H.R. 9401

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 9401 Introduced in House (IH)]

<DOC>

119th CONGRESS
2d Session
H. R. 9401

To prohibit discrimination against individuals with disabilities who 
need long-term services and supports, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

June 23, 2026

Mr. Cohen (for himself, Mr. Bacon, Ms. Barragan, Ms. Budzinski, Mr. 
Castro of Texas, Ms. Clarke of New York, Ms. Craig, Ms. Davids of 
Kansas, Ms. Dean of Pennsylvania, Mr. Fitzpatrick, Mr. Golden of Maine, 
Mr. Goldman of New York, Mr. Gottheimer, Mrs. Hayes, Mr. Horsford, Ms. 
Hoyle of Oregon, Mr. Jackson of Illinois, Mr. Johnson of Georgia, Mr. 
Larson of Connecticut, Mr. Lynch, Mrs. McBath, Ms. McBride, Ms. 
McClellan, Ms. McCollum, Ms. Moore of Wisconsin, Mr. Morelle, Mr. 
Moulton, Mr. Mullin, Mr. Neal, Mr. Panetta, Ms. Pingree, Ms. Salinas, 
Ms. Scholten, Ms. Simon, Mr. Smith of Washington, Mr. Soto, Ms. 
Stansbury, Ms. Strickland, Mr. Thompson of Mississippi, Mr. Tonko, Ms. 
Underwood, Mrs. Dingell, Mr. Van Drew, Mr. Van Orden, Mr. Vargas, Ms. 
Wasserman Schultz, Mrs. Watson Coleman, Ms. Williams of Georgia, and 
Ms. Wilson of Florida) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committee on the Judiciary, 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

_______________________________________________________________________

A BILL

To prohibit discrimination against individuals with disabilities who 
need long-term services and supports, and for other purposes.

Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Latonya Reeves Freedom Act of 
2026''.

SEC. 2. PURPOSES.

The purposes of this Act are--
(1) 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;
(2) 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;
(3) 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;
(4) to ensure that individuals with disabilities have 
maximum control over the services and supports that allow them 
to live in the community;
(5) to ensure that long-term services and supports are 
provided in a manner that allows individuals with disabilities 
to lead an independent life;
(6) 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
(7) to identify and address disparities in the provision of 
community-based long-term services and supports.

SEC. 3. DEFINITIONS AND RULE.

