[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7605 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                                H. R. 7605

 To address the worsening long-term care workforce crisis and increase 
             access to and affordability of long-term care.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 8, 2024

Mrs. Trahan (for herself and Mr. Fitzpatrick) introduced the following 
    bill; which was referred to the Committee on Education and the 
Workforce, and in addition to the Committee on Energy and Commerce, 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 address the worsening long-term care workforce crisis and increase 
             access to and affordability of long-term care.

    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 ``Safeguarding Elderly Needs through 
Innovation and Occupational Resources Act of 2024'' or the ``SENIOR Act 
of 2024''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) The United States population is aging more rapidly than 
        ever before, with 10,000 Americans turning 65 each day. In 
        2034, for the first time, the Nation will have more people over 
        the age of 65 than under the age of 18. The population 
        experiencing the fastest growth are persons 85 and older, which 
        is projected to grow 198 percent by 2060.
            (2) The Department of Health and Human Services estimates 
        that 70 percent of Americans over the age of 65 will require 
        some form of long-term care in their lifetime. By 2050, the 
        number of Americans requiring paid long-term care services will 
        triple from 8,300,00 to 27,000,000.
            (3) According to 2020 Census data, more than 40 percent of 
        baby boomers do not have any retirement savings, let alone 
        savings for their long-term care needs. A recent report by the 
        National Council on Aging found that up to 80 percent of older 
        adults would be unable to afford 4 years in an assisted living 
        community or more than 2 years of nursing home care. Put 
        another way, 47,000,000 Americans aged 60 or above do not have 
        the financial resources to cover the future care they may need.
            (4) Caring for America's aging seniors will be the single 
        most expense domestic priority and is projected to deplete 
        Federal and State Medicaid budgets. The United States spent 
        over $400,000,000,000 on long-term care in 2020, nearly 10 
        percent of all national health care spending.
            (5) According to the Congressional Research Service, State 
        and Federal programs account for 71.4 percent of all long-term 
        care spending nationwide in 2021. Medicaid and Medicare are, 
        respectively, the first and second-largest public payers, 
        accounting for a combined 64.1 percent of all spending. 
        Medicaid is by far the largest single funding source for long-
        term care, spending approximately $135,800,000,000 in 2020, a 
        figure that is projected to reach $466,000,000,000 by 2050.
            (6) A 2023 report by AARP, indicates that at least 9 
        percent of seniors in skilled nursing nationwide have low-
        acuity levels that do not warrant high skilled care, but are 
        forced into a skilled nursing home where assets can be 
        depleted, and Medicaid can become the primary payer. The report 
        by AARP indicated that this number is 20 percent in 5 States.
            (7) In 2021, the Department of Veterans Affairs testified 
        to Congress that if veterans in need of long-term care services 
        could choose assisted living instead of a nursing home, $69,101 
        per veteran per year would be saved by the Department of 
        Veterans Affairs.
            (8) Strengthening cost-effective models of long-term care 
        services, providing incentives for Americans to better afford 
        their care costs, and developing the workforce needed to care 
        for the Nation's aging population will reduce Federal and State 
        Medicaid spending.
            (9) Congregate care models of long-term care services, such 
        as assisted living, are half the cost of nursing homes, and 
        less than a third of round the clock home health aides.
            (10) Assisted living provides 24/7 personal care, chronic 
        disease management, nutrition, room and board, and 
        socialization. If assisted living were not an option, as many 
        as 61 percent of senior residents may be forced into far-
        costlier skilled nursing facilities at a cost of 
        $43,400,000,000 per year.
            (11) The senior living industry lost approximately 400,000 
        jobs between 2020 and 2022, leaving the workforce far below 
        prepandemic employment levels. In order to care for the United 
        States aging population, the senior care industry will need to 
        fill more than 20,200,000 jobs by 2040.

SEC. 3. ADDRESSING THE LONG-TERM CARE WORKFORCE CRISIS.

    (a) Workforce Programs.--
            (1) Expansion of dol workforce programs.--The Secretary of 
        Labor, acting jointly through the Assistant Secretary for 
        Employment and Training and the National Director for the 
        Office of Job Corps of the Employment and Training 
        Administration, shall establish new and expand existing 
        education and training grant programs to support the expansion 
        of the direct care workforce for purposes of caring for a 
        rapidly aging population and providing home and community-based 
        services to older adults and people with disabilities. Such 
        programs shall include support for core certification and 
        training requirements for the direct care workforce of assisted 
        living facilities.
            (2) Expansion of hrsa workforce programs.--The Secretary of 
        Health and Human Services, acting through the Administrator of 
        the Health Resources and Services Administration, shall 
        establish new and expand existing workforce education and 
        training grant programs to address shortages in the direct care 
        workforce serving the rapidly aging population and providing 
        home and community-based services to older adults and people 
        with disabilities. Such programs shall include support for core 
        certification and training requirements for the direct care 
        workforce of assisted living facilities.
    (b) Definitions.--In this section:
            (1) Assisted living facility.--The term ``assisted living 
        facility'' means any licensed, registered, certified, listed, 
        or State-regulated residence, managed residential community, 
        building, or part of a building that provides, or contracts to 
        provide, housing with supportive services on a continuing basis 
        to individuals who--
                    (A) are elderly or have a mental health, 
                developmental, or physical disability; and
                    (B) are unrelated by blood or marriage to the owner 
                or operator of the residence, community, building, or 
                part of a building, if the owner or operator is an 
                individual.
            (2) Direct care workforce.--The term ``direct care 
        workforce'' means a workforce that is composed of individuals 
        who, in exchange for compensation, provide services at an 
        assisted living facility to an individual who is elderly or who 
        has a mental health, developmental, or physical disability, 
        that promote such individual's independence, including--
                    (A) services that enhance independence and 
                community inclusion for such individual, including 
                traveling with such individual, attending and assisting 
                such individual while visiting friends and family, 
                shopping, or socializing;
                    (B) services such as coaching and supporting such 
                individual in communicating needs, achieving self-
                expression, pursuing personal goals, living 
                independently, and participating actively in employment 
                or voluntary roles in the community;
                    (C) services such as providing assistance with 
                activities of daily living (such as feeding, bathing, 
                toileting, and ambulation) and with tasks such as meal 
                preparation, shopping, light housekeeping, and laundry; 
                or
                    (D) services that support such individual at home, 
                work, school, or any other community setting.

