Teacher:In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Teacher: Now, understand the problem? Solve this instance: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Community Integration Act of 2016''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) The Supreme Court's 1999 decision in Olmstead v. L.C.,
527 U.S. 581 (1999), held that the unnecessary segregation of
individuals with disabilities is a violation of the Americans
with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.).
(2) Under Olmstead, individuals generally have the right to
receive their supports and services in home and community-based
settings, rather than in institutional settings, if they so
choose.
(3) Olmstead envisioned that States would provide
appropriate long-term services and supports to individuals with
disabilities through home and community-based services and end
forced segregation in nursing homes and other institutions.
(4) While there has been progress in rebalancing State
spending on individuals with disabilities in institutions as
compared to home and community-based settings, more than 75
percent of States continue to spend the majority of their long-
term care dollars on nursing homes and other institutional
settings, and the number of individuals with disabilities under
age 65 in nursing homes increased between 2008 and 2012.
(5) As of June 2013, there were more than 200,000
individuals younger than age 65 in nursing homes--almost 16
percent of the total nursing home population.
(6) Thirty-eight studies published from 2005 to 2012
concluded that providing services in home and community-based
settings is less costly than providing care in a nursing home
or other institutional setting.
(7) No clear or centralized reporting system exists to
compare how effectively States are meeting the Olmstead
mandate.

SEC. 3. ENSURING MEDICAID BENEFICIARIES MAY ELECT TO RECEIVE CARE IN A
HOME AND COMMUNITY-BASED SETTING.

(a) In General.--Section 1902(a) of the Social Security Act (42
U.S.C. 1396a(a)) is amended--
(1) in paragraph (81), by striking ''and'' at the end;
(2) in paragraph (82), by striking the period and inserting
''; and''; and
(3) by inserting after paragraph (82) the following new
paragraph:
''(83) in the case of any individual with respect to whom
there has been a determination that the individual requires the
level of care provided in a nursing facility, intermediate care
facility for the mentally retarded, institution for mental
disease, or other similarly restrictive or institutional
setting--
''(A) provide the individual with the choice and
opportunity to receive such care in a home and
community-based setting, including rehabilitative
services, assistance and support in accomplishing
activities of daily living, instrumental activities of
daily living, and health-related tasks, and assistance
in acquiring, maintaining, or enhancing skills
necessary to accomplish such activities, tasks, or
services;
''(B) ensure that each such individual has an equal
opportunity (when compared to the receipt and
availability of nursing facility services) to receive
care in a home and community-based setting, if the
individual so chooses, by ensuring that the provision
of such care in a home and community-based setting is
widely available on a statewide basis for all such
individuals within the State; and
''(C) meet the requirements of section 1904A
(relating to the provision of care in a home and
community-based setting).''.
(b) Requirements for Community Care Options.--Title XIX of the
Social Security Act is amended by inserting after section 1904 (42
U.S.C. 1396c) the following new section:

