the individual is determined to have income
below 250 percent of the official poverty line
(as defined by the Office of Management and
Budget, and revised annually in accordance
with section 673(2) of the Omnibus Budget
Reconciliation Act of 1981) applicable to a fam-
ily of the size involved.
(2) SERVICES.—
(A) SPECIFICATION.—Consistent with sec-
tion 404, the plan shall specify—
(i) the services made available under
the plan,
(ii) the extent and manner in which
such services are allocated and made avail-
able to individuals with disabilities, and
(iii) the manner in which services
under the plan are coordinated with each
other and with health and long-term care
services available outside the plan for indi-
viduals with disabilities.
(B) ALLOCATION.—The State plan—
(i) shall specify how it will allocate
services under the plan, during and after
the 7-fiscal-year phase-in period beginning
with fiscal year 1996, among covered indi-
viduals with disabilities, and
(ii) may not allocate such services
based on the income or other financial re-
sources of such individuals.
(C) LIMITATION ON LICENSURE OR CER-
TIFICATION.—The 
State 
may 
not 
subject
consumer-directed providers of personal assist-
ance services to licensure, certification, or other
requirements which the Secretary finds not to
be necessary for the health and safety of indi-
viduals with disabilities.
(D) CONSUMER
CHOICE.—To the extent
possible, the choice of an individual with dis-
abilities (and that individual’s family) regarding
which covered services to receive and the pro-
viders who will provide such services shall be
followed.
(E) REQUIREMENT TO SERVE LOW-INCOME
INDIVIDUALS.—The plan shall assure that—
(i) the proportion of the population of
low-income individuals with disabilities in
the State that represents individuals with
disabilities who are provided home and
community-based services either under the
plan, under the State medicaid plan, or
under both, is not less than
(ii) the proportion of the population of
the State that represents individuals who
are low-income individuals.
(3) COST SHARING.—The plan shall impose cost
sharing with respect to covered services only in ac-
cordance with section 405.
(4) TYPES OF PROVIDERS AND REQUIREMENTS
FOR PARTICIPATION.—The plan shall specify—
(A) the types of service providers eligible
to participate in the program under the plan,
which shall include consumer-directed providers,
and
(B) any requirements for participation ap-
plicable to each type of service provider.
(5) BUDGET.—The plan shall specify how the
State will manage Federal and State funds available
under the plan for each fiscal year during the period
beginning with fiscal year 1996 and ending with fis-
cal year 2003 and for each 5-fiscal-year periods
thereafter to serve all categories of individuals with
disabilities and meet the requirements of this sub-
section.
(6) PROVIDER REIMBURSEMENT.—
(A) PAYMENT METHODS.—The plan shall
specify the payment methods to be used to re-
imburse providers for services furnished under
the plan. Such methods may include retrospec-
tive reimbursement on a fee-for-service basis,
prepayment on a capitation basis, payment by
cash or vouchers to individuals with disabilities,
or any combination of these methods. In the
case of the use of cash or vouchers, the plan
shall specify how the plan will assure compli-
ance with applicable employment tax provisions.
(B) PAYMENT
RATES.—The plan shall
specify the methods and criteria to be used to
set payment rates for services furnished under
the plan (including rates for cash payments or
vouchers to individuals with disabilities).
(C) PLAN
PAYMENT
AS
PAYMENT
IN
FULL.—The plan shall restrict payment under
the plan for covered services to those providers
that agree to accept the payment under the
plan (at the rates established pursuant to sub-
paragraph (B)) and any cost sharing permitted
or provided for under section 405 as payment
in full for services furnished under the plan.
(7) QUALITY ASSURANCE AND SAFEGUARDS.—
The State plan shall provide for quality assurance
and safeguards for applicants and beneficiaries in
accordance with section 406.
(8) ADVISORY GROUP.—The State plan shall—
(A) assure the establishment and mainte-
nance of an advisory group under section
407(b), and
(B) include the documentation prepared by
the group under section 407(b)(4).
(9) ADMINISTRATION.—
(A) STATE AGENCY.—The plan shall des-
ignate a State agency or agencies to administer
(or to supervise the administration of) the plan.
(B) ADMINISTRATIVE
EXPENDITURES.—
Effective beginning with fiscal year 2003, the
plan shall contain assurances that not more
than 10 percent of expenditures under the plan
for all quarters in any fiscal year shall be for
administrative costs.
(C) COORDINATION.—The plan shall speci-
fy how the plan—
(i) will be integrated with the State
medicaid plan, titles V and XX of the So-
cial Security Act, programs under the
Older Americans Act of 1965, programs
under the Developmental Disabilities As-
sistance and Bill of Rights Act, the Indi-
viduals with Disabilities Education Act,
and any other Federal or State programs
that provide services or assistance targeted
to individuals with disabilities, and
(ii) will be coordinated with health
plans.
(10) REPORTS
AND
INFORMATION
TO
SEC-
RETARY; AUDITS.—The plan shall provide that the
State will furnish to the Secretary—
(A) such reports, and will cooperate with
such audits, as the Secretary determines are
needed concerning the State’s administration of
its plan under this title, including the process-
ing of claims under the plan, and
(B) such data and information as the Sec-
retary may require in order to carry out the
Secretary’s responsibilities.
(11) USE OF STATE FUNDS FOR MATCHING.—
The plan shall provide assurances that Federal
funds will not be used to provide for the State share
of expenditures under this title.