, 
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providers, and resources, including building 
awareness of the single-entry point system 
as a resource; 
‘‘(ii) objective, neutral, and personal 
information, counseling, and assistance to 
individuals and their caregivers in assess-
ing their existing or anticipated long-term 
care needs, and developing and imple-
menting a plan for long-term care to meet 
their needs; 
‘‘(iii) for eligibility screening and re-
ferral for services; 
‘‘(iv) for stakeholder input; 
‘‘(v) for a management information 
system; and 
‘‘(vi) for an evaluation of the effective-
ness of the single-entry point system. 
‘‘(C) A specification of the period of the 
grant request, which shall include not less than 
3 consecutive fiscal years in the 5-fiscal-year- 
period beginning with fiscal year 2010. 
‘‘(D) Such other information as the Sec-
retary determines appropriate. 
‘‘(2) APPLICATION FOR CONTINUATION.— 
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‘‘(A) IN GENERAL.—A State that receives 
an initial grant under this section shall apply, 
after consulting and coordinating with the area 
agencies on aging, for a continuation of the ini-
tial grant, which includes a description of any 
significant changes to the information provided 
in the initial application and such data con-
cerning performance measures related to the re-
quirements in the initial application as the Sec-
retary shall require. 
‘‘(B) EFFECT.—The requirement under 
subparagraph (A) shall be in effect through fis-
cal year 2020. 
‘‘(e) USE OF FUNDS.— 
‘‘(1) IN
GENERAL.—A State that receives a 
grant under this section shall use the funds made 
available through the grant to— 
‘‘(A) establish a State single-entry point 
system, to enable older individuals and individ-
uals with disabilities and their caregivers to ob-
tain resources concerning long-term services 
and supports options; and 
‘‘(B) provide information on, access to, 
and assistance regarding long-term services and 
supports. 
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‘‘(2) SERVICES.—In particular, the State sin-
gle-entry point system shall be the referral source 
to— 
‘‘(A) provide information about long-term 
care planning and available long-term services 
and supports through a variety of media (such 
as websites, seminars, and pamphlets); 
‘‘(B) provide assistance with making deci-
sions about long-term services and supports and 
determining the most appropriate services 
through options counseling, future financial 
planning, and case management; 
‘‘(C) provide streamlined access to and as-
sistance with applying for federally funded long- 
term care benefits (including medical assistance 
under title XIX, Medicare skilled nursing facil-
ity services, services under title III of the Older 
Americans Act of 1965 (42 U.S.C. 3021 et 
seq.), the services of Aging and Disability Re-
source Centers), and State-funded and privately 
funded long-term care benefits, through efforts 
to shorten and simplify the eligibility processes 
for older individuals and individuals with dis-
abilities; 
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‘‘(D) provide referrals to the State evi-
dence-based disease prevention and health pro-
motion programs under subtitle B; 
‘‘(E) allocate the State funds available 
under subtitle C and carry out the State en-
hanced nursing home diversion program under 
subtitle C; and 
‘‘(F) and provide information about, other 
services available in the State that may assist 
an individual to remain in the community, in-
cluding the Medicare and Medicaid programs, 
the State health insurance assistance program, 
the supplemental nutrition assistance program 
established under the Food and Nutrition Act 
of 2008 (7 U.S.C. 2011 et seq.), and the Low- 
Income Home Energy Assistance Program 
under the Low-Income Home Energy Assist-
ance Act of 1981 (42 U.S.C. 8621 et seq.), and 
such other services, as the State shall include. 
‘‘(3) COLLABORATIVE ARRANGEMENTS.— 
‘‘(A) CENTER
FOR
INDEPENDENT
LIV-
ING.—Each entity receiving an allotment under 
subsection (c) shall involve in the planning and 
implementation of the single-entry point system 
the local center for independent living (as de-
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fined in section 702 of the Rehabilitation Act of 
1973 (29 U.S.C. 796a)), which provides infor-
mation, referral, assistance, or services to indi-
viduals with disabilities. 
‘‘(B) OTHER
ENTITIES.—To the extent 
practicable, the State single-entry point system 
shall enter into collaborative arrangements with 
aging and disability programs, service pro-
viders, agencies, the direct care work force, and 
other entities in order to ensure that informa-
tion about such services may be made available 
to individuals accessing the State single-entry 
point system. 
