PUBLIC LAW 100-607—NOV. 4, 1988

102 STAT. 3081

"(4) give priority to the provision of outreach and home and
community-based services to eligible individuals with low
incomes.
"(b) authority for grants and contracts.—a State may make
payment for services under subsection (a) through grants to public
and nonprofit private entities and through contracts with public and
private entities. In providing such financial assistance, a State shall
give priority to public and nonprofit private entities that have
demonstrated experience in delivering home and community-based
health services to individuals with the etiologic agent for acquired
immune deficiency syndrome.
"SEC. 2403. REQUIREMENT  OF   SUBMISSION   OF  DESCRIPTION  OF  IN-   42 USC 300dd-2.
TENDED USES OF GRANT.
"The Secretary may not make payments under section 2401(a) to a
State for a fiscal year unless—
"(1) the State submits to the Secretary a description of the
purposes for which the State intends to expend such payments
for the fiscal year;
"(2) such description provides information relating to the
services and activities to be provided, including a description of
the manner in which such services and activities will be coordi-
nated with any similar services and activities of public and
private entities; and
"(3) such description includes information relating to (A) the
_S
rocess for determining which eligible individuals are medically
ependent or chronically dependent and (B) the process for
establishing written plans of care for the provision of home and
community-based health services under this part.

"SEC. 2404. RESTRICTIONS ON USE OF GRANT.

42 USC 300dd-3.

"(a) in general.—The Secretary may not make payments under
section 2401(a) for a fiscal year to a State unless the State agrees
that the payments will not be expended—
*"(!) to provide for items or services described in section
2401(dX3);
"(2) to make cash payments to intended recipients of services;
"(3) to purchase or improve real property (other than minor   Real property.
remodeling of existing improvements to real property) or to
purchase major medical equipment; or
"(4) to satisfy any requirement for the expenditure of non-
Federal funds as a condition for the receipt of Federal funds,
"(b) limitation on administrative expenses.—The Secretary
may not make payments under section 2401(a) for a fiscal year
unless the State involved agrees that the State will not expend more
than 5 percent of the payments made to the State under such
section for administrative expenses with respect to carrying out the
purpose of this part.
"(c) limitation on total payments.—
"(1) Before March 1, 1989, for fiscal year 1989 and before
September 1 of 1989 for fiscal year 1990, the Secretary shall
determine and publish the national average monthly payments,
for extended care services under part A of title XVIII of the
Social Security Act, for each resident of a skilled nursing facil-
ity the Secretary estimates will be paid in the fiscal year.
"(2) The Secretary may not make payments under section
2401(a) for a fiscal year to a State to the extent that the average