<?xml version="1.0"?>
<?xml-stylesheet type="text/xsl" href="billres.xsl"?>
<!DOCTYPE bill PUBLIC "-//US Congress//DTDs/bill.dtd//EN" "bill.dtd">
<bill bill-stage="Introduced-in-House" dms-id="HF76947E34BC44163B12947556558FE81" public-private="public" key="H" bill-type="olc"><metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>119 HR 9401 IH: Latonya Reeves Freedom Act of 2026</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2026-06-23</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">2d Session</session><legis-num display="yes">H. R. 9401</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20260623">June 23, 2026</action-date><action-desc><sponsor name-id="C001068">Mr. Cohen</sponsor> (for himself, <cosponsor name-id="B001298">Mr. Bacon</cosponsor>, <cosponsor name-id="B001300">Ms. Barragán</cosponsor>, <cosponsor name-id="B001315">Ms. Budzinski</cosponsor>, <cosponsor name-id="C001091">Mr. Castro of Texas</cosponsor>, <cosponsor name-id="C001067">Ms. Clarke of New York</cosponsor>, <cosponsor name-id="C001119">Ms. Craig</cosponsor>, <cosponsor name-id="D000629">Ms. Davids of Kansas</cosponsor>, <cosponsor name-id="D000631">Ms. Dean of Pennsylvania</cosponsor>, <cosponsor name-id="F000466">Mr. Fitzpatrick</cosponsor>, <cosponsor name-id="G000592">Mr. Golden of Maine</cosponsor>, <cosponsor name-id="G000599">Mr. Goldman of New York</cosponsor>, <cosponsor name-id="G000583">Mr. Gottheimer</cosponsor>, <cosponsor name-id="H001081">Mrs. Hayes</cosponsor>, <cosponsor name-id="H001066">Mr. Horsford</cosponsor>, <cosponsor name-id="H001094">Ms. Hoyle of Oregon</cosponsor>, <cosponsor name-id="J000309">Mr. Jackson of Illinois</cosponsor>, <cosponsor name-id="J000288">Mr. Johnson of Georgia</cosponsor>, <cosponsor name-id="L000557">Mr. Larson of Connecticut</cosponsor>, <cosponsor name-id="L000562">Mr. Lynch</cosponsor>, <cosponsor name-id="M001208">Mrs. McBath</cosponsor>, <cosponsor name-id="M001238">Ms. McBride</cosponsor>, <cosponsor name-id="M001227">Ms. McClellan</cosponsor>, <cosponsor name-id="M001143">Ms. McCollum</cosponsor>, <cosponsor name-id="M001160">Ms. Moore of Wisconsin</cosponsor>, <cosponsor name-id="M001206">Mr. Morelle</cosponsor>, <cosponsor name-id="M001196">Mr. Moulton</cosponsor>, <cosponsor name-id="M001225">Mr. Mullin</cosponsor>, <cosponsor name-id="N000015">Mr. Neal</cosponsor>, <cosponsor name-id="P000613">Mr. Panetta</cosponsor>, <cosponsor name-id="P000597">Ms. Pingree</cosponsor>, <cosponsor name-id="S001226">Ms. Salinas</cosponsor>, <cosponsor name-id="S001221">Ms. Scholten</cosponsor>, <cosponsor name-id="S001231">Ms. Simon</cosponsor>, <cosponsor name-id="S000510">Mr. Smith of Washington</cosponsor>, <cosponsor name-id="S001200">Mr. Soto</cosponsor>, <cosponsor name-id="S001218">Ms. Stansbury</cosponsor>, <cosponsor name-id="S001159">Ms. Strickland</cosponsor>, <cosponsor name-id="T000193">Mr. Thompson of Mississippi</cosponsor>, <cosponsor name-id="T000469">Mr. Tonko</cosponsor>, <cosponsor name-id="U000040">Ms. Underwood</cosponsor>, <cosponsor name-id="D000624">Mrs. Dingell</cosponsor>, <cosponsor name-id="V000133">Mr. Van Drew</cosponsor>, <cosponsor name-id="V000135">Mr. Van Orden</cosponsor>, <cosponsor name-id="V000130">Mr. Vargas</cosponsor>, <cosponsor name-id="W000797">Ms. Wasserman Schultz</cosponsor>, <cosponsor name-id="W000822">Mrs. Watson Coleman</cosponsor>, <cosponsor name-id="W000788">Ms. Williams of Georgia</cosponsor>, and <cosponsor name-id="W000808">Ms. Wilson of Florida</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committee on <committee-name committee-id="HJU00">the Judiciary</committee-name>, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned</action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To prohibit discrimination against individuals with disabilities who need long-term services and supports, and for other purposes.</official-title></form><legis-body id="H664A77DA3C284FA2889220DC3D4B8955" style="OLC"> 
<section section-type="section-one" id="H154810EAEC054D079F2206BB8E520CF2"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Latonya Reeves Freedom Act of 2026</short-title></quote>.</text></section> <section id="HED6CCDDF4BD948D2A17D2052E6771B74"><enum>2.</enum><header>Purposes</header><text display-inline="no-display-inline">The purposes of this Act are—</text> 
<paragraph id="H1DFB45ADDEC6405C9B1F458609552576"><enum>(1)</enum><text>to clarify and strengthen the integration mandate of the Americans with Disabilities Act of 1990, held by the Supreme Court in Olmstead v. L.C., 527 U.S. 581 (1999) in a manner that accelerates and improves State compliance;</text></paragraph> <paragraph id="H78AC1F776A764DCE87DF7F97E9226430"><enum>(2)</enum><text>to affirm that every individual who is eligible for long-term services and supports has a federally protected right to be integrated into that individual’s community and receive community-based long-term services and supports;</text></paragraph> 
<paragraph id="H766929775738412A89678ACB80A41ECD"><enum>(3)</enum><text display-inline="yes-display-inline">to ensure that States and LTSS insurance providers provide long-term services and supports to individuals with disabilities in a manner that allows individuals with disabilities to live in the most integrated setting, including the individual’s own home;</text></paragraph> <paragraph id="H2101E64D0FBD4D9C875C4B17653F82F6"><enum>(4)</enum><text display-inline="yes-display-inline">to ensure that individuals with disabilities have maximum control over the services and supports that allow them to live in the community;</text></paragraph> 
<paragraph id="HABBE4980C404411D8EF84A8251E711B8"><enum>(5)</enum><text>to ensure that long-term services and supports are provided in a manner that allows individuals with disabilities to lead an independent life;</text></paragraph> <paragraph id="H9E9A220C183F4A98AB34D659608B7ABC"><enum>(6)</enum><text>to establish a comprehensive planning requirement that includes enforceable, measurable objectives that are designed to transition individuals with all types of disabilities at all ages out of institutions and into the most integrated setting, if they choose that transition; and</text></paragraph> 
<paragraph id="H4632E021B3B44B439B317A4952C0E386"><enum>(7)</enum><text>to identify and address disparities in the provision of community-based long-term services and supports.</text></paragraph></section> <section id="HC5FFBC5D5B8B42549CD990658AF4AF3B"><enum>3.</enum><header>Definitions and rule</header> <subsection id="H250A84E15CC447B0AF611B4196DE23EC"><enum>(a)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this Act:</text> 
<paragraph id="H49D13BB25CF5402E8F094C13208B1005"><enum>(1)</enum><header>Activities of daily living</header><text>The term <term>activities of daily living</term> has the meaning given the term in section 441.505 of title 42, Code of Federal Regulations (or a successor regulation).</text></paragraph> <paragraph id="HADEC2BC64A454EACA6B955627AFB28E5"><enum>(2)</enum><header>Administrator</header><text>The term <term>Administrator</term> means—</text> 
<subparagraph id="H92385CC4E89D4B62976C8B73984B94E9"><enum>(A)</enum><text>the Administrator of the Administration for Community Living; or</text></subparagraph> <subparagraph id="H99744A6B06234AFF96EEE0EF96D94894"><enum>(B)</enum><text>another designee of the Secretary of Health and Human Services.</text></subparagraph></paragraph> 
<paragraph id="HFD05CA83694D4B18A9E74DA6746E9116"><enum>(3)</enum><header>Community-based; services or supports</header><text>The term <term>community-based</term>, when used in reference to services or supports, means services or supports that are provided to an individual with an LTSS disability to enable that individual to live in the community and lead an independent life, and that are delivered in whichever setting the individual with an LTSS disability has chosen out of the following settings with the following qualities:</text> <subparagraph id="HE73F28B3720B4F68AA5388015A1A400C"><enum>(A)</enum><text>In the case of a dwelling or a nonresidential setting (such as a setting in which an individual with an LTSS disability receives day services and supported employment), a dwelling or setting—</text> 