''provisions related to home and community-based care

''Sec. 1904A. (a) Definitions.--For purposes of this section,
section 1902(a)(83), and section 1905(a)(4)(A):
''(1) Activities of daily living.--The term 'activities of
daily living' includes, but is not limited to, tasks such as
eating, toileting, grooming, dressing, bathing, and
transferring.
''(2) Health-related tasks.--The term 'health-related
tasks' means specific tasks related to the needs of an
individual, including, but not limited to, bowel or bladder
care, wound care, use and care of ventilators and feeding
tubes, and the administration of medications and injections,
which, in the opinion of the individual's physician, can be
delegated to be performed by an attendant.
''(3) Home and community-based setting.--The term 'home and
community-based setting' means, with respect to an individual
who requires a level of care provided in a nursing facility,
intermediate care facility for the mentally retarded,
institution for mental disease, or other similarly restrictive
or institutional setting, a setting that--
''(A) includes a house, apartment, townhouse,
condominium, or similar public or private housing where
the individual resides that--
''(i) is owned or leased by the individual
or a member of the individual's family;
''(ii) ensures the individual's privacy,
dignity, respect, and freedom from coercion;
and
''(iii) maximizes the individual's autonomy
and independence;
''(B) is integrated in, and provides access to, the
general community in which the setting is located so
that the individual has access to the community and
opportunities to seek employment and work in
competitive integrated settings, participate in
community life, control and utilize personal resources,
benefit from community services, and participate in the
community in an overall manner that is comparable to
that available to individuals who are not individuals
with disabilities; and
''(C) has the services and supports that the
individual needs in order to live as independently as
possible.
''(4) Instrumental activities of daily living.--The term
'instrumental activities of daily living' means activities
related to living independently in the community and includes,
but is not limited to, meal planning and preparation, managing
finances, shopping for food, clothing, and other items,
performing household chores, communicating by phone or other
media, and traveling around and participating in the community.
''(5) Public entity.--The term 'public entity' means a
public entity as defined in subparagraphs (A) and (B) of
section 201(1) of the Americans with Disabilities Act of 1990.
''(b) Requirements for Providing Services in Home and Community-
Based Settings.--With respect to the availability and provision of
services under the State plan under this title, or under any waiver of
State plan requirements (subject to section 3(d) of the Community
Integration Act of 2016), in a home and community-based setting to any
individual who requires a level of care provided in a nursing facility,
intermediate care facility for the mentally retarded, institution for
mental disease, or other similarly restrictive or institutional
setting, any public entity that receives payment under the State plan
or waiver for providing services to such an individual shall not--
''(1) impose or utilize policies, practices, or procedures,
such as unnecessary requirements or arbitrary service or cost
caps, that limit the availability of services in home and
community-based settings to an individual with a disability
(including individuals with the most significant disabilities)
who need such services;
''(2) impose or utilize policies, practices, or procedures
that limit the availability of services in a home and
community-based setting (including assistance and support in
accomplishing activities of daily living, instrumental
activities of daily living, health-related tasks, and
rehabilitative services) based on the specific disability of an
otherwise eligible individual;
''(3) impose or utilize policies, practices, or procedures
that arbitrarily restrict an individual with a disability from
full and meaningful participation in community life;
''(4) impose or utilize policies, practices, or procedures
that unnecessarily delay or restrict the provision of services
in a home and community-based setting to any individual who
requires such services;
''(5) fail to establish and utilize adequate payment
structures to maintain a sufficient workforce to provide
services in home and community-based settings to any individual
who requires such services;
''(6) fail to provide information, on an ongoing basis, to
help any individual who receives care in a nursing facility,
intermediate care facility for the mentally retarded,
institution for mental disease, or other similarly restrictive
or institutional setting, understand the individual's right to
choose to receive such care in a home and community-based
setting; or
''(7) fail to provide information to help any individual
that requires the level of care provided in a nursing facility,
intermediate care facility for the mentally retarded,
institution for mental disease, or other similarly restrictive
or institutional setting, prior to the individual's placement
in such a facility or institution, understand the individual's
right to choose to receive such care in a home and community-
based setting.
''(c) Plan To Increase Affordable and Accessible Housing.--Not
later than 180 days after the enactment of this section, each State
shall develop a statewide plan to increase the availability of
affordable and accessible private and public housing stock for
individuals with disabilities (including accessible housing for
individuals with physical disabilities and those using mobility
devices).
''(d) Availability of Remedies and Procedures.--
''(1) In general.--The remedies and procedures set forth in
sections 203 and 505 of the Americans 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)(83); 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 remedy 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
matching assistance percentage applicable to the State (as
determined under section 1905(b)) if the Secretary determines
that the State has violated the requirements of subsection (b).
''(2) Rule of construction.--Nothing in paragraph (1) shall
be construed to limit any remedy or right of action that is
otherwise available to the Secretary.
''(f) Reporting Requirements.--With respect to fiscal year 2018,
and for each fiscal year thereafter, each State shall submit to the
Administrator of the Administration for Community Living of the
Department of Health and Human Services, not later than April 1 of the
succeeding 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 provided in a nursing facility,
intermediate care facility for the mentally retarded,
institution for mental disease, or other similarly restrictive
or institutional setting, disaggregated by the type of facility
or setting;
''(2) with respect to the total number described in
paragraph (1), the total number of individuals described in
that paragraph who received care in a nursing facility,
intermediate care facility for the mentally retarded,
institution for mental disease, or other similarly restrictive
or institutional setting, 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 described in
that paragraph who were transitioned from a nursing facility,
intermediate care facility for the mentally retarded,
institution for mental disease, or other similarly restrictive
or institutional setting to a home and community-based setting,
disaggregated by the type of home and community-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
activities of daily living, instrumental activities of daily living,
and health-related tasks, that are provided, at the individual'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 subsection (b)), such section and
sections 1902(a)(83) and 1905(a)(4)(A) of the Social Security Act (42
U.S.C. 1396 et seq.), as amended by subsections (a) and (c),
respectively, 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 waiver.
(e) Effective Date.--
(1) In general.--Except as provided in paragraph (2), the
amendments made by this section shall take effect on October 1,
2016.
(2) Delay permitted if state legislation required.--In the
case of a State plan under section 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 additional
requirements before the first day of the first calendar quarter
beginning after the close of the first regular session of the
State legislature that begins 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 regular session
of the State legislature.
Student:
Community Integration Act of 2016 This bill amends title XIX (Medicaid) of the Social Security Act to require a state Medicaid program to, with respect to an individual who requires a level of care provided in a nursing facility, intermediate care facility for the developmentally disabled, institution for mental disease, or other similar setting: (1) provide the individual with the choice and equal opportunity to receive such care in a home- and community-based setting; and (2) meet specified requirements relating to the provision andavailabilityof care in such a setting, including a requirement to develop a statewide plan to increase affordable and accessible housing for individuals with disabilities.