‘‘(27) community-based attendant services and
supports (to the extent allowed and as defined in
section 1935); and’’.
(3) 
IMD/ICFMR 
REQUIREMENTS.—Section
1902(a)(10)(C)(iv) of the Social Security Act (42
U.S.C. 1396a(a)(10)(C)(iv)) is amended by inserting
‘‘and (27)’’ after ‘‘(24)’’.
(d) EFFECTIVE DATES.—
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section
(other than the amendment made by subsection
(c)(1)) take effect on October 1, 2002, and apply to
medical assistance provided for community-based at-
tendant services and supports described in section
1935 of the Social Security Act furnished on or
after that date.
(2) MANDATORY
BENEFIT.—The amendment
made by subsection (c)(1) takes effect on October 1,
2006.
SEC. 102. ENHANCED FMAP FOR ONGOING ACTIVITIES OF
EARLY COVERAGE STATES THAT ENHANCE
AND PROMOTE THE USE OF COMMUNITY-
BASED 
ATTENDANT 
SERVICES 
AND 
SUP-
PORTS.
(a) IN GENERAL.—Section 1935 of the Social Secu-
rity Act, as added by section 101(b), is amended—
(1) by redesignating subsections (d) through (g)
as subsections (f) through (i), respectively;
(2) in subsection (a)(1), by striking ‘‘subsection
(g)(1)’’ and inserting ‘‘subsection (i)(1)’’;
(3) in subsection (a)(2), by inserting ‘‘, and
with respect to expenditures described in subsection
(d), the Secretary shall pay the State the amount
described in subsection (d)(1)’’ before the period;
(4) in subsection (c)(1)(C), by striking ‘‘sub-
section 
(g)(2)(B)’’ 
and 
inserting 
‘‘subsection
(i)(2)(B)’’; and
(5) by inserting after subsection (c), the fol-
lowing:
‘‘(d) INCREASED FEDERAL FINANCIAL PARTICIPA-
TION FOR EARLY COVERAGE STATES THAT MEET CER-
TAIN BENCHMARKS.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
for purposes of subsection (a)(2), the amount and
expenditures described in this subsection are an
amount equal to the Federal medical assistance per-
centage, increased by 10 percentage points, of the
expenditures incurred by the State for the provision
or conduct of the services or activities described in
paragraph (3).
‘‘(2) EXPENDITURE CRITERIA.—A State shall—
‘‘(A) develop criteria for determining the
expenditures described in paragraph (1) in col-
laboration with the individuals and representa-
tives described in subsection (b)(1); and
‘‘(B) submit such criteria for approval by
the Secretary.
‘‘(3) SERVICES AND ACTIVITIES DESCRIBED.—
For purposes of paragraph (1), the services and ac-
tivities described in this subparagraph are the fol-
lowing:
‘‘(A) One-stop intake, referral, and institu-
tional diversion services.
‘‘(B) Identifying and remedying gaps and
inequities in the State’s current provision of
long-term services, particularly those services
that are provided based on such factors as age,
disability type, ethnicity, income, institutional
bias, or other similar factors.
‘‘(C) Establishment of consumer participa-
tion and consumer governance mechanisms,
such as cooperatives and regional service au-
thorities, that are managed and controlled by
individuals with significant disabilities who use
community-based services and supports or their
representatives.
‘‘(D) Activities designed to enhance the
skills, earnings, benefits, supply, career, and fu-
ture prospects of workers who provide commu-
nity-based attendant services and supports.
‘‘(E) Continuous improvement activities
that are designed to ensure and enhance the
health and well-being of individuals who rely on
community-based attendant services and sup-
ports, particularly activities involving or initi-
ated by consumers of such services and sup-
ports or their representatives.
‘‘(F) Family support services to augment
the efforts of families and friends to enable in-
dividuals with disabilities of all ages to live in
their own homes and communities.
‘‘(G) Health promotion and wellness serv-
ices and activities.
‘‘(H) Provider recruitment and enhance-
ment activities, particularly such activities that
encourage the development and maintenance of
consumer controlled cooperatives or other small
businesses or microenterprises that provide
community-based attendant services and sup-
ports or related services.
‘‘(I) Activities designed to ensure service
and systems coordination.
‘‘(J) Any other services or activities that
the Secretary deems appropriate.’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) take effect on October 1, 2002.
SEC. 103. INCREASED FEDERAL FINANCIAL PARTICIPATION
FOR CERTAIN EXPENDITURES.
(a) IN GENERAL.—Section 1935 of the Social Secu-
rity Act, as added by section 101(b) and amended by sec-
tion 102, is amended by inserting after subsection (d) the
following:
‘‘(e) INCREASED FEDERAL FINANCIAL PARTICIPA-
TION FOR CERTAIN EXPENDITURES.—
‘‘(1) ELIGIBILITY FOR PAYMENT.—
‘‘(A) IN GENERAL.—In the case of a State
that the Secretary determines satisfies the re-
quirements of subparagraph (B), the Secretary
shall pay the State the amounts described in
paragraph (2) in addition to any other pay-
ments provided for under section 1903 or this
section for the provision of community-based at-
tendant services and supports.
‘‘(B) REQUIREMENTS.—The requirements
of this subparagraph are the following:
‘‘(i) The State has an approved plan
amendment under this section.
‘‘(ii) The State has incurred expendi-
tures described in paragraph (2).
‘‘(iii) The State develops and submits
to the Secretary criteria to identify and se-
lect such expenditures in accordance with
the requirements of paragraph (3).
‘‘(iv) The Secretary determines that
payment of the applicable percentage of
such expenditures (as determined under
paragraph (2)(B)) would enable the State
to provide a meaningful choice of receiving
community-based services and supports to
individuals with disabilities and elderly in-
dividuals who would otherwise only have
the option of receiving institutional care.