text: 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.
target: 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.
feat_title: Family Caregiver Support and Protection Act of 1996