(a) Definitions.--In this Act:
(1) Activities of daily living.--The term ``activities of 
daily living'' has the meaning given the term in section 
441.505 of title 42, Code of Federal Regulations (or a 
successor regulation).
(2) Administrator.--The term ``Administrator'' means--
(A) the Administrator of the Administration for 
Community Living; or
(B) another designee of the Secretary of Health and 
Human Services.
(3) Community-based; services or supports.--The term 
``community-based'', 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:
(A) 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--
(i) 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--
(I) 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
(II) 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;
(ii) that the individual has selected as a 
meaningful choice from among nonresidential 
setting options, including nondisability-
specific settings;
(iii) in which an individual has rights to 
privacy, dignity, and respect, and freedom from 
coercion and restraint;
(iv) 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
(v) 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.
(B) In the case of a dwelling, a dwelling--
(i) that is owned by an individual with an 
LTSS disability or the individual's family 
member;
(ii) 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
(iii) that is a group or shared residence--
(I) in which no more than 4 
unrelated individuals with an LTSS 
disability reside;
(II) 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;
(III) in which each individual with 
an LTSS disability living at the 
residence--
(aa) has privacy in the 
individual's sleeping unit, 
including a lockable entrance 
door controlled by the 
individual;
(bb) 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;
(cc) has the freedom to 
furnish and decorate the 
individual's sleeping or living 
unit as permitted under the 
lease or other agreement;
(dd) has the freedom and 
support to control the 
individual's own schedules and 
activities; and
(ee) is able to have 
visitors of the individual's 
choosing at any time; and
(IV) that is physically accessible 
to the individual with an LTSS 
disability living at the residence.
(4) Community-based; setting.--The term ``community-
based'', when used in reference to a setting, means a setting 
described in subparagraph (A) or (B) of paragraph (3).
(5) Dwelling.--The term ``dwelling'' has the meaning given 
the term in section 802 of the Fair Housing Act (42 U.S.C. 
3602).
(6) Health-related tasks.--The term ``health-related 
tasks'' 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--
(A) administration of medication;
(B) assistance with use, operation, and maintenance 
of a ventilator; and
(C) maintenance and use of a gastrostomy tube, a 
catheter, or a stable ostomy.
(7) Individual with a disability.--The term ``individual 
with a disability'' means an individual who is a person with a 
disability, as defined in section 3 of the Americans with 
Disabilities Act of 1990 (42 U.S.C. 12102).
(8) Individual with an ltss disability.--The term 
``individual with an LTSS disability'' means an individual with 
a disability who--
(A) in order to live in the community and lead an 
independent life requires assistance in accomplishing--
(i) activities of daily living;
(ii) instrumental activities of daily 
living;
(iii) health-related tasks; or
(iv) other functions, tasks, or activities 
related to an activity or task described in 
clause (i), (ii), or (iii); and
(B)(i) is currently in an institutional placement; 
or
(ii) is at risk of institutionalization if the 
individual does not receive community-based long-term 
services and supports.
(9) Institution; institutionalization.--
(A) Institution.--The term ``institution'' means--
(i) a skilled nursing facility (as defined 
in section 1819(a) of the Social Security Act 
(42 U.S.C. 1395i-3(a)));
(ii) a nursing facility (as defined in 
section 1919(a) of such Act (42 U.S.C. 
1396r(a)));
(iii) a long-term care hospital (as 
described in section 1886(d)(1)(B)(iv) of such 
Act (42 U.S.C. 1395ww(d)(1)(B)(iv)));
(iv) a facility described in section 
1905(d) of such Act (42 U.S.C. 1396d(d));
(v) an institution which is a psychiatric 
hospital (as defined in section 1861(f) of such 
Act (42 U.S.C. 1395x(f))) or that provides in-
patient psychiatric services in a residential 
setting specified by the Secretary;
(vi) an institution described in section 
1905(i) of such Act (42 U.S.C. 1396d(i)); and
(vii) any congregate setting that is not 
community-based or that has the effect of 
isolating individuals with disabilities from 
the community.
(B) Institutionalization.--The term 
``institutionalization'', 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.
(10) Instrumental activities of daily living.--The term 
``instrumental activities of daily living'' means one or more 
activities related to living independently in the community, 
including activities related to--
(A) nutrition, such as preparing meals or special 
diets, monitoring to prevent choking or aspiration, or 
assisting with special utensils;
(B) household chores and environmental maintenance 
tasks;
(C) communication and interpersonal skills, such 
as--
(i) using the telephone or other 
communications devices;
(ii) forming and maintaining interpersonal 
relationships; or
(iii) securing opportunities to participate 
in group support or peer-to-peer support 
arrangements;
(D) travel and community participation, such as 
shopping, arranging appointments, or moving around the 
community;
(E) care of others, such as raising children, 
taking care of pets, or selecting caregivers; or
(F) management of personal property and personal 
safety, such as--
(i) taking medication;
(ii) handling or managing money; or
(iii) responding to emergent situations or 
unscheduled needs requiring an immediate 
response.
(11) Long-term service or support.--
(A) In general.--The terms ``long-term service or 
support'' and ``LTSS'' 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--
(i) activities of daily living;
(ii) instrumental activities of daily 
living;
(iii) health-related tasks; or
(iv) other functions, tasks, or activities 
related to an activity or task described in 
clause (i), (ii), or (iii).
(B) Assistance.--In subparagraph (A), the term 
``assistance'' 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--
(i) help the individual identify and set 
goals, communicate needs, overcome fears, and 
manage transitions;
(ii) help the individual with executive 
functioning, decisionmaking, self-expression, 
and problem solving;
(iii) provide reassurance to the 
individual; and
(iv) help the individual with orientation, 
memory, and other activities related to 
independent living.
(12) LTSS insurance provider.--The term ``LTSS insurance 
provider'' means a public or private entity that--
(A) provides funds for long-term services and 
supports; and
(B) is engaged in commerce or in an industry or 
activity affecting commerce.
(13) Public entity.--
(A) In general.--The term ``public entity'' means 
an entity that--
(i) provides or funds institutional 
placements for individuals with LTSS 
disabilities; and
(ii) is--
(I) a State or local government; or
(II) any department, agency, entity 
administering a special purpose 
district, or other instrumentality, of 
a State or local government.
(B) Interstate commerce.--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.
(b) Rule of Construction.--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.

