IB 

Union Calendar No. 428 

109TH CONGRESS 

2D SESSION H. R. 3248 

[Report No. 109–716] 

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. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 12, 2005 

Mr. FERGUSON (for himself, Mr. LANGEVIN, Mr. TERRY, Mr. NORWOOD, Mrs. 

WILSON of New Mexico, and Mr. BROWN of Ohio) introduced the following bill; which was referred to the Committee on Energy and Commerce 

DECEMBER 5, 2006 

Additional sponsors: Mr. LARSON of Connecticut, Mr. ANDREWS, Mr. WOLF, 

Mr. PASCRELL, Mr. LARSEN of Washington, Mr. EMANUEL, Ms. JACKSON-LEE of Texas, Mr. MENENDEZ, Mr. DEFAZIO, Mr. SANDERS, Mr. 

PALLONE, Mr. GUTIERREZ, Mr. WU, Ms. LORETTA SANCHEZ of California, Mr. REYES, Mr. LYNCH, Mr. VAN HOLLEN, Mr. HINCHEY, Mr. 

RAMSTAD, Mr. DOYLE, Ms. ROYBAL-ALLARD, Mr. BISHOP of Georgia, 

Mr. BOEHLERT, Mr. MCDERMOTT, Mr. STRICKLAND, Mr. MELANCON, 

Mr. PRICE of North Carolina, Mr. PLATTS, Mrs. CAPPS, Mr. WALDEN

of Oregon, Mr. SCHWARZ of Michigan, Ms. BERKLEY, Ms. SLAUGHTER, 

Mr. SHIMKUS, Ms. BALDWIN, Mr. SNYDER, Mr. ABERCROMBIE, Ms. 

HERSETH, Mrs. DAVIS of California, Mr. RENZI, Mr. HOLT, Mr. ROTHMAN, Mr. BAIRD, Mr. NADLER, Mr. KUCINICH, Mr. SCHIFF, Ms. 

SCHAKOWSKY, Mr. MICHAUD, Mr. SHAYS, Mr. KIND, Mr. RAHALL, Mr. 

BONNER, Mr. SOUDER, Mr. BACHUS, Mr. FATTAH, Mr. WAXMAN, Mr. 

GENE GREEN of Texas, Mr. MCINTYRE, Mrs. JONES of Ohio, Ms. 

ESHOO, Mr. MOORE of Kansas, Mr. BLUMENAUER, Mr. KIRK, Ms. ZOE

LOFGREN of California, Mr. CARDIN, Mrs. JO ANN DAVIS of Virginia, 

Mr. GOODE, Mr. BURGESS, Mr. BOUCHER, Mr. SCOTT of Virginia, Mr. 

FORD, Mrs. MALONEY, Mr. ROGERS of Michigan, Mr. WYNN, Mr. PETERSON of Minnesota, Mr. RUPPERSBERGER, Ms. HOOLEY, Mr. KENNEDY of Rhode Island, and Mr. PAYNE


bajohnson on PROD1PC77 with BILLS
2 

•HR 3248 RH

DECEMBER 5, 2006 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on July 12, 2005] 

A BILL 

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, 

3 SECTION 1. SHORT TITLE. 

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

5 Act of 2006’’. 

6 SEC. 2. LIFESPAN RESPITE CARE. 

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

8 is amended by adding at the end the following: 

9 ‘‘TITLE XXIX—LIFESPAN RESPITE 

10 CARE 

11 ‘‘SEC. 2901. DEFINITIONS. 

12 ‘‘In this title: 

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

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

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

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


bajohnson on PROD1PC77 with BILLS
3 

•HR 3248 RH

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

2 to others; or 

3 ‘‘(C) avoid placement in an institutional 

4 facility. 

5 ‘‘(2) AGING AND DISABILITY RESOURCE CEN6 TER.—The term ‘aging and disability resource center’ 

7 means an entity administering a program established 

8 by the State, as part of the State’s system of long9 term care, to provide a coordinated system for pro10 viding— 

11 ‘‘(A) comprehensive information on avail12 able public and private long-term care programs, 

13 options, and resources; 

14 ‘‘(B) personal counseling to assist individ15 uals in assessing their existing or anticipated 

16 long-term care needs, and developing and imple17 menting a plan for long-term care designed to 

18 meet their specific needs and circumstances; and 

19 ‘‘(C) consumer access to the range of pub20 licly supported long-term care programs for 

21 which consumers may be eligible, by serving as 

22 a convenient point of entry for such programs. 

