,i  #aad? ,,congress  #a/ ,session  ,h4 
,r4 #cdfg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #i1 #bjae   
,ms4 ,velzquez 7= h]self & ,ms4 ,max9e  
,wat]s ( ,cali=nia7 introduc$ ! foll[+  
bill2 :i* 0 ref]r$ to ! ,committee on   
,f9ancial ,s]vices  ,a ,,bill  ,to      
e/abli% a pilot program to tra9 public  
h\s+ resid5ts z home heal? aides & 9    
home-bas$ heal? s]vices to enable su*   
resid5ts to provide cov]$ home-bas$     
heal? s]vices to resid5ts ( public h\s+ 
& resid5ts ( f$]ally-assi/$ r5tal h\s+1 
:o are eld]ly & disabl$1 & = o!r        
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,toge!r ,we ,c>e ,act (    
#bjae4  #b4 ,f9d+s & purpose  7a7 ,f9d+s
 ,! ,congress f9ds ! foll[+3  7#a7 ,!   
baby boom g5]ation w require heal? c>e  
att5tion t w exce$ ! curr5t supply (    
heal? c>e provid]s4  7#b7 ,!re is a     
%ortage ( tra9+ programs specializ+ 9   
heal? c>e & long-t]m s]vices t focus on 
home c>e in/ead ( in/itutionaliz$ c>e4  
7#c7 ,al?\gh ! ne$ = home-bas$ heal?    

s]vices transc5ds all income levels1 !  
availability ( su* s]vices is m limit$ =
 resid5ts ( public h\s+4  7#d7 ,e/imates
 indicate t !re are #ci4h million       
c>egiv]s 9 ! ,unit$ ,/ates provid+      
unpaid c>e to at lea/ "o adult4  7#e7 ,(
 work+ p]sons provid+ unpaid c>e1 #f out
 ( e #aj h _h to make adju/m5ts to "w   
s*$ules or leave employm5t4  7#f7 ,_m   
l[-income families 9 ! ,unit$ ,/ates are
 plac$ 9 an unt5able position ( *oos+   
betwe5 "w & c>egiv+ responsibilities at 
home4  7#g7 ,_m resid5ts ( public h\s+ 9
 ! ,unit$ ,/ates are ag+ & 9 ne$ ( c>e4 
7#h7 ,! ,dep>tm5t ( ,h\s+ & ,urban      
,developm5t e/imates ! p]c5tage (       
h\seholds assi/$ by ! ,dep>tm5t t are   
eld]ly h\seholds is #cc p]c5t4  7#i7    
,h\seholds t include a memb] :o is a    
p]son ) disabilities comprise #ba p]c5t 
( h\seholds liv+ 9 public h\s+4  7#aj7  
,new s]vice programs are ne$$ to provide
 home-bas$ heal? s]vices to resid5ts (  
public h\s+ & to provide job tra9+ & job
 placem5t = p]sons receiv+ assi/ance f !

 ,dep>tm5t ( ,h\s+ & ,urban ,developm5t 
ne$+ employm5t4  7#aa7 ,! ,dep>tm5t (   
,h\s+ & ,urban ,developm5t %\ld e/abli% 
a home-bas$ heal? s]vices pilot program 
to meet ! *all5ges ( ! increas+ numb] ( 
eld]ly p]sons & p]sons ) disabilities 9 
public h\s+1 :i* w\ld simultane\sly     
create an opportunity to tra9 job seek]s
 9 a trade t provides home-bas$ heal?   
s]vices4  7b7 ,purposes ,! purposes (   
?is ,act are-- 7#a7 to give flexibility 
to ! ,dep>tm5t ( ,h\s+ & ,urban         
,developm5t & o!r entities to e/abli%   
tra9+ programs 9 home-bas$ heal? s]vices
 = public h\s+ resid5ts2 &  7#b7 to     
provide ne$$ home c>e options to eld]ly 
& disabl$ public h\s+ resid5ts 7includ+ 
eld]ly & disabl$ vet]ans :o are public  
h\s+ resid5ts7 & eld]ly & disabl$       
resid5ts ( f$]ally-assi/$ r5tal h\s+ to 
all[ !m to rema9 9 _! homes & _!        
communities4  #c4 ,pilot grant program  
to tra9 public h\s+ resid5ts to provide 
cov]$ home-bas$ heal? s]vices ,section  
#cd ( ! ,unit$ ,/ates ,h\s+ ,act ( #aicg

