I
104TH CONGRESS
2D SESSION
H. R. 3585
To amend title XVIII of the Social Security Act to provide for coverage
of respite care services under part B of the Medicare program, to
amend the Internal Revenue Code of 1986 to treat qualified long-term
care services as medical care, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
JUNE 5, 1996
Mrs. LOWEY (for herself and Mr. GILMAN) introduced the following bill; which
was referred to the Committee on Ways and Means, and in addition to
the Committee on Commerce, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
A BILL
To amend title XVIII of the Social Security Act to provide
for coverage of respite care services under part B of
the Medicare program, to amend the Internal Revenue
Code of 1986 to treat qualified long-term care services
as medical care, 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 ‘‘Family Caregiver Sup-
port and Protection Act of 1996’’.
SEC. 2. COVERAGE OF RESPITE CARE SERVICES UNDER
MEDICARE.
(a) IN GENERAL.—Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (N);
(2) by striking ‘‘and’’ at the end of subpara-
graph (O); and
(3) by inserting after subparagraph (O) the fol-
lowing new subparagraph:
‘‘(P) respite care services (as defined in sub-
section (oo)); and’’.
(b) SERVICES DESCRIBED.—Section 1861 of such
Act (42 U.S.C. 1395x) is amended by adding at the end
the following new subsection:
‘‘Respite Care Services
‘‘(oo)(1)(A) Subject to subparagraph (C), the term
‘respite care services’ means any of the services described
in subparagraph (B) which are furnished to an eligible in-
dividual (as described in paragraph (2)) for the support
of a caregiver described in paragraph (2) at the individ-
ual’s home or in the community on a short-term, intermit-
tent, or emergency basis by an individual or entity who
meets such standards as the Secretary may establish.
‘‘(B) The services described in this subparagraph are
as follows:
‘‘(i) Companion services.
‘‘(ii) Homemaker services.
‘‘(iii) Personal assistance.
‘‘(iv) Community day services.
‘‘(v) Temporary care in an accredited or li-
censed residential facility.
‘‘(C) In establishing standards pursuant to subpara-
graph (A) for individuals and entities providing respite
care services, the Secretary shall consult with organiza-
tions representing providers of the services described in
such paragraph and organizations representing individuals
who typically receive such services.
‘‘(D) The term ‘respite care services’ does not include
any services furnished to an individual during a 12-month
period after the individual has been furnished 120 hours
of such services during such period.
‘‘(2) An ‘eligible individual’ described in this para-
graph is an individual with functional limitations (as de-
scribed in paragraph (3)) who is dependent on a daily
basis on a caregiver who—
‘‘(A) has primary responsibility for providing
care to the individual;
‘‘(B) does not receive financial remuneration for
providing such care; and
‘‘(B) are provided pursuant to a plan of
care prescribed by a licensed health care practi-
tioner.
‘‘(2) CHRONICALLY ILL INDIVIDUAL.—
‘‘(A) IN GENERAL.—The term ‘chronically
ill individual’ means any individual who has
been certified by a licensed health care practi-
tioner as—
‘‘(i) being unable to perform (without
substantial assistance from another indi-
vidual) at least 2 activities of daily living
for a period of at least 90 days due to a
loss of functional capacity or to cognitive
impairment,
‘‘(ii) requiring substantial supervision
to protect such individual from threats to
health or safety due to substantial cog-
nitive impairment, or
‘‘(iii) having a level of disability simi-
lar (as determined by the Secretary in con-
sultation with the Secretary of Health and
Human Services) to the level of disability
described in clause (i) or (ii).
Such term shall not include any individual oth-
erwise meeting the requirements of the preced-
ing sentence unless within the preceding 12-
month period a licensed health care practitioner
has certified that such individual meets such re-
quirements.
‘‘(B) ACTIVITIES OF DAILY LIVING.—For
purposes of subparagraph (A), each of the fol-
lowing is an activity of daily living:
‘‘(i) Eating.
‘‘(ii) Toileting.
‘‘(iii) Transferring.
‘‘(iv) Bathing.
‘‘(v) Dressing.
‘‘(vi) Continence.
‘‘(C) 
SUBSTANTIAL
ASSISTANCE.—For
purposes of subparagraph (A)(i), the term ‘sub-
stantial assistance’ includes verbal reminding or
physical cuing.
‘‘(3) MAINTENANCE OR PERSONAL CARE SERV-
ICES.—The term ‘maintenance or personal care serv-
ices’ means any care the primary purpose of which
is the provision of needed assistance with any of the
disabilities as a result of which the individual is a
chronically ill individual (including the protection
from threats to health and safety due to severe cog-
nitive impairment).
‘‘(4) 
LICENSED
HEALTH
CARE
PRACTI-
TIONER.—The term ‘licensed health care practi-
tioner’ means any physician (as defined in section
1861(r)(1) of the Social Security Act) and any reg-
istered professional nurse, licensed social worker, or
other individual who meets such requirements as
may be prescribed by the Secretary.’’
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to taxable years beginning after
December 31, 1995.
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