H. R. 3248

One Hundred Ninth Congress

of the

United States of America 

AT THE SECOND SESSION 

Begun and held at the City of Washington on Tuesday, 

the third day of January, two thousand and six 

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 
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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). 
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‘‘(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 
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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. 
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‘‘(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—
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‘‘(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.

Speaker of the House of Representatives.

Vice President of the United States and

President of the Senate.