I 
110TH CONGRESS 
2D SESSION 
H. R. 6448 
To amend the Internal Revenue Code of 1986 to provide a refundable credit 
for taxpayers with long-term care needs. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 9, 2008 
Mr. CARNEY (for himself and Mr. PLATTS) introduced the following bill; which 
was referred to the Committee on Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to provide 
a refundable credit for taxpayers with long-term care needs. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Caregiver Tax Relief 
Act of 2008’’. 
SEC. 2. CREDIT FOR TAXPAYERS WITH LONG-TERM CARE 
NEEDS. 
(a) IN GENERAL.—Subpart C of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
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1986 (relating to refundable personal credits) is amended 
by inserting after section 35 the following new section: 
‘‘SEC. 35A. CREDIT FOR TAXPAYERS WITH LONG-TERM 
CARE NEEDS. 
‘‘(a) ALLOWANCE OF CREDIT.— 
‘‘(1) IN GENERAL.—There shall be allowed as a 
credit against the tax imposed by this chapter for 
the taxable year an amount equal to the applicable 
credit amount multiplied by the number of applica-
ble individuals with respect to whom the taxpayer is 
an eligible caregiver for the taxable year. 
‘‘(2) APPLICABLE CREDIT AMOUNT.—For pur-
poses of paragraph (1), the applicable credit amount 
shall be $2,500. 
‘‘(b) LIMITATION BASED ON ADJUSTED GROSS IN-
COME.— 
‘‘(1) IN GENERAL.—The amount of the credit 
allowable under subsection (a) shall be reduced (but 
not below zero) by $100 for each $1,000 (or fraction 
thereof) by which the taxpayer’s modified adjusted 
gross income exceeds the threshold amount. For 
purposes of the preceding sentence, the term ‘modi-
fied adjusted gross income’ means adjusted gross in-
come increased by any amount excluded from gross 
income under section 911, 931, or 933. 
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‘‘(2) THRESHOLD AMOUNT.—For purposes of 
paragraph (1), the term ‘threshold amount’ means— 
‘‘(A) $150,000 in the case of a joint re-
turn, and 
‘‘(B) $75,000 in any other case. 
‘‘(3) INDEXING.—In the case of any taxable 
year beginning in a calendar year after 2009, each 
dollar amount contained in paragraph (2) shall be 
increased by an amount equal to the product of— 
‘‘(A) such dollar amount; and 
‘‘(B) the medical care cost adjustment de-
termined under section 213(d)(10)(B)(ii) for 
the calendar year in which the taxable year be-
gins, determined by substituting ‘2008’ for 
‘1996’ in subclause (II) thereof. If any increase 
determined under the preceding sentence is not 
a multiple of $50, such increase shall be round-
ed to the next lowest multiple of $50. 
‘‘(c) DEFINITIONS.—For purposes of this section: 
‘‘(1) APPLICABLE INDIVIDUAL.— 
‘‘(A) IN GENERAL.—The term ‘applicable 
individual’ means, with respect to any taxable 
year, any individual who has been certified, be-
fore the due date for filing the return of tax for 
the taxable year (without extensions), by a phy-
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sician (as defined in section 1861(r)(1) of the 
Social Security Act) as being an individual with 
long-term care needs described in subparagraph 
(B) for a period— 
‘‘(i) which is at least 180 consecutive 
days, and 
‘‘(ii) a portion of which occurs within 
the taxable year. 
Such term shall not include any individual oth-
erwise meeting the requirements of the pre-
ceding sentence unless within the 391⁄2 month 
period ending on such due date (or such other 
period as the Secretary prescribes) a physician 
(as so defined) has certified that such indi-
vidual meets such requirements. 
