; and (3) by adding at the end the following new paragraph: (88) provide for the submission to the Secretary of an implementation plan described in section 104(c) of the HCBS Access Act for approval by the Secretary prior to the beginning of the first calendar quarter beginning on or after the date that is 5 years after the date of the enactment of this paragraph. . (e) Authorization of appropriations There is authorized to be appropriated to the Secretary such sums as are necessary to carry out this section. (f) Definitions In subsections (a) through (c): (1) Home and community-based services The term home and community-based services has the meaning given such term in subsection (jj) of section 1905 of the Social Security Act ( 42 U.S.C. 1396d ), as added by section 102. (2) State The term State has the meaning given that term in section 1101(1) of the Social Security Act ( 42 U.S.C. 1301(1) ) for purposes of title XIX of such Act ( 42 U.S.C. 1396 et seq. ). 105. Quality of services (a) In general (1) Development of metrics Not later than 1 year after the date of enactment of this Act, the Director of the Agency for Healthcare Research and Quality, in consultation with State Medicaid Directors, shall develop standardized, State-level metrics of access to, and satisfaction with, providers, including primary care and specialist providers, with respect to individuals who are enrolled in State Medicaid plans under title XIX of the Social Security Act, broken down by demographics (as defined in section 2) and any other category determined by the Secretary. Such metrics shall include metrics on the total number of individuals enrolled in the State plan or under a waiver of the plan during a fiscal year that required the level of care provided in a nursing facility, intermediate care facility for individuals with intellectual disability, institution for mental disease, or other similarly restrictive or institutional setting. (2) Process The Director of the Agency for Healthcare Research and Quality shall develop the