<clause id="H8174B56EBC3F4D6D9593318907A5EB7A"><enum>(i)</enum><text>that, as a matter of infrastructure, environment, amenities, location, services, and features, is integrated into the greater community and supports, for each individual with an LTSS disability who receives services or supports at the setting—</text> <subclause id="H1DD8D29BA4614100A1E6AFF0CB11CC19"><enum>(I)</enum><text>full access to the greater community (including access to opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community); and</text></subclause> 
<subclause id="H7B04F0798A0841BDA9488929D745850E"><enum>(II)</enum><text>access to the greater community to the same extent as access to the community is enjoyed by an individual who is not receiving long-term services or supports;</text></subclause></clause> <clause id="H27C1EEFFE1704A389A546C00187870F8"><enum>(ii)</enum><text>that the individual has selected as a meaningful choice from among nonresidential setting options, including nondisability-specific settings;</text></clause> 
<clause id="H38FBA9A8B67D4542A1B50C0E0F27FCBF"><enum>(iii)</enum><text>in which an individual has rights to privacy, dignity, and respect, and freedom from coercion and restraint;</text></clause> <clause id="H911BAB09794D439DA22BFFE5BDC87448"><enum>(iv)</enum><text>that, as a matter of infrastructure, environment, amenities, location, services, and features, optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including choices about daily activities, physical environment, and persons with whom the individual interacts; and</text></clause> 
<clause commented="no" display-inline="no-display-inline" id="HB4CA08DEAA9B4C70B813788969236BD2"><enum>(v)</enum><text>that, as a matter of infrastructure, environment, amenities, location, services, and features, facilitates individual choice regarding the provision of services and supports, and who provides those services and supports.</text></clause></subparagraph> <subparagraph id="H858F48CD72874C568490408FC23A2674"><enum>(B)</enum><text>In the case of a dwelling, a dwelling—</text> 
<clause id="H531F219FA09646EF8BA86503553CF8E6"><enum>(i)</enum><text>that is owned by an individual with an LTSS disability or the individual’s family member;</text></clause> <clause id="H4F9A6D628A7747ABB08CE9F6DBA253EC"><enum>(ii)</enum><text>that is leased to the individual with an LTSS disability under an individual lease, that has lockable access and egress, and that includes living, sleeping, bathing, and cooking areas over which an individual with an LTSS disability or the individual’s family member has domain and control; or</text></clause> 
<clause id="H48F6CD59769945818FB0C6CE05903C58"><enum>(iii)</enum><text>that is a group or shared residence—</text> <subclause id="H648EE62BCF904B0688A8CEE650127512"><enum>(I)</enum><text>in which no more than 4 unrelated individuals with an LTSS disability reside;</text></subclause> 
<subclause id="HA97BC2BB50F84BDCAE5732E235193C69"><enum>(II)</enum><text>for which each individual with an LTSS disability living at the residence owns, rents, or occupies the residence under a legally enforceable agreement under which the individual has, at a minimum, the same responsibilities and protections as tenants have under applicable landlord-tenant law;</text></subclause> <subclause id="HB1AF5017DADE42D0AF0104061A3EEF66"><enum>(III)</enum><text>in which each individual with an LTSS disability living at the residence—</text> 
<item id="H17E06B292D31421E8BFF43165E31221E"><enum>(aa)</enum><text>has privacy in the individual’s sleeping unit, including a lockable entrance door controlled by the individual;</text></item> <item id="HCE4E556E03F9446AB78A80EADC1AE55B"><enum>(bb)</enum><text>shares a sleeping unit only if such individual and the individual sharing the unit choose to do so, and if individuals in the residence so choose, they also have a choice of roommates within the residence;</text></item> 
<item id="HE4C699626A1045BDA97661209EBD7CFA"><enum>(cc)</enum><text>has the freedom to furnish and decorate the individual’s sleeping or living unit as permitted under the lease or other agreement;</text></item> <item id="H2D8B1C4C19294015BC27E9DF7A59E30F"><enum>(dd)</enum><text>has the freedom and support to control the individual’s own schedules and activities; and</text></item> 
<item id="H6AE15F48164441B3B5D4D578DE2ED5AA"><enum>(ee)</enum><text>is able to have visitors of the individual’s choosing at any time; and</text></item></subclause> <subclause id="HA30821374DD74EC3B51F35470FAD3D72"><enum>(IV)</enum><text>that is physically accessible to the individual with an LTSS disability living at the residence.</text></subclause></clause></subparagraph></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H853C5E901B8F4AE9B9B91D78D223352B"><enum>(4)</enum><header>Community-based; setting</header><text>The term <term>community-based</term>, when used in reference to a setting, means a setting described in subparagraph (A) or (B) of paragraph (3).</text></paragraph> <paragraph id="H2AC83FB335D140B9A7442A1164208C49"><enum>(5)</enum><header>Dwelling</header><text>The term <term>dwelling</term> has the meaning given the term in section 802 of the Fair Housing Act (<external-xref legal-doc="usc" parsable-cite="usc/42/3602">42 U.S.C. 3602</external-xref>).</text></paragraph> 
<paragraph id="H0F75001B2D3E4BEAB97633FFEA92F3EC"><enum>(6)</enum><header>Health-related tasks</header><text>The term <term>health-related tasks</term> means specific nonacute tasks, typically regulated by States as medical or nursing tasks that an individual with a disability may require to live in the community, including—</text> <subparagraph id="H389717F5494F4A0A857C994181811BEA"><enum>(A)</enum><text>administration of medication;</text></subparagraph> 
<subparagraph id="HA7923B1B2F0A4627B5468A81890F20AE"><enum>(B)</enum><text>assistance with use, operation, and maintenance of a ventilator; and</text></subparagraph> <subparagraph id="H93E9C037C86644AC86524109D440714E"><enum>(C)</enum><text>maintenance and use of a gastrostomy tube, a catheter, or a stable ostomy.</text></subparagraph></paragraph> 
<paragraph id="H7CD58847F00F4DFCA95DB5AA50E56096"><enum>(7)</enum><header>Individual with a disability</header><text>The term <term>individual with a disability</term> means an individual who is a person with a disability, as defined in section 3 of the Americans with Disabilities Act of 1990 (<external-xref legal-doc="usc" parsable-cite="usc/42/12102">42 U.S.C. 12102</external-xref>).</text></paragraph> <paragraph id="H3A7C1CE8C9F74A8A83A582F398C893A7"><enum>(8)</enum><header>Individual with an LTSS disability</header><text>The term <term>individual with an LTSS disability</term> means an individual with a disability who—</text> 
<subparagraph id="HE15040EC06094AB6BEB79CF3D2049342"><enum>(A)</enum><text>in order to live in the community and lead an independent life requires assistance in accomplishing—</text> <clause id="HD556C56535C64F42953AAE8898A07C67"><enum>(i)</enum><text>activities of daily living;</text></clause> 
<clause id="HC7D82F4AC0E648949A41BB01EFF57D28"><enum>(ii)</enum><text>instrumental activities of daily living;</text></clause> <clause id="H6A0D95BF03934A05A648CC8326C08DE4"><enum>(iii)</enum><text>health-related tasks; or</text></clause> 
<clause id="H0FF33D49F07844B6A8B6A859F0E4164B"><enum>(iv)</enum><text>other functions, tasks, or activities related to an activity or task described in clause (i), (ii), or (iii); and</text></clause></subparagraph> <subparagraph id="HED4A0DE00AA54DAC8F58B0FD6F1F2C47"><enum>(B)</enum> <clause commented="no" display-inline="yes-display-inline" id="HD824C4F7CD9E48069DB37C61F1CC022B"><enum>(i)</enum><text>is currently in an institutional placement; or</text></clause> 
<clause id="H80A3FDE5B587470E830E2CD9CE2FE18E" indent="up1"><enum>(ii)</enum><text>is at risk of institutionalization if the individual does not receive community-based long-term services and supports.</text></clause></subparagraph></paragraph> <paragraph id="H8D908CC0632A4593B3737FFE7044C8BB"><enum>(9)</enum><header>Institution; institutionalization</header> <subparagraph commented="no" display-inline="no-display-inline" id="HC9B37DB8588C4492BB363FCA0C341205"><enum>(A)</enum><header display-inline="yes-display-inline">Institution</header><text>The term <term>institution</term> means—</text> 
