Short title

This Act may be cited as the

Home-Based Health Services Job Training and Caregiving Act of 2008

Findings and purpose

(a)

Findings

The Congress finds the following: (1)The baby boom generation will require health care attention that will exceed the current supply of health care providers. (2)There is a shortage of training programs specializing in health care services that focus on home care instead of institutionalized care. (3)Although the need for home-based health services transcends all income levels, the availability of such services is more limited for residents in public housing. (4)Estimates indicate that there are 44,000,000 caregivers in the United States providing unpaid care to at least one adult, representing 22,900,000 households. (5)Of working persons providing unpaid care, 62 percent have had to make adjustments to work schedules or leave employment. (6)Many low-income families in the United States are placed in an untenable position of choosing between work and caregiving responsibilities at home. (7)Residents in public housing in the United States are also aging and in need of care. (8)The Department of Housing and Urban Development estimates the percentage of households assisted by the Department that are elderly households is 35 percent in New York, 33 percent in Boston, 35 percent in Chicago, 24 percent in Cleveland, 40 percent in Los Angeles, and 20 percent in Puerto Rico. (9)New service programs are needed to provide home-based health services to residents in public housing and to provide job training and job placement for persons receiving assistance from the Department of Housing and Urban Development needing employment. (10)The Department of Housing and Urban Development should establish a home-based health services pilot program to meet the challenges of an increasing number of elderly in public housing, simultaneously creating an opportunity to train job seekers in a trade that provides home-based health services. (b)

Purposes

The purposes of this Act are— (1)to give flexibility to the Department of Housing and Urban Development and other entities to promote training programs and employment in home-based health services for public housing residents; and (2)to provide needed home care options to elderly and disabled public housing residents to allow them to remain in their homes and their communities.

Pilot grant program to promote home-based health services training and employment for public housing residents and to provide Medicaid covered home-based health services to elderly and disabled persons receiving HUD public housing assistance

Section 34 of the United States Housing Act of 1937 (42 U.S.C. 1437z–6) is amended by adding at the end the following new subsection:

(f)

Grant pilot program To promote training and employment in home-based health services and To provide such services to elderly and disabled public housing residents

(1)

Establishment of grant pilot program

The Secretary shall establish a grant pilot program to make grants to eligible entities under paragraph (2) for use only for promoting the training and employment of public housing residents as home health aides and as providers of home-based health services in order for such residents to provide Medicaid covered home-based health services to either elderly or disabled public housing residents, or both. (2)

Eligible Entities

A grant under this subsection may be made only to an entity that demonstrates— (A)it is a public housing agency, unit of State or local government including an agency of such unit, community health center, home care provider organization, faith-based organization, labor organization, or other organization determined to be qualified by the Secretary; and (B)to the satisfaction of the Secretary that it will establish an employment training program in home-based health services that complies with regulations issued by the Secretary. (3)

Application

To be eligible for a grant under this subsection an eligible entity under paragraph (2) shall prepare and submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary requires. (4)

Priority

In awarding grants under this subsection, the Secretary shall give priority to grant proposals from eligible entities under paragraph (2) located within any of the 5 States and territories having the most households residing in public housing. (5)

Report to Congress

Not later than 30 months after the enactment of this subsection, the Secretary shall submit a report to Congress on the use and impact of the grant program established by this subsection. (6)

Definitions

As used in this subsection: (A)

Home-based health services

The term home-based health services means health care services provided to an individual in a place of residence used as such individual’s home and includes— (i)home health services described in section 1861(m) of the Social Security Act (42 U.S.C. 1395x(m)); (ii)personal care services described in section 1905(a)(24) of such Act (42 U.S.C. 1396d(a)(24)); and (iii)home-based services which may be covered under a waiver under subsection (c) or (d) of section 1915 of such Act (42 U.S.C. 1396n). (B)

Home health aide

The term home health aide has the meaning given the term in section 1891(a)(3)(E) of the Social Security Act (42 U.S.C. 1395bbb(a)(3)(E)). (C)

Medicaid covered

The term Medicaid covered means, with respect to home-based health services, such services for which medical assistance is available under a State plan under title XIX of the Social Security Act. (7)

Inapplicability of previous subsections

Subsections (a) through (e) shall not apply to this subsection. (8)

Rule of construction

Nothing in this subsection shall be construed as affecting any requirement under State law for training, licensure, or any other certification as a home health aide or as a provider of any service included as a home-based health service under this subsection. (9)

Regulations

Not later than 6 months after the date of enactment of this subsection, the Secretary shall issue regulations to carry out this subsection. (10)

Authorization of Appropriations

There is authorized to be appropriated to carry out this subsection $2,500,000 for each of the fiscal years 2009, 2010, and 2011.

Miscellaneous provisions

Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701u) is amended— (1)in subsection (c)(2)(A) by inserting home-based health services (as defined in section 34(f) of the United States Housing Act of 1937 (42 U.S.C. 1437z–6(f)) for public housing residents, after training and employment arising in connection with; and (2)in subsection (d)(2)(A) by inserting home-based health services (as defined in section 34(f) of the United States Housing Act of 1937 (42 U.S.C. 1437z–6(f)) for public housing residents, after contracts awarded for work to be performed in connection with.

Exemption from medical assistance payment limitation for territories for home health services for elderly individuals

(a)

In general

Section 1108(g) of the Social Security Act (42 U.S.C. 1308(g)) is amended by adding at the end the following new paragraph:

(4)

Exemption from medical assistance payment limitation for home health services for elderly individuals

Payment limitations under this subsection and subsection (f) shall not apply to amounts expended for home health services for individuals 65 years of age or older.

(b)

Effective date

The amendment made by subsection (a) shall apply to fiscal years beginning with fiscal year 2008.

Exemption from part B late enrollment penalty for residents of Puerto Rico

(a)

In General

Section 1839(b) of the Social Security Act (42 U.S.C. 1395r(b)) is amended by adding at the end the following: No increase in the premium shall be effected for an individual who would have been deemed enrolled in the medical insurance program under section 1837(f) but for such individual residing in Puerto Rico.. (b)

Effective Date

The amendment made by subsection (a) shall apply to individuals with respect to initial enrollment periods under section 1837(d) of the Social Security Act (42 U.S.C. 1395p(d)) that begin on or after the first day of the first month that begins more than 60 days after the date of enactment of this Act.