[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6208 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 6208

   To expand and enhance existing adult day programs for people with 
 multiple sclerosis or other similar diseases, to support and improve 
access to respite services for family caregivers who are taking care of 
                  such people, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 23, 2010

Ms. Lee of California introduced the following bill; which was referred 
                to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To expand and enhance existing adult day programs for people with 
 multiple sclerosis or other similar diseases, to support and improve 
access to respite services for family caregivers who are taking care of 
                  such people, 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 ``Adult Day Achievement Center 
Enhancement Act''.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) Multiple sclerosis (or MS) is a chronic, often 
        disabling disease that attacks the central nervous system, 
        which is made up of the brain, spinal cord, and optic nerves. 
        Most people with multiple sclerosis are diagnosed between the 
        ages of 20 and 50 years of age.
            (2) The symptoms of MS may be mild, such as numbness in the 
        limbs, or severe, such as paralysis or loss of vision. The 
        progress, severity, and specific symptoms of MS are 
        unpredictable and vary from one person to another.
            (3) Persons living with MS who experience more severe forms 
        of MS are likely to require either home care or nursing home 
        placement, though the vast majority would prefer to remain at 
        home to receive the care they need. Where home care is 
        concerned, approximately 80 percent of such care is provided by 
        informal, unpaid, caregivers who are generally family members.
            (4) Family caregivers of people with MS generally average 
        60 years of age. Almost half spend more than 20 hours per week 
        providing care for their family member living with MS and have 
        been fulfilling this role on average for over 13 years.
            (5) In general, family caregivers, the majority of whom are 
        women, provide an estimated $306,000,000,000 in ``free'' 
        services annually. The pool of potential family caregivers is 
        dwindling, from 11 potential caregivers for each person needing 
        care today to a projected 4 to 1 ratio by 2050.
            (6) Recent studies indicate that the total estimated cost 
        to employers for full-time employees with intensive caregiving 
        responsibilities is $17,100,000,000. The total estimated cost 
        to employers for all full-time, employed caregivers is 
        $33,600,000,000 annually.
            (7) Adult day programs can offer services, including 
        medical care, rehabilitation therapies, dignified assistance 
        with activities of daily living, nutrition therapy, health 
        monitoring, social interaction, stimulating activities, and 
        transportation, to seniors, people with disabilities, and 
        younger adults with chronic diseases.
            (8) Adult day programs geared toward people living with MS, 
        or other similar diseases, provide an important response to the 
        needs of people with severe MS and their caregivers. These MS 
        Adult Day Programs (MSADPs) can help to ameliorate MS symptoms, 
        reduce dependency, provide important socialization 
        opportunities, and maintain quality of life.
            (9) MSADP programs have been shown to provide a range of 
        documented benefits to people living with MS including 
        improvements in functional status, fatigue, depression, pain 
        and social support. MSADPs also reduce ongoing medical care and 
        hospital costs and decrease admissions to nursing home 
        facilities, which can be costly for many families, by allowing 
        individuals to receive health and social services while 
        continuing to live at home.
            (10) There are less than a dozen MSADPs in the United 
        States at present and as a result the majority of people living 
        with MS are unable to access this important opportunity for 
        maximizing their health and wellness. Although people living 
        with MS may be able to access other existing adult day 
        programs, such programs are not typically intended for younger 
        adults living with chronic diseases like MS, and may not 
        provide the appropriate services to meet the age-related or 
        disability status of these individuals.

SEC. 3. ESTABLISHMENT OF ADULT DAY PROGRAMS.

