actment of this section, each State shall develop a state-
wide plan to increase the availability of affordable and ac-
cessible private and public housing stock for individuals 
with disabilities (including accessible housing for individ-
uals with physical disabilities and those using mobility de-
vices). 
‘‘(d) AVAILABILITY
OF
REMEDIES
AND
PROCE-
DURES.— 
‘‘(1) IN GENERAL.—The remedies and proce-
dures set forth in sections 203 and 505 of the Amer-
icans with Disabilities Act of 1990 shall be available 
to any person aggrieved by the failure of— 
‘‘(A) a State to comply with this section or 
section 1902(a)(87); or 
‘‘(B) a public entity (including a State) to 
comply with the requirements of subsection (b). 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to limit any rem-
edy or right of action that otherwise is available to 
an aggrieved person under this title. 
‘‘(e) ENFORCEMENT BY THE SECRETARY.— 
‘‘(1) IN GENERAL.—The Secretary may reduce 
the Federal medical assistance percentage applicable 
to the State (as determined under section 1905(b)) 
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if the Secretary determines that the State has vio-
lated the requirements of subsection (b). 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
paragraph (1) shall be construed to limit any rem-
edy or right of action that is otherwise available to 
the Secretary. 
‘‘(f) REPORTING REQUIREMENTS.—With respect to 
fiscal year 2020, and for each fiscal year thereafter, each 
State shall submit to the Administrator of the Administra-
tion for Community Living of the Department of Health 
and Human Services, not later than April 1 of the suc-
ceeding fiscal year, a report, in such form and manner 
as the Secretary shall require, that includes— 
‘‘(1) the total number of individuals enrolled in 
the State plan or under a waiver of the plan during 
such fiscal year that required the level of care pro-
vided in a nursing facility, an intermediate care fa-
cility for the mentally retarded, an institution for 
mental diseases, or any other similarly restrictive or 
institutional setting, disaggregated by the type of fa-
cility or setting; 
‘‘(2) with respect to the total number described 
in paragraph (1), the total number of individuals de-
scribed in that paragraph who received care in a 
nursing facility, an intermediate care facility for the 
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mentally retarded, an institution for mental diseases, 
or any other similarly restrictive or institutional set-
ting, disaggregated by the type of facility or setting; 
and 
‘‘(3) with respect to the total number described 
in paragraph (2), the total number of individuals de-
scribed in that paragraph who were transitioned 
from a nursing facility, an intermediate care facility 
for the mentally retarded, an institution for mental 
diseases, or any other similarly restrictive or institu-
tional setting to a home and community-based set-
ting, disaggregated by the type of home and commu-
nity-based setting.’’. 
(c) INCLUSION AS A MANDATORY SERVICE.—Section 
1905(a)(4)(A) of the Social Security Act (42 U.S.C. 
1396d(a)(4)(A)) is amended by striking ‘‘other than’’ and 
inserting ‘‘including similar services such as rehabilitative 
services and assistance and support in accomplishing ac-
tivities of daily living, instrumental activities of daily liv-
ing, and health-related tasks, that are provided, at the in-
dividual’s option, in a home and community-based setting 
(as defined in section 1904A(a)(3)), but not including’’. 
(d) APPLICATION
TO WAIVERS.—Notwithstanding 
section 1904A of the Social Security Act (as added by sub-
section (b)), such section and sections 1902(a)(87) and 
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1905(a)(4)(A) of the Social Security Act (42 U.S.C. 1396 
et seq.), as amended by subsections (a) and (c), respec-
tively, shall not apply to any individuals who are eligible 
for medical assistance for home and community-based 
services under a waiver under section 1115 or 1915 of 
the Social Security Act (42 U.S.C. 1315, 1396n) and who 
are receiving such services, to the extent such sections (as 
so added or amended) are inconsistent with any such waiv-
er. 
(e) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall take effect on October 1, 2021. 
(2) DELAY PERMITTED IF STATE LEGISLATION 
REQUIRED.—In the case of a State plan under sec-
tion 1902 of the Social Security Act (42 U.S.C. 
1396a) which the Secretary of Health and Human 
Services determines requires State legislation (other 
than legislation appropriating funds) in order for the 
plan to meet the additional requirements imposed by 
the amendments made by this section, the State 
plan shall not be regarded as failing to comply with 
the requirements of such section 1902 solely on the 
basis of the failure of the plan to meet such addi-
tional requirements before the first day of the first 
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calendar quarter beginning after the close of the 
first regular session of the State legislature that be-
gins after the date of enactment of this Act. For 
purposes of the previous sentence, in the case of a 
State that has a 2-year legislative session, each year 
of such session shall be deemed to be a separate reg-
ular session of the State legislature. 
Æ 
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