Health - Respite Care

Respite Care

Statements

H.R. 1341, The National Family Caregiver Support Act of 1999
Section-by-Section Summary

SEC. 1. FINDINGS

SEC. 2. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM.

This section amends part D of title III of the Older Americans Act of 1965 (the Act) in its entirety. As amended, part D would be entitled "National Family Caregiver Support Program", and would contain the following provisions—

Subpart 1--State Grant Program

SEC. 341. PROGRAM AUTHORIZED.

This section provides for a program of grants to States for multi-faceted systems of support for families and other informal providers of in-home and community care to older individuals. The program, like other State grant programs under the Act, would be administered through area agencies on aging; the area agencies would be required to coordinate with other community agencies and voluntary organizations providing the types of services available under the program.

Supportive services to be provided include (1) provision of information to caregivers about available services; (2) assistance in gaining access to such services; (3) individual counseling, organization of support groups, and caretaker training; (4) respite care; and (5) supplemental services, on a limited basis, to complement informal care.

Eligibility for services under the program is limited to caregivers of older individuals determined to be frail (as defined in section 102(28)) either because of (1) inability to perform unassisted at least two activities of daily living, or (2) need for substantial supervision because of a cognitive or other mental impairment.

In addition, the State must give priority to older individuals and caregivers with the greatest economic or social need, with particular attention to low-income minorities.

States have the option to require (or to permit or require area agencies to require) cost sharing for respite care or supplemental services. If they decline this option, they must report to the Assistant Secretary the methods they are using to meet the requirements to give priority to those with greatest economic and social need.

States must have in place mechanisms to assure the quality of services under this subpart, and must furnish data and reports to the Assistant Secretary as required.

The amount available for carrying out this subpart equals the amount remaining from appropriations for part D after the reservations of funds (up to 12 percent of the total) to carry out the programs under subpart 2. Funds may be used from this amount, in addition to amounts otherwise available, for administration of area plans. The Federal/State matching rate for this subpart is 75/25 (compared to 85/15 under the balance of title III).

SEC. 342. MAINTENANCE OF EFFORT.

This section provides a maintenance of effort requirement similar to current section 344: funds under this subpart must supplement and not supplant expenditures that are or would otherwise be made by Federal, State, or local government units (including area agencies on aging) for equivalent services.

Subpart 2--National Innovation Programs

SEC. 345. INNOVATION GRANT PROGRAM.

This section provides for a program of competitive grants to foster the development and testing of new evidence-based approaches to sustaining the efforts of families and other informal caregivers. The Assistant Secretary must provide for evaluation and dissemination of the results of programs funded. Up to 10 percent of appropriations under part D are to be reserved for this program; 20 percent of funds so reserved are to be used for Native American competitive grants.

SEC. 346. ACTIVITIES OF NATIONAL SIGNIFICANCE.

This section requires the Assistant Secretary, directly or by grant or contract, to carry out activities of national significance related to the provision of support to family and other informal caregivers. Up to 2 percent of appropriations under part D are to be reserved for this program.

SEC. 3. AUTHORIZATION OF APPROPRIATIONS; ALLOTMENTS.

Subsection (a) amends section 303(d) of the Act to authorize appropriations of $125 million for FY 2000, and such sums as necessary for each of the four succeeding fiscal years, to carry out the programs under title III-D.

Subsection (b) amends section 304(a)(1) to allot to States the balance remaining after the reservations of funds for the national innovation programs under subpart 2 of title III-D.

SEC. 4. AVAILABILITY OF TITLE III-D FUNDS FOR REALLOTMENT.

Section 4 amends section 304(b) of the Act to permit reallotment of unused

State funds allotted under title III-D.

SEC. 5. CONFORMING AMENDMENTS.

Subsection (a) relocates in section 321(a)(5) under part B of the Act (the authority for supportive services and senior centers) the description of in-home services for frail older individuals previously located in title III-D, in order to make clear that these services may be provided under part B.

Subsection (b) repeals title III-G (Supportive Activities for Caretakers who Provide In-Home Services to Frail Older Individuals). The activities authorized by part G (which has never been funded) are authorized under the proposed new part D.

Subsection (c) repeals obsolete references.

SEC. 6. EFFECTIVE DATE.

Section 6 provides that amendments made by the bill become effective October 1, 1999.