```

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6530 Introduced in House (IH)]

<DOC>

117th CONGRESS
  2d Session
                                H. R. 6530

  To amend the Public Health Service Act to sustain senior congregate 
care operations in the wake of ongoing COVID-19 financial burdens, and 
                          for other purposes.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                            January 28, 2022

Mrs. Trahan (for herself and Mr. Fitzpatrick) introduced the following 
 bill; which was referred to the Committee on Energy and Commerce, and 
  in addition to the Committee on Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL

 
  To amend the Public Health Service Act to sustain senior congregate 
care operations in the wake of ongoing COVID-19 financial burdens, 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 ``Safeguarding Elderly Needs for 
Infrastructure and Occupational Resources Act of 2022'' or the ``SENIOR 
Act of 2022''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Long-term care facilities and senior congregate care 
        homes provide direct and personalized care, where social 
        distancing is not possible, 24 hours a day, 7 days a week.
            (2) Assisted living, memory care, independent living, and 
        other senior congregate care settings are the homes of 
        America's seniors and critical options on the long-term care 
        continuum; these senior residences provide safety and security 
        for our Nation's most vulnerable population.
            (3) Sixty percent of a senior's health is based on social 
        determinants of health which include the need for adequate 
        nutrition, housing, and social activities; thus supporting 
        caregivers and home- and community-based care models that 
        prioritize the social determinants of senior health should be a 
        priority of the Congress.
            (4) Investing in senior care and the caregiving workforce 
        prevents hospitalization and skilled nursing expenses, 
        preserving Medicare and Medicaid budgets.
            (5) Since March of 2020, senior care facilities have lost 
        over 380,000 caregivers and are experiencing a workforce crisis 
        as America's population rapidly ages.
            (6) By 2030, the entire Baby Boomer Generation will be 65 
        years of age or older.
            (7) By 2060, nearly 95 million Americans will be 65 years 
        of age or older and the portion of the population over 85 years 
        of age will have tripled to nearly 20 million persons.
            (8) Fifty-two percent of individuals require long-term care 
        by age 65. Individuals over 65 years of age are 70 percent more 
        likely to need long-term care, with half of those seniors 
        requiring an even higher level of care.
            (9) The average duration of long-term care is nearly 4 
        years, and 14 percent of individuals need long-term care for 5 
        or more years.
            (10) Twenty-seven percent of seniors over 65 years of age 
        will spend at least $100,000 on long-term care, and 15 percent 
        will have costs for long-term care surpassing $250,000.
            (11) The average cost for long-term care for a 65-year old 
        today is $138,000.
            (12) Long-term care infrastructure must address the 
        availability of cost-effective care and housing options to meet 
        the growing needs of the Nation's aging population.
            (13) On average, assisted living costs $4,300 per month, 
        which equals $5.91 per hour of available care (based on 24/7 
        care). Nursing homes cost $8,821 per month (or $13.13 per hour 
        based on 24/7 care). In-home care costs $4,576 per month (or 
        $26 per hour based on 44 hours per week care).
            (14) An individual 85 years of age or older is 630 percent 
        more likely to die of COVID-19.
            (15) Sixty-three percent of residents of long-term care 
        facilities need assistance with bathing; 48 percent need 
        assistance with dressing; and 40 percent need assistance with 
        toileting.
            (16) More than 42 percent of residents of long-term care 
        facilities suffer from Alzheimer's disease or some other form 
        of dementia.
            (17) The people of the United States are a compassionate 
        people who are committed to protecting the most vulnerable in 
        our society, and we should not jeopardize the financial 
        underpinnings of the long-term care communities our Nation's 
        senior citizens depend on day-in and day-out.

SEC. 3. SENIOR CAREGIVER RELIEF ASSISTANCE.

    Part K of title III of the Public Health Service Act (42 U.S.C. 
280c et seq.) is amended by adding at the end the following new 
subpart:

            ``Subpart IV--Senior Caregiver Relief Assistance

``SEC. 399A-1. SENIOR CAREGIVER RELIEF ASSISTANCE.

    ``(a) Authority.--The Secretary shall provide assistance under this 
section to eligible entities to stabilize and preserve senior 
congregate care operations.
    ``(b) Eligible Entities.--
            ``(1) In general.--The Secretary may provide assistance 
        under this section only to an entity that--
                    ``(A) is an assisted living facility;
                    ``(B) demonstrates, by providing such documentation 
                as the Secretary shall require, financial need by 
                having--
                            ``(i) incurred uncompensated losses because 
                        of the public health emergency declared under 
                        section 319 with respect to COVID-19; and
                            ``(ii) consistently maintained ongoing 
                        operations during the period from March 13, 
                        2020, to December 31, 2020; and
                    ``(C) makes a good-faith certification to the 
                Secretary--
                            ``(i) that the uncertainty of existing 
                        economic conditions makes the application for 
                        assistance under this section necessary to 
                        support ongoing operations of the entity; and
                            ``(ii) that all amounts of such assistance 
                        will be used to promote the health and well-
                        being of the facility's population of seniors, 
                        to retain workers, to maintain the facility, 
                        and for other eligible uses under the relevant 
                        provisions of this section.
