II 

118TH CONGRESS 

2D SESSION S. 4736 

To amend the Older Americans Act of 1965 to develop and expand integrated 

caregiver support services for family caregivers, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 23, 2024 

Mr. MARKEY introduced the following bill; which was read twice and referred 

to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Older Americans Act of 1965 to develop 

and expand integrated caregiver support services for family caregivers, 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 ‘‘Respite Care And Re5 sources for Everyone Act’’ or the ‘‘Respite CARE Act’’. 

6 SEC. 2. CAREGIVER SUPPORT. 

7 Title IV of the Older Americans Act of 1965 is 

8 amended by inserting after section 414 (42 U.S.C. 3032c) 

9 the following: 


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1 ‘‘SEC. 415. CAREGIVER SUPPORT. 

2 ‘‘(a) GRANTS.—The Assistant Secretary may make 

3 grants to eligible entities for the development or expansion 

4 of integrated caregiver support services, through which a 

5 provider provides, at the same time and integrated setting, 

6 respite care to assist family caregivers and other sup7 portive services or support services described in section 

8 373(b) for family caregivers. 

9 ‘‘(b) ELIGIBLE ENTITY.—To be eligible to receive a 

10 grant under subsection (a), an entity shall be a State or 

11 local government agency, a nonprofit organization, an area 

12 agency on aging, the provider of a multipurpose senior 

13 center, an institution of higher education, or a Tribal or14 ganization. 

15 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

16 under subsection (a), an entity shall submit an application 

17 to the Assistant Secretary at such time, in such manner, 

18 and containing such information as the Assistant Sec19 retary may require. 

20 ‘‘(d) USE OF FUNDS.—An eligible entity receiving a 

21 grant under subsection (a) shall use the grant funds, con22 sistent with subsection (e)— 

23 ‘‘(1) to develop or expand integrated caregiver 

24 support services in order to provide respite care at 

25 the same time and integrated setting as supportive 


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1 services or support services described in section 

2 373(b) for family caregivers; and 

3 ‘‘(2) to provide services described in paragraph 

4 (1) in a manner that is accessible, as appropriate for 

5 the family caregiver or the care recipient, as the case 

6 may be, including providing the services— 

7 ‘‘(A) through assistive technology; 

8 ‘‘(B) in an accessible language; 

9 ‘‘(C) for caregivers for whom English is 

10 not their primary language, through translation 

11 or interpretation services; and 

12 ‘‘(D) in an accessible format, including for13 mats compatible with American Sign Language 

14 and multiple languages. 

15 ‘‘(e) DIRECT OR INDIRECT PROVISION.—An eligible 

16 entity receiving such a grant may use the grant funds di17 rectly, or indirectly by contract with a health care provider 

18 or child care provider, to provide respite care. 

19 ‘‘(f) DEFINITIONS.—In this section: 

20 ‘‘(1) CAREGIVER SUPPORT SERVICES.—The 

21 term ‘caregiver support services’ means services, 

22 provided for a family caregiver, that are— 

23 ‘‘(A) supportive services; or 

24 ‘‘(B) support services described in section 

25 373(b). 


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1 ‘‘(2) CHILD CARE PROVIDER.— 

2 ‘‘(A) IN GENERAL.—The term ‘child care 

3 provider’ means a center-based child care pro4 vider, a family child care provider, or other pro5 vider of child care services for compensation 

6 that— 

7 ‘‘(i) is licensed to provide child care 

8 services under State law applicable to the 

9 child care services it provides or, in the 

10 case of an Indian Tribe or Tribal organiza11 tion, meets the rules set by the Secretary 

12 of Health and Human Services; 

13 ‘‘(ii) participates in the State’s tiered 

14 system for recognizing and supporting the 

15 quality of child care services, or, in the 

16 case of an Indian Tribe or Tribal organiza17 tion, meets the rules set by the Secretary, 

18 on such schedule as the Secretary may 

19 provide; and 

20 ‘‘(iii) satisfies the State and local re21 quirements, including those requirements 

22 described in section 658E(c)(2)(I) of the 

23 Child Care and Development Block Grant 

24 Act of 1990 (42 U.S.C. 9858c(c)(2)(I)), 


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1 applicable to the child care services it pro2 vides. 

3 ‘‘(B) FAMILY CHILD CARE PROVIDER.—In 

4 subparagraph (A), the term ‘family child care 

5 provider’ means one or more individuals who 

6 provide child care services, in a private resi7 dence other than the residences of the children 

8 involved, for less than 24 hours per day per 

9 child, or for 24 hours per day per child due to 

10 the nature of the work of the parent involved. 

11 ‘‘(3) FAMILY CAREGIVER.—The term ‘family 

12 caregiver’— 

13 ‘‘(A) means— 

14 ‘‘(i) an adult family member, or an15 other individual, who is an informal pro16 vider of in-home and community care to an 

17 older individual or to an individual of any 

18 age with Alzheimer’s disease or a related 

19 disorder with neurological and organic 

20 brain dysfunction; or 

21 ‘‘(ii) an older relative caregiver; and 

22 ‘‘(B) does not include an individual pro23 viding care whose primary relationship with the 

24 individual receiving the care is based on a fi25 nancial or professional agreement. 


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1 ‘‘(4) HEALTH CARE PROVIDER.—The term 

2 ‘health care provider’ means a health care provider, 

3 as defined in section 3000 of the Public Health 

4 Service Act (42 U.S.C. 300jj) or a Federally quali5 fied health center, as defined in section 1861 of the 

6 Social Security Act (42 U.S.C. 1395x). 

7 ‘‘(5) INDIAN TRIBE, TRIBAL ORGANIZATION.— 

8 The terms ‘Indian Tribe’ and ‘Tribal organization’ 

9 have the meanings given the terms ‘Indian tribe’ and 

10 ‘tribal organization’, respectively, in section 658P of 

11 such Act (42 U.S.C. 9858n). 

12 ‘‘(6) OLDER RELATIVE CAREGIVER.—The term 

13 ‘older relative caregiver’— 

14 ‘‘(A) means a caregiver who— 

15 ‘‘(i) is age 55 or older; and 

16 ‘‘(ii) lives with, is the informal pro17 vider of in-home and community care to, 

18 and is the primary caregiver for, a child or 

19 an individual with a disability; 

20 ‘‘(B) in the case of a caregiver for a 

21 child— 

22 ‘‘(i) is the grandparent, 

23 stepgrandparent, or other relative (other 

24 than the parent) by blood, marriage, or 

25 adoption, of the child; 


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1 ‘‘(ii) is the primary caregiver of the 

2 child because the biological or adoptive 

3 parents are unable or unwilling to serve as 

4 the primary caregivers of the child; and 

5 ‘‘(iii) has a legal relationship to the 

6 child, such as legal custody, adoption, or 

7 guardianship, or is raising the child infor8 mally; and 

9 ‘‘(C) in the case of a caregiver for an indi10 vidual with a disability, is the parent, grand11 parent, or other relative by blood, marriage, or 

12 adoption, of the individual with a disability. 

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

14 means care, which may include health care and child 

15 care, for a care recipient of a family caregiver.’’. 

Æ 


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