‘‘(f) FEDERAL SHARE.— 
‘‘(1) IN GENERAL.—The Federal share of the 
cost described in subsection (b) shall be 75 percent. 
‘‘(2) NON-FEDERAL
SHARE.—The State may 
provide the non-Federal share of the cost in cash or 
in-kind, fairly evaluated, including plant, equipment, 
or services. The State may provide the non-Federal 
share from State, local, or private sources. 
‘‘(g) FUNDING.— 
‘‘(1) IN
GENERAL.—The Secretary shall use 
amounts made available under paragraph (2) to 
make the grants described in subsection (b). 
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‘‘(2) FUNDING.—There are authorized to be ap-
propriated to carry out this section— 
‘‘(A) $30,900,000 for fiscal year 2010; 
‘‘(B) $38,264,000 for fiscal year 2011; 
‘‘(C) $48,410,000 for fiscal year 2012; 
‘‘(D) $53,560,000 for fiscal year 2013; 
‘‘(E) $63,860,000 for fiscal year 2014; 
‘‘(F) $69,010,000 for fiscal year 2015; 
‘‘(G) $74,160,000 for fiscal year 2016; 
‘‘(H) $79,310,000 for fiscal year 2017; 
‘‘(I) $84,460,000 for fiscal year 2018; 
‘‘(J) $89,610,000 for fiscal year 2019; and 
‘‘(K) $95,790,000 for fiscal year 2020. 
‘‘(3) 
AVAILABILITY.—Funds 
appropriated 
under paragraph (2) shall remain available until ex-
pended. 
‘‘Subtitle B—Healthy Living 
Program 
‘‘SEC. 2221. EVIDENCE-BASED DISEASE PREVENTION AND 
HEALTH PROMOTION PROGRAMS. 
‘‘(a) PROGRAM.—The Secretary shall establish and 
carry out a healthy living program. In carrying out the 
program, the Secretary shall make grants to State agen-
cies, from allotments described in subsection (b), to pay 
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for the Federal share of the cost of carrying out evidence- 
based disease prevention and health promotion programs. 
‘‘(b) ALLOTMENTS.— 
‘‘(1) ALLOTMENTS
TO
INDIAN
TRIBES
AND 
TERRITORIES.— 
‘‘(A) RESERVATION.—The Secretary shall 
reserve from the funds made available under 
subsection (g)— 
‘‘(i) for fiscal year 2010, $1,500,952; 
and 
‘‘(ii) for each subsequent fiscal year, 
$1,500,952, increased by the percentage 
increase in the Consumer Price Index for 
All Urban Consumers, between October of 
the fiscal year preceding the subsequent 
fiscal year and October 2007. 
‘‘(B) ALLOTMENTS.—The Secretary shall 
use the reserved funds under subparagraph (A) 
to make allotments to— 
‘‘(i) Indian tribes; and 
‘‘(ii) Guam, American Samoa, the 
Commonwealth of the Northern Mariana 
Islands, the Commonwealth of Puerto 
Rico, and the United States Virgin Islands. 
‘‘(2) IN GENERAL.— 
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‘‘(A) AMOUNTS.— 
‘‘(i) IN
GENERAL.—Except as pro-
vided in paragraph (3), the Secretary shall 
allot to each eligible State for a fiscal year 
an amount that bears the same relation-
ship to the funds made available under this 
section and not reserved under paragraph 
(1) for that fiscal year as the number of 
older individuals in the State bears to the 
number of older individuals in all the 
States. 
‘‘(ii) 
OLDER
INDIVIDUALS.—The 
number of older individuals in any State 
and in all States shall be determined by 
the Secretary on the basis of the most re-
cent data available from the Bureau of the 
Census, and other reliable demographic 
data satisfactory to the Secretary. 
‘‘(B) SUBGRANTS.— 
‘‘(i) IN GENERAL.—Each State agency 
that receives an amount under subpara-
graph (A) shall award subgrants to area 
agencies on aging that can demonstrate 
performance capacity to carry out activities 
under this section whether such area agen-
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cy on aging carries out the activities di-
rectly or through contract with an aging 
network entity. 
‘‘(ii) SUBGRANTS
TO
OTHER
ENTI-
TIES.—A State agency may make sub-
grants described in clause (i) to other 
qualified aging network entities only if the 
area agency on aging chooses not to apply 
for a subgrant or is not able to dem-
onstrate performance capacity to carry out 
the activities described in this section. 
