[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1083 Introduced in House (IH)]







108th CONGRESS
  1st Session
                                H. R. 1083

To amend the Public Health Service Act to establish a program to assist 
  family caregivers in accessing affordable and high-quality respite 
                     care, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 5, 2003

 Mr. Langevin (for himself, Mr. Abercrombie, Mr. Ackerman, Mr. Allen, 
 Mr. Brady of Pennsylvania, Ms. Corrine Brown of Florida, Mr. Brown of 
 Ohio, Mrs. Christensen, Ms. DeLauro, Mr. Doyle, Mr. Engel, Mr. Evans, 
 Mr. Foley, Mr. Ford, Mr. Frank of Massachusetts, Mr. Frost, Mr. Green 
 of Texas, Mr. Greenwood, Mr. Gutierrez, Mr. Hoeffel, Mrs. Johnson of 
   Connecticut, Mrs. Jones of Ohio, Mr. Kildee, Mr. Kennedy of Rhode 
Island, Mr. Lantos, Mr. Matsui, Mr. McDermott, Mr. McHugh, Mr. McNulty, 
 Ms. Millender-McDonald, Mr. George Miller of California, Mr. Nadler, 
Mrs. Napolitano, Ms. Norton, Mr. Oberstar, Mr. Owens, Mr. Pascrell, Mr. 
Payne, Mr. Serrano, Mr. Simmons, Mr. Skelton, Mr. Stenholm, Mr. Towns, 
Mr. Waxman, Ms. Woolsey, Ms. Berkley, Mr. Davis of Illinois, Ms. Ginny 
  Brown-Waite of Florida, Mr. Clyburn, Ms. Jackson-Lee of Texas, Mr. 
   Crowley, and Mr. Markey) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to establish a program to assist 
  family caregivers in accessing affordable and high-quality respite 
                     care, 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 ``Lifespan Respite Care Act of 2003''.

SEC. 2. LIFESPAN RESPITE CARE.

    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by 
adding at the end the following:

                  ``TITLE XXIX--LIFESPAN RESPITE CARE

``SEC. 2901. FINDINGS AND PURPOSES.

    ``(a) Findings.--Congress finds that--
            ``(1) an estimated 26,000,000 individuals in the United 
        States care each year for 1 or more adult family members or 
        friends who are chronically ill, disabled, or terminally ill;
            ``(2) an estimated 18,000,000 children in the United States 
        have chronic physical, developmental, behavioral, or emotional 
        conditions that demand caregiver monitoring, management, 
        supervision, or treatment beyond that required of children 
        generally;
            ``(3) approximately 6,000,000 children in the United States 
        live with a grandparent or other relative because their parents 
        are unable or unwilling to care for them;
            ``(4) an estimated 165,000 children with disabilities in 
        the United States live with a foster care parent;
            ``(5) nearly 4,000,000 individuals in the United States of 
        all ages who have mental retardation or another developmental 
        disability live with their families;
            ``(6) almost 25 percent of the Nation's elders experience 
        multiple chronic disabling conditions that make it necessary to 
        rely on others for help in meeting their daily needs;
            ``(7) every year, approximately 600,000 Americans die at 
        home and many of these individuals rely on extensive family 
        caregiving before their deaths;
            ``(8) of all individuals in the United States needing 
        assistance in daily living, 42 percent are under age 65;
            ``(9) there are insufficient resources to replace family 
        caregivers with paid workers;
            ``(10) if services provided by family caregivers had to be 
        replaced with paid services, it would cost approximately 
        $200,000,000,000 annually;
            ``(11) the family caregiver role is personally rewarding 
        but can result in substantial emotional, physical, and 
        financial hardship;
            ``(12) approximately 75 percent of family caregivers are 
        women;
            ``(13) family caregivers often do not know where to find 
        information about available respite care or how to access it;
            ``(14) available respite care programs are insufficient to 
        meet the need and are primarily directed at lower income 
        populations and family caregivers of the elderly, leaving large 
        numbers of family caregivers without adequate support; and
            ``(15) there are a limited number of available respite care 
        programs, and these programs have difficulty recruiting 
        appropriately trained respite workers.
    ``(b) Purposes.--The purposes of this title are--
            ``(1) to encourage States to establish State and local 
        lifespan respite care programs;
            ``(2) to improve and coordinate the dissemination of 
        respite care information and resources to family caregivers;
            ``(3) to provide, supplement, or improve respite care 
        services to family caregivers;
            ``(4) to promote innovative, flexible, and comprehensive 
        approaches to--
                    ``(A) the delivery of respite care;
                    ``(B) respite care worker and volunteer recruitment 
                and training programs; and
                    ``(C) training programs for family caregivers to 
                assist such family caregivers in making informed 
                decisions about respite care services;
            ``(5) to support evaluative research to identify effective 
        respite care services that alleviate, reduce, or minimize any 
        negative consequences of caregiving; and
            ``(6) to promote the dissemination of results, findings, 
        and information from programs and research projects relating to 
        respite care delivery, family caregiver strain, respite care 
        worker and volunteer recruitment and training, and training 
        programs for family caregivers that assist such family 
        caregivers in making informed decisions about respite care 
        services.

