124 STAT. 299 PUBLIC LAW 111–148—MAR. 23, 2010 representatives and consults and collaborates with such individuals; ‘‘(B) provide consumer controlled home and community- based attendant services and supports to individuals on a statewide basis, in a manner that provides such services and supports in the most integrated setting appropriate to the individual’s needs, and without regard to the individ- ual’s age, type or nature of disability, severity of disability, or the form of home and community-based attendant serv- ices and supports that the individual requires in order to lead an independent life; ‘‘(C) with respect to expenditures during the first full fiscal year in which the State plan amendment is imple- mented, maintain or exceed the level of State expenditures for medical assistance that is provided under section 1905(a), section 1915, section 1115, or otherwise to individ- uals with disabilities or elderly individuals attributable to the preceding fiscal year; ‘‘(D) establish and maintain a comprehensive, contin- uous quality assurance system with respect to community- based attendant services and supports that— ‘‘(i) includes standards for agency-based and other delivery models with respect to training, appeals for denials and reconsideration procedures of an individual plan, and other factors as determined by the Secretary; ‘‘(ii) incorporates feedback from consumers and their representatives, disability organizations, pro- viders, families of disabled or elderly individuals, mem- bers of the community, and others and maximizes con- sumer independence and consumer control; ‘‘(iii) monitors the health and well-being of each individual who receives home and community-based attendant services and supports, including a process for the mandatory reporting, investigation, and resolu- tion of allegations of neglect, abuse, or exploitation in connection with the provision of such services and supports; and ‘‘(iv) provides information about the provisions of the quality assurance required under clauses (i) through (iii) to each individual receiving such services; and ‘‘(E) collect and report information, as determined nec- essary by the Secretary, for the purposes of approving the State plan amendment, providing Federal oversight, and conducting an evaluation under paragraph (5)(A), including data regarding how the State provides home and community-based attendant services and supports and other home and community-based services, the cost of such services and supports, and how the State provides individ- uals with disabilities who otherwise qualify for institutional care under the State plan or under a waiver the choice to instead receive home and community-based services in lieu of institutional care. ‘‘(4) COMPLIANCE WITH CERTAIN LAWS.—A State shall ensure that, regardless of whether the State uses an agency- provider model or other models to provide home and commu- nity-based attendant services and supports under a State plan Reports. Determination.