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

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


bajohnson on PROD1PC77 with BILLS
4 

•HR 3248 RH

1 than 18 years of age who requires care or supervision 

2 beyond that required of children generally to— 

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

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

5 injury to others. 

6 ‘‘(4) ELIGIBLE STATE AGENCY.—The term ‘eligi7 ble State agency’ means a State agency that— 

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

9 the Older Americans Act of 1965, administers 

10 the State’s program under title XIX of the Social 

11 Security Act, or is designated by the Governor of 

12 such State to administer the State’s programs 

13 under this title; 

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

15 center; 

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

17 or private nonprofit statewide respite care coali18 tion or organization; and 

19 ‘‘(D) demonstrates— 

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

21 State and community-based agencies; 

22 ‘‘(ii) an understanding of respite care 

23 and family caregiver issues across all age 

24 groups, disabilities, and chronic conditions; 

25 and 


bajohnson on PROD1PC77 with BILLS
5 

•HR 3248 RH

1 ‘‘(iii) the capacity to ensure meaning2 ful involvement of family members, family 

3 caregivers, and care recipients. 

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

5 caregiver’ means an unpaid family member, a foster 

6 parent, or another unpaid adult, who provides in7 home monitoring, management, supervision, or treat8 ment of a child or adult with a special need. 

9 ‘‘(6) LIFESPAN RESPITE CARE.—The term ‘life10 span respite care’ means a coordinated system of ac11 cessible, community-based respite care services for 

12 family caregivers of children or adults with special 

13 needs. 

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

15 means planned or emergency care provided to a child 

16 or adult with a special need in order to provide tem17 porary relief to the family caregiver of that child or 

18 adult. 

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

20 several States, the District of Columbia, the Virgin Is21 lands of the United States, the Commonwealth of 

22 Puerto Rico, Guam, American Samoa, and the Com23 monwealth of the Northern Mariana Islands. 


bajohnson on PROD1PC77 with BILLS
6 

•HR 3248 RH

1 ‘‘SEC. 2902. LIFESPAN RESPITE CARE GRANTS AND COOPER2 ATIVE AGREEMENTS. 

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

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

5 to family caregivers; 

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

7 coordination of respite care; and 

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

9 and quality of respite care services to family care10 givers, thereby reducing family caregiver strain. 

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

12 Secretary is authorized to award grants or cooperative 

13 agreements for the purposes described in subsection (a) to 

14 eligible State agencies for which an application is sub15 mitted pursuant to subsection (d). 

16 ‘‘(c) FEDERAL LIFESPAN APPROACH.—In carrying out 

17 this section, the Secretary shall work in cooperation with 

18 the National Family Caregiver Support Program of the Ad19 ministration on Aging and other respite care programs 

20 within the Department of Health and Human Services to 

21 ensure coordination of respite care services for family care22 givers of children and adults with special needs. 

23 ‘‘(d) APPLICATION.— 

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

25 eligible State agency of his or her State to receive a 

26 grant or cooperative agreement under this section 


bajohnson on PROD1PC77 with BILLS
7 

•HR 3248 RH

1 shall submit an application on behalf of such agency 

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

3 containing such information as the Secretary shall re4 quire. 

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

6 under this section shall include— 

7 ‘‘(A) a description of the eligible State agen8 cy’s— 

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

10 and community-based agencies; 

11 ‘‘(ii) understanding of respite care and 

12 family caregiver issues across all age 

13 groups, disabilities, and chronic conditions; 

14 and 

15 ‘‘(iii) capacity to ensure meaningful 

16 involvement of family members, family 

17 caregivers, and care recipients; 

18 ‘‘(B) with respect to the population of fam19 ily caregivers to whom respite care information 

