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Policy & Legislation 
This purpose of this page is to identify and track government policy and legislation
which has a direct impact on PAS. Updates and comments are provided when available.
An audio and text summary of legislation for the current period can be found on our
Audio Update page.
Current policy and legislation:
Achieving a Better Life Experience Act of 2009 (ABLE)
Senate Bill Number: 493, pdf version
& House of Representatives Bill Number: 1205, pdf version
Sponsors: Senator Robert Casey Jr. (D-PA) & Representative Ander Crenshaw (R-FL)
THOMAS (Library of Congress) status: S.493
THOMAS (Library of Congress) status: H.R.1205
Summary
The ABLE Act will give individuals with disabilities and their families the ability to save for their child's future just like every other American family, and help people with disabilities live full, productive lives in their communities.
The ABLE Act will allow individuals with disabilities to create a disability savings accounts or 'ABLE Accounts' that would accrue interest tax-free. The account could fund a variety of essential expenses for the individual, including medical and dental care, education, community based supports, personal assistance services, employment training, assistive technology, housing, and transportation. The legislation prohibits amounts held by, or paid or distributed from any ABLE accounts from being treated as income or assets when determining eligibility for benefits provide by any Federal benefits program.
Additional Information
Alzheimer’s Family Assistance Act of 2009
Senate Bill Number: 2958, pdf version
& House of Representatives Bill Number: 1192, pdf version
Sponsors: Senator Bob Menendez (D-NJ)
& Representative Eddie Bernice Johnson (D-TX)
THOMAS (Library of Congress) status: S.2958
THOMAS (Library of Congress) status: H.R.1192
Summary
Senator Bob Menendez (D-NJ) and Representative Eddie Bernice Johnson (D-TX) recently
reintroduced his legislation from 2007, the Caregiver Assistance and Relief Effort (CARE)
Act (S 2958/ H.R. 1192). The bill would provide a tax credit to those caring for a family
member with long-term care needs; the credit would start at $2,500 in 2010, with a
reduction of $100 for every $1,000 the taxpayer earns over $75,000.
The credit would increase to $2,750 in 2011 and $3,000 in 2012. In addition, the bill
would increase funding for the National Family Caregiver Support Program (NFCSP) to $250
million in FY 2011, up from $154 million in FY 2010. It would also allow a tax deduction
for long-term care insurance premiums and apply certain consumer protection provisions
to long-term care insurance contracts.
Alzheimer's Treatment and Caregiver Support Act
House of Representatives Bill Number: 4123, pdf version
Sponsors: Representative Maxine Waters (D-CA)
THOMAS (Library of Congress) status: H.R. 4123
Summary
To amend the Public Health Service Act to authorize grants for treatment and support
services for Alzheimer's patients and their families.
Additional information:
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Americans Giving care to Elders (AGE) Act
Senate Bill Number: 1604, pdf version
Sponsors: Senator Amy Klobuchar (D-MN)
THOMAS (Library of Congress) status: S.1604
Summary
On August 6, 2009, Senator Amy Klobuchar reintroduced the Americans Giving care to Elders (AGE) Act (S. 1604). The bill would provide $12 million over four years for the establishment of a National Resource Center on Family Caregiving, which would identify and develop "best practices," provide information on caregiver policies and programs, convene educational programs and web-based seminars, and provide a website with a national database of caregiver programs and resources. The bill would also provide a tax credit of up to $1200 for eldercare expenses and increase funding for the National Family Caregiver Support Program (NFCSP).
Additional Information
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Caregivers and Veterans Omnibus Health Services Act of 2009
Senate Bill Number: 1963, pdf version
Sponsors: Senator Daniel Akaka (D-HI)
THOMAS (Library of Congress) status: S.1963
Summary
On October 28, 2009, Senator Daniel Akaka (D-HI) introduced the Veterans' Caregiver and Omnibus Health
Benefits Act (S.1963). The bill combines the key provisions of the Veterans Health Care
Authorization Act (S.252) and the Veterans Insurance and Benefits Enhancement Act (S.728).
The legislation includes provisions to provide family caregivers of veterans who were injured
in the line of duty after September 11, 2009, with necessary information and training, respite,
counseling, ongoing information and support online, health care and a caregiver stipend.
Veterans groups are working hard to advocate passage of the bill, but are battling
some procedural hurdles.
