,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #cbj  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #h1 #bjai,ms4 
,lee ( ,cali=nia introduc$ ! foll[+     
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,a ,,bill  ,to exp& &
 enhance exi/+ adult day programs =     
y\ng] p ) neurological diseases or      
conditions 7su* z multiple scl]osis1    
,p>k9son's disease1 traumatic bra9      
injury1 or o!r simil> diseases or       
conditions7 to support & improve access 
to respite s]vices = family c>egiv]s :o 
are tak+ c>e ( su* p1 & = o!r purposes4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,adult ,day ,c5t] ,enhancem5t ,act4   
#b4 ,f9d+s ,! ,congress f9ds ! foll[+3  
7#a7 ,"o 9 #f p 9 ! ,unit$ ,/ates lives 
) a neurological disease or condition t 
c (t5 result 9 disability1 & :i* may    
require ! individual to seek assi/ance 9
 c>ry+ out ! activities ( daily liv+4   
,neurological diseases or conditions su*
 z multiple scl]osis 7,,ms71 e>ly-onset 
,p>k9son's disease1 & traumatic bra9    

injury 7,,tbi7 c also typically affect  
y\ng] adults 9 ! middle ( _! lives4     
7#b7 ,multiple scl]osis is a *ronic1 (t5
 disabl+ disease t attacks ! c5tral     
n]v\s sy/em ) symptoms rang+ f numbness 
9 limbs to p>alysis & loss ( vision4    
,mo/ p ) ,,ms are diagnos$ betwe5 ! ages
 ( #bj & #ej ye>s ( age4 ,,ms is a lead+
 cause ( disability 9 "y adults4 ,p]sons
 liv+ ) ,,ms :o exp]i5ce m sev]e =ms ( !
 disease are likely to require ei!r home
 c>e or nurs+ home placem5t1 ?\gh ! va/ 
majority w\ld pref] to rema9 at home to 
receive ! c>e !y ne$4 ,:]e home c>e is  
conc]n$1 approximately #hj p]c5t ( su*  
c>e is provid$ by unpaid c>egiv]s :o are
 g5]ally family memb]s4  7#c7 ,p>k9son's
 disease is a *ronic1 progressive       
neurological disease4 ,! f\r prim>y     
symptoms ( ,p>k9son's disease are       
tremor1 or trembl+ 9 h&s1 arms1 legs1   
jaw1 & face2 rigidity1 or /iffness ( !  
limbs & trunk2 bradyk9esia1 or sl[ness (
 movem5t2 & po/ural in/ability1 or      
impair$ balance & coord9ation4 ,o!r     

symptoms may include cognitive *anges2  
difficulty 9 swall[+1 *ew+1 & speak+2   
ur9>y problems or con/ipation2 sk9      
problems2 & sleep disruptions4 ,z ^!    
symptoms become m pron\nc$1 pati5ts may 
h difficulty walk+1 talk+1 or complet+  
o!r simple tasks4 ,x is e/imat$ t ne>ly 
#a1jjj1jjjj1jjj ,am]icans w be liv+ )   
,p>k9son's by #bjbj & ( ^? #e to #aj    
p]c5t are diagnos$ y\ng] ?an #ej & deem$
 e>ly-onset4  7#d7 ,traumatic bra9      
injury is a neurological condition t    
typically results f a bl[ or jolt to !  
head or a p5etrat+ head injury & t c    
impact "o or m p>ts ( ! bra91 !reby     
tempor>ily or p]man5tly disrupt+ normal 
bra9 function4 ,! ,c5t]s = ,disease     
,control & ,prev5tion e/imates t #aec   
,am]icans die f ,,tbi e day1 & t ,t,b,is
 contribute to approximately #cj p]c5t (
 all injury dea?s4 ,traumatic bra9      
injury is also a s]i\s issue t affects  
milit>y s]vicememb]s4 ,e/imates 9 prior 
milit>y conflicts indicate t ,,tbi 0    
pres5t 9 #ad-bj p]c5t ( surviv+         

casualties4  7#e7 ,family c>egiv]s are a
 crucial s\rce ( support & assi/ance =  
individuals suff]+ ) disabilities4      
,family c>egiv]s1 ! majority ( :om are  
wom51 provide an e/imat$                
#dgj1jjj1jjj1jjj 9 free s]vices         
annually4 ,! supply ( family c>egiv]s is
 unlikely to keep pace ) future dem&4 ,!
 c>egiv] support ratio ( pot5tial       
c>egiv]s ag$ #de to #fd = ea* p]son ag$ 
#hj & old]1 = in/ance1 is #g to #a 9    
#bjaj1 #d to #a 9 #bjcj1 & #c to #a 9   
#bjej4  7#f7 ,! majority ( family       
c>egiv]s 7or #ec p]c5t7 are c>+ =       
someone ages #ah to #gd4 ,=ty-sev5 p]c5t
 ( family c>egiv]s are c>+ = someone #ge
 or old]4  7#g7 ,adult day programs c   
(f] s]vices1 includ+ m$ical c>e1        
rehabilitation !rapies1 dignifi$        
assi/ance ) ! activities ( daily liv+1  
nutrition !rapy1 heal? monitor+1 social 
int]action1 /imulat+ activities1 &      
transportation to s5iors1 p )           
disabilities1 & y\ng] adults ) *ronic   
diseases4  7#h7 ,adult day programs ge>$