SEC. 4. DISCRIMINATION.

(a) In General.--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.
(b) Specific Prohibitions.--For purposes of this Act, 
discrimination by a public entity or LTSS insurance provider includes--
(1) 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;
(2) 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;
(3) 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;
(4) 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;
(5) 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;
(6) 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;
(7) 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;
(8) 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;
(9) a failure to implement a formal procedure and a 
mechanism to ensure that--
(A) individuals with LTSS disabilities are offered 
the alternative of community-based long-term services 
and supports prior to institutionalization; and
(B) if selected by an individual with an LTSS 
disability, the community-based long-term services and 
supports described in subparagraph (A) are provided;
(10) 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;
(11) 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
(12) 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.
(c) Construction.--Nothing in this section--
(1) shall be construed--
(A) 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;
(B) to limit the rights of an individual with a 
disability under any provision of law other than this 
section;
(C) 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
(D) to establish a right for an individual with an 
LTSS disability to remain in a specific institution;
(2) shall be construed to affect the scope of obligations 
imposed by any other provision of law; or
(3) 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.

SEC. 5. ADMINISTRATION.

(a) Authority and Responsibility.--
(1) Department of justice.--The Attorney General shall 
investigate and take enforcement action for violations of this 
Act.
(2) Department of health and human services.--The Secretary 
of Health and Human Services, through the Administrator, 
shall--
(A) review, and approve or disapprove, transition 
plans submitted by public entities, under section 
6(b)(10);
(B) 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--
(i) 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
(ii) 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
(C) refer information on violations of this Act to 
the Attorney General for investigation and enforcement 
action under this Act.
(b) Cooperation of Executive Departments and Agencies.--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.

SEC. 6. REGULATIONS.

