II 

109TH CONGRESS 

2D SESSION H. R. 3248 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 6, 2006 

Received 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Lifespan Respite Care 

3 Act of 2006’’. 

4 SEC. 2. LIFESPAN RESPITE CARE. 

5 The Public Health Service Act (42 U.S.C. 201 et 

6 seq.) is amended by adding at the end the following: 

7 ‘‘TITLE XXIX—LIFESPAN 

8 RESPITE CARE 

9 ‘‘SEC. 2901. DEFINITIONS. 

10 ‘‘In this title: 

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

12 ‘adult with a special need’ means a person 18 years 

13 of age or older who requires care or supervision to— 

14 ‘‘(A) meet the person’s basic needs; 

15 ‘‘(B) prevent physical self-injury or injury 

16 to others; or 

17 ‘‘(C) avoid placement in an institutional 

18 facility. 

19 ‘‘(2) AGING AND DISABILITY RESOURCE CEN20 TER.—The term ‘aging and disability resource cen21 ter’ means an entity administering a program estab22 lished by the State, as part of the State’s system of 

23 long-term care, to provide a coordinated system for 

24 providing— 


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1 ‘‘(A) comprehensive information on avail2 able public and private long-term care pro3 grams, options, and resources; 

4 ‘‘(B) personal counseling to assist individ5 uals in assessing their existing or anticipated 

6 long-term care needs, and developing and imple7 menting a plan for long-term care designed to 

8 meet their specific needs and circumstances; 

9 and 

10 ‘‘(C) consumer access to the range of pub11 licly supported long-term care programs for 

12 which consumers may be eligible, by serving as 

13 a convenient point of entry for such programs. 

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

15 ‘child with a special need’ means an individual less 

16 than 18 years of age who requires care or super17 vision beyond that required of children generally 

18 to— 

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

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

21 injury to others. 

22 ‘‘(4) ELIGIBLE STATE AGENCY.—The term ‘eli23 gible State agency’ means a State agency that— 

24 ‘‘(A) administers the State’s program 

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1 isters the State’s program under title XIX of 

2 the Social Security Act, or is designated by the 

3 Governor of such State to administer the 

4 State’s programs under this title; 

5 ‘‘(B) is an aging and disability resource 

6 center; 

7 ‘‘(C) works in collaboration with a public 

8 or private nonprofit statewide respite care coali9 tion or organization; and 

10 ‘‘(D) demonstrates— 

11 ‘‘(i) an ability to work with other 

12 State and community-based agencies; 

13 ‘‘(ii) an understanding of respite care 

14 and family caregiver issues across all age 

15 groups, disabilities, and chronic conditions; 

16 and 

17 ‘‘(iii) the capacity to ensure meaning18 ful involvement of family members, family 

19 caregivers, and care recipients. 

20 ‘‘(5) FAMILY CAREGIVER.—The term ‘family 

21 caregiver’ means an unpaid family member, a foster 

22 parent, or another unpaid adult, who provides in23 home monitoring, management, supervision, or 

24 treatment of a child or adult with a special need. 


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1 ‘‘(6) LIFESPAN RESPITE CARE.—The term ‘life2 span respite care’ means a coordinated system of ac3 cessible, community-based respite care services for 

4 family caregivers of children or adults with special 

5 needs. 

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

7 means planned or emergency care provided to a 

8 child or adult with a special need in order to provide 

9 temporary relief to the family caregiver of that child 

10 or adult. 

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

12 the several States, the District of Columbia, the Vir13 gin Islands of the United States, the Commonwealth 

14 of Puerto Rico, Guam, American Samoa, and the 

15 Commonwealth of the Northern Mariana Islands. 

16 ‘‘SEC. 2902. LIFESPAN RESPITE CARE GRANTS AND COOP17 ERATIVE AGREEMENTS. 

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

19 ‘‘(1) to expand and enhance respite care serv20 ices to family caregivers; 

21 ‘‘(2) to improve the statewide dissemination and 

22 coordination of respite care; and 

23 ‘‘(3) to provide, supplement, or improve access 

24 and quality of respite care services to family care25 givers, thereby reducing family caregiver strain. 


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

2 Secretary is authorized to award grants or cooperative 

3 agreements for the purposes described in subsection (a) 

4 to eligible State agencies for which an application is sub5 mitted pursuant to subsection (d). 

6 ‘‘(c) FEDERAL LIFESPAN APPROACH.—In carrying 

7 out this section, the Secretary shall work in cooperation 

8 with the National Family Caregiver Support Program of 

9 the Administration on Aging and other respite care pro10 grams within the Department of Health and Human Serv11 ices to ensure coordination of respite care services for fam12 ily caregivers of children and adults with special needs. 

