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[109th Congress Public Law 442]
[From the U.S. Government Printing Office]

[DOCID: f:publ442.109]

[[Page 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. <<NOTE: Dec. 21, 2006 -  [H.R. 3248]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress <<NOTE: Lifespan Respite Care Act 
of 2006. 42 USC 201 note.>> 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. <<NOTE: 42 USC 300ii.>> 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

[[Page 120 STAT. 3292]]

        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, community-based 
        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. <<NOTE: Inter- governmental relations. 42 USC 300ii-
                        1.>> 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).

[[Page 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

[[Page 120 STAT. 3294]]

                      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.

[[Page 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.--Non-
                Federal 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. <<NOTE: 42 USC 300ii-2.>> 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. <<NOTE: 42 USC 300ii-3.>> 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--

[[Page 120 STAT. 3296]]

            ``(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. <<NOTE: 42 USC 300ii-4.>> 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 <<NOTE: Evaluation.>> 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.

LEGISLATIVE HISTORY--H.R. 3248:
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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.

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