PUBLIC LAW 109–442—DEC. 21, 2006 120 STAT. 3291

Public Law 109–442

109th Congress

An Act

To amend the Public Health Service Act to establish a program to assist family

caregivers in accessing affordable and high-quality respite care, 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 ‘‘Lifespan Respite Care Act of

2006’’.

SEC. 2. LIFESPAN RESPITE CARE.

The Public Health Service Act (42 U.S.C. 201 et seq.) is

amended by adding at the end the following:

‘‘TITLE XXIX—LIFESPAN RESPITE CARE

‘‘SEC. 2901. DEFINITIONS.

‘‘In this title:

‘‘(1) ADULT WITH A SPECIAL NEED.—The term ‘adult with

a special need’ means a person 18 years of age or older who

requires care or supervision to—

‘‘(A) meet the person’s basic needs;

‘‘(B) prevent physical self-injury or injury to others;

or

‘‘(C) avoid placement in an institutional facility.

‘‘(2) AGING AND DISABILITY RESOURCE CENTER.—The term

‘aging and disability resource center’ means an entity administering a program established by the State, as part of the

State’s system of long-term care, to provide a coordinated

system for providing—

‘‘(A) comprehensive information on available public and

private long-term care programs, options, and resources;

‘‘(B) personal counseling to assist individuals in

assessing their existing or anticipated long-term care needs,

and developing and implementing a plan for long-term

care designed to meet their specific needs and circumstances; and

‘‘(C) consumer access to the range of publicly supported

long-term care programs for which consumers may be

eligible, by serving as a convenient point of entry for such

programs.

‘‘(3) CHILD WITH A SPECIAL NEED.—The term ‘child with

a special need’ means an individual less than 18 years of

42 USC 300ii.

Lifespan Respite

Care Act of 2006.

42 USC 201 note.

Dec. 21, 2006

[H.R. 3248]

120 STAT. 3292 PUBLIC LAW 109–442—DEC. 21, 2006

age who requires care or supervision beyond that required

of children generally to—

‘‘(A) meet the child’s basic needs; or

‘‘(B) prevent physical injury, self-injury, or injury to

others.

‘‘(4) ELIGIBLE STATE AGENCY.—The term ‘eligible State

agency’ means a State agency that—

‘‘(A) administers the State’s program under the Older

Americans Act of 1965, administers the State’s program

under title XIX of the Social Security Act, or is designated

by the Governor of such State to administer the State’s

programs under this title;

‘‘(B) is an aging and disability resource center;

‘‘(C) works in collaboration with a public or private

nonprofit statewide respite care coalition or organization;

and

‘‘(D) demonstrates—

‘‘(i) an ability to work with other State and community-based agencies;

‘‘(ii) an understanding of respite care and family

caregiver issues across all age groups, disabilities, and

chronic conditions; and

‘‘(iii) the capacity to ensure meaningful involvement of family members, family caregivers, and care

recipients.

‘‘(5) FAMILY CAREGIVER.—The term ‘family caregiver’ means

an unpaid family member, a foster parent, or another unpaid

adult, who provides in-home monitoring, management, supervision, or treatment of a child or adult with a special need.

‘‘(6) LIFESPAN RESPITE CARE.—The term ‘lifespan respite

care’ means a coordinated system of accessible, communitybased respite care services for family caregivers of children

or adults with special needs.

‘‘(7) RESPITE CARE.—The term ‘respite care’ means planned

or emergency care provided to a child or adult with a special

need in order to provide temporary relief to the family caregiver

of that child or adult.

‘‘(8) STATE.—The term ‘State’ means any of the several

States, the District of Columbia, the Virgin Islands of the

United States, the Commonwealth of Puerto Rico, Guam, American Samoa, and the Commonwealth of the Northern Mariana

Islands.

‘‘SEC. 2902. LIFESPAN RESPITE CARE GRANTS AND COOPERATIVE

AGREEMENTS.

‘‘(a) PURPOSES.—The purposes of this section are—

‘‘(1) to expand and enhance respite care services to family

caregivers;

‘‘(2) to improve the statewide dissemination and coordination of respite care; and

‘‘(3) to provide, supplement, or improve access and quality

of respite care services to family caregivers, thereby reducing

family caregiver strain.

‘‘(b) AUTHORIZATION.—Subject to subsection (e), the Secretary

is authorized to award grants or cooperative agreements for the

purposes described in subsection (a) to eligible State agencies for

which an application is submitted pursuant to subsection (d).

Intergovernmental

relations.