13 ‘‘(d) APPLICATION.— 

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

15 eligible State agency of his or her State to receive 

16 a grant or cooperative agreement under this section 

17 shall submit an application on behalf of such agency 

18 to the Secretary at such time, in such manner, and 

19 containing such information as the Secretary shall 

20 require. 

21 ‘‘(2) CONTENTS.—Each application submitted 

22 under this section shall include— 

23 ‘‘(A) a description of the eligible State 

24 agency’s— 


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1 ‘‘(i) ability to work with other State 

2 and community-based agencies; 

3 ‘‘(ii) understanding of respite care 

4 and family caregiver issues across all age 

5 groups, disabilities, and chronic conditions; 

6 and 

7 ‘‘(iii) capacity to ensure meaningful 

8 involvement of family members, family 

9 caregivers, and care recipients; 

10 ‘‘(B) with respect to the population of fam11 ily caregivers to whom respite care information 

12 or services will be provided or for whom respite 

13 care workers and volunteers will be recruited 

14 and trained, a description of— 

15 ‘‘(i) the population of family care16 givers; 

17 ‘‘(ii) the extent and nature of the res18 pite care needs of that population; 

19 ‘‘(iii) existing respite care services for 

20 that population, including numbers of fam21 ily caregivers being served and extent of 

22 unmet need; 

23 ‘‘(iv) existing methods or systems to 

24 coordinate respite care information and 


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1 services to the population at the State and 

2 local level and extent of unmet need; 

3 ‘‘(v) how respite care information dis4 semination and coordination, respite care 

5 services, respite care worker and volunteer 

6 recruitment and training programs, or 

7 training programs for family caregivers 

8 that assist such family caregivers in mak9 ing informed decisions about respite care 

10 services will be provided using grant or co11 operative agreement funds; 

12 ‘‘(vi) a plan for administration, col13 laboration, and coordination of the pro14 posed respite care activities with other re15 lated services or programs offered by pub16 lic or private, nonprofit entities, including 

17 area agencies on aging; 

18 ‘‘(vii) how the population, including 

19 family caregivers, care recipients, and rel20 evant public or private agencies, will par21 ticipate in the planning and implementa22 tion of the proposed respite care activities; 

23 ‘‘(viii) how the proposed respite care 

24 activities will make use, to the maximum 

25 extent feasible, of other Federal, State, 


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1 and local funds, programs, contributions, 

2 other forms of reimbursements, personnel, 

3 and facilities; 

4 ‘‘(ix) respite care services available to 

5 family caregivers in the eligible State agen6 cy’s State or locality, including unmet 

7 needs and how the eligible State agency’s 

8 plan for use of funds will improve the co9 ordination and distribution of respite care 

10 services for family caregivers of children 

11 and adults with special needs; 

12 ‘‘(x) the criteria used to identify fam13 ily caregivers eligible for respite care serv14 ices; 

15 ‘‘(xi) how the quality and safety of 

16 any respite care services provided will be 

17 monitored, including methods to ensure 

18 that respite care workers and volunteers 

19 are appropriately screened and possess the 

20 necessary skills to care for the needs of the 

21 care recipient in the absence of the family 

22 caregiver; and 

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1 dures to be used for evaluating those re2 sults; 

3 ‘‘(C) assurances that, where appropriate, 

4 the eligible State agency will have a system for 

5 maintaining the confidentiality of care recipient 

6 and family caregiver records; and 

7 ‘‘(D) a memorandum of agreement regard8 ing the joint responsibility for the eligible State 

9 agency’s lifespan respite program between— 

10 ‘‘(i) the eligible State agency; and 

11 ‘‘(ii) a public or private nonprofit 

12 statewide respite coalition or organization. 

13 ‘‘(e) PRIORITY; CONSIDERATIONS.—When awarding 

14 grants or cooperative agreements under this section, the 

15 Secretary shall— 

16 ‘‘(1) give priority to eligible State agencies that 

17 the Secretary determines show the greatest likeli18 hood of implementing or enhancing lifespan respite 

19 care statewide; and 

20 ‘‘(2) give consideration to eligible State agencies 

21 that are building or enhancing the capacity of their 

22 long-term care systems to respond to the comprehen23 sive needs, including respite care needs, of their resi24 dents. 


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1 ‘‘(f) USE OF GRANT OR COOPERATIVE AGREEMENT

2 FUNDS.— 

3 ‘‘(1) IN GENERAL.— 

4 ‘‘(A) REQUIRED USES OF FUNDS.—Each 

5 eligible State agency awarded a grant or coop6 erative agreement under this section shall use 

7 all or part of the funds— 

8 ‘‘(i) to develop or enhance lifespan 

9 respite care at the State and local levels; 

10 ‘‘(ii) to provide respite care services 

11 for family caregivers caring for children or 

12 adults; 

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

14 workers and volunteers; 

15 ‘‘(iv) to provide information to care16 givers about available respite and support 

17 services; and 

18 ‘‘(v) to assist caregivers in gaining ac19 cess to such services. 