SEC. 4. SENIOR CARE COST REDUCTION PROGRAM.

    Part A of title III of the Older Americans Act of 1965 (42 U.S.C. 
3021 et seq.) is amended by adding at the end the following:

``SEC. 317. SENIOR CARE COST REDUCTION PROGRAM.

    ``(a) Establishment of Program.--The Assistant Secretary, acting 
through the Administration, shall establish a `Senior Care Cost 
Reduction Program' for making allotments to States to administer 
monthly cost reduction amounts to assist low-income seniors to reside 
and receive services in assisted living facilities located in the State 
as an alternative to more costly institutional care.
    ``(b) State Application.--In order to be eligible to receive an 
allotment under this section, the State shall submit an application to 
the Assistant Secretary at such time, in such manner, and accompanied 
by such information as the Assistant Secretary may reasonably require.
    ``(c) Cost Reduction Amount.--
            ``(1) Initial amount.--Upon establishment of the Program, 
        the monthly amount provided by the State to eligible recipients 
        shall be $1,000.
            ``(2) Adjustments in consumer price index.--Beginning one 
        year after the establishment of the Program, and each 
        subsequent year, the monthly amount required under paragraph 
        (1) shall be increased by the percentage, if any, by which the 
        Consumer Price Index for all urban consumers (all items; United 
        States city average) for the most recent calendar year exceeds 
        the Consumer Price Index for the previous calendar year, 
        rounded to the nearest dollar.
    ``(d) Eligibility.--In order to be eligible for a cost reduction 
amount under this section, the individual must--
            ``(1) submit an application to and be approved by the 
        relevant State agency tasked with administering the Program;
            ``(2) be at least 70 years old as of the date of 
        application;
            ``(3) be accepted for admission as a resident in, or 
        currently reside in, an assisted living facility which has been 
        approved by the relevant State agency to participate in this 
        Program;
            ``(4) be either a `chronically ill individual' (as defined 
        in section 7702B(c)(2) of the Internal Revenue Code of 1986) or 
        eligible to receive long-term services and supports under the 
        relevant State's Medicaid program; and
            ``(5) be determined to be financially eligible, pursuant to 
        subsection (e).
    ``(e) Financial Eligibility.--An individual is financially eligible 
under this section only if the individual's--
            ``(1) net monthly income is less than the approved monthly 
        fees for the services provided at the assisted living facility;
            ``(2) net annual income is not higher than 60 percent of 
        the median income for the State in which the individual 
        resides, as determined by the Secretary of Housing and Urban 
        Development; and
            ``(3) resources are not greater than $19,000 if single, or 
        $25,000 if married.
    ``(f) Implementation.--The Secretary, acting through the Assistant 
Secretary, may issue such regulations as may be necessary to carry out 
this section.
    ``(g) Assisted Living Facility Defined.--As used in this section, 
the term `assisted living facility' means any licensed, registered, 
certified, listed, or State-regulated residence, managed residential 
community, building, or part of a building that provides, or contracts 
to provide, housing with supportive services on a continuing basis to 
individuals who--
            ``(1) are elderly or have a mental health, developmental, 
        or physical disability; and
            ``(2) are unrelated by blood or marriage to the owner or 
        operator of the residence, community, building, or part of a 
        building, if the owner or operator is an individual.''.

SEC. 5. AUTHORIZATION OF APPROPRIATIONS.

    Amounts that have been returned to or recovered by the Health 
Resources and Services Administration or the Department of the 
Treasury, including all amounts returned or recovered after the date of 
enactment of this Act, from amounts made available and disbursed to 
eligible health care providers for health care-related expenses or lost 
revenues attributable to coronavirus under the heading ``Public Health 
and Social Services Emergency Fund'' in title VIII of division B of 
Public Law 116-136, title I of division B of Public Law 116-139, and 
title III of division M of Public Law 116-260, are authorized to be 
appropriated to carry out this Act and the amendment made by this Act.
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