‘‘(3) MINIMUM
ALLOTMENT.—No State shall 
receive an allotment under this section for a fiscal 
year that is less than 0.5 percent of the funds made 
available to carry out this section for that fiscal year 
and not reserved under paragraph (1). 
‘‘(4) ELIGIBILITY.—In addition to the States 
determined by the Secretary to be eligible for a 
grant under this section, a State that receives a 
Federal grant for evidence-based disease prevention 
is eligible for a grant under this section. 
‘‘(c) APPLICATIONS.—To be eligible to receive a grant 
under this section, a State agency shall, after consulting 
and coordinating with consumers, other stakeholders, and 
area agencies on aging in the State, if any, submit an ap-
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plication to the Secretary at such time, in such manner, 
and containing the following information: 
‘‘(1) A description of the evidence-based disease 
prevention and health promotion program. 
‘‘(2) Sufficient information to demonstrate that 
the infrastructure exists to support the program. 
‘‘(3) A specification of the period of the grant 
request, which shall include not less than 3 consecu-
tive fiscal years in the 5 fiscal year period beginning 
with fiscal year 2010. 
‘‘(4) Such other information as the Secretary 
determines appropriate. 
‘‘(d) APPLICATION FOR CONTINUATION.— 
‘‘(1) IN GENERAL.—A State that receives an 
initial grant under this section shall apply, after con-
sulting and coordinating with the area agencies on 
aging, for a continuation of the initial grant, which 
application shall include— 
‘‘(A) a description of any significant 
changes to the information provided in the ini-
tial application; and 
‘‘(B) such data concerning performance 
measures related to the requirements in the ini-
tial application as the Secretary shall require. 
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‘‘(2) EFFECT.—The requirement under para-
graph (1) shall be in effect through fiscal year 2020. 
‘‘(e) USE OF FUNDS.—A State that receives a grant 
under this section shall use the funds made available 
through the grant to carry out— 
‘‘(1) an evidence-based chronic disease self- 
management program; 
‘‘(2) an evidence-based falls prevention pro-
gram; or 
‘‘(3) another evidence-based disease prevention 
and health promotion program. 
‘‘(f) FEDERAL SHARE.— 
‘‘(1) IN GENERAL.—The Federal share of the 
cost described in subsection (a) shall be 85 percent. 
‘‘(2) NON-FEDERAL
SHARE.—The State may 
provide the non-Federal share of the cost in cash or 
in-kind, fairly evaluated, including plant, equipment, 
or services. The State may provide the non-Federal 
share from State, local, or private sources. 
‘‘(g) FUNDING.— 
‘‘(1) IN
GENERAL.—The Secretary shall use 
amounts made available under paragraph (2) to 
make the grants described in subsection (a). 
‘‘(2) FUNDING.—There are authorized to be ap-
propriated to carry out this section— 
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‘‘(A) $36,050,000 for fiscal year 2010; 
‘‘(B) $41,200,000 for fiscal year 2011; 
‘‘(C) $56,650,000 for fiscal year 2012; 
‘‘(D) $77,250,000 for fiscal year 2013; 
‘‘(E) $92,700,000 for fiscal year 2014; 
‘‘(F) $103,000,000 for fiscal year 2015; 
‘‘(G) $118,450,000 for fiscal year 2016; 
‘‘(H) $133,900,000 for fiscal year 2017; 
‘‘(I) $149,350,000 for fiscal year 2018; 
‘‘(J) $157,590,000 for fiscal year 2019; 
and 
‘‘(K) $173,040,000 for fiscal year 2020. 
‘‘(3) 
AVAILABILITY.—Funds 
appropriated 
under paragraph (2) shall remain available until ex-
pended. 
‘‘Subtitle C—Diversion Programs 
‘‘SEC. 2231. ENHANCED NURSING HOME DIVERSION PRO-
GRAMS. 
‘‘(a) DEFINITION.—In this section: 
‘‘(1) LOW-INCOME SENIOR.—The term ‘low-in-
come senior’ means an individual who— 
‘‘(A) is age 75 or older; and 
‘‘(B) is from a household with a household 
income that is not less than 150 percent, and 
not more than 300 percent, of the poverty line. 
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‘‘(2) NURSING
HOME.—The term ‘nursing 
home’ means— 
‘‘(A) a skilled nursing facility, as defined 
in section 1819(a); or 
‘‘(B) a nursing facility, as defined in sec-
tion 1919(a). 