42 USC 300ii–1.

PUBLIC LAW 109–442—DEC. 21, 2006 120 STAT. 3293

‘‘(c) FEDERAL LIFESPAN APPROACH.—In carrying out this section,

the Secretary shall work in cooperation with the National Family

Caregiver Support Program of the Administration on Aging and

other respite care programs within the Department of Health and

Human Services to ensure coordination of respite care services

for family caregivers of children and adults with special needs.

‘‘(d) APPLICATION.—

‘‘(1) SUBMISSION.—Each Governor desiring the eligible

State agency of his or her State to receive a grant or cooperative

agreement under this section shall submit an application on

behalf of such agency to the Secretary at such time, in such

manner, and containing such information as the Secretary shall

require.

‘‘(2) CONTENTS.—Each application submitted under this section shall include—

‘‘(A) a description of the eligible State agency’s—

‘‘(i) ability to work with other State and community-based agencies;

‘‘(ii) understanding of respite care and family caregiver issues across all age groups, disabilities, and

chronic conditions; and

‘‘(iii) capacity to ensure meaningful involvement

of family members, family caregivers, and care recipients;

‘‘(B) with respect to the population of family caregivers

to whom respite care information or services will be provided or for whom respite care workers and volunteers

will be recruited and trained, a description of—

‘‘(i) the population of family caregivers;

‘‘(ii) the extent and nature of the respite care needs

of that population;

‘‘(iii) existing respite care services for that population, including numbers of family caregivers being

served and extent of unmet need;

‘‘(iv) existing methods or systems to coordinate

respite care information and services to the population

at the State and local level and extent of unmet need;

‘‘(v) how respite care information dissemination

and coordination, respite care services, respite care

worker and volunteer recruitment and training programs, or training programs for family caregivers that

assist such family caregivers in making informed

decisions about respite care services will be provided

using grant or cooperative agreement funds;

‘‘(vi) a plan for administration, collaboration, and

coordination of the proposed respite care activities with

other related services or programs offered by public

or private, nonprofit entities, including area agencies

on aging;

‘‘(vii) how the population, including family caregivers, care recipients, and relevant public or private

agencies, will participate in the planning and

implementation of the proposed respite care activities;

‘‘(viii) how the proposed respite care activities will

make use, to the maximum extent feasible, of other

120 STAT. 3294 PUBLIC LAW 109–442—DEC. 21, 2006

Federal, State, and local funds, programs, contributions, other forms of reimbursements, personnel, and

facilities;

‘‘(ix) respite care services available to family caregivers in the eligible State agency’s State or locality,

including unmet needs and how the eligible State

agency’s plan for use of funds will improve the

coordination and distribution of respite care services

for family caregivers of children and adults with special

needs;

‘‘(x) the criteria used to identify family caregivers

eligible for respite care services;

‘‘(xi) how the quality and safety of any respite

care services provided will be monitored, including

methods to ensure that respite care workers and volunteers are appropriately screened and possess the necessary skills to care for the needs of the care recipient

in the absence of the family caregiver; and

‘‘(xii) the results expected from proposed respite

care activities and the procedures to be used for evaluating those results;

‘‘(C) assurances that, where appropriate, the eligible

State agency will have a system for maintaining the confidentiality of care recipient and family caregiver records;

and

‘‘(D) a memorandum of agreement regarding the joint

responsibility for the eligible State agency’s lifespan respite

program between—

‘‘(i) the eligible State agency; and

‘‘(ii) a public or private nonprofit statewide respite

coalition or organization.

‘‘(e) PRIORITY; CONSIDERATIONS.—When awarding grants or

cooperative agreements under this section, the Secretary shall—

‘‘(1) give priority to eligible State agencies that the Secretary determines show the greatest likelihood of implementing

or enhancing lifespan respite care statewide; and

‘‘(2) give consideration to eligible State agencies that are

building or enhancing the capacity of their long-term care systems to respond to the comprehensive needs, including respite

care needs, of their residents.

‘‘(f) USE OF GRANT OR COOPERATIVE AGREEMENT FUNDS.—

‘‘(1) IN GENERAL.—

‘‘(A) REQUIRED USES OF FUNDS.—Each eligible State

agency awarded a grant or cooperative agreement under

this section shall use all or part of the funds—

‘‘(i) to develop or enhance lifespan respite care

at the State and local levels;

‘‘(ii) to provide respite care services for family caregivers caring for children or adults;

‘‘(iii) to train and recruit respite care workers and

volunteers;

‘‘(iv) to provide information to caregivers about

available respite and support services; and

‘‘(v) to assist caregivers in gaining access to such

services.

