As used in this section:
(1) The term "individuals infected with the etiologic agent for acquired immune deficiency syndrome" means individuals who have a disease, or are recovering from a disease, attributable to the infection of such individuals with such etiologic agent, and as a result of the effects of such disease, are in need of subacute-care services.
(2) The term "subacute care" means medical and health care services that are required for individuals recovering from acute care episodes that are less intensive than the level of care provided in acute-care hospitals, and includes skilled nursing care, hospice care, and other types of health services provided in other long-term-care facilities.
The Secretary shall conduct three demonstration projects to determine the effectiveness and cost of providing the subacute-care services described in subsection (b) of this section to individuals infected with the etiologic agent for acquired immune deficiency syndrome, and the impact of such services on the health status of such individuals.
(1) The services provided under each demonstration project shall be designed to meet the specific needs of individuals infected with the etiologic agent for acquired immune deficiency syndrome, and shall include—
(A) the care and treatment of such individuals by providing—
(i) subacute care;
(ii) emergency medical care and specialized diagnostic and therapeutic services as needed and where appropriate, either directly or through affiliation with a hospital that has experience in treating individuals with acquired immune deficiency syndrome; and
(iii) case management services to ensure, through existing services and programs whenever possible, appropriate discharge planning for such individuals; and
(B) technical assistance, to other facilities in the region served by such facility, that is directed toward education and training of physicians, nurses, and other health-care professionals in the subacute care and treatment of individuals infected with the etiologic agent for acquired immune deficiency syndrome.
(2) Services provided under each demonstration project may also include—
(A) hospice services;
(B) outpatient care; and
(C) outreach activities in the surrounding community to hospitals and other health-care facilities that serve individuals infected with the etiologic agent for acquired immune deficiency syndrome.
The demonstration projects shall be conducted—
(1) during a 4-year period beginning not later than 9 months after November 4, 1988; and
(2) at sites that—
(A) are geographically diverse and located in areas that are appropriate for the provision of the required and authorized services; and
(B) have the highest incidence of cases of acquired immune deficiency syndrome and the greatest need for subacute-care services.
The Secretary shall evaluate the operations of the demonstration projects and shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Labor and Human Resources of the Senate—
(1) not later than 18 months after the beginning of the first project, a preliminary report that contains—
(A) a description of the sites at which the projects are being conducted and of the services being provided in each project; and
(B) a preliminary evaluation of the experience of the projects in the first 12 months of operation; and
(2) not later than 6 months after the completion of the last project, a final report that contains—
(A) an assessment of the costs of subacute care for individuals infected with the etiologic agent for acquired immune deficiency syndrome, including a breakdown of all other sources of funding for the care provided to cover subacute care; and
(B) recommendations for appropriate legislative changes.
Each demonstration project shall provide for other research to be carried out at the site of such demonstration project including—
(1) clinical research on acquired immune deficiency syndrome, concentrating on research on the neurological manifestations resulting from infection with the etiologic agent for such syndrome; and
(2) the study of the psychological and mental health issues related to such syndrome.
(1) To carry out this section, there are authorized to be appropriated $10,000,000 for fiscal year 1989 and such sums as are necessary for each of the fiscal years 1990 through 1992.
(2) Amounts appropriated pursuant to paragraph (1) shall remain available until September 10, 1992.
The Secretary shall enter into an agreement with the Secretary of the Department of Veterans Affairs to ensure that appropriate provision will be made for the furnishing, through demonstration projects, of services to eligible veterans, under contract with the Department of Veterans Affairs pursuant to section 1720 of title 38.
(July 1, 1944, ch. 373, title XXIV, §2421, as added Pub. L. 100–607, title II, §211, Nov. 4, 1988, 102 Stat. 3088; amended Pub. L. 100–527, §10(1), (2), Oct. 25, 1988, 102 Stat. 2640, 2641; Pub. L. 100–690, title II, §2618(h), Nov. 18, 1988, 102 Stat. 4241; Pub. L. 102–83, §5(c)(2), Aug. 6, 1991, 105 Stat. 406.)
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