‘‘(b) PROGRAM.— 
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish and carry out a diversion program. In carrying 
out the program, the Secretary shall make grants to 
States, from allotments described in subsection (c), 
to pay for the Federal share of the cost of carrying 
out enhanced nursing home diversion programs. 
‘‘(2) COHORTS.—The Secretary shall make the 
grants to— 
‘‘(A) a first year cohort consisting of one- 
third of the States, for fiscal year 2010; 
‘‘(B) a second year cohort consisting of the 
cohort described in subparagraph (A) and an 
additional one-third of the States, for fiscal 
year 2011; and 
‘‘(C) a third year cohort consisting of all 
the eligible States, for fiscal year 2012 and 
each subsequent fiscal year. 
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‘‘(3) READINESS.—In determining whether to 
include an eligible State in the first year, second 
year, or third year and subsequent year cohort, the 
Secretary shall consider the readiness of the State to 
carry out an enhanced nursing home diversion pro-
gram under this section. Readiness shall be deter-
mined based on a consideration of the following fac-
tors: 
‘‘(A) Availability of a comprehensive array 
of home and community-based services. 
‘‘(B) Sufficient home and community- 
based services provider capacity. 
‘‘(C) Availability of housing. 
‘‘(D) Availability of supports for consumer- 
directed services, including whether a fiscal 
intermediary is in place. 
‘‘(E) Ability to perform timely eligibility 
determinations and assessment for services. 
‘‘(F) Existence of a quality assessment and 
improvement program for home and commu-
nity-based services. 
‘‘(G) Such other factors as the Secretary 
determines appropriate. 
‘‘(c) ALLOTMENTS.— 
‘‘(1) IN GENERAL.— 
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‘‘(A) AMOUNT.—The Secretary shall allot 
to an eligible State (within the applicable co-
hort) for a fiscal year an amount that bears the 
same relationship to the funds made available 
under subsection (i) for that fiscal year as the 
number of low-income seniors in the State bears 
to the number of low-income seniors within 
States in the applicable cohort for that fiscal 
year. 
‘‘(B) LOW-INCOME SENIORS.—The number 
of low-income seniors in any State and in all 
States shall be determined by the Secretary on 
the basis of the most recent data available from 
the American Community Survey, and other re-
liable demographic data satisfactory to the Sec-
retary. 
‘‘(2) ELIGIBILITY.—In addition to the States 
determined by the Secretary to be eligible for a 
grant under this section, a State that receives a 
Federal grant for a nursing home diversion is eligi-
ble for a grant under this section. 
‘‘(d) APPLICATIONS.—To be eligible to receive a 
grant under this section, a State agency shall, after con-
sulting and coordinating with consumers, other stake-
holders, and area agencies on aging in the State, if any, 
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submit an application to the Secretary at such time, in 
such manner, and containing such information as the Sec-
retary may require, including a specification of the period 
of the grant request, which shall include not less than 3 
consecutive fiscal years in the 5 fiscal year period begin-
ning with the fiscal year prior to the year of application. 
‘‘(e) APPLICATION FOR CONTINUATION.— 
‘‘(1) IN GENERAL.—A State that receives an 
initial grant under this section shall apply, after con-
sulting and coordinating with the area agencies on 
aging, for a continuation of the initial grant, which 
application shall include— 
‘‘(A) a description of any significant 
changes to the information provided in the ini-
tial application; and 
‘‘(B) such data concerning performance 
measures related to the requirements in the ini-
tial application as the Secretary shall require. 
‘‘(2) EFFECT.—The requirement under para-
graph (1) shall be in effect through fiscal year 2020. 
‘‘(f) USE OF FUNDS.— 
‘‘(1) IN
GENERAL.—A State that receives a 
grant under this section shall carry out the fol-
lowing: 
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‘‘(A) Use the funds made available through 
the grant to carry out an enhanced nursing 
home diversion program that enables eligible in-
dividuals to avoid admission into nursing homes 
by enabling the individuals to obtain alternative 
long-term services and supports and remain in 
their communities. 
‘‘(B) Award subgrants to area agencies on 
aging that can demonstrate performance capac-
ity to carry out activities under this section 
whether such area agency on aging carries out 
the activities directly or through contract with 
an aging network entity. A State may make 
subgrants to other qualified aging network enti-
ties only if the area agency on aging chooses 
not to apply for a subgrant or is not able to 
demonstrate performance capacity to carry out 
the activities described in this section. 