 7#db ,u4,s4,c4 #adcgz-#f7 is am5d$ by  
add+ at ! end ! foll[+ new subsections3 
7f7 ,pilot grant program ,to tra9 public
 h\s+ resid5ts ,to provide cov]$        
home-,bas$ heal? s]vices  7#a7          
,e/abli%m5t ( pilot grant program ,!    
,secret>y1 9 consultation ) ! ,secret>y 
( ,heal? & ,human ,s]vices1 %all e/abli%
 a competitive grant program to make    
grants to eligible entities "u p>agraph 
7#b7 = use = ! tra9+ ( public h\s+      
resid5ts z home heal? aides & z provid]s
 ( home-bas$ heal? s]vices 7includ+ z   
p]sonal & home c>e aides7 to enable su* 
resid5ts to provide cov]$ home-bas$     
heal? s]vices to--  7,a7 resid5ts (     
public h\s+ :o are eld]ly or disabl$1 or
 bo? 7includ+ eld]ly & disabl$ vet]ans  
:o are resid5ts ( public h\s+72 &  7,b7 
subject to ! crit]ia set =? pursuant to 
p>agraph 7#c71 resid5ts ( f$]ally-assi/$
 r5tal h\s+ :o are eld]ly or disabl$1 or
 bo?4  7#b7 ,eligible ,entities ,a grant
 "u ?is subsection may be made only to  
an entity t-- 7,a7 is a public h\s+     

ag5cy or o!r unit ( ,/ate or local      
gov]nm5t 7includ+ an ag5cy ( su* unit71 
community heal? c5t]1 home c>e provid]  
organization1 fai?-bas$ organization1   
labor organization1 or o!r organization 
det]m9$ to be qualifi$ by ! ,secret>y2 &
  7,b7 demon/rates to ! satisfaction ( !
 ,secret>y t x has e/abli%$1 or provides
 su* assurances t x w e/abli%1 an       
employm5t tra9+ program to tra9 public  
h\s+ resid5ts to provide cov]$ home-bas$
 heal? s]vices t complies ) regulations 
t ! ,secret>y %all issue4  7#c7         
,resid5ts ( f$]ally-assi/$ r5tal h\s+ ,!
 ,secret>y may set =? crit]ia "u :i* an 
entity receiv+ fund+ "u ?is subsection  
may tra9 public h\s+ resid5ts to provide
 cov]$ home-bas$ heal? s]vices to eld]ly
 & disabl$ resid5ts ( f$]ally-assi/$    
r5tal h\s+4  7#d7 ,application ,to be   
eligible = a grant "u ?is subsection an 
eligible entity "u p>agraph 7#b7 %all   
submit to ! ,secret>y an application at 
su* "t1 9 su* mann]1 & conta9+ su*      
in=mation z ! ,secret>y %all require4   

