To promote training and employment for public housing residents in home-based health services so such residents can provide Medicaid covered home-based health services to elderly and disabled persons receiving public housing assistance from the Department of Housing and Urban Development.

Summary: Home-Based Health Services Job Training and Caregiving Act of 2008 - Amends the United States Housing Act of 1937 to require the Secretary of Housing and Urban Development to establish a pilot program to make grants to eligible entities to promote the training and employment of public housing residents as home health aides and 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.

Qualifies as an eligible entity any public housing agency, state or local government (or agency), community health center, home care provider organization, faith-based organization, labor organization, or other organization meeting specified criteria.

Amends the Housing and Urban Development Act of 1968 to require the Secretary to: (1) ensure low- and very low-income persons, residing within a home-based health services public housing project, opportunities for training and employment arising in connection with such project; and (2) award contracts to businesses that provide such training and employment opportunities.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Home-Based Health Services Job 
Training and Caregiving Act of 2008''.

SEC. 2. 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.

SEC. 3. 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.''.

SEC. 4. 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''.

SEC. 5. 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.

SEC. 6. 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.