<clause id="HBE181D1DE8B2476C90A31628EDE5FEFD"><enum>(i)</enum><text>a skilled nursing facility (as defined in section 1819(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395i-3">42 U.S.C. 1395i–3(a)</external-xref>));</text></clause> <clause id="HB1AF1C8254F44E00828711B6A620787E"><enum>(ii)</enum><text>a nursing facility (as defined in section 1919(a) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396r">42 U.S.C. 1396r(a)</external-xref>));</text></clause> 
<clause id="H283373B13BDF45179026D391B731BC42"><enum>(iii)</enum><text>a long-term care hospital (as described in section 1886(d)(1)(B)(iv) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395ww">42 U.S.C. 1395ww(d)(1)(B)(iv)</external-xref>));</text></clause> <clause id="H94C97D203E5345C19B147CF1548D35D8"><enum>(iv)</enum><text>a facility described in section 1905(d) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(d)</external-xref>);</text></clause> 
<clause id="HDA3513E7EA22445FA939DC83037C5E6A"><enum>(v)</enum><text>an institution which is a psychiatric hospital (as defined in section 1861(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(f)</external-xref>)) or that provides in-patient psychiatric services in a residential setting specified by the Secretary;</text></clause> <clause id="H7F2728DD6696478D84FBB9DC1245DCD3"><enum>(vi)</enum><text>an institution described in section 1905(i) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(i)</external-xref>); and</text></clause> 
<clause id="HBADA3187604A44C1B1DE033F9EFE84C7"><enum>(vii)</enum><text>any congregate setting that is not community-based or that has the effect of isolating individuals with disabilities from the community.</text></clause></subparagraph> <subparagraph id="H290A06FC3AD1401DA826E061F2D4053A" commented="no"><enum>(B)</enum><header>Institutionalization</header><text>The term <term>institutionalization</term>, used with respect to an individual with an LTSS disability, refers to the individual living or receiving services or supports in a setting that is not community-based.</text></subparagraph></paragraph> 
<paragraph id="H61935A5586904611B53465E4070F6C63"><enum>(10)</enum><header>Instrumental activities of daily living</header><text>The term <term>instrumental activities of daily living</term> means one or more activities related to living independently in the community, including activities related to—</text> <subparagraph id="H8001DF6729A44AB3853E7950229FF7E1"><enum>(A)</enum><text>nutrition, such as preparing meals or special diets, monitoring to prevent choking or aspiration, or assisting with special utensils;</text></subparagraph> 
<subparagraph id="H30966B1E94BD4DFA89D0194A097FAC23"><enum>(B)</enum><text>household chores and environmental maintenance tasks;</text></subparagraph> <subparagraph id="H74FE476DDBB8490688DF99CC838C7681"><enum>(C)</enum><text>communication and interpersonal skills, such as—</text> 
<clause id="HA67D042B779940B98F2237D1C617EE96"><enum>(i)</enum><text>using the telephone or other communications devices;</text></clause> <clause id="H34CE69D72B1B40D6A478BD128C55E7ED"><enum>(ii)</enum><text>forming and maintaining interpersonal relationships; or</text></clause> 
<clause id="H01746E4FBA004D0E9E908B95226EF3EF"><enum>(iii)</enum><text>securing opportunities to participate in group support or peer-to-peer support arrangements;</text></clause></subparagraph> <subparagraph id="HCE82323071104A608E8790DC38C91D0A"><enum>(D)</enum><text>travel and community participation, such as shopping, arranging appointments, or moving around the community;</text></subparagraph> 
<subparagraph id="HC6EE79258E6A4FE9ADDDE0952B6BD136"><enum>(E)</enum><text>care of others, such as raising children, taking care of pets, or selecting caregivers; or</text></subparagraph> <subparagraph id="H5B96BEBEDF9145568AF4EC35E9878B39"><enum>(F)</enum><text>management of personal property and personal safety, such as—</text> 
<clause id="H34E692B3B57045B9AB5BA9E2E3B880AE"><enum>(i)</enum><text>taking medication;</text></clause> <clause id="H67A07F29E0564594828436E51A031F06"><enum>(ii)</enum><text>handling or managing money; or</text></clause> 
<clause id="HB725216A3C0C454F8DFA5EC24F9B4783"><enum>(iii)</enum><text>responding to emergent situations or unscheduled needs requiring an immediate response.</text></clause></subparagraph></paragraph> <paragraph id="H2D8503859B1D4CA0830543ED1A588522"><enum>(11)</enum><header>Long-term service or support</header> <subparagraph commented="no" display-inline="no-display-inline" id="H1E0FEBFDFD734FF6BFEF58EF9833CB3B"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The terms <term>long-term service or support</term> and <term>LTSS</term> mean assistance, equipment, technology, or other support, provided to an individual with a disability in accomplishing, acquiring the means or ability to accomplish, maintaining, or enhancing—</text> 
<clause id="H07D9026547D64314B0180A0BF75C0274"><enum>(i)</enum><text>activities of daily living;</text></clause> <clause id="H3CD4203F77864F1D9164ABFCBAC49DE3"><enum>(ii)</enum><text>instrumental activities of daily living;</text></clause> 
<clause id="H4AFF36732A06472DB45FA9A62FF64381"><enum>(iii)</enum><text>health-related tasks; or</text></clause> <clause id="HB0080A1D542847428DFF8F4224D54A21"><enum>(iv)</enum><text>other functions, tasks, or activities related to an activity or task described in clause (i), (ii), or (iii).</text></clause></subparagraph> 
<subparagraph id="H6B4F251AD52E44498369DBA8451E90A6"><enum>(B)</enum><header>Assistance</header><text>In subparagraph (A), the term <term>assistance</term> includes support provided to an individual by another person due to confusion, dementia, behavioral symptoms, or cognitive, intellectual, mental, or emotional disabilities, including support to—</text> <clause id="HC7D7A2B3DF9947BB88C50BED160C936B"><enum>(i)</enum><text>help the individual identify and set goals, communicate needs, overcome fears, and manage transitions;</text></clause> 
<clause id="HB5F97E8276914D8C935147BEDB2BE338">
              <enum>(ii)</enum>
 <text>help the individual with executive functioning, decisionmaking, self-expression, and problem solving;</text>
            </clause> 
<clause id="HA253F0CB38D3457F8B212449233CE9EC"><enum>(iii)</enum><text>provide reassurance to the individual; and</text></clause> <clause id="H2845CDAC5029415594E4CCB1342C7BF4"><enum>(iv)</enum><text>help the individual with orientation, memory, and other activities related to independent living.</text></clause></subparagraph></paragraph> 
<paragraph id="H76879272352D4FC1A97911A66FE43F27"><enum>(12)</enum><header>LTSS insurance provider</header><text>The term <term>LTSS insurance provider</term> means a public or private entity that—</text> <subparagraph id="HEB444BC0A8FB433A8F2CE9D6622F8DDA"><enum>(A)</enum><text>provides funds for long-term services and supports; and</text></subparagraph> 
<subparagraph id="HF34AA3C8539A4B78825F4B7743AD7347"><enum>(B)</enum><text>is engaged in commerce or in an industry or activity affecting commerce.</text></subparagraph></paragraph> <paragraph id="H2503F69353FF476C8339789AE7CCF6D5"><enum>(13)</enum><header>Public entity</header> <subparagraph id="H0A1BCDA2E60941DDA3356B4C41E34559"><enum>(A)</enum><header>In general</header><text>The term <term>public entity</term> means an entity that—</text> 
<clause id="H63D74BB14A7A48548DE08DF9BEE91E54"><enum>(i)</enum><text>provides or funds institutional placements for individuals with LTSS disabilities; and</text></clause> <clause id="HD3B337CCEA1245E59BFDA359286FC6B9"><enum>(ii)</enum><text>is—</text> 
<subclause id="HE2DC26DF542B46749F54C95DFA1B117D"><enum>(I)</enum><text>a State or local government; or</text></subclause> <subclause id="H6E1EFB1085964FA5B9C78DD64ACA86D8"><enum>(II)</enum><text>any department, agency, entity administering a special purpose district, or other instrumentality, of a State or local government.</text></subclause></clause></subparagraph> 
