I 108th CONGRESS 2d Session H. R. 4095 IN THE HOUSE OF REPRESENTATIVES March 31, 2004 Ms. Millender-McDonald (for herself, Mrs. Christensen, and Mr. Cummings) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committees on Energy and Commerce, Education and the Workforce, Government Reform, and House Administration, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII of the Social Security Act to provide for the use of qualified family caregivers in the provision of home health aide services under the Medicare Program, to amend the Family and Medical Leave Act of 1993, and for other purposes.

1.

Short title

This Act may be cited as &short-title1;.

2.

Provision of qualified family caregiver services under the medicare program

(a)

In general

Section 1891(a) of the Social Security Act (42 U.S.C. 1395bbb(a)) is amended by adding at the end the following new paragraph: (7) (A)The agency permits an individual who is under its care to have home health aide services or personal care assistant services provided by a qualified family caregiver (as defined in subparagraph (B)) under an approved plan of care and provides for payment for the services of the caregiver, regardless of whether the caregiver is an employee of the agency, at a rate comparable to the rate otherwise paid for such services provided by other qualified personnel. In addition, in the case of such a caregiver the agency shall provide for appropriate training and oversight of such services by a registered nurse in the same or similar manner to that provided in the case of such services furnished by another qualified individual and shall provide the caregiver, as part of the plan of care, with educational information and resources related to family caregiver health and wellness. (B)For purposes of this paragraph, the term qualified family caregiver means, with respect to the provision of home health aide services or personal care assistant services to an individual, an individual who is a family caregiver (as defined in section 372(2) of the National Family Caregiver Support Act) of the individual and who demonstrates proficiency in the provision of the home health aide services or personal care assistant services involved to the satisfaction of the supervising registered professional nurse. (C)This paragraph shall supersede any other restriction of this title (including section 1862(a)(11)) on the provision of home health aide services or personal care assistant services by a qualified family caregiver described in subparagraph (B) on the basis of the caregiver’s relationship to the recipient of such services. This subparagraph shall not affect any disqualification of an individual from providing services on the basis of the individual’s lack of qualification to provide the services or on the basis of an exclusion of participation of the individual under part B of title XI. (D)The Secretary, in consultation with the Secretary of Labor, shall provide guidance to home health agencies on payment administration and management methodologies to facilitate the provision of home health aide services and personal assistant care services by qualified family caregivers under this paragraph.. (b)

Effective date

The amendment made by subsection (a) shall take effect on January 1, 2005, and shall apply to services furnished on or after such date. (c)

Construction

Nothing in this section shall be construed as preventing the application of fraud and abuse sanctions (including those under sections 1128, 1128A, and 1128B of the Social Security Act) with respect to family caregivers under section 1891(a)(7) of the Social Security Act, as added by subsection (a), in the same manner as such sanctions may be applied to other individuals who provide home health aide services or personal assistant care services. (d)

Prohibition of denial of services because of refusal of physical therapy services during rehabilitation

Nothing in title XVIII of the Social Security Act shall be construed as authorizing the exclusion of coverage of skilled nursing services for an individual who is 75 years of age or older as part of home health services solely on the basis of the individual’s refusal of physical therapy services during rehabilitation, regardless of whether such physical therapy services are part of the plan of care for the individual.

3.

Amendments to Family and Medical Leave Act of 1993

(a)

Inclusion of nurse practitioners as health care

Section 101(6)(C) of the Family and Medical Leave Act of 1993 (29 U.S.C. 2611(6)(C)) is amended— (1)by striking or at the end of subparagraph (A); (2)by redesignating subparagraph (B) as subparagraph (C); and (3)by inserting after subparagraph (A) the following new subparagraph: (B)a nurse practitioner; or. (b)

Extension to domestic partners

Section 101(13) of such Act (29 U.S.C. 2611(13)) is amended by inserting before the period at the end the following: , and includes a domestic or civil partner registered or recognized under the applicable domestic or civil partnership of State or local law. (c)

Extension of period of family or medical leave for spouses employed by same employer

Section 102(f) of such Act (29 U.S.C. 2612(f)) is amended 12 workweeks and inserting 24 workweeks. (d)

Clarification of coverage of outpatient hospice care

Section 101(11) of such Act (29 U.S.C. 2611(11)) is amended— (1)by striking or at the end of subparagraph (A); (2)by redesignating subparagraph (B) as subparagraph (C); and (3)by inserting after subparagraph (A) the following new subparagraph: (B) hospice care; or.