article: 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.''.
summary: 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.