Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter one hundred and eighteen E of the general laws is hereby further amended by adding after section 9C the following new section:

Section 9D. An individual age sixty or over who is entitled to medical assistance under the state plan either in the community or in an institution, and who is determined to be likely to require the level of care provided in a nursing facility, shall be permitted to choose to receive home or community based care rather than nursing facility services in the most integrated setting appropriate to the needs of such individual, provided that such individual shall be allowed to receive up to the same amount or greater service expenditures per month for home or community based services as he or she would have received under the state plan in a nursing facility, provided that on average the per capita expenditures estimated by the commonwealth in any fiscal year for medical assistance provided with respect to such individuals under this section shall not exceed 100 percent nor be less than 50 percent of the average per capita expenditures that the commonwealth reasonably estimates would have been made under the state plan in that fiscal year for expenditures that such individuals would have received in a nursing facility.