<subparagraph id="HEB73ABFC96C1497C8ACA44CE5E5DA7C6"><enum>(B)</enum><header>Interstate commerce</header><text>For purposes of subparagraph (A), a public entity shall be considered to be a person engaged in commerce or in an industry or activity affecting commerce.</text></subparagraph></paragraph></subsection> <subsection id="HA40E5DD66FE74E8F8846F2E31C9F0DCC"><enum>(b)</enum><header>Rule of construction</header><text>Nothing in subsection (a) or any other provision of this section shall be construed to preclude an individual with a disability from receiving community-based services and supports in an integrated community setting such as a grocery store, retail establishment, restaurant, bank, park, concert venue, theater, or workplace.</text></subsection></section> 
<section id="HE8E6CF9F4C92486E9BF6158118CBBA1F"><enum>4.</enum><header>Discrimination</header> 
<subsection id="HC495383DD0CA4A8B92212C261358CC98"><enum>(a)</enum><header>In general</header><text>No public entity or LTSS insurance provider shall deny an individual with an LTSS disability who is eligible for institutional placement, or otherwise discriminate against that individual in the provision of, community-based long-term services and supports that enable the individual to live in the community and lead an independent life.</text></subsection> <subsection id="HC64C6876AC9F4FD2A81A9FFB8D670CD9"><enum>(b)</enum><header>Specific prohibitions</header><text>For purposes of this Act, discrimination by a public entity or LTSS insurance provider includes—</text> 
<paragraph id="H6DF69FFFD4C44758B498DD4A611A1D07"><enum>(1)</enum><text>the imposition or application of eligibility criteria or another policy that prevents or tends to prevent an individual with an LTSS disability, or any class of individuals with LTSS disabilities, from receiving a community-based long-term service or support;</text></paragraph> <paragraph id="H3C90D5A321C441ECA6B3994EDC1C70CB"><enum>(2)</enum><text>the imposition or application of a policy or other mechanism, such as a service or cost cap, that prevent or tends to prevent an individual with an LTSS disability, or any class of individuals with LTSS disabilities, from receiving a community-based long-term service or support;</text></paragraph> 
<paragraph id="HEB0AEEA3D5FF4865B8E0E8AF5C87919B"><enum>(3)</enum><text>a failure to provide a specific community-based long-term service or support or a type of community-based long-term service or support needed for an individual with an LTSS disability, or any class of individuals with LTSS disabilities;</text></paragraph> <paragraph id="H5530806DF20E4036ADBAE9AF2997B7DE"><enum>(4)</enum><text>the imposition or application of a policy, rule, regulation, or restriction that interferes with the opportunity for an individual with an LTSS disability, or any class of individuals with LTSS disabilities, to live in the community and lead an independent life, which may include a requirement that an individual with an LTSS disability receive a service or support (such as day services or employment services) in a congregate or disability-specific setting;</text></paragraph> 
<paragraph id="H3576223871DD4EAB81407853561DF301"><enum>(5)</enum><text>the imposition or application of a waiting list or other mechanism that delays or restricts access of an individual with an LTSS disability to a community-based long-term service or support;</text></paragraph> <paragraph id="HAA663E9B4F25467A9A55DAA07E266181"><enum>(6)</enum><text>a failure to establish an adequate rate or other payment structure that is necessary to ensure the availability of a workforce sufficient to support an individual with an LTSS disability in living in the community and leading an independent life;</text></paragraph> 
<paragraph id="H9F3583929C1F4A338D3B47E0C1708210"><enum>(7)</enum><text>a failure to provide community-based services and supports, on an intermittent, short-term, or emergent basis, that assist an individual with an LTSS disability to live in the community and lead an independent life;</text></paragraph> <paragraph id="HFE7D967F20D1496E8303FF411607F1C4"><enum>(8)</enum><text>the imposition or application of a policy, such as a requirement that an individual utilize informal support, that restricts, limits, or delays the ability of an individual with an LTSS disability to secure a community-based long-term service or support to live in the community or lead an independent life;</text></paragraph> 
<paragraph id="H60600AC69EF04F0686816B370AFE7911"><enum>(9)</enum><text>a failure to implement a formal procedure and a mechanism to ensure that—</text> <subparagraph id="H7927DDF388AF4A6A867B006517E9A94C"><enum>(A)</enum><text>individuals with LTSS disabilities are offered the alternative of community-based long-term services and supports prior to institutionalization; and</text></subparagraph> 
<subparagraph id="H301C728CC4184A5F9B13650BD69AA061"><enum>(B)</enum><text>if selected by an individual with an LTSS disability, the community-based long-term services and supports described in subparagraph (A) are provided;</text></subparagraph></paragraph> <paragraph id="HF56BF776FD7B4C06BE110F643E1F4AD6"><enum>(10)</enum><text>a failure to ensure that each institutionalized individual with an LTSS disability is regularly notified of the alternative of community-based long-term services and supports and that those community-based long-term services and supports are provided if the individual with an LTSS disability selects such services and supports;</text></paragraph> 
<paragraph id="H31AF42FBC56A478E90840A32BA994ECA"><enum>(11)</enum><text>a failure to make a reasonable modification in a policy, practice, or procedure, when such modification is necessary to allow an individual with an LTSS disability to receive a community-based long-term service or support; and</text></paragraph> <paragraph id="HE4E897613823470C8A3041354F1F667B"><enum>(12)</enum><text display-inline="yes-display-inline">a failure to ensure that an individual with an LTSS disability has access to affordable, accessible, and integrated housing, that allows the individual to live in the community and lead an independent life, including access to an option to live in housing where the receipt of LTSS is not tied to tenancy.</text></paragraph></subsection> 
<subsection id="H813A1321A53C416495C5D5E01FE5B9CC"><enum>(c)</enum><header>Construction</header><text>Nothing in this section—</text> <paragraph id="H5A3147D1C7CF42518E9BD261FB9513CE"><enum>(1)</enum><text>shall be construed—</text> 
<subparagraph id="H3625FB07D24A4963A3DD4D4E48428BF6"><enum>(A)</enum><text>to prevent a public entity or LTSS insurance provider from providing community-based long-term services and supports at a level that is greater than the level that is required by this section;</text></subparagraph> <subparagraph id="H1AE0D4F4AA784405A6D44D7E406CFEC0"><enum>(B)</enum><text>to limit the rights of an individual with a disability under any provision of law other than this section;</text></subparagraph> 
<subparagraph id="HD37B7C23A201472E90F037884D452686"><enum>(C)</enum><text>to require that an individual with an LTSS disability live or receive services or supports in a more integrated setting if the individual chooses a less integrated setting; or</text></subparagraph> <subparagraph id="H31548ED8B13D4F8482997C98C6FD3008"><enum>(D)</enum><text display-inline="yes-display-inline">to establish a right for an individual with an LTSS disability to remain in a specific institution;</text></subparagraph></paragraph> 
<paragraph id="HBFD902DD1F2C42798D5091ABD3481884"><enum>(2)</enum><text>shall be construed to affect the scope of obligations imposed by any other provision of law; or</text></paragraph> <paragraph id="H2023DE75211848A591621B4B86C88C5D"><enum>(3)</enum><text>shall be construed to prohibit a public entity or LTSS insurance provider from using managed care techniques, as long as the use of such techniques does not have the effect of discriminating against an individual in the provision of community-based long-term services and supports, as prohibited by this Act.</text></paragraph></subsection></section> 
<section id="H1041F15429234731B6E412034B2F415D"><enum>5.</enum><header>Administration</header> 
<subsection id="HAC14FC5ECD5F4D1A845A750A5AC2A4FF"><enum>(a)</enum><header>Authority and responsibility</header> 
