I 
111TH CONGRESS 
2D SESSION 
H. R. 6208 
To expand and enhance existing adult day programs for people with multiple 
sclerosis or other similar diseases, to support and improve access to 
respite services for family caregivers who are taking care of such people, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 23, 2010 
Ms. LEE of California introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To expand and enhance existing adult day programs for 
people with multiple sclerosis or other similar diseases, 
to support and improve access to respite services for 
family caregivers who are taking care of such people, 
and for other purposes. 
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 ‘‘Adult Day Achieve-
ment Center Enhancement Act’’. 
SEC. 2. FINDINGS. 
The Congress finds the following: 
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(1) Multiple sclerosis (or MS) is a chronic, 
often disabling disease that attacks the central nerv-
ous system, which is made up of the brain, spinal 
cord, and optic nerves. Most people with multiple 
sclerosis are diagnosed between the ages of 20 and 
50 years of age. 
(2) The symptoms of MS may be mild, such as 
numbness in the limbs, or severe, such as paralysis 
or loss of vision. The progress, severity, and specific 
symptoms of MS are unpredictable and vary from 
one person to another. 
(3) Persons living with MS who experience 
more severe forms of MS are likely to require either 
home care or nursing home placement, though the 
vast majority would prefer to remain at home to re-
ceive the care they need. Where home care is con-
cerned, approximately 80 percent of such care is 
provided by informal, unpaid, caregivers who are 
generally family members. 
(4) Family caregivers of people with MS gen-
erally average 60 years of age. Almost half spend 
more than 20 hours per week providing care for 
their family member living with MS and have been 
fulfilling this role on average for over 13 years. 
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(5) In general, family caregivers, the majority 
of 
whom 
are 
women, 
provide 
an 
estimated 
$306,000,000,000 in ‘‘free’’ services annually. The 
pool of potential family caregivers is dwindling, from 
11 potential 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) Adult day programs can offer services, in-
cluding medical care, rehabilitation therapies, dig-
nified assistance with activities of daily living, nutri-
tion therapy, health monitoring, social interaction, 
stimulating activities, and transportation, to seniors, 
people with disabilities, and younger adults with 
chronic diseases. 
(8) Adult day programs geared toward people 
living with MS, or other similar diseases, provide an 
important response to the needs of people with se-
vere MS and their caregivers. These MS Adult Day 
Programs (MSADPs) can help to ameliorate MS 
symptoms, reduce dependency, provide important so-
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cialization opportunities, and maintain quality of 
life. 
(9) MSADP programs have been shown to pro-
vide a range of documented benefits to people living 
with MS including improvements in functional sta-
tus, fatigue, depression, pain and social support. 
MSADPs also reduce ongoing medical care and hos-
pital costs and decrease admissions to nursing home 
facilities, which can be costly for many families, by 
allowing individuals to receive health and social serv-
ices while continuing to live at home. 
(10) There are less than a dozen MSADPs in 
the United States at present and as a result the ma-
jority of people living with MS are unable to access 
this important opportunity for maximizing their 
health and wellness. Although people living with MS 
may be able to access other existing adult day pro-
grams, such programs are not typically intended for 
younger adults living with chronic diseases like MS, 
and may not provide the appropriate services to 
meet the age-related or disability status of these in-
dividuals. 
SEC. 3. ESTABLISHMENT OF ADULT DAY PROGRAMS. 
(a) SURVEY OF EXISTING ADULT DAY PROGRAMS.— 
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(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 living with mul-
tiple sclerosis, including any multiple sclerosis adult 
day programs and other similar adult day programs 
as defined in this Act. 
(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 MSADPs 
and other similar adult day programs, including 
by providing a brief description of how such 
programs were initially established and funded; 
(B) develop a set of best practices to help 
guide the establishment and replication of addi-
tional successful MSADPs and other similar 
adult day programs, including— 
(i) program guidelines; 
(ii) recommendations on the scope of 
services that should be provided (which 
may include rehabilitation therapy, psycho-
social support, social stimulation and inter-
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action, 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 
(C) evaluate the extent to which the Ad-
ministration on Aging supports MSADPs and 
other similar adult day programs, either di-
rectly or indirectly, through current Federal 
grant programs. 
