H. R. 3248
One Hundred Ninth Congress
of the
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Tuesday, 
the third day of January, two thousand and six 
An Act 
To amend the Public Health Service Act to establish a program to assist family 
caregivers in accessing affordable and high-quality respite care, and for other 
purposes.
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Lifespan Respite Care Act of 
2006’’. 
SEC. 2. LIFESPAN RESPITE CARE. 
The Public Health Service Act (42 U.S.C. 201 et seq.) is 
amended by adding at the end the following: 
‘‘TITLE XXIX—LIFESPAN RESPITE CARE 
‘‘SEC. 2901. DEFINITIONS. 
‘‘In this title: 
‘‘(1) ADULT WITH A SPECIAL NEED.—The term ‘adult with 
a special need’ means a person 18 years of age or older who 
requires care or supervision to—
‘‘(A) meet the person’s basic needs; 
‘‘(B) prevent physical self-injury or injury to others; 
or 
‘‘(C) avoid placement in an institutional facility. 
‘‘(2) AGING AND DISABILITY RESOURCE CENTER.—The term 
‘aging and disability resource center’ means an entity admin-
istering a program established by the State, as part of the 
State’s system of long-term care, to provide a coordinated 
system for providing—
‘‘(A) comprehensive information on available public and 
private long-term care programs, options, and resources; 
‘‘(B) personal counseling to assist individuals in 
assessing their existing or anticipated long-term care needs, 
and developing and implementing a plan for long-term 
care designed to meet their specific needs and cir-
cumstances; and 
‘‘(C) consumer access to the range of publicly supported 
long-term care programs for which consumers may be 
eligible, by serving as a convenient point of entry for such 
programs. 
‘‘(3) CHILD WITH A SPECIAL NEED.—The term ‘child with 
a special need’ means an individual less than 18 years of
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age who requires care or supervision beyond that required 
of children generally to—
‘‘(A) meet the child’s basic needs; or 
‘‘(B) prevent physical injury, self-injury, or injury to 
others. 
‘‘(4) ELIGIBLE
STATE
AGENCY.—The term ‘eligible State 
agency’ means a State agency that—
‘‘(A) administers the State’s program under the Older 
Americans Act of 1965, administers the State’s program 
under title XIX of the Social Security Act, or is designated 
by the Governor of such State to administer the State’s 
programs under this title; 
‘‘(B) is an aging and disability resource center; 
‘‘(C) works in collaboration with a public or private 
nonprofit statewide respite care coalition or organization; 
and 
‘‘(D) demonstrates—
‘‘(i) an ability to work with other State and commu-
nity-based agencies; 
‘‘(ii) an understanding of respite care and family 
caregiver issues across all age groups, disabilities, and 
chronic conditions; and 
‘‘(iii) the capacity to ensure meaningful involve-
ment of family members, family caregivers, and care 
recipients. 
‘‘(5) FAMILY CAREGIVER.—The term ‘family caregiver’ means 
an unpaid family member, a foster parent, or another unpaid 
adult, who provides in-home monitoring, management, super-
vision, or treatment of a child or adult with a special need. 
‘‘(6) LIFESPAN RESPITE CARE.—The term ‘lifespan respite 
care’ means a coordinated system of accessible, community-
based respite care services for family caregivers of children 
or adults with special needs. 
‘‘(7) RESPITE CARE.—The term ‘respite care’ means planned 
or emergency care provided to a child or adult with a special 
need in order to provide temporary relief to the family caregiver 
of that child or adult. 
‘‘(8) STATE.—The term ‘State’ means any of the several 
States, the District of Columbia, the Virgin Islands of the 
United States, the Commonwealth of Puerto Rico, Guam, Amer-
ican Samoa, and the Commonwealth of the Northern Mariana 
Islands. 
‘‘SEC. 2902. LIFESPAN RESPITE CARE GRANTS AND COOPERATIVE 
AGREEMENTS. 
‘‘(a) PURPOSES.—The purposes of this section are—
‘‘(1) to expand and enhance respite care services to family 
caregivers; 
‘‘(2) to improve the statewide dissemination and coordina-
tion of respite care; and 
‘‘(3) to provide, supplement, or improve access and quality 
of respite care services to family caregivers, thereby reducing 
family caregiver strain. 
‘‘(b) AUTHORIZATION.—Subject to subsection (e), the Secretary 
is authorized to award grants or cooperative agreements for the 
purposes described in subsection (a) to eligible State agencies for 
which an application is submitted pursuant to subsection (d).
