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SECTION 1. FINDINGS.

Congress finds that--
(1) there is no Federal program to support family
caregivers;
(2) most older individuals and persons with mental
retardation and related developmental disabilities (as defined
in section 102 of the Developmental Disabilities Assistance and
Bill of Rights Act (42 U.S.C. 6000) (referred to in this
section as ''developmental disabilities'')) prefer to receive
care in their homes, rather than in institutions;
(3)(A) more than 22,000,000 family caregivers actively care
for aging or ailing older individuals in the United States;
(B) fewer than 2,000,000 older individuals receive care
through nursing homes in the United States; and
(C) therefore, a large portion of the care provided for the
Nation's older individuals is provided by family caregivers;
(4)(A) there are an estimated 3,170,000 persons with mental
retardation and related developmental disabilities in the
United States;
(B) 1,890,000 of individuals with mental retardation and
related developmental disabilities live with family caregivers;
(C) 479,862 of individuals with mental retardation and
related developmental disabilities who are living at home
receive care from caregivers who are 60 years old or older; and
(D) like services for the elderly population, a large
portion of supports and care for persons with mental
retardation and related developmental disabilities is provided
by family caregivers;
(5) nearly 75 percent of family caregivers are women, many
of whom have other major responsibilities, such as young
children or jobs;
(6) the loss in productivity of businesses due to necessary
absences of caregiving employees ranges from $11,000,000,000 to
$29,000,000,000 a year;
(7) family caregivers offer support that is worth billions
of dollars;
(8) without the efforts of family caregivers, many
additional older individuals, and persons with mental
retardation and related developmental disabilities, would
receive care services in a hospital, State facility,
intermediate care facility for the mentally retarded, or
nursing home, or would receive, although less costly, home and
community-based waiver services under section 1915(c) of the
Social Security Act (42 U.S.C. 1396n(c)), such a result being
far more expensive for taxpayers than assisting family
caregivers since--
(A) the Federal medicare and medicaid programs pay
for a large portion of expenses associated with such
institutional care; and
(B) such institutional care is more expensive than
family caregiving;
(9) caregivers, on average, spend $2,000 per year for food,
medication, and other expenses related to caregiving;
(10)(A) caregiving is physically demanding and emotionally
draining to provide, with as many as 30 percent of caregivers
reporting physical or mental health problems due to caregiving;
and
(B) caregivers need resources that will support and help
ease the overwhelming burden that the caregivers are expected
to shoulder on a daily basis; and
(11) with millions of baby boomers set to retire in the
near future, it is crucial to begin preparing today for what
will be dramatically increased long-term care needs of older
individuals.

SEC. 2. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM.

(a) Establishment of Program.--Part D of title III of the Older
Americans Act of 1965 (42 U.S.C. 3030h et seq.) is amended to read as
follows:

''PART D--NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM

''Subpart 1--State Grant Program

''SEC. 341. PROGRAM AUTHORIZED.

