article: SECTION 1. SHORT TITLE. This Act may be cited as the ``Family Caregiver Support and Protection Act of 1996''. SEC. 2. COVERAGE OF RESPITE CARE SERVICES UNDER MEDICARE. (a) In General.--Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended-- (1) by striking ``and'' at the end of subparagraph (N); (2) by striking ``and'' at the end of subparagraph (O); and (3) by inserting after subparagraph (O) the following new subparagraph: ``(P) respite care services (as defined in subsection (oo)); and''. (b) Services Described.--Section 1861 of such Act (42 U.S.C. 1395x) is amended by adding at the end the following new subsection: ``Respite Care Services ``(oo)(1)(A) Subject to subparagraph (C), the term `respite care services' means any of the services described in subparagraph (B) which are furnished to an eligible individual (as described in paragraph (2)) for the support of a caregiver described in paragraph (2) at the individual's home or in the community on a short-term, intermittent, or emergency basis by an individual or entity who meets such standards as the Secretary may establish. ``(B) The services described in this subparagraph are as follows: ``(i) Companion services. ``(ii) Homemaker services. ``(iii) Personal assistance. ``(iv) Community day services. ``(v) Temporary care in an accredited or licensed residential facility. ``(C) In establishing standards pursuant to subparagraph (A) for individuals and entities providing respite care services, the Secretary shall consult with organizations representing providers of the services described in such paragraph and organizations representing individuals who typically receive such services. ``(D) The term `respite care services' does not include any services furnished to an individual during a 12-month period after the individual has been furnished 120 hours of such services during such period. ``(2) An `eligible individual' described in this paragraph is an individual with functional limitations (as described in paragraph (3)) who is dependent on a daily basis on a caregiver who-- ``(A) has primary responsibility for providing care to the individual; ``(B) does not receive financial remuneration for providing such care; and ``(C) has provided such care for a period of not less than 3 consecutive months. ``(3)(A) In paragraph (2), an `individual with functional limitations' is an individual who is certified (in accordance with such criteria as the Secretary may establish consistent with subparagraph (C)) as-- ``(i) being unable to perform without substantial assistance from another individual (including assistance involving verbal reminding or physical cueing) at least 2 of the activities of daily living described in subparagraph (B) for a period of at least 90 days due to a loss of functional capacity or to cognitive or other mental impairment; ``(ii) requiring substantial supervision to protect the individual from threats to the individual's health or safety due to substantial cognitive or other mental impairment; or ``(iii) having a level of disability similar (as determined by the Secretary) to the level of disability described in clause (i) or (ii). ``(B) The activities of daily living described in this subparagraph are as follows: ``(i) Eating. ``(ii) Toileting. ``(iii) Transferring. ``(iv) Bathing. ``(v) Dressing. ``(vi) Continence. ``(C) In establishing criteria pursuant to subparagraph (A) for the certification of individuals with functional limitations, the Secretary may not require that such certification be performed only by a physician.''. (c) Payment on Hourly Basis.--Section 1833 of such Act (42 U.S.C. 1395l) is amended by inserting after subsection (o) the following new subsection: ``(p) Payment for respite care services shall be paid on the basis of an hour of such services provided.''. (d) Conforming Amendment.--Section 1862(a) of such Act (42 U.S.C. 1395y(a)) is amended-- (1) by striking ``or'' at the end of paragraph (14); (2) by striking the period at the end of paragraph (15) and inserting ``; or''; and (3) by inserting after paragraph (15) the following new paragraph: ``(16) in the case of respite care services, which are furnished to an individual during a 12-month period after the individual has been furnished 120 hours of such services during such period.''. (e) Effective Date.--The amendments made by this section shall apply to services furnished on or after January 1, 1997. SEC. 3. TREATMENT OF LONG-TERM CARE SERVICES AS MEDICAL CARE. (a) General Rule.--Paragraph (1) of section 213(d) (defining medical care) is amended by striking ``or'' at the end of subparagraph (B), by striking the period at the end of subparagraph (C) and inserting ``, or'', and by adding at the end the following new subparagraph: ``(D) for qualified long-term care services (as defined in subsection (f)).'' (b) Definition of Qualified Long-Term Care Services.--Section 213 of such Code is amended by adding at the end the following new subsection: ``(f) Qualified Long-Term Care Services.--For purposes of this section-- ``(1) In general.--The term `qualified long-term care services' means necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, and rehabilitative services, and maintenance or personal care services, which-- ``(A) are required by a chronically ill individual, and ``(B) are provided pursuant to a plan of care prescribed by a licensed health care practitioner. ``(2) Chronically ill individual.-- ``(A) In general.--The term `chronically ill individual' means any individual who has been certified by a licensed health care practitioner as-- ``(i) being unable to perform (without substantial assistance from another individual) at least 2 activities of daily living for a period of at least 90 days due to a loss of functional capacity or to cognitive impairment, ``(ii) requiring substantial supervision to protect such individual from threats to health or safety due to substantial cognitive impairment, or ``(iii) having a level of disability similar (as determined by the Secretary in consultation with the Secretary of Health and Human Services) to the level of disability described in clause (i) or (ii). Such term shall not include any individual otherwise meeting the requirements of the preceding sentence unless within the preceding 12-month period a licensed health care practitioner has certified that such individual meets such requirements. ``(B) Activities of daily living.--For purposes of subparagraph (A), each of the following is an activity of daily living: ``(i) Eating. ``(ii) Toileting. ``(iii) Transferring. ``(iv) Bathing. ``(v) Dressing. ``(vi) Continence. ``(C) Substantial assistance.--For purposes of subparagraph (A)(i), the term `substantial assistance' includes verbal reminding or physical cuing. ``(3) Maintenance or personal care services.--The term `maintenance or personal care services' means any care the primary purpose of which is the provision of needed assistance with any of the disabilities as a result of which the individual is a chronically ill individual (including the protection from threats to health and safety due to severe cognitive impairment). ``(4) Licensed health care practitioner.--The term `licensed health care practitioner' means any physician (as defined in section 1861(r)(1) of the Social Security Act) and any registered professional nurse, licensed social worker, or other individual who meets such requirements as may be prescribed by the Secretary.'' (c) Effective Date.--The amendments made by this section shall apply to taxable years beginning after December 31, 1995.
summary: Family Caregiver Support and Protection Act of 1996 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of respite care services, paid for on an hourly basis, under Medicare part B (Supplementary Medical Insurance). Amends the Internal Revenue Code to treat qualified long-term care services as deductible medical care expenses.