H. R. 3248—3
‘‘(c) FEDERAL LIFESPAN APPROACH.—In carrying out this section, 
the Secretary shall work in cooperation with the National Family 
Caregiver Support Program of the Administration on Aging and 
other respite care programs within the Department of Health and 
Human Services to ensure coordination of respite care services 
for family caregivers of children and adults with special needs. 
‘‘(d) APPLICATION.—
‘‘(1) SUBMISSION.—Each Governor desiring the eligible 
State agency of his or her State to receive a grant or cooperative 
agreement under this section shall submit an application on 
behalf of such agency to the Secretary at such time, in such 
manner, and containing such information as the Secretary shall 
require. 
‘‘(2) CONTENTS.—Each application submitted under this sec-
tion shall include—
‘‘(A) a description of the eligible State agency’s—
‘‘(i) ability to work with other State and commu-
nity-based agencies; 
‘‘(ii) understanding of respite care and family care-
giver issues across all age groups, disabilities, and 
chronic conditions; and 
‘‘(iii) capacity to ensure meaningful involvement 
of family members, family caregivers, and care recipi-
ents; 
‘‘(B) with respect to the population of family caregivers 
to whom respite care information or services will be pro-
vided or for whom respite care workers and volunteers 
will be recruited and trained, a description of—
‘‘(i) the population of family caregivers; 
‘‘(ii) the extent and nature of the respite care needs 
of that population; 
‘‘(iii) existing respite care services for that popu-
lation, including numbers of family caregivers being 
served and extent of unmet need; 
‘‘(iv) existing methods or systems to coordinate 
respite care information and services to the population 
at the State and local level and extent of unmet need; 
‘‘(v) how respite care information dissemination 
and coordination, respite care services, respite care 
worker and volunteer recruitment and training pro-
grams, or training programs for family caregivers that 
assist such family caregivers in making informed 
decisions about respite care services will be provided 
using grant or cooperative agreement funds; 
‘‘(vi) a plan for administration, collaboration, and 
coordination of the proposed respite care activities with 
other related services or programs offered by public 
or private, nonprofit entities, including area agencies 
on aging; 
‘‘(vii) how the population, including family care-
givers, care recipients, and relevant public or private 
agencies, 
will 
participate 
in 
the 
planning 
and 
implementation of the proposed respite care activities; 
‘‘(viii) how the proposed respite care activities will 
make use, to the maximum extent feasible, of other
H. R. 3248—4
Federal, State, and local funds, programs, contribu-
tions, other forms of reimbursements, personnel, and 
facilities; 
‘‘(ix) respite care services available to family care-
givers in the eligible State agency’s State or locality, 
including unmet needs and how the eligible State 
agency’s plan for use of funds will improve the 
coordination and distribution of respite care services 
for family caregivers of children and adults with special 
needs; 
‘‘(x) the criteria used to identify family caregivers 
eligible for respite care services; 
‘‘(xi) how the quality and safety of any respite 
care services provided will be monitored, including 
methods to ensure that respite care workers and volun-
teers are appropriately screened and possess the nec-
essary skills to care for the needs of the care recipient 
in the absence of the family caregiver; and 
‘‘(xii) the results expected from proposed respite 
care activities and the procedures to be used for evalu-
ating those results; 
‘‘(C) assurances that, where appropriate, the eligible 
State agency will have a system for maintaining the con-
fidentiality of care recipient and family caregiver records; 
and 
‘‘(D) a memorandum of agreement regarding the joint 
responsibility for the eligible State agency’s lifespan respite 
program between—
‘‘(i) the eligible State agency; and 
‘‘(ii) a public or private nonprofit statewide respite 
coalition or organization. 
‘‘(e) PRIORITY; CONSIDERATIONS.—When awarding grants or 
cooperative agreements under this section, the Secretary shall—
‘‘(1) give priority to eligible State agencies that the Sec-
retary determines show the greatest likelihood of implementing 
or enhancing lifespan respite care statewide; and 
‘‘(2) give consideration to eligible State agencies that are 
building or enhancing the capacity of their long-term care sys-
tems to respond to the comprehensive needs, including respite 
care needs, of their residents. 