 t[>d p liv+ ) neurological diseases or 
conditions su* z ,,ms1 ,p>k9son's       
disease1 ,,tbi1 or o!r simil> diseases  
or conditions provide an important      
response to ! ne$s ( p liv+ ) ^!        
conditions & _! family c>egiv]s4 ,adult 
day programs c help to ameliorate       
symptoms1 r$uce dep5d5cy1 provide       
important socialization opportunities1 &
 ma9ta9 quality ( life4  7#i7 ,adult day
 programs h be5 %[n to provide a range (
 docum5t$ b5efits includ+ improvem5ts 9 
functional /atus1 social support1 &     
r$uctions 9 fatigue1 depression & pa94  
,adult day programs also r$uce ongo+    
m$ical c>e & hospital co/s & decrease   
admissions to nurs+ home facilities1 :i*
 c be co/ly = _m families1 by all[+     
individuals to receive heal? & social   
s]vices :ile cont9u+ to live at home4   
7#aj7 ,!re are curr5tly few adult day   
programs focus$ on y\ng] adult          
populations 9 ! ,unit$ ,/ates4 ,al?\gh  
"y p liv+ ) neurological diseases or    
conditions may be able to access exi/+  

adult day programs1 su* programs are n  
typically int5d$ = y\ng] adults liv+ )  
*ronic diseases or conditions1 & may n  
provide ! appropriate s]vices to meet ! 
age-relat$ or disability /atus ( ^!     
individuals4  #c4 ,e/abli%m5t ( adult   
day programs  7a7 ,survey ( exi/+ adult 
day programs  7#a7 ,9 g5]al ,n lat] ?an 
#ij days aft] ! date ( ! enactm5t ( ?is 
section1 ! ,assi/ant ,secret>y = ,ag+   
%all initiate a compreh5sive survey (   
curr5t adult day programs t provide c>e 
& support to individuals includ+ "y     
adults liv+ ) neurological diseases or  
conditions su* z multiple scl]osis1     
,p>k9son's disease1 traumatic bra9      
injury1 or any simil> disease or        
condition4  7#b7 ,survey elem5ts ,9     
c>ry+ out ! survey "u p>agraph 7#a71 !  
,assi/ant ,secret>y = ,ag+ may utilize  
exi/+ publicly available rese>* on adult
 day programs1 & %all--  7,a7 id5tify   
ongo+ successful adult day programs1    
includ+ by provid+ a brief description (
 h[ su* programs 7 initially e/abli%$ & 

fund$2  7,b7 id5tify :i* adult day      
programs are s]v+ "y adults liv+ )      
neurological diseases or conditions2    
7,c7 develop a set ( be/ practices to   
help guide ! e/abli%m5t & replication ( 
additional successful adult day         
programs1 includ+--  7i7 program        
guidel9es2  7ii7 recomm5dations on !    
scope ( s]vices t %\ld be provid$ to    
individuals ) neurological diseases or  
conditions includ+ "y adults 7:i* may   
include rehabilitation !rapy1           
psy*osocial support1 social /imulation &
 int]action1 & spiritual1 educational1  
or o!r su* s]vices72 &  7iii7 p]=mance  
goals & indicators to measure & analyze 
! outcomes g5]at$ by ! s]vices provid$ &
 to evaluate ! ov]all success ( !       
program2 &  7,d7 evaluate ! ext5t to :i*
 ! ,adm9i/ration = ,community ,liv+     
supports adult day programs1 ei!r       
directly or indirectly1 ?r\gh curr5t    
,f$]al grant programs4  7#c7 ,report ,n 
lat] ?an #ahj days aft] initiat+ !      
survey "u p>agraph 7#a71 ! ,assi/ant    

,secret>y = ,ag+ %all produce & make    
publicly available a summ>y report on ! 
results ( ! survey4 ,su* report %all    
include ea* ( ! elem5ts describ$ 9      
p>agraph 7#b74  7b7 ,e/abli%m5t ( grant 
program  7#a7 ,9 g5]al ,n lat] ?an #ij  
days aft] produc+ ! report requir$ by   
subsection 7a77#c71 ! ,assi/ant         
,secret>y = ,ag+ %all e/abli% )9 !      
,adm9i/ration = ,community ,liv+ a      
competitive grant program = aw>d+ grants
 annually to eligible entities1 bas$ on 
! be/ practices develop$ "u subsection  
7a71 to fund adult day programs s]v+    
y\ng] p ) neurological diseases or      
conditions4  7#b7 ,eligible entities ,9 
ord] to be eligible = a grant "u ?is    
subsection1 an entity %all demon/rate ! 
foll[+3  7,a7 ,und]/&+ ( ! special ne$s 
( y\ng] p liv+ ) neurological diseases  
or conditions su* z multiple scl]osis1  
,p>k9son's disease1 traumatic bra9      
injury1 or o!r simil> diseases or       
conditions1 includ+ _! functional       
abilities & ! pot5tial complications    

