Lifespan Respite Care Act of 2006
PL 109-442 (H.R.3248), enacted 12/21/2006

120 STAT. 3291
PUBLIC LAW 109–442—DEC. 21, 2006
Public Law 109–442
109th Congress
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
42 USC 300ii.
Lifespan Respite
Care Act of 2006.
42 USC 201 note.
Dec. 21, 2006
[H.R. 3248]
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120 STAT. 3292
PUBLIC LAW 109–442—DEC. 21, 2006
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).
Inter-
governmental
relations.
42 USC 300ii–1.
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120 STAT. 3293
PUBLIC LAW 109–442—DEC. 21, 2006
‘‘(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
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120 STAT. 3294
PUBLIC LAW 109–442—DEC. 21, 2006
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.
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120 STAT. 3295
PUBLIC LAW 109–442—DEC. 21, 2006
‘‘(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—
42 USC 300ii–3.
42 USC 300ii–2.
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120 STAT. 3296
PUBLIC LAW 109–442—DEC. 21, 2006
LEGISLATIVE HISTORY—H.R. 3248:
HOUSE REPORTS: No. 109–716 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 152 (2006):
Dec. 6, considered and passed House.
Dec. 8, considered and passed Senate.
‘‘(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.
Approved December 21, 2006.
Evaluation.
42 USC 300ii–4.
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