‘‘(f) USE OF GRANT OR COOPERATIVE AGREEMENT FUNDS.—
‘‘(1) IN GENERAL.—
‘‘(A) REQUIRED USES OF FUNDS.—Each eligible State 
agency awarded a grant or cooperative agreement under 
this section shall use all or part of the funds—
‘‘(i) to develop or enhance lifespan respite care 
at the State and local levels; 
‘‘(ii) to provide respite care services for family care-
givers caring for children or adults; 
‘‘(iii) to train and recruit respite care workers and 
volunteers; 
‘‘(iv) to provide information to caregivers about 
available respite and support services; and 
‘‘(v) to assist caregivers in gaining access to such 
services.
H. R. 3248—5
‘‘(B) OPTIONAL USES OF FUNDS.—Each eligible State 
agency awarded a grant or cooperative agreement under 
this section may use part of the funds for—
‘‘(i) training programs for family caregivers to 
assist such family caregivers in making informed 
decisions about respite care services; 
‘‘(ii) other services essential to the provision of 
respite care as the Secretary may specify; or 
‘‘(iii) training and education for new caregivers. 
‘‘(2) SUBCONTRACTS.—Each eligible State agency awarded 
a grant or cooperative agreement under this section may carry 
out the activities described in paragraph (1) directly or by 
grant to, or contract with, public or private entities. 
‘‘(3) MATCHING FUNDS.—
‘‘(A) IN GENERAL.—With respect to the costs of the 
activities to be carried out under paragraph (1), a condition 
for the receipt of a grant or cooperative agreement under 
this section is that the eligible State agency agrees to 
make available (directly or through donations from public 
or private entities) non-Federal contributions toward such 
costs in an amount that is not less than 25 percent of 
such costs. 
‘‘(B) DETERMINATION OF AMOUNT CONTRIBUTED.—Non-
Federal contributions required by subparagraph (A) may 
be in cash or in kind, fairly evaluated, including plant, 
equipment, or services. Amounts provided by the Federal 
Government, or services assisted or subsidized to any 
significant extent by the Federal Government, may not 
be included in determining the amount of such non-Federal 
contributions. 
‘‘(g) TERM OF GRANTS OR COOPERATIVE AGREEMENTS.—
‘‘(1) IN GENERAL.—The Secretary shall award grants or 
cooperative agreements under this section for terms that do 
not exceed 5 years. 
‘‘(2) RENEWAL.—The Secretary may renew a grant or 
cooperative agreement under this section at the end of the 
term of the grant or cooperative agreement determined under 
paragraph (1). 
‘‘(h) MAINTENANCE OF EFFORT.—Funds made available under 
this section shall be used to supplement and not supplant other 
Federal, State, and local funds available for respite care services. 
‘‘SEC. 2903. NATIONAL LIFESPAN RESPITE RESOURCE CENTER. 
‘‘(a) ESTABLISHMENT.—The Secretary may award a grant or 
cooperative agreement to a public or private nonprofit entity to 
establish a National Resource Center on Lifespan Respite Care 
(referred to in this section as the ‘center’). 
‘‘(b) PURPOSES OF THE CENTER.—The center shall—
‘‘(1) maintain a national database on lifespan respite care; 
‘‘(2) provide training and technical assistance to State, 
community, and nonprofit respite care programs; and 
‘‘(3) provide information, referral, and educational programs 
to the public on lifespan respite care. 
‘‘SEC. 2904. REPORT. 
‘‘Not later than January 1, 2009, the Secretary shall report 
to the Congress on the activities undertaken under this title. Such 
report shall evaluate—
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‘‘(1) the number of States that have lifespan respite care 
programs; 
‘‘(2) the demographics of the caregivers receiving respite 
care services through grants or cooperative agreements under 
this title; and 
‘‘(3) the effectiveness of entities receiving grants or coopera-
tive agreements under this title. 
‘‘SEC. 2905. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There are authorized to be appropriated to carry out this 
title—
‘‘(1) $30,000,000 for fiscal year 2007; 
‘‘(2) $40,000,000 for fiscal year 2008; 
‘‘(3) $53,330,000 for fiscal year 2009; 
‘‘(4) $71,110,000 for fiscal year 2010; and 
‘‘(5) $94,810,000 for fiscal year 2011.’’. 
SEC. 3. GAO REPORT ON LIFESPAN RESPITE CARE PROGRAMS. 
Not later than January 1, 2011,
the Comptroller General of 
the United States shall conduct an evaluation and submit a report 
to the Congress on the effectiveness of lifespan respite programs, 
including an analysis of cost benefits and improved efficiency in 
service delivery.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.