    (a) Survey of Existing Adult Day Programs.--
            (1) In general.--Not later than 90 days after the date of 
        the enactment of this section, the Assistant Secretary for 
        Aging shall initiate a comprehensive survey of current adult 
        day programs that provide care and support to individuals 
        living with multiple sclerosis, including any multiple 
        sclerosis adult day programs and other similar adult day 
        programs as defined in this Act.
            (2) Survey elements.--In carrying out the survey under 
        paragraph (1), the Assistant Secretary for Aging may utilize 
        existing publicly available research on adult day programs, and 
        shall--
                    (A) identify ongoing successful MSADPs and other 
                similar adult day programs, including by providing a 
                brief description of how such programs were initially 
                established and funded;
                    (B) develop a set of best practices to help guide 
                the establishment and replication of additional 
                successful MSADPs and other similar adult day programs, 
                including--
                            (i) program guidelines;
                            (ii) recommendations on the scope of 
                        services that should be provided (which may 
                        include rehabilitation therapy, psychosocial 
                        support, social stimulation and interaction, 
                        and spiritual, educational, or other such 
                        services); and
                            (iii) performance goals and indicators to 
                        measure and analyze the outcomes generated by 
                        the services provided and to evaluate the 
                        overall success of the program; and
                    (C) evaluate the extent to which the Administration 
                on Aging supports MSADPs and other similar adult day 
                programs, either directly or indirectly, through 
                current Federal grant programs.
            (3) Report.--Not later than 180 days after initiating the 
        survey under paragraph (1), the Assistant Secretary for Aging 
        shall produce and make publicly available a summary report on 
        the results of the survey. Such report shall include each of 
        the elements described in paragraph (2).
    (b) Establishment of Grant Program.--
            (1) In general.--Not later than 90 days after producing the 
        report required by subsection (a)(3), the Assistant Secretary 
        for Aging shall establish within the Administration on Aging a 
        competitive grant program for awarding grants annually to 
        eligible entities, based on the best practices developed under 
        subsection (a), to fund MSADPs and other similar adult day 
        programs.
            (2) Eligible entities.--In order to be eligible for a grant 
        under this subsection, an entity shall demonstrate the 
        following:
                    (A) Understanding of the special needs of people 
                living with multiple sclerosis or other similar 
                diseases, including their functional abilities and the 
                potential complications across all types of cases and 
                stages of multiple sclerosis or other such similar 
                diseases.
                    (B) Understanding of the issues experienced by 
                family caregivers who assist a family member with 
                multiple sclerosis or another such similar disease.
                    (C) A capacity to provide the services recommended 
                by the best practices developed under subsection (a).
            (3) Additional selection requirement.--The Assistant 
        Secretary for Aging shall not award a grant to an entity under 
        this subsection if the amount of the award would constitute 
        more than 40 percent of the operating budget of the entity in 
        the fiscal year for which funds for the grant are authorized to 
        be expended. For purposes of this subsection, the fair market 
        value of annual in-kind contributions of equipment or services 
        shall be considered as part of the operating budget of the 
        entity.
            (4) Selection of grant recipients.--Not later than 90 days 
        after establishing the grant program under this subsection, the 
        Assistant Secretary for Aging shall award the first annual 
        series of grants under the program. In awarding grants under 
        this subsection, the Assistant Secretary should ensure, to the 
        extent practicable, a diverse geographic representation among 
        grant recipients and that, subject to the availability of 
        appropriations--
                    (A) a minimum of 5 entities are selected as grant 
                recipients for the first fiscal year for which such 
                grants are awarded;
                    (B) a minimum of 10 entities are selected as grant 
                recipients for the second such fiscal year;
                    (C) a minimum of 12 entities are selected as grant 
                recipients for the third such fiscal year; and
                    (D) a minimum of 15 entities are selected as grant 
                recipients for the fourth such fiscal year.
            (5) Report.--No later than 1 year after the initial award 
        of grants under this subsection, and annually thereafter, the 
        Assistant Secretary for Aging shall produce and make publicly 
        available a brief summary report on the grant program under 
        this section. Each such report shall include the following:
                    (A) A description of the adult day programs 
                receiving funding under this section, including the 
                amount of Federal funding awarded and the expected 
                outcomes of each program.
                    (B) A description of performance goals and 
                indicators to monitor the progress of grant recipients 
                in--
                            (i) responding to the needs of individuals 
                        living with multiple sclerosis or other such 
                        similar chronic diseases; and
                            (ii) assisting the family caregivers of 
                        such individuals.
                    (C) Any plans for improving oversight and 
                management of the grant program.
    (c) Definitions.--In this Act:
            (1) The term ``multiple sclerosis adult day program'' or 
        ``MSADP'' means an adult day program that provides 
        comprehensive and effective care and support services to 
        individuals living with multiple sclerosis and their family 
        caregivers and that may assist participants in ways that--
                    (A) maintain or improve their functional abilities, 
                or otherwise help them adjust to their changing 
                functional abilities;
                    (B) prevent the onset of complications associated 
                with severe forms of the disease;
                    (C) promote alternatives to placement in nursing 
                homes;
                    (D) reduce the strain on family caregivers taking 
                care of a family member with multiple sclerosis; or
                    (E) focus on supporting the emotional, social, and 
                intellectual needs of a younger adult population.
            (2) The term ``other similar adult day program'' means an 
        adult day program that provides a set of services similar to 
        those of an MSADP, but for individuals living with other 
        chronic diseases similar to multiple sclerosis that affect an 
        individual's central nervous system, and that may result in a 
        functional or degenerative disability.
            (3) The term ``family caregiver'' means a family member or 
        foster parent who provides unpaid assistance (which may include 
        in-home monitoring, management, supervision, care and 
        treatment, or other similar assistance) to another adult family 
        member with a special need.
    (d) Authorization of Appropriations.--To carry out this section, in 
addition to amounts otherwise made available for such purpose, there 
are authorized to be appropriated, and to remain available until 
expended, the following:
            (1) $1,000,000 for fiscal year 2011.
            (2) $3,000,000 for fiscal year 2012.
            (3) $6,000,000 for fiscal year 2013.
            (4) $8,000,000 for fiscal year 2014.
            (5) $10,000,000 for fiscal year 2015.
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