20 or services will be provided or for whom respite 

21 care workers and volunteers will be recruited and 

22 trained, a description of— 

23 ‘‘(i) the population of family care24 givers; 


bajohnson on PROD1PC77 with BILLS
8 

•HR 3248 RH

1 ‘‘(ii) the extent and nature of the res2 pite care needs of that population; 

3 ‘‘(iii) existing respite care services for 

4 that population, including numbers of fam5 ily caregivers being served and extent of 

6 unmet need; 

7 ‘‘(iv) existing methods or systems to co8 ordinate respite care information and serv9 ices to the population at the State and local 

10 level and extent of unmet need; 

11 ‘‘(v) how respite care information dis12 semination and coordination, respite care 

13 services, respite care worker and volunteer 

14 recruitment and training programs, or 

15 training programs for family caregivers 

16 that assist such family caregivers in making 

17 informed decisions about respite care serv18 ices will be provided using grant or cooper19 ative agreement funds; 

20 ‘‘(vi) a plan for administration, col21 laboration, and coordination of the proposed 

22 respite care activities with other related 

23 services or programs offered by public or 

24 private, nonprofit entities, including area 

25 agencies on aging; 


bajohnson on PROD1PC77 with BILLS
9 

•HR 3248 RH

1 ‘‘(vii) how the population, including 

2 family caregivers, care recipients, and rel3 evant public or private agencies, will par4 ticipate in the planning and implementa5 tion of the proposed respite care activities; 

6 ‘‘(viii) how the proposed respite care 

7 activities will make use, to the maximum 

8 extent feasible, of other Federal, State, and 

9 local funds, programs, contributions, other 

10 forms of reimbursements, personnel, and fa11 cilities; 

12 ‘‘(ix) respite care services available to 

13 family caregivers in the eligible State agen14 cy’s State or locality, including unmet 

15 needs and how the eligible State agency’s 

16 plan for use of funds will improve the co17 ordination and distribution of respite care 

18 services for family caregivers of children 

19 and adults with special needs; 

20 ‘‘(x) the criteria used to identify fam21 ily caregivers eligible for respite care serv22 ices; 

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

24 respite care services provided will be mon25 itored, including methods to ensure that resVerDate Aug 31 2005 00:20 Dec 06, 2006 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6203 E:\BILLS\H3248.RH H3248

bajohnson on PROD1PC77 with BILLS
10 

•HR 3248 RH

1 pite care workers and volunteers are appro2 priately screened and possess the necessary 

3 skills to care for the needs of the care recipi4 ent in the absence of the family caregiver; 

5 and 

6 ‘‘(xii) the results expected from pro7 posed respite care activities and the proce8 dures to be used for evaluating those results; 

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

10 the eligible State agency will have a system for 

11 maintaining the confidentiality of care recipient 

12 and family caregiver records; and 

13 ‘‘(D) a memorandum of agreement regard14 ing the joint responsibility for the eligible State 

15 agency’s lifespan respite program between— 

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

17 ‘‘(ii) a public or private nonprofit 

18 statewide respite coalition or organization. 

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

20 grants or cooperative agreements under this section, the Sec21 retary shall— 

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

23 the Secretary determines show the greatest likelihood 

24 of implementing or enhancing lifespan respite care 

25 statewide; and 


bajohnson on PROD1PC77 with BILLS
11 

•HR 3248 RH

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

2 that are building or enhancing the capacity of their 

3 long-term care systems to respond to the comprehen4 sive needs, including respite care needs, of their resi5 dents. 

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

7 FUNDS.— 

8 ‘‘(1) IN GENERAL.— 

9 ‘‘(A) REQUIRED USES OF FUNDS.—Each el10 igible State agency awarded a grant or coopera11 tive agreement under this section shall use all or 

12 part of the funds— 

13 ‘‘(i) to develop or enhance lifespan res14 pite care at the State and local levels; 

15 ‘‘(ii) to provide respite care services for 

16 family caregivers caring for children or 

17 adults; 

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

19 workers and volunteers; 

20 ‘‘(iv) to provide information to care21 givers about available respite and support 

22 services; and 

23 ‘‘(v) to assist caregivers in gaining ac24 cess to such services. 


bajohnson on PROD1PC77 with BILLS
12 

•HR 3248 RH

1 ‘‘(B) OPTIONAL USES OF FUNDS.—Each eli2 gible State agency awarded a grant or coopera3 tive agreement under this section may use part 

4 of the funds for— 

5 ‘‘(i) training programs for family care6 givers to assist such family caregivers in 

7 making informed decisions about respite 

8 care services; 

9 ‘‘(ii) other services essential to the pro10 vision of respite care as the Secretary may 

11 specify; or 

12 ‘‘(iii) training and education for new 

13 caregivers. 