PUBLIC LAW 109–442—DEC. 21, 2006 120 STAT. 3295

‘‘(B) OPTIONAL USES OF FUNDS.—Each eligible State

agency awarded a grant or cooperative agreement under

this section may use part of the funds for—

‘‘(i) training programs for family caregivers to

assist such family caregivers in making informed

decisions about respite care services;

‘‘(ii) other services essential to the provision of

respite care as the Secretary may specify; or

‘‘(iii) training and education for new caregivers.

‘‘(2) SUBCONTRACTS.—Each eligible State agency awarded

a grant or cooperative agreement under this section may carry

out the activities described in paragraph (1) directly or by

grant to, or contract with, public or private entities.

‘‘(3) MATCHING FUNDS.— ‘‘(A) IN GENERAL.—With respect to the costs of the

activities to be carried out under paragraph (1), a condition

for the receipt of a grant or cooperative agreement under

this section is that the eligible State agency agrees to

make available (directly or through donations from public

or private entities) non-Federal contributions toward such

costs in an amount that is not less than 25 percent of

such costs.

‘‘(B) DETERMINATION OF AMOUNT CONTRIBUTED.—NonFederal contributions required by subparagraph (A) may

be in cash or in kind, fairly evaluated, including plant,

equipment, or services. Amounts provided by the Federal

Government, or services assisted or subsidized to any

significant extent by the Federal Government, may not

be included in determining the amount of such non-Federal

contributions.

‘‘(g) TERM OF GRANTS OR COOPERATIVE AGREEMENTS.— ‘‘(1) IN GENERAL.—The Secretary shall award grants or

cooperative agreements under this section for terms that do

not exceed 5 years.

‘‘(2) RENEWAL.—The Secretary may renew a grant or

cooperative agreement under this section at the end of the

term of the grant or cooperative agreement determined under

paragraph (1).

‘‘(h) MAINTENANCE OF EFFORT.—Funds made available under

this section shall be used to supplement and not supplant other

Federal, State, and local funds available for respite care services.

‘‘SEC. 2903. NATIONAL LIFESPAN RESPITE RESOURCE CENTER.

‘‘(a) ESTABLISHMENT.—The Secretary may award a grant or

cooperative agreement to a public or private nonprofit entity to

establish a National Resource Center on Lifespan Respite Care

(referred to in this section as the ‘center’).

‘‘(b) PURPOSES OF THE CENTER.—The center shall—

‘‘(1) maintain a national database on lifespan respite care;

‘‘(2) provide training and technical assistance to State,

community, and nonprofit respite care programs; and

‘‘(3) provide information, referral, and educational programs

to the public on lifespan respite care.

‘‘SEC. 2904. REPORT.

‘‘Not later than January 1, 2009, the Secretary shall report

to the Congress on the activities undertaken under this title. Such

report shall evaluate—

42 USC 300ii–3.

42 USC 300ii–2.

120 STAT. 3296 PUBLIC LAW 109–442—DEC. 21, 2006

LEGISLATIVE HISTORY—H.R. 3248:

HOUSE REPORTS: No. 109–716 (Comm. on Energy and Commerce).

CONGRESSIONAL RECORD, Vol. 152 (2006):

Dec. 6, considered and passed House.

Dec. 8, considered and passed Senate.

Æ

‘‘(1) the number of States that have lifespan respite care

programs;

‘‘(2) the demographics of the caregivers receiving respite

care services through grants or cooperative agreements under

this title; and

‘‘(3) the effectiveness of entities receiving grants or cooperative agreements under this title.

‘‘SEC. 2905. AUTHORIZATION OF APPROPRIATIONS.

‘‘There are authorized to be appropriated to carry out this

title—

‘‘(1) $30,000,000 for fiscal year 2007;

‘‘(2) $40,000,000 for fiscal year 2008;

‘‘(3) $53,330,000 for fiscal year 2009;

‘‘(4) $71,110,000 for fiscal year 2010; and

‘‘(5) $94,810,000 for fiscal year 2011.’’.

SEC. 3. GAO REPORT ON LIFESPAN RESPITE CARE PROGRAMS.

Not later than January 1, 2011, the Comptroller General of

the United States shall conduct an evaluation and submit a report

to the Congress on the effectiveness of lifespan respite programs,

including an analysis of cost benefits and improved efficiency in

service delivery.

Approved December 21, 2006.

Evaluation.

42 USC 300ii–4.