Additional Information
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Caregiver Assistance & Enhancement Act
House of Representatives Bill Number: 3155
Sponsors: Representative Michael H. Michaud (D-ME2)
THOMAS (Library of Congress) status: H.R.3155
Summary
Caregiver Assistance and Resource Enhancement Act - Directs the Secretary of Veterans Affairs (VA), with respect to individuals providing noninstitutional extended care to disabled veterans, to make support services available to such caregivers, both family and non-family, including: (1) educational sessions teaching caring techniques, strategies, and skills; (2) respite care; (3) nursing care; (4) counseling and mental health services; (5) medical care; and (6) lodging and subsistence.
Additional Information
Press release, July 27, 2009, Michaud Bill providing Help for Caregivers of Veterans Passes House
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Community Choice Act of 2009 (CCA)
Senate Bill Number: 683, pdf version & House of Representatives Bill Number: 1670, pdf version
Sponsors: Senator Tom Harkin (D-IA) & Representative Danny Davis (D-IL)
THOMAS (Library of Congress) status: S.683
THOMAS (Library of Congress) status: H.R.1670
Summary
CCA would give individuals who receive Medicaid and are eligible for nursing home services or other institutional care equal access to community-based services and supports. The legislation also provides enhanced federal matching funds to help states develop their long-term care infrastructure and grant funds to help states increase their ability to provide home and community-based services. Finally, this bill creates a demonstration project to evaluate service coordination and cost sharing approaches for those eligible for both Medicaid and Medicare services.
Advocacy
Additional Information
- Press release, March 24, 2009, “Measure Offers Choice and Independence for People with Disabilities”.
http://harkin.senate.gov/pr/p.cfm?i=310417
- Press release, March, 2009, “Davis, Harkin Introduce H.R. 1670, the Community Choice Act. Measure Offers Choice and Independence for Persons with Disabilities”. http://www.davis.house.gov/index.php?option=com_content&task=view&id=74&Itemid=55
- “Supporting the Community Choice Act,” Barack Obama and Joe Biden’s Plan to Empower Americans with Disabilities Fact Sheet:
http://www.barackobama.com/pdf/DisabilityPlanFactSheet.pdf
- LaPlante, MP, Kaye, HS, & Harrington, C. (2007). Estimating the expense of a mandatory home- and community- based personal assistance services benefit under Medicaid. Journal of Aging & Social Policy, 19(3), 47-64. DOI: 10.1300/ J031v19n03_04
http://www.adapt.org/freeourpeople/download/estimating%20expense.pdf
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Community Living Assistance Services and Supports (CLASS) Act of 2009
Senate Bill Number: 697, pdf version & House of Representatives Bill Number: 1721, pdf version
Sponsors: Senator Ted Kennedy (D-MA) & Representative Frank Pallone (D-NJ)
THOMAS (Library of Congress) status: S.697
THOMAS (Library of Congress) status: H.R.1721
Summary
The Community Living Assistance Services and Supports (CLASS) Act of 2009 would amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes.
Additional Information
- “Supporting the CLASS Act,” Barack Obama and Joe Biden’s Plan to Empower Americans with Disabilities Fact Sheet:
http://www.barackobama.com/pdf/DisabilityPlanFactSheet.pdf
- Press release: Kennedy-Pallone-Dingell Open Doors of Opportunity by Helping Individuals Overcome Barriers to Independence,
March 25, 2009
- Press release: New Bipartisan Insurance Program Would Help Those With Severe Functional Impairments Gain Independence, July 10, 2007
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Elder Caregiver Support and Information Enhancement Act of 2009
House of Representatives Bill Number: 519, pdf version
Sponsor: Representative Steve Israel (D-NY)
THOMAS (Library of Congress) status: H.R.519
Summary
To authorize additional appropriations for the family caregiver support program under the Older Americans Act of 1965, and for the National Clearinghouse for Long-Term Care Information, for fiscal years 2010, 2011, and 2012.
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Empowered at Home Act of 2009
Senate Bill Number: 434, pdf version
Sponsors: Senator John Kerry (D-MA) & Senator Chuck Grassley (R-IA)
THOMAS (Library of Congress) status: S.434
Summary
Empowered at Home Act of 2009 - Amends title XIX (Medicaid) of the Social Security Act (SSA) to revise the income eligibility level for home and community-based (HCBS) services for elderly and disabled individuals.
