II 

108TH CONGRESS 

2D SESSION S. 2029

To amend the Internal Revenue Code of 1986 to allow a deduction from 

gross income for home care and adult day and respite care expenses 

of individual taxpayers with respect to a dependent of the taxpayer 

who suffers from Alzheimer’s disease or related organic brain disorders. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 26, 2004

Ms. SNOWE introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL

To amend the Internal Revenue Code of 1986 to allow a 

deduction from gross income for home care and adult 

day and respite care expenses of individual taxpayers 

with respect to a dependent of the taxpayer who suffers 

from Alzheimer’s disease or related organic brain disorders.

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. DEDUCTION ALLOWANCE FOR HOME HEALTH 

2 CARE AND ADULT DAY AND RESPITE CARE 

3 EXPENSES OF INDIVIDUALS FOR DEPEND4 ENTS WITH ALZHEIMER’S DISEASE OR RE5 LATED ORGANIC BRAIN DISORDERS. 

6 (a) IN GENERAL.—Part VII of subchapter B of chap7 ter 1 of the Internal Revenue Code of 1986 (relating to 

8 additional itemized deductions for individuals) is amended 

9 by redesignating section 224 as section 225 and by insert10 ing after section 223 the following new section: 

11 ‘‘SEC. 224. HOME HEALTH CARE AND ADULT DAY AND RES12 PITE CARE EXPENSES FOR DEPENDENTS 

13 WITH ALZHEIMER’S DISEASE OR RELATED 

14 ORGANIC BRAIN DISORDERS. 

15 ‘‘(a) DEDUCTION ALLOWED.—In the case of an indi16 vidual who maintains a household which includes a quali17 fied dependent of such individual, there shall be allowed 

18 as a deduction the qualified home health care and adult 

19 day respite care expenses of such individual with respect 

20 to such dependent. 

21 ‘‘(b) DEFINITIONS.—For purposes of this section—

22 ‘‘(1) QUALIFIED DEPENDENT.—The term 

23 ‘qualified dependent’ means any individual (includ24 ing the spouse of the taxpayer but not including the 

25 taxpayer) who—
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1 ‘‘(A) has as his principal place of abode 

2 the principal residence of the taxpayer, and is 

3 a member of the taxpayer’s household, for more 

4 than 180 days of the calendar year during 

5 which the taxable year of the taxpayer begins, 

6 ‘‘(B) is a dependent of the taxpayer (with7 in the meaning given to such term by sub8 section (a) of section 152 other than paragraph 

9 (9) of such subsection) for such calendar year, 

10 and 

11 ‘‘(C) at the close of such calendar year, 

12 suffers from Alzheimer’s disease (or a related 

13 organic brain disorder) and is physically or 

14 mentally incapable of caring for himself, as de15 termined by a physician. 

16 ‘‘(2) QUALIFIED HOME HEALTH CARE AND

17 ADULT DAY AND RESPITE CARE EXPENSES.—The 

18 term ‘qualified home health care and adult day and 

19 respite care expenses’ means the excess of—

20 ‘‘(A) the reasonable and necessary ex21 penses paid or incurred by the taxpayer for—

22 ‘‘(i) household services for a qualified 

23 dependent, and 
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1 ‘‘(ii) the care (including respite care) 

2 of such dependent in the home or in an 

3 adult day care center, over 

4 ‘‘(B) the reasonable and necessary ex5 penses such taxpayer would have paid or in6 curred for household services for, and the care 

7 of, such qualified dependent if such dependent 

8 had been capable of caring for himself. 

9 ‘‘(3) PHYSICIAN.—The term ‘physician’ has the 

10 meaning given to such term by section 1861(r) of 

11 the Social Security Act (42 U.S.C. 1395x(r)). 

12 ‘‘(c) SPECIAL RULES.—For purposes of this sec13 tion—

14 ‘‘(1) MAINTAINING A HOUSEHOLD.—An indi15 vidual shall be treated as maintaining a household 

16 for any period only if over half the cost of maintain17 ing the household for such period is furnished by 

18 such individual (or, if the individual is married, by 

19 the individual and his spouse). 

20 ‘‘(2) MARRIED COUPLE MUST FILE JOINT RE21 TURN.—If the taxpayer is married at the close of 

22 the taxable year, the deduction shall be allowed 

23 under subsection (a) only if the taxpayer and his 

24 spouse file a joint return under section 6013 for the 

25 taxable year. 
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1 ‘‘(d) CERTIFICATION OF DIAGNOSIS BY PHYSI2 CIAN.—Any determination by a physician that—

3 ‘‘(1) an individual suffers from Alzheimer’s dis4 ease or a related organic brain disorder, and 

5 ‘‘(2) such individual is mentally or physically 

6 incapable of caring for himself, 

7 shall be certified by the physician to the Secretary at such 

8 time and in such manner as the Secretary shall by regula9 tion prescribe. 

10 ‘‘(e) COORDINATION WITH SECTIONS 21 AND 213.—

11 If any amount allowable as a deduction under this section 

12 would (but for this subsection) also be taken into account 

13 for purposes of determining the amount of any credit al14 lowable under section 21 (relating to expenses for house15 hold and dependent care services necessary for gainful em16 ployment) or any deduction allowable under section 213 

17 (relating to medical, dental, etc. expenses), this section 

18 shall apply only if the taxpayer elects its application. If 

19 this section is elected with respect to any amount, such 

20 amount shall not be taken into account under section 21 

21 or 213. Such election shall be made at such time and in 

22 such manner as the Secretary shall by regulation pre23 scribe.’’. 

24 (b) DEDUCTION ALLOWED IN ARRIVING AT AD25 JUSTED GROSS INCOME.—Section 62(a) of such Code (de-
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1 fining adjusted gross income) is amended by inserting 

2 after paragraph (19) the following new paragraph: 

3 ‘‘(20) QUALIFIED HOME HEALTH CARE AND

4 ADULT DAY AND RESPITE CARE EXPENSES.—The 

5 deduction allowed by section 224.’’. 

6 (c) CLERICAL AMENDMENT.—The table of sections 

7 for part VII of subchapter B of chapter 1 of such Code 

8 is amended by striking the last item and inserting the fol9 lowing new items:

‘‘Sec. 224. Home health care and adult day and respite care expenses for dependents with Alzheimer’s disease or 

related organic brain disorders. 

‘‘Sec. 225. Cross reference.’’.

10 (d) EFFECTIVE DATE.—The amendments made by 

11 this section shall apply to taxable years beginning after 

12 December 31, 2003.

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