7#e7 ,competitive grant aw>ds  7,a7     
,g5]al crit]ia = selection ,! ,secret>y 
%all e/abli% policies & proc$ures =     
review+ & approv+ fund+ = eligible      
entities ?r\gh a competitive process    
tak+ into consid]ation--  7i7 ) respect 
to ! s]vice area 9 :i* public h\s+      
resid5ts tra9$ "u an employm5t tra9+    
program describ$ 9 p>agraph 7#b77;,b7 w 
provide cov]$ home-bas$ heal? s]vices-- 
7,i7 ! p]c5tage ( resid5ts age #fb &    
old]2  7,,ii7 ! p]c5tage ( disabl$      
resid5ts2 &  7,,iii7 ! p]c5tage (       
unemploy$ or und]employ$ resid5ts2  7ii7
 ! ability ( an eligible entity to      
provide tra9+ t leads to ! provision (  
quality c>e2  7iii7 ! record ( ! quality
 ( c>e ( an eligible entity2 &  7iv7 su*
 o!r crit]ia z det]m9$ by ! ,secret>y4  
7,b7 ,geographic consid]ation ,9 aw>d+  
grants1 ! ,secret>y %all consid] a      
geographic mix ( a v>iety ( eligible    
entities s t ! grant program w include  
at lea/--  7i7 "o employm5t tra9+       
program describ$ 9 p>agraph 7#b77;,b7 t 

prim>ily s]ves an urban population2     
7ii7 "o employm5t tra9+ program describ$
 9 p>agraph 7#b77;,b7 t prim>ily s]ves a
 rural population2  7iii7 "o employm5t  
tra9+ program describ$ 9 p>agraph       
7#b77;,b7 t prim>ily s]ves an ,indian   
population2 &  7iv7 "o employm5t tra9+  
program describ$ 9 p>agraph 7#b77;,b7 t 
prim>ily s]ves a population 9 !         
,commonweal? ( ,pu]to ,rico1 ! ,unit$   
,/ates ,virg9 ,isl&s1 ,guam1 ,am]ican   
,samoa1 or ! ,commonweal? ( ! ,nor!rn   
,m>iana ,isl&s4  7#f7 ,use ( grant funds
 ,an entity receiv+ fund+ "u ?is        
subsection may use su* funds-- 7,a7 to  
e/abli% 7or ma9ta97 & c>ry out an       
employm5t tra9+ program to tra9 public  
h\s+ resid5ts to provide cov]$ home-bas$
 heal? c>e s]vices to eld]ly & disabl$  
public h\s+ resid5ts & eld]ly & disabl$ 
resid5ts ( f$]ally-assi/$ r5tal h\s+2   
7,b7 = ! transportation exp5ses ( public
 h\s+ resid5ts 9 tra9+ "u su* an        
employm5t tra9+ program2  7,c7 = ! *ild 
c>e exp5ses ( public h\s+ resid5ts 9    

tra9+ "u su* an employm5t tra9+ program2
  7,d7 = ! adm9i/rative exp5ses ( c>ry+ 
out su* an employm5t tra9+ program2 &   
7,e7 = any o!r activity ! ,secret>y     
det]m9es appropriate4  7#g7 ,report to  
,congress ,n lat] ?an #bd mon?s aft] !  
date ( ! enactm5t ( ! ,toge!r ,we ,c>e  
,act ( #bjae1 ! ,secret>y %all submit to
 ! ,congress a report on ! use & impact 
( ! grant program e/abli%$ by ?is       
subsection4 ,! report %all include--    
7,a7 a review ( ! effectiv5ess ( !      
program 9-- 7i7 provid+ jobs = public   
h\s+ resid5ts2  7ii7 meet+ ! unmet heal?
 & long-t]m c>e ne$s ( eld]ly & disabl$ 
resid5ts ( public h\s+ & eld]ly &       
disabl$ resid5ts ( f$]ally-assi/$ r5tal 
h\s+2 &  7iii7 enabl+ ! provision (     
quality c>e2 &  7,b7 any recomm5dations 
! ,secret>y det]m9es appropriate reg>d+ 
! grant program4  7#h7 ,def9itions ,z   
us$ 9 ?is subsection1 subsection 7g71 & 
subsection 7h73 7,a7 ,home-bas$ heal?   
s]vices ,! t]m home-bas$ heal? s]vices  
means heal? c>e & long-t]m s]vices      