‘‘(B) INDIVIDUALS WITH LONG-TERM CARE 
NEEDS.—An individual is described in this sub-
paragraph if the individual meets any of the fol-
lowing requirements: 
‘‘(i) The individual is at least 18 years 
of age and— 
‘‘(I) is unable to perform (with-
out substantial assistance from an-
other individual) at least 3 activities 
of daily living (as defined in section 
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7702B(c)(2)(B)) due to a loss of 
functional capacity, or 
‘‘(II) requires substantial super-
vision to protect such individual from 
threats to health and safety due to se-
vere cognitive impairment and is un-
able to perform at least 1 activity of 
daily living (as so defined) or to the 
extent provided in regulations pre-
scribed by the Secretary (in consulta-
tion with the Secretary of Health and 
Human Services), is unable to engage 
in age appropriate activities. 
‘‘(ii) The individual is at least 6 but 
not 18 years of age and— 
‘‘(I) is unable to perform (with-
out substantial assistance from an-
other individual) at least 3 activities 
of daily living (as defined in section 
7702B(c)(2)(B)) due to a loss of 
functional capacity, 
‘‘(II) requires substantial super-
vision to protect such individual from 
threats to health and safety due to se-
vere cognitive impairment and is un-
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able to perform at least 1 activity of 
daily living (as so defined) or to the 
extent provided in regulations pre-
scribed by the Secretary (in consulta-
tion with the Secretary of Health and 
Human Services), is unable to engage 
in age appropriate activities, 
‘‘(III) has a level of disability 
similar to the level of disability de-
scribed in subclause (I) (as deter-
mined under regulations promulgated 
by the Secretary), or 
‘‘(IV) has a complex medical con-
dition (as defined by the Secretary) 
that requires medical management 
and coordination of care. 
‘‘(iii) The individual is at least 2 but 
not 6 years of age and— 
‘‘(I) is unable due to a loss of 
functional capacity to perform (with-
out substantial assistance from an-
other individual) at least 2 of the fol-
lowing activities: eating, transferring, 
or mobility, 
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‘‘(II) has a level of disability 
similar to the level of disability de-
scribed in subclause (I) (as deter-
mined under regulations promulgated 
by the Secretary), or 
‘‘(III) has a complex medical con-
dition (as defined by the Secretary) 
that requires medical management 
and coordination of care. 
‘‘(iv) The individual is under 2 years 
of age and— 
‘‘(I) requires specific durable 
medical equipment by reason of a se-
vere health condition or requires a 
skilled practitioner trained to address 
the individual’s condition to be avail-
able if the individual’s parents or 
guardians are absent, 
‘‘(II) has a level of disability 
similar to the level of disability de-
scribed in subclause (I) (as deter-
mined under regulations promulgated 
by the Secretary), or 
‘‘(III) has a complex medical con-
dition (as defined by the Secretary) 
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that requires medical management 
and coordination of care. 
‘‘(v) The individual has 5 or more 
chronic conditions (as defined in subpara-
graph (C)) and is unable to perform (with-
out substantial assistance from another in-
dividual) at least 1 activity of daily living 
(as so defined) due to a loss of functional 
capacity. 
‘‘(C) CHRONIC CONDITION.—For purposes 
of this paragraph, the term ‘chronic condition’ 
means a condition that lasts for at least 6 con-
secutive months and requires ongoing medical 
care. 
‘‘(2) ELIGIBLE CAREGIVER.— 
‘‘(A) IN GENERAL.—A taxpayer shall be 
treated as an eligible caregiver for any taxable 
year with respect to each of the following indi-
viduals: 
‘‘(i) The taxpayer. 
‘‘(ii) The taxpayer’s spouse. 
‘‘(iii) An individual who is a quali-
fying child (as defined in section 152(c)) 
or a qualifying relative (as defined in sec-
tion 152(d)) with respect to whom the tax-
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payer is allowed a deduction under section 
151(c) for the taxable year. 
‘‘(iv) An individual who would be a 
qualifying relative described in clause (iii) 
for the taxable year if section 152(d)(1)(B) 
were applied by substituting for the exemp-
tion amount an amount equal to the sum 
of the exemption amount, the standard de-
duction under section 63(c)(2)(C), and any 
additional standard deduction under sec-
tion 63(c)(3) which would be applicable to 
the individual if clause (iii) applied. 