‘‘(2) CASE MANAGEMENT.— 
‘‘(A) IN
GENERAL.—The State, through 
the State single-entry point system established 
under subtitle A, shall provide for case manage-
ment services to the eligible individuals. 
‘‘(B) USE
OF
EXISTING
SERVICES.—In 
carrying out subparagraph (A), the State agen-
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cy or area agency on aging may utilize existing 
case management services delivery networks 
if— 
‘‘(i) the networks have adequate safe-
guards against potential conflicts of inter-
est; and 
‘‘(ii) the State agency or area agency 
on aging includes a description of such 
safeguards in the grant application. 
‘‘(C) CARE PLAN.—The State shall provide 
for development of a care plan for each eligible 
individual served, in consultation with the eligi-
ble individual and their caregiver, as appro-
priate. In developing the care plan, the State 
shall explain the option of consumer directed 
care and assist an individual, who so requests, 
with developing a consumer-directed care plan 
that shall include arranging for support services 
and funding. Such assistance shall include pro-
viding information and outreach to individuals 
in the hospital, in a nursing home for post- 
acute care, or undergoing changes in their 
health status or caregiver situation. 
‘‘(g) ELIGIBLE INDIVIDUALS.—In this section, the 
term ‘eligible individual’ means an individual— 
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‘‘(1) who has been determined by the State to 
be at high functional risk of nursing home place-
ment, as defined by the State agency in the State 
agency’s grant application; 
‘‘(2) who is not eligible for medical assistance 
under title XIX; and 
‘‘(3) who meets the income and asset eligibility 
requirements established by the State and included 
in such State’s grant application for approval by the 
Secretary. 
‘‘(h) FEDERAL SHARE.— 
‘‘(1) IN GENERAL.—The Federal share of the 
cost described in subsection (b) shall be, for a State 
and for a fiscal year, the sum of— 
‘‘(A) the Federal medical assistance per-
centage applicable to the State for the year 
under section 1905(b); and 
‘‘(B) 5 percentage points. 
‘‘(2) NON-FEDERAL
SHARE.—The State may 
provide the non-Federal share of the cost in cash or 
in-kind, fairly evaluated, including plant, equipment, 
or services. The State may provide the non-Federal 
share from State, local, or private sources. 
‘‘(i) FUNDING.— 
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subsequent grant years on a satisfactory determina-
tion that the State agency is meeting benchmarks 
specified in the grant agreement for each grant 
awarded under this title. 
‘‘(2) EVALUATIONS.—The Secretary shall meas-
ure and evaluate, either directly or through grants 
or contracts, the impact of the programs authorized 
under this title. Not later than June 1 of the year 
that is 6 years after the year of the date of enact-
ment of the Project 2020: Building on the Promise 
of Home and Community-Based Services Act of 
2009 and every 2 years thereafter, the Secretary 
shall— 
‘‘(A) compile the reports of the measures 
and evaluations of the grantees; 
‘‘(B) 
establish 
benchmarks 
to 
show 
progress toward savings; and 
‘‘(C) present a compilation of the informa-
tion under this paragraph to Congress. 
‘‘(3) TECHNICAL
ASSISTANCE
GRANTS.—The 
Secretary shall award technical assistance grants, in-
cluding State specific grants whenever practicable, 
to carry out the programs authorized under this 
title. 
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‘‘(4) TRANSFER.—There are authorized to be 
appropriated for such evaluation and technical as-
sistance under this subsection— 
‘‘(A) $4,206,474 for fiscal year 2010; 
‘‘(B) $9,811,535 for fiscal year 2011; 
‘‘(C) $8,461,158 for fiscal year 2012; 
‘‘(D) $11,166,517 for fiscal year 2013; 
‘‘(E) $12,829,859 for fiscal year 2014; 
‘‘(F) $14,527,252 for fiscal year 2015; 
‘‘(G) $16,463,427 for fiscal year 2016; 
‘‘(H) $17,677,299 for fiscal year 2017; 
‘‘(I) $19,054,107 for fiscal year 2018; 
‘‘(J) $20,552,158 for fiscal year 2019; and 
‘‘(K) $22,202,641 for fiscal year 2020. 
‘‘(c) AVAILABILITY.—Funds appropriated under this 
section shall remain available until expended.’’. 
Æ 
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