provid$ to an individual 9 a place (    
resid5ce us$ z su* individual's home &  
includes--  7i7 home heal? s]vices      
describ$ 9 section #ahfa7m7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciex7m772  7ii7 p]sonal c>e s]vices   
describ$ 9 section #aije7;a77#bd7 ( su* 
,act 7#db ,u4,s4,c4 #acif;d7a77#bd772 & 
7iii7 home-bas$ s]vices :i* may be cov]$
 "u a waiv] "u subsection 7c7 or 7d7 (  
section #aiae ( su* ,act 7#db ,u4,s4,c4 
#acifn74  7,b7 ,home heal? aide ,! t]m  
home heal? aide has ! mean+ giv5 ! t]m 9
 section #ahia7;a77#c77;,e7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acie;bbb7a77#c77;,e774  7,c7 ,cov]$ ,! 
t]m cov]$ means1 ) respect to home-bas$ 
heal? s]vices1 su* s]vices-- 7i7 = :i*  
m$ical assi/ance is available "u a ,/ate
 plan "u title ,,xix ( ! ,social        
,security ,act2 or  7ii7 = :i* f9ancial 
assi/ance is available "u subsection 7g7
 ( ?is section4  7,d7 ,f$]ally-assi/$   
r5tal h\s+ ,! t]m f$]ally-assi/$ r5tal  
h\s+ means--  7i7 h\s+ assi/$ "u section

 #bjb ( ! ,h\s+ ,act ( #aiei 7#ab       
,u4,s4,c4 #agjaq72  7ii7 h\s+ assi/$ "u 
section #eae ( ! ,h\s+ ,act ( #aidi 7#db
 ,u4,s4,c4 #adhe72  7iii7 h\s+ assi/$ "u
 section #h ( ! ,unit$ ,/ates ,h\s+ ,act
 ( #aicg 7#db ,u4,s4,c4 #adcg;f7        
7includ+ project-bas$ & t5ant-bas$      
assi/ance72  7iv7 h\s+ assi/$ "u ! block
 grant program "u ! ,native ,am]ican    
,h\s+ ,assi/ance & ,self-,det]m9ation   
,act ( #aiif 7#be ,u4,s4,c4 #daja et    
seq472  7v7 h\s+ f9anc$ by a mortgage   
insur$ "u section #bba7;d77#c7 ( !      
,national ,h\s+ ,act 7#ab ,u4,s4,c4     
#agael7d77#c77 or held by ! ,secret>y1 a
 ,/ate1 or ,/ate ag5cy2  7vi7 h\s+      
assi/$ "u section #haa ( !              
,cran/on-,gonzalez ,national ,af=dable  
,h\s+ ,act 7#db ,u4,s4,c4 #hjac72 &     
7vii7 h\s+ assi/$ "u any program "u     
title ,,iv ( ! ,mc,kinney-,v5to         
,homeless ,assi/ance ,act 7#db ,u4,s4,c4
 #aacfj et seq474  7#i7 ,inapplicability
 ( previ\s subsections ,subsections 7a7 
?r\gh 7e7 %all n apply to ?is           

subsection1 subsection 7g71 & subsection
 7h74  7#aj7 ,rule ( con/ruction ,?is   
subsection & subsection 7g7 may n be    
con/ru$ z affect+ any requirem5t "u     
,/ate law = tra9+1 lic5sure1 or any o!r 
c]tification z a home heal? aide or z a 
provid] ( any home-bas$ heal? s]vice "u 
?is subsection & subsection 7g74  7#aa7 
,regulations ,n lat] ?an #f mon?s aft] !
 date ( enactm5t ( ! ,toge!r ,we ,c>e   
,act ( #bjae1 ! ,secret>y %all issue    
regulations to c>ry out ?is subsection4 
7#ab7 ,au?orization ( ,appropriations   
,!re are au?oriz$ to be appropriat$     
#b1ejj1jjj = ea* ( ! fiscal ye>s #bjaf1 
#bjag1 & #bjah1 = grants "u ?is         
subsection4  7g7 ,f9ancial assi/ance =  
home-,bas$ heal? s]vices 9 c]ta9        
jurisdictions  7#a7 ,f9ancial assi/ance 
,! ,secret>y1 9 consultation ) !        
,secret>y ( ,heal? & ,human ,s]vices1   
may provide f9ancial assi/ance "u ?is   
subsection to entities receiv+ grant    
funds "u ! pilot program e/abli%$ "u    
subsection 7f7 t provide tra9+ = public 