<paragraph id="HF70102E0F5694621BDC9B8A64E09DCF3"><enum>(1)</enum><header>Department of Justice</header><text>The Attorney General shall investigate and take enforcement action for violations of this Act.</text></paragraph> <paragraph id="H60D957F117504AABA12DD707A002D62B"><enum>(2)</enum><header>Department of Health and Human Services</header><text>The Secretary of Health and Human Services, through the Administrator, shall—</text> 
<subparagraph id="HFD647FB7D1DA45F3AAB22419711BF844"><enum>(A)</enum><text>review, and approve or disapprove, transition plans submitted by public entities, under section 6(b)(10);</text></subparagraph> <subparagraph id="H83856E704CB74A77A404D36130D64E11"><enum>(B)</enum><text>establish a task force to identify socio-demographic, geographic, and other factors that are barriers that prevent individuals with LTSS disabilities from receiving community-based long-term services and supports or from being able to choose alternatives in the community to institutionalization and identify other disparities in the availability and provision of community-based long-term services and supports, which task force shall be responsible for—</text> 
<clause id="H9ACBA517901F4D7DACD289265BF09422"><enum>(i)</enum><text>overseeing studies regarding the nature and extent of those barriers and disparities and the impact that those barriers and disparities have on the institutionalization of individuals with LTSS disabilities; and</text></clause> <clause id="H82E4917D82C04CCC8E4F182670DDEB4C"><enum>(ii)</enum><text>submitting to Congress not later than 2 years after the date of enactment of this Act a report on the nature and extent of those barriers and disparities, including a description of legislative or executive action to address the barriers and disparities; and</text></clause></subparagraph> 
<subparagraph id="H3B12B567F36A4147817BA6402B6EF74E"><enum>(C)</enum><text>refer information on violations of this Act to the Attorney General for investigation and enforcement action under this Act.</text></subparagraph></paragraph></subsection> <subsection id="H24D5F2A2E2E9401FABA087DF45A65CB4"><enum>(b)</enum><header>Cooperation of executive departments and agencies</header><text>Each Federal agency and, in particular, each Federal agency covered by Executive Order 13217 (66 Fed. Reg. 33155; relating to community-based alternatives for individuals with disabilities), shall carry out programs and activities relating to the institutionalization of individuals with LTSS disabilities and the provision of community-based long-term services and supports for individuals with LTSS disabilities in accordance with this Act and shall cooperate with the Attorney General and the Administrator to further the purposes of this Act.</text></subsection></section> 
<section id="H1CA29FF9BD6242D2992478C8A703BF66"><enum>6.</enum><header>Regulations</header> 
<subsection id="H66C685A707C54DC9A7ECBE1B3C1A82A8"><enum>(a)</enum><header>Issuance of regulations</header><text>Not later than 2 years after the date of enactment of this Act, the Attorney General shall issue, in accordance with section 553 of title 5, United States Code, final regulations to carry out this Act, which shall include the regulations described in subsection (b).</text></subsection> <subsection id="H43F56427F59B402F9C65E3CA6AFD9733"><enum>(b)</enum><header>Required contents of regulations</header> <paragraph id="H27DD0BB2A0F4432CA46E3B73FEAE0312"><enum>(1)</enum><header>Protected individuals</header><text>The regulations shall require each public entity and LTSS insurance provider to offer, and, if accepted, provide community-based long-term services and supports as required under this Act to any individual with an LTSS disability who would otherwise qualify for institutional placement provided or funded by the public entity or LTSS insurance provider.</text></paragraph> 
<paragraph id="HCA2254A3D1F543B78C355D1359F45636"><enum>(2)</enum><header>Services to be provided</header><text>The regulations issued under this section shall require each public entity and LTSS insurance provider to provide the Attorney General and the Administrator (for purposes of enabling the Attorney General to consult with the Administrator) with an assurance that the public entity or LTSS insurance provider—</text> <subparagraph id="H52264ED77D1E4DED9153A4518FFE3F96"><enum>(A)</enum><text>ensures that individuals with LTSS disabilities receive assistance through hands-on assistance, training, cueing, and safety monitoring, including access to backup systems, with—</text> 
<clause id="H0F917E8B3D1C425B9C656213DE438F99"><enum>(i)</enum><text>activities of daily living;</text></clause> <clause id="H838CCE2E52614B93A204FB6E79F67510"><enum>(ii)</enum><text>instrumental activities of daily living;</text></clause> 
<clause id="H339B2958A69B4B2185CB555D503B3375"><enum>(iii)</enum><text>health-related tasks; or</text></clause> <clause id="H547611769824409F8EDA52A42B5F5AF9"><enum>(iv)</enum><text>other functions, tasks, or activities related to an activity or task described in clause (i), (ii), or (iii);</text></clause></subparagraph> 
<subparagraph id="HE0EA41BF6E2344C0BC75E5D73041247B"><enum>(B)</enum><text>coordinates, conducts, performs, provides, or funds discharge planning from acute and rehabilitation facilities, and other institutions, to promote individuals with LTSS disabilities living in the most integrated setting chosen by the individuals;</text></subparagraph> <subparagraph id="HB178FB2C1E0E4763BF4E69510FADBF42"><enum>(C)</enum><text>issues, conducts, performs, provides, or funds policies and programs to promote self-direction and the provision of consumer-directed services and supports for all populations of individuals with LTSS disabilities served;</text></subparagraph> 
<subparagraph id="HC48EAAB5D1194473A3E7B826507BD5F2"><enum>(D)</enum><text>issues, conducts, performs, provides, or funds policies and programs to support informal caregivers who provide services for individuals with LTSS disabilities; and</text></subparagraph> <subparagraph id="HDF38FCA803E44A8995037F7DE4A0AC29"><enum>(E)</enum><text>ensures that individuals with all types of LTSS disabilities are able to live in the community and lead an independent life, including ensuring that the individuals have maximum control over the services and supports that the individuals receive, choose the setting in which the individuals receive those services and supports, and exercise control and direction over their own lives.</text></subparagraph></paragraph> 
<paragraph id="H940861AB783745C391EB3087C4A294FB"><enum>(3)</enum><header>Public participation</header> 
<subparagraph id="HB988B44805D44BACAC8C6FC538471D33"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The regulations issued under this section shall require each public entity and LTSS insurance provider to carry out a public participation process that involves holding a public hearing, providing an opportunity for public comment, and consulting with individuals with LTSS disabilities, in preparing the public entity or LTSS insurance provider’s self-evaluation under paragraph (5) and transition plan under paragraph (10).</text></subparagraph> <subparagraph id="HBC63D1B1028D411EAFE35B2C1DB226B7"><enum>(B)</enum><header>Process</header><text>In carrying out a public participation process under subparagraph (A), a public entity or LTSS insurance provider shall ensure that the process meets the requirements of subparagraphs (A) and (C) of section 1115(d)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1315">42 U.S.C. 1315(d)(2)</external-xref>), except that—</text> 
<clause id="HA5D371A2C6AA45728EEC801D100C4E8F"><enum>(i)</enum><text>the reference to <quote>at the State level</quote> shall be disregarded; and</text></clause> <clause id="H7556092F1F99407091625F1502D83D60"><enum>(ii)</enum><text>the reference to an application shall be considered to be a reference to the self-evaluation or plan involved.</text></clause></subparagraph></paragraph> 