(a) Issuance of Regulations.--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).
(b) Required Contents of Regulations.--
(1) Protected individuals.--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.
(2) Services to be provided.--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--
(A) ensures that individuals with LTSS disabilities 
receive assistance through hands-on assistance, 
training, cueing, and safety monitoring, including 
access to backup systems, with--
(i) activities of daily living;
(ii) instrumental activities of daily 
living;
(iii) health-related tasks; or
(iv) other functions, tasks, or activities 
related to an activity or task described in 
clause (i), (ii), or (iii);
(B) 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;
(C) 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;
(D) issues, conducts, performs, provides, or funds 
policies and programs to support informal caregivers 
who provide services for individuals with LTSS 
disabilities; and
(E) 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.
(3) Public participation.--
(A) In general.--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).
(B) Process.--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 
(42 U.S.C. 1315(d)(2)), except that--
(i) the reference to ``at the State level'' 
shall be disregarded; and
(ii) the reference to an application shall 
be considered to be a reference to the self-
evaluation or plan involved.
(4) Additional services and supports.--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.
(5) Self-evaluation.--
(A) In general.--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--
(i) 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--
(I) 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 (42 
U.S.C. 300u-6); and
(II) 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;
(ii) 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;
(iii) 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;
(iv) 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;
(v) 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
(vi) 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.
(B) Additional requirements.--Public entities and 
LTSS insurance providers shall--
(i) provide the self-evaluation described 
in subparagraph (A) to the Attorney General;
(ii) make the self-evaluation described in 
subparagraph (A) available on the public 
internet website of the entity; and
(iii) 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.
(6) Housing.--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--
(A) 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;
(B) establish relationships with State and local 
housing authorities in order to address the need for 
affordable, accessible, and integrated housing;
(C) establish, where needed, necessary preferences 
and set-asides in housing programs for individuals with 
LTSS disabilities who are transitioning from or 
avoiding institutional placement;
(D) establish a process to fund necessary home 
modifications so that individuals with LTSS 
disabilities can live independently; and
(E) 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.
(7) Designation of responsible employee.--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.
(8) Grievance procedures.--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.
(9) Provision of service by others.--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.
(10) Transition plans.--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--
(A) establish measurable objectives to address the 
barriers to community living identified in the self-
evaluation under paragraph (5);
(B) 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;
(C) describe specific efforts to support 
individuals with LTSS disabilities to avoid unwanted 
institutionalization through the provision of LTSS;
(D) 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
(E) describe the steps taken to ensure that the 
transition plan addresses the needs of individuals from 
all sociodemographic and geographic backgrounds.
(11) Annual reporting.--
(A) In general.--The regulations issued under this 
section shall establish annual reporting requirements 
for each public entity or LTSS insurance provider 
covered by this section.
(B) Progress on objectives, targets, and efforts.--
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).
(c) Review of Transition Plans.--
(1) General rule.--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.
(2) Disapproval.--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.
(3) Modification of disapproved plan.--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.
(d) Rule of Construction.--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.

SEC. 7. EXEMPTIONS FOR RELIGIOUS ORGANIZATIONS.

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.

SEC. 8. ENFORCEMENT.

(a) Civil Action.--
(1) In general.--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.
(2) Aggrieved individual.--
(A) In general.--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.
(B) Standing.--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--
(i) is an individual with an LTSS 
disability; and
(ii) 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).
(3) Appointment of attorney; no fees, costs, or security.--
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.
(4) Futile gesture not required.--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.
(b) Damages and Injunctive Relief.--If the court finds that a 
violation of this Act has occurred or is about to occur, the court may 
award to the plaintiff--
(1) actual and punitive damages;
(2) immediate injunctive relief to prevent 
institutionalization;
(3) 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
(4) 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.
(c) Attorney's Fees; Liability of United States for Costs.--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.
(d) Enforcement by Attorney General.--
(1) Denial of rights.--
(A) Duty to investigate.--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.
(B) Potential violation.--The Attorney General may 
commence a civil action in any appropriate Federal 
district court if the Attorney General has reasonable 
cause to believe that--
(i) 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
(ii) any individual, including a group, has 
been subjected to a violation of this Act and 
the violation raises an issue of general public 
importance.
(2) Authority of court.--In a civil action under paragraph 
(1)(B), the court--
(A) may grant any equitable relief that such court 
considers to be appropriate, including, to the extent 
required by this Act--
(i) granting temporary, preliminary, or 
permanent relief; and
(ii) requiring the modification of a 
policy, practice, or procedure, or the 
provision of an alternative method of providing 
LTSS;
(B) 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
(C) may, to vindicate the public interest, assess a 
civil penalty against the public entity or LTSS 
insurance provider in an amount--
(i) not exceeding $100,000 for a first 
violation; and
(ii) not exceeding $200,000 for any 
subsequent violation.
(3) Single violation.--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.

SEC. 9. CONSTRUCTION.

For purposes of construing this Act--
(1) 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 
(42 U.S.C. 12182(b)(2)(A)(ii));
(2) 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);
(3) 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 (42 U.S.C. 3607(a));
(4) 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 (42 U.S.C. 
12188(a)(1)); and
(5) 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 (42 U.S.C. 
12188(b)(1)(B)).
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