(3) REPORT.—Not later than 180 days after 
initiating the survey under paragraph (1), the As-
sistant Secretary for Aging shall produce and make 
publicly available a summary report on the results of 
the survey. Such report shall include each of the ele-
ments described in paragraph (2). 
(b) ESTABLISHMENT OF GRANT PROGRAM.— 
(1) IN GENERAL.—Not later than 90 days after 
producing the report required by subsection (a)(3), 
the Assistant Secretary for Aging shall establish 
within the Administration on Aging a competitive 
grant program for awarding grants annually to eligi-
ble entities, based on the best practices developed 
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under subsection (a), to fund MSADPs and other 
similar adult day programs. 
(2) ELIGIBLE ENTITIES.—In order to be eligi-
ble for a grant under this subsection, an entity shall 
demonstrate the following: 
(A) Understanding of the special needs of 
people living with multiple sclerosis or other 
similar diseases, including their functional abili-
ties and the potential complications across all 
types of cases and stages of multiple sclerosis 
or other such similar diseases. 
(B) Understanding of the issues experi-
enced by family caregivers who assist a family 
member with multiple sclerosis or another such 
similar disease. 
(C) A capacity to provide the services rec-
ommended by the best practices developed 
under subsection (a). 
(3) ADDITIONAL SELECTION REQUIREMENT.— 
The Assistant Secretary for Aging shall not award 
a grant to an entity under this subsection if the 
amount of the award would constitute more than 40 
percent of the operating budget of the entity in the 
fiscal year for which funds for the grant are author-
ized to be expended. For purposes of this subsection, 
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(5) REPORT.—No later than 1 year after the 
initial award of grants under this subsection, and 
annually thereafter, the Assistant Secretary for 
Aging shall produce and make publicly available a 
brief summary report on the grant program under 
this section. Each such report shall include the fol-
lowing: 
(A) A description of the adult day pro-
grams receiving funding under this section, in-
cluding the amount of Federal funding awarded 
and the expected outcomes of each program. 
(B) A description of performance goals and 
indicators to monitor the progress of grant re-
cipients in— 
(i) responding to the needs of individ-
uals living with multiple sclerosis or other 
such similar chronic diseases; and 
(ii) assisting the family caregivers of 
such individuals. 
(C) Any plans for improving oversight and 
management of the grant program. 
(c) DEFINITIONS.—In this Act: 
(1) The term ‘‘multiple sclerosis adult day pro-
gram’’ or ‘‘MSADP’’ means an adult day program 
that provides comprehensive and effective care and 
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support services to individuals living with multiple 
sclerosis and their family caregivers and that may 
assist participants in ways that— 
(A) maintain or improve their functional 
abilities, or otherwise help them adjust to their 
changing functional abilities; 
(B) prevent the onset of complications as-
sociated with severe forms of the disease; 
(C) promote alternatives to placement in 
nursing homes; 
(D) reduce the strain on family caregivers 
taking care of a family member with multiple 
sclerosis; or 
(E) focus on supporting the emotional, so-
cial, and intellectual needs of a younger adult 
population. 
(2) The term ‘‘other similar adult day pro-
gram’’ means an adult day program that provides a 
set of services similar to those of an MSADP, but 
for individuals living with other chronic diseases 
similar to multiple sclerosis that affect an individ-
ual’s central nervous system, and that may result in 
a functional or degenerative disability. 
(3) The term ‘‘family caregiver’’ means a family 
member or foster parent who provides unpaid assist-
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ance (which may include in-home monitoring, man-
agement, supervision, care and treatment, or other 
similar assistance) to another adult family member 
with a special need. 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, in addition to amounts otherwise made 
available for such purpose, there are authorized to be ap-
propriated, and to remain available until expended, the fol-
lowing: 
(1) $1,000,000 for fiscal year 2011. 
(2) $3,000,000 for fiscal year 2012. 
(3) $6,000,000 for fiscal year 2013. 
(4) $8,000,000 for fiscal year 2014. 
(5) $10,000,000 for fiscal year 2015. 
Æ 
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