Gives states the option to provide HCBS services under a waiver to eligible individuals whose income does not exceed 300% of the supplemental security income (SSI) benefit rate.
Gives states the option to provide HCBS waiver services to individuals for whom such services are likely to prevent, delay, or decrease the likelihood of an individual's need for institutionalized care.
Directs the Secretary of Health and Human Services to award assistance grants to states electing to provide HCBS waiver services under Medicaid through the state plan amendment option.
Reauthorizes Medicaid transformation grants at increased funding and specifies additional permissible uses to facilitate the provision of HCBS and other long-term care (LTC) services.
Directs the Secretary to award grants on a competitive basis to eligible states to conduct an evidence- and community-based health promotion program.
Amends the Internal Revenue Code to allow: (1) a tax deduction for premiums on qualified LTC insurance contracts; and (2) a tax credit for certain caregivers taking care of individuals with LTC needs.
Revises requirements for the model regulation and model Act concerning LTC insurance consumer protections and the excise tax for failing to meet requirements for such protections.
Amends SSA title XIX, with respect to treatment of the income and resources of HCBS waiver services recipients who would otherwise be institutionalized, to repeal the state option for (thus requiring) application to such individuals of spousal impoverishment protection requirements.
Allows states to elect to exclude up to six months of the average cost of nursing facility services from an individual's assets or resources for purposes of eligibility for HCBS waiver services.
Directs the Secretary, acting through the Administrator of the Centers for Medicare & Medicaid Services, to revise certain data reporting forms and systems to ensure uniform and consistent state reporting under this Act.
Directs the Comptroller General to study and report to Congress on: (1) the provision of home health services under different state Medicaid plans; and (2) the extent to which states offer consumer self-direction of such services, or allow for other consumer-oriented policies with respect to them.
Additional information
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Fair Home Health Act
Senate Bill Number: 2061, pdf version & House of Representatives Bill Number: 3582, pdf version
Sponsor: Senator Tom Harkin (D-IA) & Representative Lynn Woolsey (D-CA)
THOMAS (Library of Congress) status: S.2061
THOMAS (Library of Congress) status: H.R.3582
Summary
Fair Home Health Care Act (S. 2061 & H.R. 3582), would require minimum wage and overtime pay protections for workers in the home health care industry. It would amend the Fair Labor Standards Act of 1938 to exempt certain home health care workers who are employed on a casual basis from the minimum wage and maximum hour requirements under such Act. Defines employment on a "casual basis" as employment which is irregular or intermittent and does not exceed 20 hours per week in the aggregate.
Advocacy
Additional information
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Heroes at Home Act of 2009
House of Representatives Bill Number: 667, pdf version
Sponsor: John T. Salazar (D-CO)
THOMAS (Library of Congress) status: H.R.667
Summary
Heroes at Home Act of 2009 - Directs the Secretary of Veterans Affairs to:
- establish a program on training and certification of family caregivers of veterans and
members with traumatic brain injury (TBI); and
- conduct outreach to enhance awareness of veterans and the public about the
symptoms of post-traumatic stress disorder (PTSD) and TBI and the services provided by
the Department of Veterans Affairs to veterans with such symptoms.
Directs the Secretaries of Defense and Veterans Affairs to jointly:
- establish a demonstration project to assess the feasibility and advisability of using
telehealth technology to assess cognitive functioning of members who have sustained head
trauma in order to improve their diagnosis and treatment;
- conduct an ongoing study of all matters relating to the telehealth and telemental
health services of the Departments of Defense and Veterans Affairs.
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Inclusive Home Design Act of 2009
House of Representatives Bill Number: 1408, pdf version
Sponsor: Representative Janice Schakowsky (D-IL)
THOMAS (Library of Congress) status: H.R.1408
Summary
Inclusive Home Design Act of 2009 - Requires, with exceptions, newly constructed, federally assisted single family houses and town houses to include at least one level that complies with the following accessibility features for persons with disabilities:
- Accessible entrance
- Accessible interior doors
- Accessible environmental controls
- Accessible habitable space and an accessible bathroom
Requires:
- Each applicant for federal financial assistance to submit compliance assurances to the relevant federal agency
- Eeach person who arranges for design or construction of a covered dwelling to submit architectural and construction plans for state or local approval. Prohibits federal financial assistance to a state or local government unit unless the recipient is taking certain enforcement actions with regard to covered dwellings.