``SEC. 2902. DEFINITIONS.

    ``In this title:
            ``(1) Condition.--The term `condition' includes--
                    ``(A) Alzheimer's disease and other neurological 
                disorders;
                    ``(B) developmental disabilities;
                    ``(C) mental retardation;
                    ``(D) physical disabilities;
                    ``(E) chronic illness, including cancer;
                    ``(F) behavioral, mental, and emotional conditions;
                    ``(G) cognitive impairments;
                    ``(H) situations in which there exists a high risk 
                of abuse or neglect or of being placed in the foster 
                care system due to abuse and neglect;
                    ``(I) situations in which a child's parent is 
                unavailable due to the parent's death, incapacitation, 
                or incarceration;
                    ``(J) traumatic brain injury; and
                    ``(K) such conditions as the Secretary may 
                designate by regulation.
            ``(2) Eligible recipient.--The term `eligible recipient' 
        means--
                    ``(A) a State agency;
                    ``(B) any other public entity that is capable of 
                operating on a statewide basis;
                    ``(C) a private, nonprofit organization that is 
                capable of operating on a statewide basis;
                    ``(D) a political subdivision of a State that has a 
                population of not less than 3,000,000 individuals; or
                    ``(E) any recognized State respite coordinating 
                agency that has--
                            ``(i) a demonstrated ability to work with 
                        other State and community-based agencies;
                            ``(ii) an understanding of respite care and 
                        family caregiver issues; and
                            ``(iii) the capacity to ensure meaningful 
                        involvement of family members, family 
                        caregivers, and care recipients.
            ``(3) Family caregiver.--The term `family caregiver' means 
        an unpaid family member, a foster parent, or another unpaid 
        adult, who provides in-home monitoring, management, 
        supervision, or treatment of a child or adult with a special 
        need.
            ``(4) Lifespan respite care.--The term `lifespan respite 
        care' means a coordinated system of accessible, community-based 
        respite care services for family caregivers of individuals 
        regardless of the individual's age, race, ethnicity, or special 
        need.
            ``(5) Respite care.--The term `respite care' means planned 
        or emergency care provided to an individual with a special 
        need--
                    ``(A) in order to provide temporary relief to the 
                family caregiver of that individual; or
                    ``(B) when the family caregiver of that individual 
                is unable to provide care.
            ``(6) Secretary.--The term `Secretary' means the Secretary 
        of Health and Human Services.
            ``(7) Special need.--The term `special need' means the 
        particular needs of an individual of any age who requires care 
        or supervision because of a condition in order to meet the 
        individual's basic needs or to prevent harm to the individual.

``SEC. 2903. LIFESPAN RESPITE CARE GRANTS AND COOPERATIVE AGREEMENTS.

