[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 1072 Introduced in Senate (IS)]
103d CONGRESS
1st Session
S. 1072
To amend the Social Security Act to provide assistance to States in
providing services to support informal caregivers of individuals with
functional limitations.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 28 (legislative day, April 19), 1993
Mr. Bradley introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend the Social Security Act to provide assistance to States in
providing services to support informal caregivers of individuals with
functional limitations.
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 ``Family Caregiver Support Act of
1993''.
SEC. 2. FAMILY CAREGIVER SUPPORT PROGRAM ESTABLISHED.
(a) In General.--The Social Security Act (42 U.S.C. 301 et seq.) is
amended by adding at the end thereof the following new title:
``TITLE XXI--GRANTS TO STATES FOR FAMILY CAREGIVER SUPPORT PROGRAMS
``purpose of title; authorization of appropriations
``Sec. 2101. For the purpose of enabling each State to furnish
services to support informal caregivers of individuals with functional
limitations by providing services designed to facilitate and strengthen
informal support systems to help maintain individuals with functional
limitations within the community, there are authorized to be
appropriated for each fiscal year such sums as may be necessary to
carry out the purposes of this title. The sums made available under
this section shall be used for making payments to States which have
submitted, and had approved by the Secretary, State plans for family
caregiver support services.
``state plans for family caregiver support services
``Sec. 2102. A State plan for family caregiver support services
must--
``(1) provide that it shall be in effect in all political
subdivisions of the State, and if administered by them, be
mandatory upon them;
``(2) provide for financial participation by the State
equal to not less than 50 percent of the administrative costs
of operating the program in the State;
``(3) provide either for the establishment or designation
of a single State agency or agencies (such agency may be the
same agency established or designated under section 1902 of
this Act) to administer or supervise the administration of the
plan in coordination with home and community-based services
provided under title XIX of this Act;
``(4) describe the steps that will be taken to ensure that
all State government agencies responsible for the provision of
family caregiver support services funded under this title with
other Federal or State agencies or both on behalf of
individuals with functional limitations and their caregivers
shall be included in the development of the State plan so that
all such services are coordinated with all other types of
services and benefits such individuals and their caregivers may
be receiving (or are eligible to receive);
``(5) describe the steps to be taken to ensure equitable
access to family caregiver support services funded under this
title for individuals of all ages with functional limitations
and their caregivers, including individuals who have cognitive,
mental, developmental, physical, sensory, or other impairments
that meet the criteria of section 2104(b)(1);
``(6) describe the manner in which family caregiver support
services funded under this title will be organized, delivered,
and coordinated, statewide and within the various localities of
the State, in order to achieve the objectives specified in
subparagraphs (4) and (5) of this subsection;
``(7) specify the procedures used in notifying and
obtaining input on the contents of the State plan from non-
governmental organizations and individuals with an interest in
the welfare of individuals with functional limitations;
``(8) provide that the State agency or agencies--
``(A) make a determination of the need for family
caregiver support services for the individual with
functional limitations;
``(B) establish quality assurance for the delivery
of family caregiver support services, including
evaluation of individual and family satisfaction with
the services provided;
``(C) establish a family caregiver support plan for
each individual with functional limitations for
services under this title, and provide for periodic
review and revision as necessary; and
``(D) establish reimbursement levels for family
caregiver support services;
``(9) provide that family caregiver support services funded
under this title to an individual with functional limitations
shall not supplant services otherwise provided to such
individual for which such individual is eligible under titles
XVIII or XIX of this Act or under any other public or private
program;
``(10) provide--
``(A) that no copayment shall be required for
individuals with functional limitations with incomes
below 200 percent of the income official poverty line
(as determined by the Office of Management and Budget
and revised annually in accordance with section 673(2)
of the Omnibus Budget Reconciliation Act of 1981); and
``(B) that a copayment shall be required on a
sliding scale basis (as determined by the State) for
individuals with functional limitations with incomes in
excess of 200 percent of such income line; and
``(11) provide for making family caregiver support services
available, including at least the care and services described
in paragraphs (1) through (4) of section 2104(a) to all
individuals with functional limitations.
``payment to states
``Sec. 2103. (a)(1) The Secretary (except as otherwise provided in
this section) shall pay to each State which has a plan approved under
this title, for each quarter, beginning with the quarter commencing
January 1, 1994--
``(A) an amount equal to 100 percent of the total amount
expended during such quarter as family caregiver support
services under the State plan subject to the applicable Federal
payment limitation described in paragraph (2); and
``(B) an amount equal to 50 percent of so much of the sums
expended during such quarter as found necessary by the
Secretary for the proper and efficient administration of the
State plan (including costs of needs determination and care
planning).
``(2)(A) The applicable Federal payment limitation described in
this paragraph is $2,400 per calendar year per individual with
functional limitations, reduced by the offset, if any, described in
subparagraph (B).
``(B) The total Federal payment to any State for each individual
with functional limitations for a calendar year shall be reduced by the
amount of any copayment paid by such an individual for family caregiver
support services funded under this title in accordance with paragraph
(10) of section 2102.
``(b) No payment shall be made under this title with respect to any
amount expended for family caregiver support services in a calendar
quarter for any individual with functional limitations with an income
in excess of $75,000 per year.
``definitions
``Sec. 2104. (a) For purposes of this title, the term `family
caregiver support services' means care and services in the home, or in
the community, provided on a temporary, short term, intermittent, or
emergency basis to support a caregiver in caring for an individual with
functional limitations, including--
``(1) companion services;
``(2) homemaker services;
``(3) personal assistance;
``(4) day services in the community;
``(5) temporary care in accredited or licensed facilities
(admission to a hospital or nursing home for out-of-home care
for a brief stay); and
``(6) such other services, as specified in State plan.
``(b)(1) For purposes of this title, an `individual with functional
limitations'--
``(A) is an individual 18 years of age or over who--
``(i) cannot perform (without substantial human
assistance, including supervision) at least 3 of the
activities of daily living described in subparagraphs
(A) through (E) of paragraph (2); or
``(ii) needs substantial human assistance or
supervision because of cognitive or other mental
impairment that--
``(I) impedes ability to function; or
``(II) causes behavior that poses a serious
health or safety hazard to such individual or
others; or
``(B) is a child who is receiving disability payments, or
would be eligible for such payments, but for the income or
resource limitations considered for determining eligibility
under title XVI of this Act.
``(2) The activities of daily living described in this paragraph
are--
``(A) toileting;
``(B) eating;
``(C) transferring;
``(D) dressing; and
``(E) bathing.
``(c) For purposes of this title, the term `caregiver' means a
spouse, parent, child, relative or other person who--
``(A) has primary responsibility (as defined by the
Secretary) of providing care for one individual with functional
limitations;
``(B) does not receive financial remuneration for providing
such care for such individual; and
``(C) who has provided such care to such individual for a
period of not less than 3 months.
``(d) For purposes of this title, the term `family caregiver
support plan' means a written plan, developed in cooperation with the
caregiver and the individual with functional limitations to reflect
their choices and preferences for the type, frequency, and duration of
family caregiver support services to be provided under the plan.
``maintenance of effort
``Sec. 2105. States receiving payments under section 2103 must
maintain current levels of funding for family caregiver support
services to individuals with functional limitations and their
caregivers in order to be eligible to continue to receive payments for
such services under this title.''.
(b) Effective Date.--The amendment made by subsection (a) shall
become effective with respect to services furnished on or after January
1, 1994.
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