text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Hospital to Home- and Community-Care 
  Linkage Development and Incentive Grant Program''.
  
  SEC. 2. FINDINGS.
  
      Congress finds that--
              (1) demonstration programs and projects have been developed 
          to offer care management to hospitalized individuals awaiting 
          discharge who are in need of long-term health care services 
          that meet individual needs and preferences in home- and 
          community-based settings as an alternative to long-term nursing 
          home care or institutional placement; and
              (2) there is a need to disseminate information and 
          technical assistance to hospitals and State and local community 
          organizations regarding such programs and projects and to 
          provide incentive grants to State and local public and private 
          agencies, including area agencies on aging, to establish and 
          expand programs that offer care management to individuals 
          awaiting discharge from acute care hospitals who are in need of 
          long-term care so that services to meet individual needs and 
          preferences can be arranged in home- and community-based 
          settings as an alternative to long-term placement in nursing 
          homes or other institutional settings.
  
  SEC. 3. DISSEMINATION OF INFORMATION, TECHNICAL ASSISTANCE AND 
                INCENTIVE GRANTS TO ASSIST IN THE DEVELOPMENT OF HOSPITAL 
                LINKAGE PROGRAMS.
  
      Part C of title III of the Public Health Service Act (42 U.S.C. 248 
  et seq.) is amended by adding at the end thereof the following new 
  section:
  
  ``SEC. 327B. DISSEMINATION OF INFORMATION, TECHNICAL ASSISTANCE AND 
                INCENTIVE GRANTS TO ASSIST IN THE DEVELOPMENT OF HOSPITAL 
                LINKAGE PROGRAMS.
  