14 ‘‘(2) SUBCONTRACTS.—Each eligible State agen15 cy awarded a grant or cooperative agreement under 

16 this section may carry out the activities described in 

17 paragraph (1) directly or by grant to, or contract 

18 with, public or private entities. 

19 ‘‘(3) MATCHING FUNDS.— 

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

21 costs of the activities to be carried out under 

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

23 grant or cooperative agreement under this sec24 tion is that the eligible State agency agrees to 

25 make available (directly or through donations 


bajohnson on PROD1PC77 with BILLS
13 

•HR 3248 RH

1 from public or private entities) non-Federal con2 tributions toward such costs in an amount that 

3 is not less than 25 percent of such costs. 

4 ‘‘(B) DETERMINATION OF AMOUNT CONTRIB5 UTED.—Non-Federal contributions required by 

6 subparagraph (A) may be in cash or in kind, 

7 fairly evaluated, including plant, equipment, or 

8 services. Amounts provided by the Federal Gov9 ernment, or services assisted or subsidized to any 

10 significant extent by the Federal Government, 

11 may not be included in determining the amount 

12 of such non-Federal contributions. 

13 ‘‘(g) TERM OF GRANTS OR COOPERATIVE AGREE14 MENTS.— 

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

16 grants or cooperative agreements under this section 

17 for terms that do not exceed 5 years. 

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

19 grant or cooperative agreement under this section at 

20 the end of the term of the grant or cooperative agree21 ment determined under paragraph (1). 

22 ‘‘(h) MAINTENANCE OF EFFORT.—Funds made avail23 able under this section shall be used to supplement and not 

24 supplant other Federal, State, and local funds available for 

25 respite care services. 


bajohnson on PROD1PC77 with BILLS
14 

•HR 3248 RH

1 ‘‘SEC. 2903. NATIONAL LIFESPAN RESPITE RESOURCE CEN2 TER. 

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

4 grant or cooperative agreement to a public or private non5 profit entity to establish a National Resource Center on 

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

7 ‘center’). 

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

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

10 respite care; 

11 ‘‘(2) provide training and technical assistance to 

12 State, community, and nonprofit respite care pro13 grams; and 

14 ‘‘(3) provide information, referral, and edu15 cational programs to the public on lifespan respite 

16 care. 

17 ‘‘SEC. 2904. REPORT. 

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

19 report to the Congress on the activities undertaken under 

20 this title. Such report shall evaluate— 

21 ‘‘(1) the number of States that have lifespan res22 pite care programs; 

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

24 respite care services through grants or cooperative 

25 agreements under this title; and 


bajohnson on PROD1PC77 with BILLS
15 

•HR 3248 RH

1 ‘‘(3) the effectiveness of entities receiving grants 

2 or cooperative agreements under this title. 

3 ‘‘SEC. 2905. AUTHORIZATION OF APPROPRIATIONS. 

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

5 this title— 

6 ‘‘(1) $30,000,000 for fiscal year 2007; 

7 ‘‘(2) $40,000,000 for fiscal year 2008; 

8 ‘‘(3) $53,330,000 for fiscal year 2009; 

9 ‘‘(4) $71,110,000 for fiscal year 2010; and 

10 ‘‘(5) $94,810,000 for fiscal year 2011.’’. 


bajohnson on PROD1PC77 with BILLS
Union Calendar No. 428 

109TH CONGRESS 

2D SESSION H. R. 3248 

[Report No. 109

–716] 

A BILL 

To amend the Public Health Service Act to estaband for other purposes. cessing affordable and high-quality respite care, lish a program to assist family caregivers in acDECEMBER 5, 2006 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


bajohnson on PROD1PC77 with BILLS