‘‘(v) An individual who would be a 
qualifying relative described in clause (iii) 
for the taxable year if— 
‘‘(I) the requirements of clause 
(iv) are met with respect to the indi-
vidual; and 
‘‘(II) the requirements of sub-
paragraph (B) are met with respect to 
the individual in lieu of the support 
test of section 152(d)(1)(C). 
‘‘(B) RESIDENCY
TEST.—The require-
ments of this subparagraph are met if an indi-
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vidual has as his principal place of abode the 
home of the taxpayer and— 
‘‘(i) in the case of an individual who 
is an ancestor or descendant of the tax-
payer or the taxpayer’s spouse, is a mem-
ber of the taxpayer’s household for over 
half the taxable year, or 
‘‘(ii) in the case of any other indi-
vidual, is a member of the taxpayer’s 
household for the entire taxable year. 
‘‘(C) SPECIAL RULES WHERE MORE THAN 
1 ELIGIBLE CAREGIVER.— 
‘‘(i) IN GENERAL.—If more than 1 in-
dividual is an eligible caregiver with re-
spect to the same applicable individual for 
taxable years ending with or within the 
same calendar year, a taxpayer shall be 
treated as the eligible caregiver if each 
such individual (other than the taxpayer) 
files a written declaration (in such form 
and manner as the Secretary may pre-
scribe) that such individual will not claim 
such applicable individual for the credit 
under this section. 
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‘‘(ii) NO AGREEMENT.—If each indi-
vidual required under clause (i) to file a 
written declaration under clause (i) does 
not do so, the individual with the highest 
modified adjusted gross income (as defined 
in section 32(c)(5) (as in effect on the day 
before the enactment of the Economic 
Growth and Tax Relief Reconciliation Act 
of 2001)) shall be treated as the eligible 
caregiver. 
‘‘(iii) MARRIED
INDIVIDUALS
FILING 
SEPARATELY.—In the case of married indi-
viduals filing separately, the determination 
under this subparagraph as to whether the 
husband or wife is the eligible caregiver 
shall be made under the rules of clause (ii) 
(whether or not one of them has filed a 
written declaration under clause (i)). 
‘‘(d) IDENTIFICATION
REQUIREMENT.—No credit 
shall be allowed under this section to a taxpayer with re-
spect to any applicable individual unless the taxpayer in-
cludes the name and taxpayer identification number of 
such individual, and the identification number of the phy-
sician certifying such individual, on the return of tax for 
the taxable year. 
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‘‘(e) TAXABLE YEAR MUST BE FULL TAXABLE 
YEAR.—Except in the case of a taxable year closed by rea-
son of the death of the taxpayer, no credit shall be allow-
able under this section in the case of a taxable year cov-
ering a period of less than 12 months. 
‘‘(f) CITIZENS
OR NATIONALS
OF OTHER COUN-
TRIES.— 
‘‘(1) IN GENERAL.—The terms ‘applicable indi-
vidual’ and ‘eligible caregiver’ do not include an indi-
vidual who is not a citizen or national of the United 
States unless such individual is a resident alien (as 
defined in section 7702(b)). 
‘‘(2) EXCEPTION FOR ADOPTED CHILD.—Para-
graph (1) shall not exclude any child of a taxpayer 
(within the meaning of section 151(f)(1)(B)) if— 
‘‘(A) for the taxable year of the taxpayer, 
the child has the same principal place of abode 
as the taxpayer and is a member of the tax-
payer’s household, and 
‘‘(B) the taxpayer is a citizen, national, or 
resident alien of the United States.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 6213(g)(2) of such Code is amend-
ed by striking ‘‘and’’ at the end of subparagraph 
(L)(ii), by striking the period at the end of subpara-
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