I 
112TH CONGRESS 
1ST SESSION 
H. R. 883 
To expand and enhance existing adult day programs for people with neuro-
logical diseases or conditions (such as multiple sclerosis, Parkinson’s 
disease, traumatic brain injury, or other similar diseases or conditions) 
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 
MARCH 2, 2011 
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 neurological diseases or conditions (such as 
multiple sclerosis, Parkinson’s disease, traumatic brain 
injury, or other similar diseases or conditions) to support 
and improve access to respite services for family care-
givers 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’’. 
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SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) One in 6 people in the United States lives 
with a neurological disease or condition that can 
often result in disability, and which may require the 
individual to seek assistance in carrying out the ac-
tivities of daily living. Neurological diseases or condi-
tions such as multiple sclerosis (MS), early-onset 
Parkinson’s disease, and traumatic brain injury 
(TBI) can also typically affect younger adults in the 
middle of their lives. 
(2) Multiple sclerosis is a chronic, often dis-
abling disease that attacks the central nervous sys-
tem with symptoms ranging from numbness in limbs 
to paralysis and loss of vision. Most people with MS 
are diagnosed between the ages of 20 and 50 years 
of age. It is estimated that over 400,000 people in 
the United States are living with MS. Persons living 
with MS who experience more severe forms of the 
disease are likely to require either home care or 
nursing home placement, though the vast majority 
would prefer to remain at home to receive the care 
they need. Where home care is concerned, approxi-
mately 80 percent of such care is provided by infor-
mal, unpaid caregivers who are generally family 
members. 
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(3) Parkinson’s disease is a chronic, progressive 
neurological disease. The 4 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. It is estimated that nearly 
1,000,000 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-
matic brain injury is also a serious issue that affects 
military service members. 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 
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disabilities. Family caregivers, the majority of whom 
are women, provide an estimated $306,000,000,000 
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) Adult day programs can offer services, in-
cluding medical care, rehabilitation therapies, dig-
nified assistance with the activities of daily living, 
nutrition therapy, health monitoring, social inter-
action, stimulating activities, and transportation to 
seniors, people with disabilities, and younger adults 
with chronic diseases. 
(8) 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 with living with these condi-
tions and their caregivers. Adult day programs can 
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help to ameliorate symptoms, reduce dependency, 
provide important socialization opportunities, and 
maintain quality of life. 
(9) 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. 
(10) There are currently few adult day pro-
grams focused on younger adult populations in the 
United States. As a result, the majority of people 
living with neurological diseases are unable to access 
this important opportunity for maximizing their 
health and wellness. Although people living with neu-
rological diseases or conditions may be able to access 
other 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. 
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