Permits:
- Private civil actions in a U.S. district court or state court for violations under this Act
- The Attorney General to commence civil actions or intervene in civil actions under this Act.
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Independence at Home Act of 2009
Senate Bill Number: 1133, pdf version & House of Representatives Bill Number: 2560, pdf version
Sponsors: Senator Ron Wyden (D-OR) & Representative Ed Markey (D-MA)
THOMAS (Library of Congress) status: 1133, 2560
Summary
- Establishes a three-year Medicare pilot project using a patient-centered health care delivery model
to ensure that Medicare beneficiaries with multiple chronic conditions can remain independent for as
long as possible in a comfortable environment
- Advances Medicare reform by creating incentives for providers to develop better and lower-cost
health care for the highest cost beneficiaries
- Incorporates lessons from past Medicare pilot projects
- Provides for coordinated-care programs that hold physician, nurse practitioners, physician
assistants, and other team members accountable for quality, patient satisfaction, and mandatory
annual minimum savings
- Generates savings by providing better care to Medicare beneficiaries with multiple chronic
conditions and reducing duplicative and unnecessary services, hospitalization, and other health
care costs
- Allows for continuation of home-based coordinated care as an ongoing Medicare benefit after
successful evaluation of Phase I. Persons eligible for the program include Medicare beneficiaries
with functional impairments, two or more chronic health problems, and recent use of other health
services. Each Independence at Home (IAH) patient will receive a comprehensive assessment at least
annually. The IAH organization, responsible for all aspects of care coordination, will be required
to demonstrate savings of at least 5 percent annually compared with the costs of serving
non-participating Medicare chronically ill beneficiaries. The IAH organization may keep 80 percent
of savings beyond the required 5 percent savings as an incentive to maximize the financial benefits
of being an IAH member. Any savings beyond 25% would be shared with 50% directed to the IAH
Organization and 50% to Medicare.
Additional information
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Medicare Adult Day Care Services Act of 2009
House of Representatives Bill Number: 3043, pdf version
Sponsors: Representative Linda Sánchez (D-CA)
THOMAS (Library of Congress) status: 3043
Summary
On June 25, 2009, Representative Linda Sánchez introduced the Medicare Adult Day Care Services Act (H.R. 3043) which would allow Medicare to cover adult day care services as a substitute for in-home care for beneficiaries currently eligible for such services. The option would give Medicare recipients more care hours and more services, including physical and occupational therapies, meals and transportation provided by adult day centers, at an all-inclusive rate that is lower than many home health care services.
Additional information
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Medicare Transitional Care Act of 2009
House of Representatives Bill Number: 2773, pdf version
Sponsors: Representative Earl Blumenauer (D-OR)
THOMAS (Library of Congress) status: H.R. 2773
Summary
Amends title XVIII (Medicare) of the Social Security Act to provide for coverage under Medicare part B (Supplementary Medical Insurance) of benefits for transitional care services for qualified individuals following discharge from a hospital or critical access hospital.
Additional information
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National Defense Authorization Act for Fiscal Year 2010
House of Representatives Bill Number: 2647, pdf version
Sponsors: Representative Ike Skelton (MO-4)
THOMAS (Library of Congress) status: H.R. 2647
Summary
On October 28, 2009, President Barack Obama signed into law the National Defense
Authorization Act (H.R.2647/ S.1390). Amendments to support family caregivers of
service members are included in the new law. An amendment by Rep. Lynn Woolsey and
Sen. Chris Dodd (Amendment 1766) will amend the Family and Medical Leave Act's
(FMLA) military family provisions, first enacted in Fiscal Year 2008, by
extending the time in which the family member can take such leave to be within
a five-year period. The amendment also expands the scope of those covered by
exigency leave provisions to allow working family members of deployed service
members to take time off to manage their family or personal affairs while the
service member is deployed. An amendment by Sen. Dick Durbin (D-IL) (Amendment 1662)
increases the maximum amount of monthly compensation for service members who are
injured or become ill while in the line-of-duty and who need help with everyday
activities. The amendment also creates a bridge to the family caregiver program
in the Department of Veterans Affairs.
