Page:United States Statutes at Large Volume 120.djvu/135

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[120 STAT. 104]
PUBLIC LAW 109-000—MMMM. DD, 2006
[120 STAT. 104]

120 STAT. 104

PUBLIC LAW 109–171—FEB. 8, 2006 care services for an eligible individual, such services for the individual which are planned and purchased under the direction and control of such individual or the individual’s authorized representative (as defined by the Secretary), including the amount, duration, scope, provider, and location of such services, under the State Medicaid program consistent with the following requirements: (A) ASSESSMENT.—There is an assessment of the needs, capabilities, and preferences of the individual with respect to such services. (B) SERVICE PLAN.—Based on such assessment, there is developed jointly with such individual or the individual’s authorized representative a plan for such services for such individual that is approved by the State and that— (i) specifies those services, if any, which the individual or the individual’s authorized representative would be responsible for directing; (ii) identifies the methods by which the individual or the individual’s authorized representative or an agency designated by an individual or representative will select, manage, and dismiss providers of such services; (iii) specifies the role of family members and others whose participation is sought by the individual or the individual’s authorized representative with respect to such services; (iv) is developed through a person-centered process that— (I) is directed by the individual or the individual’s authorized representative; (II) builds upon the individual’s capacity to engage in activities that promote community life and that respects the individual’s preferences, choices, and abilities; and (III) involves families, friends, and professionals as desired or required by the individual or the individual’s authorized representative; (v) includes appropriate risk management techniques that recognize the roles and sharing of responsibilities in obtaining services in a self-directed manner and assure the appropriateness of such plan based upon the resources and capabilities of the individual or the individual’s authorized representative; and (vi) may include an individualized budget which identifies the dollar value of the services and supports under the control and direction of the individual or the individual’s authorized representative. (C) BUDGET PROCESS.—With respect to individualized budgets described in subparagraph (B)(vi), the State application under subsection (c)— (i) describes the method for calculating the dollar values in such budgets based on reliable costs and service utilization; (ii) defines a process for making adjustments in such dollar values to reflect changes in individual assessments and service plans; and

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