            ``(2) Basis of determinations.--Any individual 
        determination of qualification of an entity as an eligible 
        entity for purposes of this section shall be based on review of 
        the entity's existing versus recent historic financials, 
        including--
                    ``(A) profit-loss statements;
                    ``(B) account receivables;
                    ``(C) Federal tax filings; and
                    ``(D) such other materials that the Secretary deems 
                relevant to meet the purposes of this section.
    ``(c) Applications.--The Secretary shall--
            ``(1) provide for eligible entities to submit applications 
        for assistance under this section; and
            ``(2) require such applications--
                    ``(A) to set forth the proposed uses of such 
                assistance; and
                    ``(B) to contain such other assurances and 
                information as the Secretary may require.
    ``(d) Formula Grants for Health Care-Related Expenses and Lost 
Revenue Attributable to COVID-19.--
            ``(1) In general.--To the extent and in the amount of 
        appropriations made in advance to carry out this section, the 
        Secretary shall--
                    ``(A) make grants to eligible entities for health 
                care-related expenses attributable to COVID-19 or to 
                supplant lost revenue attributable to COVID-19; and
                    ``(B) distribute such amounts among eligible 
                entities in an equitable and timely manner, but not 
                later than December 31, 2022, based on the order in 
                which approvable applications from such entities are 
                received by the Secretary.
            ``(2) Limitation on administrative expenses.--As a 
        condition on receipt of a grant under this section, an eligible 
        entity shall agree to use not more than 5 percent of the 
        amounts received through the grant for administrative expenses.
            ``(3) Amount.--The amount of assistance distributed to an 
        eligible entity pursuant to this subsection shall be--
                    ``(A) based on the number of beds in the facility 
                to be assisted; and
                    ``(B) proportional to the uncompensated losses of 
                the eligible entity referred to in subsection 
                (b)(1)(B)(i).
            ``(4) Rule of construction.--Nothing in this subsection 
        shall be construed as preventing the Secretary from making 
        assistance available to eligible entities at any time before 
        the date specified in paragraph (1)(B).
    ``(e) Senior Caregiver Relief Grants.--
            ``(1) In general.--To the extent and in the amount of 
        appropriations made in advance to carry out this section, the 
        Secretary shall make grants to eligible entities for use 
        (subject to paragraph (2)) only for the following purposes:
                    ``(A) Enhanced broadband connectivity and 
                telehealth support.--To ensure regular and reliable 
                communications connections between seniors residing in 
                the assisted living facility of the entity and their 
                physicians and medical support personnel.
                    ``(B) Caregiver sustainability.--For costs of 
                operating and maintaining the assisted living facility 
                of the entity, including--
                            ``(i) for payments of principal or interest 
                        on any mortgage obligation in connection with 
                        the facility, but not including any prepayment 
                        of principal on such a mortgage obligation;
                            ``(ii) for payments of rent for a facility, 
                        including rent under a lease agreement, but not 
                        including any prepayment of rent;
                            ``(iii) for costs of activities to prevent, 
                        prepare for, and mitigate the presence of 
                        COVID-19 on facility premises, including costs 
                        of purchasing and installing equipment and 
                        supplies to disinfect the premises, support 
                        emergency management operations, and provide 
                        for associated staff-related expenses;
                            ``(iv) for maintenance expenses for the 
                        facility for the purposes of COVID-19 
                        mitigation and infection control, including 
                        construction to accommodate social distancing 
                        and other preventive measures, such as 
                        plexiglass barriers;
                            ``(v) for costs of supplies for the 
                        facility, including protective equipment and 
                        cleaning materials; and
                            ``(vi) for any other expenses that the 
                        Secretary determines to be essential to 
                        maintaining the facility.
            ``(2) Other activities.--Nothing in this subsection may be 
        construed to prevent the Secretary from approving applications 
        providing for use of funds for other costs, purposes, and 
        activities not specifically identified in paragraph (1) that 
        the Secretary deems appropriate and consistent with the 
        purposes of this section.
    ``(f) Reporting.--Each recipient of a grant under subsection (d) or 
(e) shall submit reports and maintain documentation by such deadlines, 
in such form, and containing such content as the Secretary determines 
necessary to ensure compliance with the conditions of the grant.
    ``(g) Tax Treatment.--
            ``(1) Exclusion from gross income.--For purposes of the 
        Internal Revenue Code of 1986, amounts received by an eligible 
        entity from the Secretary under a grant under subsection (d) or 
        (e) shall not be included in the gross income of such eligible 
        entity.
            ``(2) Effect of exclusion.--An eligible entity shall not 
        have a tax deduction denied, a tax attribute reduced, or any 
        basis increased by reason of the exclusion from gross income 
        pursuant to paragraph (1).
    ``(h) GAO Report to Congress.--Not later than 2 years after the 
date of enactment of this Act, the Comptroller General of the United 
States shall submit to the Congress a report assessing the efficacy of 
assistance made available under this section and the activities 
supported with such assistance.
