(3) Parkinson’s disease is a chronic, progressive 
neurological disease. The four primary symptoms of 
Parkinson’s disease are tremor, or trembling in 
hands, arms, legs, jaw, and face; rigidity, or stiffness 
of the limbs and trunk; bradykinesia, or slowness of 
movement; and postural instability, or impaired bal-
ance and coordination. Other symptoms may include 
cognitive changes; difficulty in swallowing, chewing, 
and speaking; urinary problems or constipation; skin 
problems; and sleep disruptions. As these symptoms 
become more pronounced, patients may have dif-
ficulty walking, talking, or completing other simple 
tasks. It is estimated that nearly 500,000 to 
1,500,000 people live with Parkinson’s and of those 
5 to 10 percent are diagnosed younger than 60 and 
deemed ‘‘early-onset’’. 
(4) Traumatic brain injury is a neurological 
condition that typically results from a blow or jolt to 
the head or a penetrating head injury and that can 
impact one or more parts of the brain, thereby tem-
porarily or permanently disrupting normal brain 
function. The Centers for Disease Control and Pre-
vention estimates that 1,400,000 TBIs occur annu-
ally, resulting in disabilities affecting up to 90,000 
people among a broad range of age groups. Trau-
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matic brain injury is also a serious issue that affects 
military servicemembers. Estimates in prior military 
conflicts indicate that TBI was present in 14–20 
percent of surviving casualties. 
(5) Family caregivers are a crucial source of 
support and assistance for individuals suffering with 
disabilities. Family caregivers, the majority of whom 
are women, provide an estimated $450,000,000,000 
in ‘‘free’’ services annually. The current pool of po-
tential family caregivers is dwindling, from 11 po-
tential caregivers for each person needing care today 
to a projected 4 to 1 ratio by 2050. 
(6) Recent studies indicate that the total esti-
mated cost to employers for full-time employees with 
intensive 
caregiving 
responsibilities 
is 
$17,100,000,000. The total estimated cost to em-
ployers for all full-time, employed caregivers is 
$33,600,000,000 annually. 
(7) Currently more than half of care recipients 
(56 percent) are under age 75, and almost one-third 
(28 percent) are under age 50 reflecting the need to 
offer age-appropriate services. 
(8) Adult day programs can offer services, in-
cluding medical care, rehabilitation therapies, dig-
nified assistance with the activities of daily living, 
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nutrition therapy, health monitoring, social inter-
action, stimulating activities, and transportation to 
seniors, people with disabilities, and younger adults 
with chronic diseases. 
(9) Adult day programs geared toward people 
living with neurological diseases or conditions such 
as MS, Parkinson’s disease, TBI, or other similar 
diseases or conditions provide an important response 
to the needs of people living with these conditions 
and their caregivers. Adult day programs can help to 
ameliorate symptoms, reduce dependency, provide 
important socialization opportunities, and maintain 
quality of life. 
(10) Adult day programs have been shown to 
provide a range of documented benefits including 
improvements in functional status, social support, 
and reductions in fatigue, depression and pain. 
Adult day programs also reduce ongoing medical 
care and hospital costs and decrease admissions to 
nursing home facilities, which can be costly for many 
families, by allowing individuals to receive health 
and social services while continuing to live at home. 
(11) There are currently few adult day pro-
grams focused on younger adult populations in the 
United States. Although young people living with 
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neurological diseases or conditions may be able to 
access existing adult day programs, such programs 
are not typically intended for younger adults living 
with chronic diseases or conditions, and may not 
provide the appropriate services to meet the age-re-
lated or disability status of these individuals. 
SEC. 3. ESTABLISHMENT OF ADULT DAY PROGRAMS. 
(a) SURVEY OF EXISTING ADULT DAY PROGRAMS.— 
(1) IN GENERAL.—Not later than 90 days after 
the date of the enactment of this section, the Assist-
ant Secretary for Aging shall initiate a comprehen-
sive survey of current adult day programs that pro-
vide care and support to individuals including young 
adults living with neurological diseases or conditions 
such as multiple sclerosis, Parkinson’s disease, trau-
matic brain injury, or any similar disease or condi-
tion. 
(2) SURVEY ELEMENTS.—In carrying out the 
survey under paragraph (1), the Assistant Secretary 
for Aging may utilize existing publicly available re-
search on adult day programs, and shall— 
(A) identify ongoing successful adult day 
programs, including by providing a brief de-
scription of how such programs were initially 
established and funded; 
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(B) identify which adult day programs are 
serving young adults living with neurological 
diseases or conditions; 
(C) develop a set of best practices to help 
guide the establishment and replication of addi-
tional successful adult day programs, includ-
ing— 
(i) program guidelines; 
(ii) recommendations on the scope of 
services that should be provided to individ-
uals with neurological diseases or condi-
tions including young adults (which may 
include rehabilitation therapy, psychosocial 
support, social stimulation and interaction, 
and spiritual, educational, or other such 
services); and 
(iii) performance goals and indicators 
to measure and analyze the outcomes gen-
erated by the services provided and to 
evaluate the overall success of the pro-
gram; and 
(D) evaluate the extent to which the Ad-
ministration for Community Living supports 
adult day programs, either directly or indi-
rectly, through current Federal grant programs. 
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