''(a) In General.--The Assistant Secretary shall carry out a
program for making grants to States with State plans approved under
section 307, to pay for the Federal share of the cost of carrying out
State programs, to enable eligible area agencies on aging to provide
multifaceted systems of support services for family caregivers, and
other caregivers, who are informal providers of in-home and community
care to older individuals.
''(b) Family Caregiver Support Services.--In providing services
under this subpart, an area agency on aging shall provide support
services, including providing--
''(1) information to eligible caregivers about available
services;
''(2) assistance to eligible caregivers in gaining access
to the services;
''(3) individual counseling, organization of support
groups, and caregiver training to eligible caregivers to assist
the caregivers in making decisions and solving problems
relating to their caregiving roles;
''(4) respite care to enable eligible caregivers to be
temporarily relieved from their caregiving responsibilities;
and
''(5) supplemental services, on a limited basis, to
complement the care provided by eligible caregivers.
''(c) Eligibility and Priority.--
''(1) Eligibility.--In order for a caregiver of an older
individual to be eligible to receive services provided by a
State program under this subpart, the State shall--
''(A) find that the caregiver is a caregiver
described in subsection (a); and
''(B) determine that the older individual meets the
condition specified in subparagraph (A)(i) or (B) of
section 102(28).
''(2) Priority.--In providing the services, the State shall
give priority for services to older individuals with greatest
social need, older individuals with greatest economic need, and
older individuals providing care and supports to persons with
mental retardation and related developmental disabilities (as
defined in section 102 of the Developmental Disabilities
Assistance and Bill of Rights Act (42 U.S.C. 6000) (referred to
in this part as ''developmental disabilities'')) consistent
with the requirements of section 305(a)(2)(E), and their
caregivers.
''(d) Coordination With Service Providers.--In carrying out this
subpart, each area agency on aging shall coordinate the activities of
the agency with the activities of other community agencies and
voluntary organizations providing the types of services described in
subsection (b).
''(e) Quality Standards and Mechanisms and Accountability.--
''(1) Quality standards and mechanisms.--The State shall
establish standards and mechanisms designed to assure the
quality of services provided with assistance made available
under this subpart.
''(2) Data and records.--The State shall collect data and
maintain records relating to the State program in a
standardized format specified by the Assistant Secretary. The
State shall furnish the records to the Assistant Secretary, at
such time as the Assistant Secretary may require, in order to
enable the Assistant Secretary to monitor State program
administration and compliance, and to evaluate and compare the
effectiveness of the State programs.
''(3) Reports.--The State shall prepare and submit to the
Assistant Secretary reports on the data and records required
under paragraph (2), including information on the services
funded under this subpart, and standards and mechanisms by
which the quality of the services shall be assured.
''(f) Availability of Funds.--
''(1) In general.--A State shall use the portion of the
State allotment under section 304 that is from amounts
appropriated under section 303(d) to carry out the State
program under this subpart.
''(2) Use of funds for administration of area plans.--
Amounts made available to a State to carry out the State
program under this subpart may be used, in addition to amounts
available in accordance with section 303(c)(1), for costs of
administration of area plans.
''(3) Federal share.--
''(A) In general.--Notwithstanding section
304(d)(1)(D), the Federal share of the cost of carrying
out a State program under this subpart shall be 75 percent.
''(B) Non-federal share.--The non-Federal share of
the costs shall be provided from State and local
sources.

''SEC. 342. MAINTENANCE OF EFFORT.

''Funds made available under this subpart shall supplement, and not
supplant, any Federal, State, or local funds expended by a State or
unit of general purpose local government (including an area agency on
aging) to provide services described in section 341(b).

''Subpart 2--National Innovation Programs

''SEC. 346. INNOVATION GRANT PROGRAM.

''(a) In General.--The Assistant Secretary shall carry out a
program for making grants to appropriate entities on a competitive
basis to foster the development and testing of new approaches to--
''(1) sustaining the efforts of family caregivers and other
informal caregivers of older individuals;
''(2) serving the needs of particular groups of caregivers
of older individuals, including minority caregivers and distant
caregivers; and
''(3) linking family support programs with the State entity
or agency that administers or funds programs for persons with
mental retardation or related developmental disabilities and
their families.
''(b) Evaluation and Dissemination of Results.--The Assistant
Secretary shall provide for evaluation of the effectiveness of programs
and activities funded with grants made under this section, and for
dissemination to States of descriptions and evaluations of the programs
and activities, to enable States to incorporate successful approaches
into their individual State programs under this part.
''(c) Availability of Funds.--
''(1) In general.--The Assistant Secretary shall reserve
not more than 10 percent of the amount appropriated under
section 303(d) for a fiscal year to carry out the program of
the Assistant Secretary under this section.
''(2) Native American programs and activities.--Twenty
percent of the amount reserved under paragraph (1) shall be
available for programs and activities under this section for
caregivers serving Indians and Native Hawaiians, as defined in
section 625.

''SEC. 347. ACTIVITIES OF NATIONAL SIGNIFICANCE.

''(a) In General.--The Assistant Secretary shall, directly or by
grant or contract, carry out activities of national significance to
promote quality and continuous improvement in the support services
provided to family caregivers and other informal caregivers of older
individuals, through program evaluation, training, technical
assistance, and research.
''(b) Availability of Funds.--The Assistant Secretary shall reserve
not more than 2 percent of the amount appropriated under section 303(d)
to carry out the activities under this section.''.

SEC. 3. AUTHORIZATION OF APPROPRIATIONS; ALLOTMENTS.