    ``(i) Definitions.--In this section:
            ``(1) The term `assisted living facility' means a licensed, 
        registered, certified, listed, or State-regulated residence, 
        managed residential community, building, or part of a building 
        that provides, or contracts to provide, housing with supportive 
        services on a continuing basis to individuals who--
                    ``(A) are elderly or have a mental health, 
                developmental, or physical disability; and
                    ``(B) are unrelated by blood or marriage to the 
                owner or operator of the residence, community, 
                building, or part of a building if the owner or 
                operator is an individual.
            ``(2) The term `eligible entity' means an entity that is 
        eligible under subsection (b) to be provided assistance under 
        this section.
            ``(3) The term `health care-related expenses attributable 
        to COVID-19' means health care-related expenses to prevent, 
        prepare for, and respond to COVID-19, including the building or 
        construction of a temporary structure, the leasing of a 
        property, the purchase of medical supplies and equipment 
        (including personal protective equipment and testing supplies), 
        providing for an expanded workforce (including by training 
        staff, maintaining staff, and hiring additional staff), the 
        operation of an emergency operation center, retrofitting a 
        facility, providing for surge capacity, and other expenses 
        determined appropriate by the Secretary.
            ``(4) The term `lost revenue attributable to COVID-19' 
        means the cost of services that were received, building 
        modifications made, and tangible property ordered for 
        mitigation and prevention of COVID-19, including the difference 
        between such provider's budgeted and actual revenue if such 
        budget was established and approved before March 27, 2020, for 
        the purposes of preventing, preparing for, and responding to 
        COVID-19.
    ``(j) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $10,000,000,000 for fiscal year 
2022, to remain available until expended.''.

SEC. 4. SENIOR CAREGIVING WORKFORCE DEVELOPMENT SUSTAINMENT GRANTS.

    Part K of title III of the Public Health Service Act (42 U.S.C. 
280c et seq.) is amended by inserting after section 399A-1, as added by 
section 3 of this Act, the following:

``SEC. 399A-2. SENIOR CAREGIVING WORKFORCE DEVELOPMENT SUSTAINMENT 
              GRANTS.

    ``(a) In General.--The Secretary may award grants to eligible 
entities to establish or expand a senior caregiver workforce training 
and recruitment program on the campus of the respective eligible 
entity.
    ``(b) Amount; Duration.--A grant under this section shall be for--
            ``(1) an amount of not more than $1,000,000; and
            ``(2) a term of not more than 4 years.
    ``(c) Use of Funds.--Amounts provided to an eligible entity through 
a grant under this section shall be used to cover the costs of--
            ``(1) establishing or expanding a senior caregiver 
        workforce training and recruitment program described in 
        subsection (a), including costs associated with recruitment, 
        training, and retention of senior caregivers; and
            ``(2) technical assistance provided by the eligible entity 
        in connection with such program.
    ``(d) Application.--An eligible entity seeking a grant under this 
section shall submit an application to the Secretary at such time, in 
such manner, and containing such information as the Secretary may 
require.
    ``(e) Reports.--Each recipient of a grant under this section shall 
submit reports and maintain documentation by such deadlines, in such 
form, and containing such content as the Secretary determines necessary 
to ensure compliance with the conditions of the grant.
    ``(f) Tax Treatment.--
            ``(1) Exclusion from gross income.--For purposes of the 
        Internal Revenue Code of 1986, amounts received by an eligible 
        entity from the Secretary under a grant under this section 
        shall not be included in the gross income of such eligible 
        entity.
            ``(2) Effect of exclusion.--An eligible entity shall not 
        have a tax deduction denied, a tax attribute reduced, or any 
        basis increased by reason of the exclusion from gross income 
        pursuant to paragraph (1).
    ``(g) Definitions.--
            ``(1) The term `eligible entity'--
                    ``(A) means an assisted living facility as defined 
                in section 399A-1; and
                    ``(B) excludes any skilled nursing facility as 
                defined in section 1819(a) of the Social Security Act.
            ``(2) The term `senior caregiver' means an individual who 
        furnishes direct personal care, assistance with activities of 
        daily living, or any other related service for older adults 
        located on a campus of an eligible entity.
    ``(h) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $1,250,000,000 for fiscal year 
2022, to remain available until expended.''.

SEC. 5. NATIONAL HEALTH CARE WORKFORCE COMMISSION.

    The National Health Care Workforce Commission established under 
section 5101 of the Patient Protection and Affordable Care Act (42 
U.S.C. 294q) shall--
            (1) not later than 180 days after the date of enactment of 
        this Act, pursuant to subsection (d)(4) of such section 5101, 
        designate as a ``high priority area'' the current and projected 
        workforce needs of assisted living and other senior care 
        settings that attend to the care of the senior population; and
            (2) not later than 1 year after finalizing such 
        designation, submit a report pursuant to subsection (d)(2)(D) 
        of such section 5101 to the Congress and the Administration 
        containing a review of, and recommendations on, such high 
        priority area.
                                 <all>
```