<paragraph id="HF6F4BFC657014FB28D24C58F071AD40C"><enum>(4)</enum><header>Additional services and supports</header><text display-inline="yes-display-inline">The regulations issued under this section shall establish circumstances under which a public entity or LTSS insurance provider shall provide community-based long-term services and supports under this section beyond the level of community-based long-term services and supports which would otherwise be required under this subsection.</text></paragraph> <paragraph id="H2591168E86A64FC09C0ADEEFFE63A082"><enum>(5)</enum><header>Self-evaluation</header> <subparagraph id="H31376E2CCFF647A18E922959F0C11CD2"><enum>(A)</enum><header>In general</header><text>The regulations issued under this section shall require each public entity and each LTSS insurance provider, not later than 36 months after the date of enactment of this Act, to evaluate current services, policies, and practices, and the effects thereof, that do not or may not meet the requirements of this Act and, to the extent modification of any such services, policies, and practices is required to meet the requirements of this Act, make the necessary modifications. The self-evaluation shall include—</text> 
<clause id="H7FC0298130DA4D30A246E45F74DD3750"><enum>(i)</enum><text>collection of baseline information, including the numbers of individuals with LTSS disabilities in various institutional and community-based settings served by the public entity or LTSS insurance provider, including demographic data that—</text> <subclause id="HAB8350DCDF07479881F80907DDD9A4EB"><enum>(I)</enum><text>specifies whether the individuals are women, veterans, or members of a racial and ethnic minority group, as defined in section 1707 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300u-6">42 U.S.C. 300u–6</external-xref>); and</text></subclause> 
<subclause id="H9BB4C7CF083F48BB946CFBD86AE76AEF"><enum>(II)</enum><text>is disaggregated by race in a manner that captures all the racial groups specified in the American Community Survey conducted by the Bureau of the Census;</text></subclause></clause> <clause id="H1A7EC94D15E3405ABD29DB2DFBDA9D6F"><enum>(ii)</enum><text display-inline="yes-display-inline">a review of community capacity, in communities served by the public entity or LTSS insurance provider, in providing community-based long-term services and supports;</text></clause> 
<clause id="H419AFB24AF484DBF9F35DB4DD0DBE10E"><enum>(iii)</enum><text display-inline="yes-display-inline">an assessment of the availability of accessible, affordable transportation and whether transportation barriers prevent individuals served by the public entity or LTSS insurance provider from receiving long-term services and supports in the community;</text></clause> <clause id="H942347D2A88E47AC80DEB98B9B0170F7"><enum>(iv)</enum><text>identification of improvements needed to ensure that all community-based long-term services and supports provided by the public entity or LTSS insurance provider to individuals with LTSS disabilities are comprehensive, are accessible, are not duplicative of existing (as of the date of the identification) services and supports, meet the needs of persons who are likely to require assistance in order to live, or lead a life, as described in section 4(a), and are culturally competent, high-quality services and supports, which may include identifying system improvements that create an option to self-direct receipt of such services and supports for all populations of such individuals served;</text></clause> 
<clause id="H3B6325856E8F41A7A3F2F1444F5AC775"><enum>(v)</enum><text>a review of funding sources for community-based long-term services and supports and an analysis of how those funding sources could be organized into a fair, coherent system that affords individuals reasonable and timely access to culturally competent, community-based long-term services and supports; and</text></clause> <clause id="H664017EEADA649F09B8244A3FE8457F9"><enum>(vi)</enum><text display-inline="yes-display-inline">a review of all agents, subcontractors, or other instrumentalities funded by the public entity or LTSS insurance provider to authorize or provide LTSS, to ensure that the agents, subcontractors, or other instrumentalities comply with this Act.</text></clause></subparagraph> 
<subparagraph id="H087D07469A38431B9C8672AE8ACC94C4"><enum>(B)</enum><header>Additional requirements</header><text>Public entities and LTSS insurance providers shall—</text> <clause id="H4463397DF86E46F78E0D97D7934F9152"><enum>(i)</enum><text>provide the self-evaluation described in subparagraph (A) to the Attorney General;</text></clause> 
<clause id="H4C856A32865049DB9FA8C3BB4E4768E1"><enum>(ii)</enum><text display-inline="yes-display-inline">make the self-evaluation described in subparagraph (A) available on the public internet website of the entity; and</text></clause> <clause id="H3A9F99415AD14E6A80C59AD3F8D3A6CE"><enum>(iii)</enum><text display-inline="yes-display-inline">keep the self-evaluation described in subparagraph (A) on file, and may be required to produce such self-evaluation in the event of a review, investigation, or action described in section 8.</text></clause></subparagraph> </paragraph> 
<paragraph id="H73E8E91AD77F4CABA1FE2D9A97887F89"><enum>(6)</enum><header>Housing</header><text display-inline="yes-display-inline">The regulations issued under this section shall require a public entity and require an LTSS insurance provider, who funds or provides housing and housing services to review and improve community capacity in providing affordable, accessible, and integrated housing, including conducting an evaluation of available units, unmet need, and other identifiable barriers to the provision of that housing. In carrying out that improvement, the public entity or LTSS insurance provider shall—</text> <subparagraph id="H314662FD300E4D2AA1EA5B988155971C"><enum>(A)</enum><text>ensure, and assure the Attorney General and the Administrator that there is, sufficient availability of affordable, accessible, and integrated housing in a setting that is not a disability-specific residential setting or a setting where services are tied to tenancy, in order to provide individuals with LTSS disabilities a meaningful choice in their housing;</text></subparagraph> 
<subparagraph commented="no" id="H577E83769B3E43FEA3F0623D86123F57"><enum>(B)</enum><text display-inline="yes-display-inline">establish relationships with State and local housing authorities in order to address the need for affordable, accessible, and integrated housing;</text> </subparagraph> <subparagraph id="H7CDDF0D97C4A41049B30C9EF74BD2670"><enum>(C)</enum><text>establish, where needed, necessary preferences and set-asides in housing programs for individuals with LTSS disabilities who are transitioning from or avoiding institutional placement;</text></subparagraph> 
<subparagraph id="HCA2C33DF1171446C87EAF6C786A0F674"><enum>(D)</enum><text>establish a process to fund necessary home modifications so that individuals with LTSS disabilities can live independently; and</text></subparagraph> <subparagraph id="H9A079F3C449D4CD6BD3F0202F0D26910"><enum>(E)</enum><text display-inline="yes-display-inline">ensure, and assure the Attorney General and the Administrator, that funds and programs implemented or overseen by the public entity or LTSS insurance provider are targeted toward affordable, accessible, integrated housing for individuals with an LTSS disability who have the lowest income levels as a priority over any other development until capacity barriers for such housing are removed or unmet needs for such housing have been met.</text></subparagraph></paragraph> 
<paragraph id="HAAF04E0743294B05B203E6620793A455"><enum>(7)</enum><header>Designation of responsible employee</header><text>The regulations issued under this section shall require each public entity and LTSS insurance provider to designate at least one employee to coordinate the entity’s or provider’s efforts to comply with and carry out the entity or provider’s responsibilities under this Act, including the investigation of any complaint communicated to the entity or provider that alleges a violation of this Act. Each public entity and LTSS insurance provider shall make available to all interested individuals the name, office address, and telephone number of the employee designated pursuant to this paragraph.</text></paragraph> <paragraph id="HBB99F630DC4A4376913DE1DDC9D57E96"><enum>(8)</enum><header>Grievance procedures</header><text>The regulations issued under this section shall require public entities and LTSS insurance providers to adopt and publish grievance procedures providing for prompt and equitable resolution of complaints alleging a violation of this Act.</text></paragraph> 
