I
103D CONGRESS
1ST SESSION
H. R. 633
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 HOUSE OF REPRESENTATIVES
JANUARY 26, 1993
Ms. SNOWE 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 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 dis-
orders.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. DEDUCTION ALLOWANCE FOR HOME HEALTH
CARE AND ADULT DAY AND RESPITE CARE
EXPENSES OF INDIVIDUALS FOR DEPEND-
ENTS WITH ALZHEIMER’S DISEASE OR RELAT-
ED ORGANIC BRAIN DISORDERS.
(a) IN GENERAL.—Part VII of subchapter B of chap-
ter 1 of the Internal Revenue Code of 1986 (relating to
additional itemized deductions for individuals) is amended
by redesignating section 220 as section 221 and by insert-
ing after section 219 the following new section:
‘‘SEC. 220. HOME HEALTH CARE AND ADULT DAY AND RES-
PITE CARE EXPENSES FOR DEPENDENTS
WITH ALZHEIMER’S DISEASE OR RELATED
ORGANIC BRAIN DISORDERS.
‘‘(a) DEDUCTION ALLOWED.—In the case of an indi-
vidual who maintains a household which includes a quali-
fied dependent of such individual, there shall be allowed
as a deduction the qualified home health care and adult
day respite care expenses of such individual with respect
to such dependent.
‘‘(b) DEFINITIONS.—For purposes of this section—
‘‘(1) 
QUALIFIED
DEPENDENT.—The 
term
‘qualified dependent’ means any individual (includ-
ing the spouse of the taxpayer but not including the
taxpayer) who—
‘‘(A) has as his principal place of abode
the principal residence of the taxpayer, and is
a member of the taxpayer’s household, for more
than 180 days of the calendar year during
which the taxable year of the taxpayer begins,
‘‘(B) is a dependent of the taxpayer (with-
in the meaning given to such term by sub-
section (a) of section 152 other than paragraph
(9) of such subsection) for such calendar year,
and
‘‘(C) at the close of such calendar year,
suffers from Alzheimer’s disease (or a related
organic brain disorder) and is physically or
mentally incapable of caring for himself, as de-
termined by a physician.
‘‘(2) QUALIFIED
HOME
HEALTH
CARE
AND
ADULT
DAY
AND
RESPITE
CARE
EXPENSES.—The
term ‘qualified home health care and adult day and
respite care expenses’ means the excess of—
‘‘(A) the reasonable and necessary ex-
penses paid or incurred by the taxpayer for—
‘‘(i) household services for a qualified
dependent, and
‘‘(ii) the care (including respite care)
of such dependent in the home or in an
adult day care center, over
‘‘(B) the reasonable and necessary ex-
penses such taxpayer would have paid or in-
curred for household services for, and the care
of, such qualified dependent if such dependent
had been capable of caring for himself.
‘‘(3) PHYSICIAN.—The term ‘physician’ has the
meaning given to such term by section 1861(r) of
the Social Security Act (42 U.S.C. 1395x(r)).
‘‘(c) SPECIAL RULES.—For purposes of this sec-
tion—
‘‘(1) MAINTAINING A HOUSEHOLD.—An individ-
ual shall be treated as maintaining a household for
any period only if over half the cost of maintaining
the household for such period is furnished by such
individual (or, if the individual is married, by the in-
dividual and his spouse).
‘‘(2) MARRIED COUPLE MUST FILE JOINT RE-
TURN.—If the taxpayer is married at the close of
the taxable year, the deduction shall be allowed
under subsection (a) only if the taxpayer and his
spouse file a joint return under section 6013 for the
taxable year.
‘‘(d) CERTIFICATION
OF
DIAGNOSIS
BY
PHYSI-
CIAN.—Any determination by a physician that—
‘‘(1) an individual suffers from Alzheimer’s dis-
ease or a related organic brain disorder, and
‘‘(2) such individual is mentally or physically
incapable of caring for himself,
shall be certified by the physician to the Secretary at such
time and in such manner as the Secretary shall by regula-
tion prescribe.
‘‘(e) COORDINATION WITH SECTIONS 21 AND 213.—
If any amount allowable as a deduction under this section
would (but for this subsection) also be taken into account
for purposes of determining the amount of any credit al-
lowable under section 21 (relating to expenses for house-
hold and dependent care services necessary for gainful em-
ployment) or any deduction allowable under section 213
(relating to medical, dental, etc. expenses), this section
shall apply only if the taxpayer elects its application. If
this section is elected with respect to any amount, such
amount shall not be taken into account under section 21
or 213. Such election shall be made at such time and in
such manner as the Secretary shall by regulation pre-
scribe.’’
(b) DEDUCTION ALLOWED
IN ARRIVING
AT AD-
JUSTED GROSS INCOME.—Section 62(a) of such Code (de-
fining adjusted gross income) is amended by inserting
after paragraph (13) the following new paragraph:
‘‘(14) QUALIFIED
HOME
HEALTH
CARE
AND
ADULT
DAY
AND
RESPITE
CARE
EXPENSES.—The
deduction allowed by section 220.’’
(c) CLERICAL AMENDMENT.—The table of sections
for part VII of subchapter B of chapter 1 of such Code
is amended by striking the last item and inserting the fol-
lowing new items:
‘‘Sec. 220. Home health care and adult day and respite care ex-
penses for dependents with Alzheimer’s disease or
related organic brain disorders.
‘‘Sec. 221. Cross reference.’’
(d) EFFECTIVE DATE.—The amendments made by
this section shall apply to taxable years beginning after
December 31, 1992.
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