    ``(a) Purposes.--The purposes of this section are--
            ``(1) to expand and enhance respite care services to family 
        caregivers;
            ``(2) to improve the statewide dissemination and 
        coordination of respite care; and
            ``(3) to provide, supplement, or improve access and quality 
        of respite care services to family caregivers, thereby reducing 
        family caregiver strain.
    ``(b) Authorization.--Subject to subsection (f), the Secretary may 
award grants or cooperative agreements to eligible recipients who 
submit an application pursuant to subsection (d).
    ``(c) Federal Lifespan Approach.--In carrying out this section, the 
Secretary, acting through the Maternal and Child Health Bureau of the 
Health Resources and Services Administration, and in cooperation with 
the National Family Caregiver Support Program in the Administration on 
Aging, the Administration for Children and Families, the Administration 
on Developmental Disabilities, and the Substance Abuse and Mental 
Health Services Administration, shall ensure coordination of respite 
care services for family caregivers of individuals of all ages with 
special needs.
    ``(d) Application.--
            ``(1) Submission.--Each eligible recipient desiring to 
        receive a grant or cooperative agreement under this section 
        shall submit an application to the Secretary at such time, in 
        such manner, and containing such information as the Secretary 
        shall require.
            ``(2) Contents.--Each application submitted under this 
        section shall include--
                    ``(A) a description of the applicant's--
                            ``(i) understanding of respite care and 
                        family caregiver issues;
                            ``(ii) capacity to ensure meaningful 
                        involvement of family members, family 
                        caregivers, and care recipients; and
                            ``(iii) collaboration with other State and 
                        community-based public, nonprofit, or private 
                        agencies;
                    ``(B) with respect to the population of family 
                caregivers to whom respite care information or services 
                will be provided or for whom respite care workers and 
                volunteers will be recruited and trained, a description 
                of--
                            ``(i) the population;
                            ``(ii) the extent and nature of the respite 
                        care needs of the population;
                            ``(iii) existing respite care services for 
                        the population, including numbers of family 
                        caregivers being served and extent of unmet 
                        need;
                            ``(iv) existing methods or systems to 
                        coordinate respite care information and 
                        services to the population at the State and 
                        local level and extent of unmet need;
                            ``(v) how respite care information 
                        dissemination and coordination, respite care 
                        services, respite care worker and volunteer 
                        recruitment and training programs, or training 
                        programs for family caregivers that assist such 
                        family caregivers in making informed decisions 
                        about respite care services, will be provided 
                        using grant or cooperative agreement funds;
                            ``(vi) a plan for collaboration and 
                        coordination of the proposed respite care 
                        activities with other related services or 
                        programs offered by public or private, 
                        nonprofit entities, including area agencies on 
                        aging;
                            ``(vii) how the population, including 
                        family caregivers, care recipients, and 
                        relevant public or private agencies, will 
                        participate in the planning and implementation 
                        of the proposed respite care activities;
                            ``(viii) how the proposed respite care 
                        activities will make use, to the maximum extent 
                        feasible, of other Federal, State, and local 
                        funds, programs, contributions, other forms of 
                        reimbursements, personnel, and facilities;
                            ``(ix) respite care services available to 
                        family caregivers in the applicant's State or 
                        locality, including unmet needs and how the 
                        applicant's plan for use of funds will improve 
                        the coordination and distribution of respite 
                        care services for family caregivers of 
                        individuals of all ages with special needs;
                            ``(x) the criteria used to identify family 
                        caregivers eligible for respite care services;
                            ``(xi) how the quality and safety of any 
                        respite care services provided will be 
                        monitored, including methods to ensure that 
                        respite care workers and volunteers are 
                        appropriately screened and possess the 
                        necessary skills to care for the needs of the 
                        care recipient in the absence of the family 
                        caregiver; and
                            ``(xii) the results expected from proposed 
                        respite care activities and the procedures to 
                        be used for evaluating those results; and
                    ``(C) assurances that, where appropriate, the 
                applicant will have a system for maintaining the 
                confidentiality of care recipient and family caregiver 
                records.
    ``(e) Review of Applications.--
            ``(1) Establishment of review panel.--The Secretary shall 
        establish a panel to review applications submitted under this 
        section.
            ``(2) Meetings.--The panel shall meet as often as may be 
        necessary to facilitate the expeditious review of applications.
            ``(3) Function of panel.--The panel shall--
                    ``(A) review and evaluate each application 
                submitted under this section; and
                    ``(B) make recommendations to the Secretary 
                concerning whether the application should be approved.
    ``(f) Awarding of Grants or Cooperative Agreements.--
            ``(1) In general.--The Secretary shall award grants or 
        cooperative agreements from among the applications recommended 
        for approval by the panel under subsection (e)(3).
            ``(2) Priority.--When awarding grants or cooperative 
        agreements under this subsection, the Secretary shall give 
        priority to applicants that show the greatest likelihood of 
        implementing or enhancing lifespan respite care statewide.
    ``(g) Use of Grant or Cooperative Agreement Funds.--
            ``(1) In general.--The Secretary may not award a grant or 
        cooperative agreement to an eligible recipient under this 
        section unless the recipient agrees to use the funds for--
                    ``(A) the development of lifespan respite care at 
                the State and local levels, taking into consideration 
                models and best practices in respite care delivery and 
                coordination;
                    ``(B) respite care services to meet unmet needs and 
                provide worker, volunteer, and family training 
                programs; and
                    ``(C) an evaluation of the effectiveness of such 
                development and services.
            ``(2) Subcontracts.--Each eligible recipient that is 
        awarded a grant or cooperative agreement under this section may 
        use the funds to subcontract with a public or nonprofit agency 
        to carry out the activities described in paragraph (1).
    ``(h) Term of Grants or Cooperative Agreements.--
            ``(1) In general.--The Secretary shall award grants or 
        cooperative agreements under this section for terms that do not 
        exceed 5 years.
            ``(2) Renewal.--The Secretary may renew a grant or 
        cooperative agreement under this section at the end of the term 
        of the grant or cooperative agreement determined under 
        paragraph (1).
    ``(i) Supplement, Not Supplant.--Funds made available under this 
section shall be used to supplement and not supplant other Federal, 
State, and local funds available for respite care services.

``SEC. 2904. NATIONAL LIFESPAN RESPITE RESOURCE CENTER.

    ``(a) Establishment.--The Secretary shall award a grant or 
cooperative agreement to a public or private nonprofit entity to 
establish a National Resource Center on Lifespan Respite Care (referred 
to in this section as the `Center').
    ``(b) Duties.--The Center shall--
            ``(1) maintain a national database on lifespan respite 
        care;
            ``(2) provide training and technical assistance to State, 
        community, and nonprofit respite care programs; and
            ``(3) provide information, referral, and educational 
        programs to the public on lifespan respite care.

``SEC. 2905. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this title 
such sums as may be necessary.''.
                                 <all>