(a) Authorization of Appropriations.--Section 303(d) of the Older
Americans Act of 1965 (42 U.S.C. 3023(d)) is amended to read as
follows:
''(d) There are authorized to be appropriated $125,000,000 for
fiscal year 2000, and such sums as may be necessary for each of fiscal
years 2001 through 2004, to carry out part D (relating to the national
family caregiver support program).''.
(b) Allotments to States.--Section 304(a)(1) of the Older Americans
Act of 1965 (42 U.S.C. 3024(a)(1)) is amended in the first sentence--
(1) in the matter preceding subparagraph (A), by inserting
'', and remaining after reservations of funds made under
sections 346 and 347,'' after ''from the sums appropriated
under section 303 for each fiscal year''; and
(2) in subparagraphs (A), (B), and (C), by striking ''sum
appropriated'' and inserting ''remaining sums''.

SEC. 4. AVAILABILITY OF FUNDS FOR REALLOTMENT.

Section 304(b) of the Older Americans Act of 1965 (42 U.S.C.
3024(b)) is amended in the first sentence by striking ''part B or C''
and inserting ''part B or C, or subpart 1 of part D,''.

SEC. 5. CONFORMING AMENDMENTS.

(a) Relocation of Provisions Concerning In-Home Services for Frail
Older Individuals.--Section 321 of the Older Americans Act of 1965 (42
U.S.C. 3030d) is amended--
(1) in subsection (a)(5), by striking ''including'' and all
that follows and inserting ''including--
''(A) client assessment, case management services,
and development and coordination of community services;
''(B) in-home services for frail older individuals
(including supportive activities for older individuals
with Alzheimer's disease and related disorders with
neurological and organic brain dysfunction) and for the
families of the individuals;
''(C) supportive activities to meet the special
needs of caregivers, including caretakers who provide
in-home services to frail older individuals; and
''(D) in-home services and other community
services, including shopping, escort, reader, and
letterwriting services, and provision of home-delivered
meals and transportation, to assist older individuals
to live independently in a home environment;''; and
(2) by adding at the end the following:
''(c) In this section, the term 'in-home services' includes--
''(1) homemaker and home health aide services;
''(2) visiting and telephone reassurance;
''(3) chore maintenance;
''(4) in-home respite care for families, and adult day care
as a respite service for families;
''(5) minor modification of homes that is necessary to help
older individuals remain at home and that is not available
under other programs, except that not more than $150 per client
may be expended under this part for the modification;
''(6) personal care services; and
''(7) other in-home services as defined--
''(A) by the State agency in the State plan
submitted in accordance with section 307; and
''(B) by the area agency on aging in the area plan
submitted in accordance with section 306.''.
(b) Repeal of Part G.--Part G (relating to supportive activities
for caretakers who provide in-home services to frail older individuals)
of title III of the Older Americans Act of 1965 (42 U.S.C. 3030p et
seq.) is repealed.
(c) Other Conforming Amendments.--
(1) Section 303 of the Older Americans Act of 1965 (42
U.S.C. 3023) is amended by striking subsection (g).
(2) Section 304(a) of the Older Americans Act of 1965 (42
U.S.C. 3024(a)) is amended--
(A) in paragraph (1)--
(i) in the first sentence, by striking
''Subject to paragraphs (2) and (3)'' and
inserting ''Subject to paragraph (2),''; and
(ii) in the last sentence, by striking
''For the purposes of paragraph (3) and the
exception'' and inserting ''For the purposes of
the exception''; and
(B) by striking paragraph (3).
(3) Section 306(a)(2) of the Older Americans Act of 1965
(42 U.S.C. 3026(a)(2)) is amended by striking subparagraph (B)
and inserting the following:
''(B) in-home services (as defined in section
321);''.
(4) Section 307(a) of the Older Americans Act of 1965 (42
U.S.C. 3027(a)) is amended--
(A) in paragraph (10), by striking ''section 342''
and inserting ''section 321'';
(B) in paragraph (27), by striking ''in-home
services under section 341'' and inserting ''in-home
services under section 321'';
(C) by striking paragraph (40); and
(D) in paragraph (44), by inserting ''(as defined
in section 321)'' after ''in-home services''.
(5) Section 422(b)(11)(A)(ii)(III) of the Older Americans
Act of 1965 (42 U.S.C. 3035a(b)(11)(A)(ii)(III)) is amended by
striking ''part D'' and inserting ''part B''.
(6) Section 429F(a)(2) of the Older Americans Act of 1965
(42 U.S.C. 3035n(a)(2)) is amended by striking ''section 342''
and inserting ''section 321''.

SEC. 6. EFFECTIVE DATE.

The amendments made by this Act take effect on October 1, 1999.
Authorizes appropriations. Makes unused State grant program funds available for reallotment.