Additional information
- Office of the Press Secretary, The White House, October 28, 2009,
“Remarkes by the President at the Signing of the National Defense Authorization
Act for Fiscal Year 2010.”
http://www.whitehouse.gov/the-press-office/remarks-president-signing-national-defense-authorization-act-fiscal-year-2010
- Press release, October 28, 2009, "Dodd Measure Extending Family and Medical Leave for Families of
Troops Becomes Law." http://dodd.senate.gov/?q=node/5300
- Press release, October 28, 2009, "Durbin Legislation to Provide Support to Families of Severely Disabled Service Members Signed Into Law."
http://durbin.senate.gov/showRelease.cfm?releaseId=319444
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Project 2020: Building on the Promise of Home and Community-Based Services Act of 2009
Senate Bill Number: 1257, pdf version & House of Representatives Bill Number: 2852, pdf version
Sponsors: Senator Maria Cantwell (D-WA), Representative Bruce Braley (D-IA)
THOMAS (Library of Congress) status: S.1257
THOMAS (Library of Congress) status: H.R.2852
Summary
A bill to amend the Social Security Act to build on the aging network to establish long-term services and supports through single-entry point systems, evidence based disease prevention and health promotion programs, and enhanced nursing home diversion programs.
Additional information
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Re-Aligning Care Act
Senate Bill Number: 1004, pdf version & House of Representatives Bill Number: 2307, pdf version
Sponsors: Senator Blanche Lincoln (D-AR), Representative Gene Green (D-TX)
THOMAS (Library of Congress) status: S.1004
THOMAS (Library of Congress) status: H.R.2307
Summary
To amend title XVIII of the Social Security Act to provide Medicare beneficiaries with access to geriatric assessments and chronic care management and coordination services, and for other purposes.
Additional information
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Retooling the Health Care Workforce for an Aging America Act of 2009
Senate Bill Number: 245, pdf version & House of Representatives Bill Number: 468, pdf version
Sponsors: Senator Herb Kohl (D-WI) & Representative Janice Schakowsky (D-IL)
THOMAS (Library of Congress) status: S.245
Summary
Retooling the Health Care Workforce for an Aging America Act of 2009 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to expand training for health professionals in the fields of geriatrics, long-term care, and chronic care management.
Requires an analysis of the health and long-term care workforce.
Amends the Workforce Investment Act of 1998 to provide for information to adults and dislocated workers about health care and long-term care occupations. Provides for information to veterans about training, internship, and employment opportunities in geriatrics, gerontology, and long-term care.
Amends the Older Americans Act of 1965 to require the Assistant Secretary for Aging to:
- Develop family caregiver training materials
- Provide for the establishment and operation of a National Resource Center on Volunteers, Students, and Seniors to promote partnerships between entities in the aging network and institutions of higher education and secondary schools, and to encourage projects that involve underserved communities
Requires the Secretary to:
- Provide for the development of core training competencies for personal or home care aides and additional training content for nurse aides and home health aides
- Establish a panel of long-term care workforce experts
Provides for the development of information and referral protocols for family caregivers of Medicare beneficiaries.
Amends title XIX (Medicaid) of the Social Security Act to provide for coverage of assessments of family caregiver support needs.
Provides for studies on:
- The mental health workforce
- The aging network's capacity to meet current and future needs
- Retention and tenure of nurse aides and home health aides
- Spending by the National Institutes of Health (NIH) on conditions and illnesses that disproportionately impact the health of older individuals
Additional information
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Social Security Caregiver Credit Act of 2009
House of Representatives Bill Number: 769, pdf version
Sponsor: Representative Nita M. Lowey (D-NY)
THOMAS (Library of Congress) status: H.R.769
Summary
Social Security Caregiver Credit Act of 2009 - Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act with respect to determining entitlement to and the amount of any monthly benefit, including any lump-sum death payment, payable under OASDI on the basis of the wages and self-employment income of any individual. Deems such an individual to have been paid a wage (according to a specified formula) during each month during which the individual was engaged for at least 80 hours in providing care to a dependent relative without monetary compensation for up to five years of such service. Makes this Act inapplicable in the case of any monthly benefit or lump-sum death payment if a larger benefit or payment would be payable without its application.
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