20 ‘‘(B) OPTIONAL USES OF FUNDS.—Each 

21 eligible State agency awarded a grant or coop22 erative agreement under this section may use 

23 part of the funds for— 

24 ‘‘(i) training programs for family 

25 caregivers to assist such family caregivers 


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1 in making informed decisions about respite 

2 care services; 

3 ‘‘(ii) other services essential to the 

4 provision of respite care as the Secretary 

5 may specify; or 

6 ‘‘(iii) training and education for new 

7 caregivers. 

8 ‘‘(2) SUBCONTRACTS.—Each eligible State 

9 agency awarded a grant or cooperative agreement 

10 under this section may carry out the activities de11 scribed in paragraph (1) directly or by grant to, or 

12 contract with, public or private entities. 

13 ‘‘(3) MATCHING FUNDS.— 

14 ‘‘(A) IN GENERAL.—With respect to the 

15 costs of the activities to be carried out under 

16 paragraph (1), a condition for the receipt of a 

17 grant or cooperative agreement under this sec18 tion is that the eligible State agency agrees to 

19 make available (directly or through donations 

20 from public or private entities) non-Federal 

21 contributions toward such costs in an amount 

22 that is not less than 25 percent of such costs. 

23 ‘‘(B) DETERMINATION OF AMOUNT CON24 TRIBUTED.—Non-Federal contributions re25 quired by subparagraph (A) may be in cash or 


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1 in kind, fairly evaluated, including plant, equip2 ment, or services. Amounts provided by the 

3 Federal Government, or services assisted or 

4 subsidized to any significant extent by the Fed5 eral Government, may not be included in deter6 mining the amount of such non-Federal con7 tributions. 

8 ‘‘(g) TERM OF GRANTS OR COOPERATIVE AGREE9 MENTS.— 

10 ‘‘(1) IN GENERAL.—The Secretary shall award 

11 grants or cooperative agreements under this section 

12 for terms that do not exceed 5 years. 

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

14 grant or cooperative agreement under this section at 

15 the end of the term of the grant or cooperative 

16 agreement determined under paragraph (1). 

17 ‘‘(h) MAINTENANCE OF EFFORT.—Funds made 

18 available under this section shall be used to supplement 

19 and not supplant other Federal, State, and local funds 

20 available for respite care services. 

21 ‘‘SEC. 2903. NATIONAL LIFESPAN RESPITE RESOURCE CEN22 TER. 

23 ‘‘(a) ESTABLISHMENT.—The Secretary may award a 

24 grant or cooperative agreement to a public or private non25 profit entity to establish a National Resource Center on 


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1 Lifespan Respite Care (referred to in this section as the 

2 ‘center’). 

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

4 shall— 

5 ‘‘(1) maintain a national database on lifespan 

6 respite care; 

7 ‘‘(2) provide training and technical assistance 

8 to State, community, and nonprofit respite care pro9 grams; and 

10 ‘‘(3) provide information, referral, and edu11 cational programs to the public on lifespan respite 

12 care. 

13 ‘‘SEC. 2904. REPORT. 

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

15 report to the Congress on the activities undertaken under 

16 this title. Such report shall evaluate— 

17 ‘‘(1) the number of States that have lifespan 

18 respite care programs; 

19 ‘‘(2) the demographics of the caregivers receiv20 ing respite care services through grants or coopera21 tive agreements under this title; and 

22 ‘‘(3) the effectiveness of entities receiving 

23 grants or cooperative agreements under this title. 


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1 ‘‘SEC. 2905. AUTHORIZATION OF APPROPRIATIONS. 

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

3 this title— 

4 ‘‘(1) $30,000,000 for fiscal year 2007; 

5 ‘‘(2) $40,000,000 for fiscal year 2008; 

6 ‘‘(3) $53,330,000 for fiscal year 2009; 

7 ‘‘(4) $71,110,000 for fiscal year 2010; and 

8 ‘‘(5) $94,810,000 for fiscal year 2011.’’. 

9 SEC. 3. GAO REPORT ON LIFESPAN RESPITE CARE PRO10 GRAMS. 

11 Not later than January 1, 2011, the Comptroller 

12 General of the United States shall conduct an evaluation 

13 and submit a report to the Congress on the effectiveness 

14 of lifespan respite programs, including an analysis of cost 

15 benefits and improved efficiency in service delivery. 

Passed the House of Representatives December 6, 

2006. 

Attest: KAREN L. HAAS, 

Clerk. 


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