; and (iii) updating, developing, and adopting qualification standards and training opportunities for the continuum of direct care professionals, including programs for independent direct care professionals and agency direct care professionals, as well as unique programs. (B) Payment rates In carrying out subparagraph (A)(i), the State shall— (i) address insufficient payment rates under the State Medicaid program for delivery of long-term care services with an emphasis on supporting the recruitment and retention of direct care professionals; (ii) update payment rates under the State Medicaid program for long-term care services, including home and community-based services, nursing home services, skilled nursing facility services, and intermediate care facility services at least every 2 years through a transparent process involving meaningful input from stakeholders, in which the majority of stakeholders are recipients of such services, families, direct care professionals, chosen representatives of direct care workers, aging, disability, and workforce advocates, long-term care providers, and may also include health plans; and (iii) ensure that, with respect to any increases in the payment rates under the State Medicaid program for long-term care services— (I) at a minimum, 85 percent of such payment rate increases are passed through to direct care professionals and direct care professional managers who provide such services and in a manner that is determined with input from the stakeholders described in clause (ii); (II) such payment rate increases are incorporated into payment rates for such services provided under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ) by a managed care entity (as defined in section 1932(a)(1)(B) of the Social Security Act ( 42 U.S.C. 1396u–2(a)(1)(B) ) or a prepaid inpatient health plan or prepaid ambulatory health plan, as defined in section 438.2 of title 42, Code of Federal Regulations (or any successor regulation)), under a contract with the State