      ``(a) Dissemination of Information.--The Secretary shall compile, 
  evaluate, publish and disseminate to appropriate State and local 
  officials and to private organizations and agencies that provide 
  services to individuals in need of long-term health care services, such 
  information and materials as may assist such entities in replicating 
  successful programs that are aimed at offering care management to 
  hospitalized individuals who are in need of long-term care so that 
  services to meet individual needs and preferences can be arranged in 
  home- and community-based settings as an alternative to long-term 
  nursing home placement. The Secretary may provide technical assistance 
  to entities seeking to replicate such programs.
      ``(b) Incentive Grants to Assist in the Development of Hospital 
  Linkage Programs.--The Secretary shall establish a program under which 
  incentive grants may be awarded to assist private and public agencies, 
  including area agencies on aging, and organizations in developing and 
  expanding programs and projects that facilitate the discharge of 
  individuals in hospitals or other acute care facilities who are in need 
  of long-term care services and placement of such individuals into home- 
  and community-based settings.
      ``(c) Administrative Provisions.--
              ``(1) Eligible entities.--To be eligible to receive a grant 
          under subsection (b) an entity shall be--
                      ``(A)(i) a State agency as defined in section 
                  102(43) of the Older Americans Act of 1965; or
                      ``(ii) a State agency responsible for administering 
                  home and community care programs under title XIX of the 
                  Social Security Act; or
                      ``(B) if no State agency described in subparagraph 
                  (A) applies with respect to a particular State, a 
                  public or nonprofit private entity.
              ``(2) Applications.--To be eligible to receive an incentive 
          grant under subsection (b), an entity shall prepare and submit 
          to the Secretary an application at such time, in such manner 
          and containing such information as the Secretary may require, 
          including--
                      ``(A) an assessment of the need within the 
                  community to be served for the establishment or 
                  expansion of a program to facilitate the discharge of 
                  individuals in need of long-term care who are in 
                  hospitals or other acute care facilities into home- and 
                  community-care programs that provide individually 
                  planned, flexible services that reflect individual 
                  choice or preference rather than nursing home or 
                  institutional settings;
                      ``(B) a plan for establishing or expanding a 
                  program for identifying individuals in hospital or 
                  acute care facilities who are in need of individualized 
                  long-term care provided in home- and community-based 
                  settings rather than nursing homes or other 
                  institutional settings and undertaking the planning and 
                  management of individualized care plans to facilitate 
                  discharge into such settings;
                      ``(C) assurances that nongovernmental case 
                  management agencies funded under grants awarded under 
                  this section are not direct providers of home- and 
                  community-based services;
                      ``(D) satisfactory assurances that adequate home- 
                  and community-based long term care services are 
                  available, or will be made available, within the 
                  community to be served so that individuals being 
                  discharged from hospitals or acute care facilities 
                  under the proposed program can be served in such home- 
                  and community-based settings, with flexible, 
                  individualized care which reflects individual choice 
                  and preference;
                      ``(E) a description of the manner in which the 
                  program to be administered with amounts received under 
                  the grant will be continued after the termination of 
                  the grant for which such application is submitted; and
                      ``(F) a description of any waivers or approvals 
                  necessary to expand the number of individuals served in 
                  federally funded home- and community-based long term 
                  care programs in order to provide satisfactory 
                  assurances that adequate home- and community-based long 
                  term care services are available in the community to be 
                  served.
              ``(3) Awarding of grants.--
                      ``(A) Preferences.--In awarding grants under 
                  subsection (b), the Secretary shall give preference to 
                  entities submitting applications that--
                              ``(i) demonstrate an ability to coordinate 
                          activities funded using amounts received under 
                          the grant with programs providing 
                          individualized home- and community-based case 
                          management and services to individuals in need 
                          of long term care with hospital discharge 
                          planning programs; and
                              ``(ii) demonstrate that adequate home- and 
                          community-based long term care management and 
                          services are available, or will be made 
                          available to individuals being served under the 
                          program funded with amounts received under 
                          subsection (b).
                      ``(B) Distribution.--In awarding grants under 
                  subsection (b), the Secretary shall ensure that such 
                  grants--
                              ``(i) are equitably distributed on a 
                          geographic basis;
                              ``(ii) include projects operating in urban 
                          areas and projects operating in rural areas; 
                          and
                              ``(iii) are awarded for the expansion of 
                          existing hospital linkage programs as well as 
                          the establishment of new programs.
                      ``(C) Expedited consideration.--The Secretary shall 
                  provide for the expedited consideration of any waiver 
                  application that is necessary under title XIX of the 
                  Social Security Act to enable an applicant for a grant 
                  under subsection (b) to satisfy the assurance required 
                  under paragraph (1)(D).
              ``(4) Use of grants.--An entity that receives amounts under 
          a grant under subsection (b) may use such amounts for planning, 
          development and evaluation services and to provide 
          reimbursements for the costs of one or more case mangers to be 
          located in or assigned to selected hospitals who would--
                      ``(A) identify patients in need of individualized 
                  care in home- and community-based long-term care;
                      ``(B) assess and develop care plans in cooperation 
                  with the hospital discharge planning staff; and
                      ``(C) arrange for the provision of community care 
                  either immediately upon discharge from the hospital or 
                  after any short term nursing-home stay that is needed 
                  for recuperation or rehabilitation;
              ``(5) Direct services subject to reimbursements.--None of 
          the amounts provided under a grant under this section may be 
          used to provide direct services, other than case management, 
          for which reimbursements are otherwise available under title 
          XVIII or XIX of the Social Security Act.
              ``(6) Limitations.--
                      ``(A) Term.--Grants awarded under this section 
                  shall be for terms of less than 3 years.
                      ``(B) Amount.--Grants awarded to an entity under 
                  this section shall not exceed $300,000 per year. The 
                  Secretary may waive the limitation under this 
                  subparagraph where an applicant demonstrates that the 
                  number of hospitals or individuals to be served under 
                  the grant justifies such increased amounts.
                      ``(C) Supplanting of funds.--Amounts awarded under 
                  a grant under this section may not be used to supplant 
                  existing State funds that are provided to support 
                  hospital link programs.
      ``(d) Evaluation and Reports.--
              ``(1) By grantees.--An entity that receives a grant under 
          this section shall evaluate the effectiveness of the services 
          provided under the grant in facilitating the placement of 
          individuals being discharged from hospitals or acute care 
          facilities into home- and community-based long term care 
          settings rather than nursing homes. Such entity shall prepare 
          and submit to the Secretary a report containing such 
          information and data concerning the activities funded under the 
          grant as the Secretary determines appropriate.
              ``(2) By secretary.--Not later than the end of the third 
          fiscal year for which funds are appropriated under subsection 
          (e), the Secretary shall prepare and submit to the appropriate 
          committees of Congress, a report concerning the results of the 
          evaluations and reports conducted and prepared under paragraph 
          (1).
      ``(e) Authorization of Appropriations.--There are authorized to be 
  appropriated to carry out this section, $5,000,000 for each of the 
  fiscal years 1994 through 1996.''.
target: Hospital to Home- and Community-Care Linkage Development and Incentive Grant Program - Amends the Public health Service Act to direct the Secretary of Health and Human Services to disseminate information and materials to assist specified entities in replicating successful programs aimed at offering care management to hospitalized individuals in need of long-term care so that services to meet individual needs and preferences can be arranged in home- and community-based settings as an alternative to long-term nursing home placement.  Authorizes the Secretary to provide technical assistance to such entities. 
  Directs the Secretary to establish a program under which incentive grants may be awarded to assist agencies and organizations in developing and expanding programs and projects that facilitate the discharge of individuals in hospitals or other acute care facilities who are in need of long-term care services and placement of such individuals into home- and community-based settings. 
  Sets forth provisions regarding:  (1) eligibility to receive grants; (2) application requirements; (3) criteria for the award of grants; (4) use of, and limitations on, grants; and (5) evaluation and reports. 
  Authorizes appropriations.
feat_title: Hospital to Home- and Community-Care Linkage Development and Incentive Grant Program