<paragraph id="H205DCEBE27D14819A7F47C669BF4D1C1"><enum>(9)</enum><header>Provision of service by others</header><text display-inline="yes-display-inline">The regulations issued under this section shall require each public entity or LTSS insurance provider submitting a self-evaluation under paragraph (5) to identify, as part of the transition plan described in paragraph (10), any other entity that is, or acts as, an agent, subcontractor, or other instrumentality of the public entity or LTSS insurance provider with regards to a service, support, policy, or practice described in such plan or self-evaluation.</text></paragraph> <paragraph id="H936CD18F6A174D6888EEE0B23D078E7C"><enum>(10)</enum><header>Transition plans</header><text display-inline="yes-display-inline">The regulations issued under this section shall require each public entity, and each LTSS insurance provider, that is not able to demonstrate full compliance with this Act through its self-evaluation, not later than 54 months after the date of enactment of this Act. The regulations shall require that public entity or LTSS insurance provider to submit to the Administrator and, on approval by the Administrator, begin implementing a transition plan for carrying out this Act that establishes the achievement of the requirements of this Act, as soon as practicable, but in no event later than 12 years after the date of enactment of this Act. The transition plan shall—</text> 
<subparagraph id="H9E1FE8C147B04910A19B5163E3EB1F47"><enum>(A)</enum><text>establish measurable objectives to address the barriers to community living identified in the self-evaluation under paragraph (5);</text></subparagraph> <subparagraph id="H3854A0DCD4534E2F918B7DE427283C27"><enum>(B)</enum><text>establish specific annual targets for the transition of individuals with LTSS disabilities, and shifts in funding, from institutional settings to integrated community-based services and supports, and related programs;</text></subparagraph> 
<subparagraph id="H706F4173CC3144B7B54337ACEC78944A"><enum>(C)</enum><text>describe specific efforts to support individuals with LTSS disabilities to avoid unwanted institutionalization through the provision of LTSS;</text></subparagraph> <subparagraph id="H785DEDFA45B34C0FA5E0041A7947E998"><enum>(D)</enum><text display-inline="yes-display-inline">describe the manner in which the public entity or LTSS insurance provider has obtained or plans to obtain necessary funding and resources needed for implementation of the plan (regardless of whether the entity or provider began carrying out the objectives of this Act prior to the date of enactment of this Act); and</text></subparagraph> 
<subparagraph id="H305149ADCF31472BA9BCB2F75E1A30FB">
            <enum>(E)</enum>
 <text>describe the steps taken to ensure that the transition plan addresses the needs of individuals from all sociodemographic and geographic backgrounds.</text>
          </subparagraph></paragraph> 
<paragraph id="H144A2A0B863249F0B26AD267D283BE53"><enum>(11)</enum><header>Annual reporting</header> 
<subparagraph id="H607E9B9DD4EE4FDFA230AB316C705C90"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The regulations issued under this section shall establish annual reporting requirements for each public entity or LTSS insurance provider covered by this section.</text></subparagraph> <subparagraph id="HBFF78D40568A4CF799AB3CCDD4D75748"><enum>(B)</enum><header>Progress on objectives, targets, and efforts</header><text display-inline="yes-display-inline">The regulations issued under this section shall require each public entity or LTSS insurance provider that has submitted a transition plan, to make publicly available on the entity’s website an annual report on the progress the public entity or LTSS insurance provider has made during the previous year in meeting the measurable objectives, specific annual targets, and specific efforts described in paragraph (10).</text></subparagraph></paragraph></subsection> 
<subsection id="H2D7F096AD998412E8C1F4141493BEEFC"><enum>(c)</enum><header>Review of transition plans</header> 
<paragraph id="H21DCBEB3F811430EA238F26742591A24"><enum>(1)</enum><header>General rule</header><text>The Administrator shall review a transition plan submitted in accordance with subsection (b)(10), not later than 90 days after receiving the plan, for the purpose of determining whether such plan meets the requirements of this Act, including the regulations issued under this section.</text></paragraph> <paragraph id="HF054B6EC0D7542D2A9627B67D62B333B"><enum>(2)</enum><header>Disapproval</header><text display-inline="yes-display-inline">If the Administrator determines that a transition plan reviewed under this subsection fails to meet the requirements of this Act, the Administrator shall disapprove the transition plan and notify the public entity or LTSS insurance provider that submitted the transition plan of, and the reasons for, such disapproval.</text></paragraph> 
<paragraph id="H00B4D943E9E54A6F8559B9DC43FEA35D"><enum>(3)</enum><header>Modification of disapproved plan</header><text display-inline="yes-display-inline">Not later than 90 days after the date of disapproval of a transition plan under this subsection, the public entity or LTSS insurance provider that submitted the transition plan shall modify the transition plan to meet the requirements of this section and shall submit the modified plan to the Administrator. Not later than 90 days after receiving the modified plan, the Administrator shall review the plan and, on approval by the Administrator, the public entity or LTSS insurance provider shall begin implementing the plan.</text></paragraph></subsection> <subsection id="H743216AFCC7F452B9FE6E0C56471AB3F"><enum>(d)</enum><header>Rule of construction</header><text>Nothing in subsection (b)(10) or (c) or any other provision of this Act shall be construed to limit the rights, protections, or requirements of any other Federal law, relating to integration of individuals with disabilities into the community and enabling those individuals to live in the most integrated setting.</text></subsection></section> 
<section id="H2FA3F22AE18A4B6D9E2B6D65DB090D39"><enum>7.</enum><header>Exemptions for religious organizations</header><text display-inline="no-display-inline">This Act shall not prohibit a religious organization, association, or society from giving preference in providing community-based long-term services and supports to individuals of a particular religion connected with the beliefs of such organization, association, or society.</text></section> <section id="H303FEEF6158E4BF7BEF5385555FC2548"><enum>8.</enum><header>Enforcement</header> <subsection id="H7ED660884F4A44D68BE3C1A47E64E40D"><enum>(a)</enum><header>Civil action</header> <paragraph id="HE4AC51CFE0B04747952EEC78E22B64D2"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">A civil action for preventive relief, including an application for a permanent or temporary injunction, restraining order, or other order, may be instituted by an individual described in paragraph (2) in an appropriate district court of the United States not earlier than 2 years after the date of enactment of this Act.</text></paragraph> 
<paragraph id="HD581DFF64A2942CC893F39ED324FB7B8"><enum>(2)</enum><header>Aggrieved individual</header> 
<subparagraph id="HA7C11F648C5443D8AF940697CC7F5FC7"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">This Act provides the remedies and procedures set forth in this section to any individual who is being subjected to a violation of this Act, or who has reasonable grounds for believing that such individual is about to be subjected to such a violation.</text></subparagraph> <subparagraph id="HF33815AEF1CF450E8AA6A7F2DC9C0BD9"><enum>(B)</enum><header>Standing</header><text display-inline="yes-display-inline">An individual with a disability (including an individual acting on their behalf) shall have standing to institute a civil action under this subsection if the individual makes a prima facie showing that the individual with a disability—</text> 