h\s+ resid5ts z home heal? aides & z    
provid]s ( home-bas$ heal? s]vices &    
provide 7or pay =7 su* s]vices = use    
only = _! co/s 9 provid+ 7or pay+ =7 su*
 s]vices to--  7,a7 resid5ts ( public   
h\s+ :o are eld]ly or disabl$1 or bo?   
7includ+ eld]ly or disabl$ vet]ans :o   
are resid5ts ( public h\s+72 or  7,b7 at
 ! discretion ( ! ,secret>y1 resid5ts ( 
f$]ally-assi/$ r5tal h\s+ :o are eld]ly 
or disabl$1 or bo?4  7#b7 ,requirem5ts  
7,a7 ,location ,assi/ance "u p>agraph   
7#a7 may be provid$ only = s]vices      
furni%$ 9 locations 9 :i* m$ical        
assi/ance = home-bas$ heal? s]vices is n
 available "u a ,/ate plan "u title     
,,xix ( ! ,social ,security ,act4  7,b7 
,tra9$ public h\s+ resid5ts ,assi/ance  
"u p>agraph 7#a7 may be us$ only = co/s 
( s]vices describ$ 9 p>agraph 7#a7 t are
 provid$ by public h\s+ resid5ts tra9$  
by an entity receiv+ grant funds "u !   
pilot program e/abli%$ "u subsection    
7f74  7#c7 ,eligibility ,to be eligible 
= f9ancial assi/ance "u ?is subsection  

an entity %all-- 7,a7 provide su*       
assurances z ! ,secret>y %all require t 
x w use ! funds only z provid$ 9        
p>agraphs 7#a7 & 7#b72  7,b7 submit to !
 ,secret>y an application at su* "t1 9  
su* mann]1 & conta9+ su* in=mation z !  
,secret>y requires2 &  7,c7 comply ) su*
 o!r t]ms & conditions z ! ,secret>y    
%all e/abli% to c>ry out ?is subsection4
  7#d7 ,au?orization ( appropriations   
,!re are au?oriz$ to be appropriat$     
#b1ejj1jjj = ea* ( ! fiscal ye>s #bjaf1 
#bjag1 & #bjah1 = f9ancial assi/ance "u 
?is subsection4  7h7 ,impact ( ,income  
on ,eligibility = ,h\s+ ,b5efits ,= any 
resid5t ( public h\s+ :o is tra9$ z a   
home heal? aide or z a provid] (        
home-bas$ heal? s]vices pursuant to !   
program "u subsection 7f71 any income   
receiv$ by su* resid5t = provid+ cov]$  
home-bas$ heal? s]vices %all apply t[>ds
 eligibility = b5efits "u ,f$]al h\s+   
programs z foll[s3  7#a7 ,no income     
receiv$ %all apply = ! #ab mon?s aft] ! 
completion ( ! tra9+ ( su* resid5t4     

7#b7 #be p]c5t ( income receiv$ %all    
apply = ! p]iod t is #ab to #bd mon?s   
aft] ! completion ( ! tra9+ ( su*       
resid5t4  7#c7 #ej p]c5t ( income       
receiv$ %all apply = ! p]iod t is #bd to
 #cf mon?s aft] ! completion ( ! tra9+ (
 su* resid5t4  7#d7 #ajj p]c5t ( income 
receiv$ %all apply = any p]iod t beg9s  
aft] #cf mon?s aft] ! completion ( !    
tra9+ ( su* resid5t4  4