<clause id="HF6BB7BF2E4C14E3CB955C00290C30E5C"><enum>(i)</enum><text>is an individual with an LTSS disability; and</text></clause> <clause id="HA5267E7EBC8E403A9793AB287294D047"> <enum>(ii)</enum> <text display-inline="yes-display-inline">is being subjected to, or has the reasonable grounds described in subparagraph (A) concerning, such a violation (including a violation) of section 4(b)(11).</text>
            </clause></subparagraph></paragraph> 
<paragraph id="H0CF2F69D1E0540D58585B8ABBCA2A8B1"><enum>(3)</enum><header>Appointment of attorney; no fees, costs, or security</header><text>Upon application by the plaintiff described in paragraph (2) and in such circumstances as the court may determine to be just, the court may appoint an attorney for the plaintiff and may authorize the commencement of such civil action without the payment of fees, costs, or security.</text></paragraph> <paragraph id="H49603B29B3BE43E7BFF37D406FFC2FCF"><enum>(4)</enum><header>Futile gesture not required</header><text>Nothing in this section shall require an individual with an LTSS disability to engage in a futile gesture if such person has actual notice that a public entity or LTSS insurance provider does not intend to comply with the provisions of this Act.</text></paragraph></subsection> 
<subsection id="H73791F867C084BCBBE2B7A4068046A97"><enum>(b)</enum><header>Damages and injunctive relief</header><text>If the court finds that a violation of this Act has occurred or is about to occur, the court may award to the plaintiff—</text> <paragraph id="H047E1574290E4CA8827371FF0CF8EFF7"><enum>(1)</enum><text>actual and punitive damages;</text></paragraph> 
<paragraph id="H8921E267ACCB447896BA884ECC00AF40"><enum>(2)</enum><text>immediate injunctive relief to prevent institutionalization;</text></paragraph> <paragraph id="H76DF87EAC4A945E982C1AC44F3BFC5A3"><enum>(3)</enum><text>as the court determines to be appropriate, any permanent or temporary injunction (including an order to immediately provide or maintain community-based long-term services or supports for an individual to prevent institutionalization or further institutionalization), temporary restraining order, or other order (including an order enjoining the defendant from engaging in a practice that violates this Act or ordering such affirmative action as may be appropriate); and</text></paragraph> 
<paragraph id="H5984196B1CEA4FBF86B8C1C89D038A01"><enum>(4)</enum><text>in an appropriate case, injunctive relief to require the modification of a policy, practice, or procedure, or the provision of an alternative method of providing LTSS, to the extent required by this Act.</text></paragraph></subsection> <subsection id="H910638AA7E2D4F8BA532F7203DB33302"><enum>(c)</enum><header>Attorney’s fees; liability of United States for costs</header><text>In any action commenced pursuant to this Act, the court, in its discretion, may allow the party bringing a claim or counterclaim under this Act, other than the United States, a reasonable attorney’s fee as part of the costs, and the United States shall be liable for costs to the same extent as a private person.</text></subsection> 
<subsection id="H82B387DED4F44EE1858234D6F7D13DBE"><enum>(d)</enum><header>Enforcement by attorney general</header> 
<paragraph id="HFEC8D399494B4F7D83E300BB9C256C33"><enum>(1)</enum><header>Denial of rights</header> 
<subparagraph id="H25A74E3288CC43E7BC3AE7DCE5389D12"><enum>(A)</enum><header>Duty to investigate</header><text>The Attorney General shall investigate alleged violations of this Act, and shall undertake periodic reviews of the compliance of public entities and LTSS insurance providers under this Act.</text></subparagraph> <subparagraph id="H73409EECB4B54278800C2E4A64F3A84D"><enum>(B)</enum><header>Potential violation</header><text>The Attorney General may commence a civil action in any appropriate Federal district court if the Attorney General has reasonable cause to believe that—</text> 
<clause id="H9099C3FF72EA48E28DA227555C0685AC"><enum>(i)</enum><text>any public entity or LTSS insurance provider, including a group of public entities or LTSS insurance providers, is engaged in a pattern or practice of violations of this Act; or</text></clause> <clause id="H38AAEB0AF46E4BB59F0B94F3DD39E8A0"><enum>(ii)</enum><text>any individual, including a group, has been subjected to a violation of this Act and the violation raises an issue of general public importance.</text></clause></subparagraph></paragraph> 
<paragraph id="HB68DB19FCD054D7C8429F280018633AA"><enum>(2)</enum><header>Authority of court</header><text>In a civil action under paragraph (1)(B), the court—</text> <subparagraph id="H798CA08090BA43C6900A2B235C369AB3"><enum>(A)</enum><text>may grant any equitable relief that such court considers to be appropriate, including, to the extent required by this Act—</text> 
<clause id="H0C253A2F3A1E42E3A31338DA1A94C605"><enum>(i)</enum><text>granting temporary, preliminary, or permanent relief; and</text></clause> <clause id="H2B9D31CA31DE4F188431D8DA63FF6826"><enum>(ii)</enum><text>requiring the modification of a policy, practice, or procedure, or the provision of an alternative method of providing LTSS;</text></clause></subparagraph> 
<subparagraph id="HC8450DAC1951467CB70318878EA60DE0"><enum>(B)</enum><text>may award such other relief as the court considers to be appropriate, including damages to individuals described in subsection (a)(2), when requested by the Attorney General; and</text></subparagraph> <subparagraph id="H6B437645C5A04D76B1A310165C0DDD68"><enum>(C)</enum><text>may, to vindicate the public interest, assess a civil penalty against the public entity or LTSS insurance provider in an amount—</text> 
<clause id="HB71877A524DC4B6B9572052EE4768F6E"><enum>(i)</enum><text>not exceeding $100,000 for a first violation; and</text></clause> <clause id="HB62180E33437441C8CC46B38009B8680"><enum>(ii)</enum><text>not exceeding $200,000 for any subsequent violation.</text></clause></subparagraph></paragraph> 
<paragraph id="H4E54A445D6164CE38ADAD8BAB9A7435B"><enum>(3)</enum><header>Single violation</header><text>For purposes of paragraph (2)(C), in determining whether a first or subsequent violation has occurred, a determination in a single action, by judgment or settlement, that the public entity or LTSS insurance provider has engaged in more than one violation of this Act shall be counted as a single violation.</text></paragraph></subsection></section> <section id="H01B9876D6D9E49D4855B68E95C1E538F"><enum>9.</enum><header>Construction</header><text display-inline="no-display-inline">For purposes of construing this Act—</text> 
<paragraph id="HA9FF1D1AA2BC4DC2BF6E94DA0D0F0226"><enum>(1)</enum><text>section 4(b)(11) shall be construed in a manner that takes into account its similarities with section 302(b)(2)(A)(ii) of the Americans with Disabilities Act of 1990 (<external-xref legal-doc="usc" parsable-cite="usc/42/12182">42 U.S.C. 12182(b)(2)(A)(ii)</external-xref>);</text></paragraph> <paragraph id="H255D7DFCDDFD48BBA83AFA0B2A514712"><enum>(2)</enum><text>the first sentence of section 6(b)(5)(A) shall be construed in a manner that takes into account its similarities with section 35.105(a) of title 28, Code of Federal Regulations (as in effect on the day before the date of enactment of this Act);</text></paragraph> 
<paragraph id="HD0A278D32FEC4A96845AECB7DC3BD7B0"><enum>(3)</enum><text>section 7 shall be construed in a manner that takes into account its similarities with section 807(a) of the Civil Rights Act of 1968 (<external-xref legal-doc="usc" parsable-cite="usc/42/3607">42 U.S.C. 3607(a)</external-xref>);</text></paragraph> <paragraph id="HA7B02FEE88EE4988AD54724D15DEA3CA"><enum>(4)</enum><text>section 8(a)(2) shall be construed in a manner that takes into account its similarities with section 308(a)(1) of the Americans with Disabilities Act of 1990 (<external-xref legal-doc="usc" parsable-cite="usc/42/12188">42 U.S.C. 12188(a)(1)</external-xref>); and</text></paragraph> 
<paragraph commented="no" display-inline="no-display-inline" id="H1D4DC7EBDC234F619ECC740C83E99ACC"><enum>(5)</enum><text>section 8(d)(1)(B) shall be construed in a manner that takes into account its similarities with section 308(b)(1)(B) of the Americans with Disabilities Act of 1990 (<external-xref legal-doc="usc" parsable-cite="usc/42/12188">42 U.S.C. 12188(b)(1)(B)</external-xref>).</text></paragraph></section> </legis-body></bill>