across all types ( cases & /ages ( su*  
diseases or conditions4  7,b7 ,und]/&+ (
 ! issues exp]i5c$ by family c>egiv]s :o
 assi/ a family memb] ) neurological    
diseases or conditions su* z multiple   
scl]osis1 ,p>k9son's disease1 traumatic 
bra9 injury1 or o!r simil> diseases or  
conditions4  7,c7 ,a capacity to provide
 ! s]vices recomm5d$ by ! be/ practices 
develop$ "u subsection 7a74  7#c7       
,additional selection requirem5t ,!     
,assi/ant ,secret>y = ,ag+ %all n aw>d a
 grant to an entity "u ?is subsection if
 ! am\nt ( ! aw>d w\ld con/itute m ?an  
#dj p]c5t ( ! op]at+ budget ( ! entity 9
 ! fiscal ye> = :i* funds = ! grant are 
au?oriz$ to be exp5d$4 ,= purposes ( ?is
 subsection1 ! fair m>ket value ( annual
 9-k9d contributions ( equipm5t or      
s]vices %all be consid]$ z "p ( ! op]at+
 budget ( ! entity4  7#d7 ,selection (  
grant recipi5ts ,n lat] ?an #ij days    
aft] e/abli%+ ! grant program "u ?is    
subsection1 ! ,assi/ant ,secret>y = ,ag+
 %all aw>d ! fir/ annual s]ies ( grants 

"u ! program4 ,9 aw>d+ grants "u ?is    
subsection1 ! ,assi/ant ,secret>y %\ld  
ensure1 to ! ext5t practicable1 a div]se
 geographic repres5tation among grant   
recipi5ts & t1 subject to ! availability
 ( appropriations--  7,a7 a m9imum ( #e 
entities are select$ z grant recipi5ts =
 ! fir/ fiscal ye> = :i* su* grants are 
aw>d$2  7,b7 a m9imum ( #aj entities are
 select$ z grant recipi5ts = ! second   
su* fiscal ye>2  7,c7 a m9imum ( #ab    
entities are select$ z grant recipi5ts =
 ! ?ird su* fiscal ye>2 &  7,d7 a m9imum
 ( #ae entities are select$ z grant     
recipi5ts = ! f\r? su* fiscal ye>4  7#e7
 ,report ,no lat] ?an #a ye> aft] !     
initial aw>d ( grants "u ?is subsection1
 & annually !reaft]1 ! ,assi/ant        
,secret>y = ,ag+ %all produce & make    
publicly available a brief summ>y report
 on ! grant program "u ?is section4 ,ea*
 su* report %all include ! foll[+3  7,a7
 ,a description ( ! adult day programs  
receiv+ fund+ "u ?is section1 includ+ ! 
am\nt ( ,f$]al fund+ aw>d$ & ! expect$  

outcomes ( ea* program4  7,b7 ,a        
description ( p]=mance goals &          
indicators to monitor ! progress ( grant
 recipi5ts 9-- 7i7 respond+ to ! ne$s ( 
y\ng] individuals liv+ ) neurological   
diseases or conditions su* z multiple   
scl]osis1 ,p>k9son's disease1 traumatic 
bra9 injury1 or o!r simil> diseases or  
conditions2 &  7ii7 assi/+ ! family     
c>egiv]s ( su* individuals4  7,c7 ,any  
plans = improv+ ov]sight & managem5t ( !
 grant program4  7c7 ,def9itions ,9 ?is 
,act3 7#a7 ,! t]m adult day program     
means a program t provides compreh5sive 
& effective c>e & support s]vices to    
individuals liv+ ) neurological diseases
 or conditions su* z multiple scl]osis1 
,p>k9son's disease1 traumatic bra9      
injury1 or o!r simil> diseases or       
conditions t may result 9 a functional  
or deg5]ative disability & to _! family 
c>egiv]s & t may assi/ p>ticipants 9    
ways t--  7,a7 ma9ta9 or improve _!     
functional abilities1 or o!rwise help !m
 adju/ to _! *ang+ functional abilities2

  7,b7 prev5t ! onset ( complications   
associat$ ) sev]e =ms ( ! disease or    
condition2  7,c7 promote alt]natives to 
placem5t 9 nurs+ homes2  7,d7 r$uce !   
/ra9 on family c>egiv]s tak+ c>e ( a    
family memb] liv+ ) su* diseases or     
conditions2  7,e7 focus on support+ !   
emotional1 social1 & intellectual ne$s (
 a y\ng] adult population2 or  7,f7     
address ! ne$s ( vet]ans liv+ ) su*     
diseases or conditions4  7#b7 ,! t]m    
family c>egiv] means a family memb] or  
fo/] p>5t :o provides unpaid assi/ance  
7:i* may include 9-home monitor+1       
managem5t1 sup]vision1 c>e & treatm5t1  
or o!r simil> assi/ance7 to ano!r adult 
family memb] ) a special ne$4  7d7      
,au?orization ( appropriations ,to c>ry 
out ?is section1 9 addition to am\nts   
o!rwise made available = su* purpose1   
!re are au?oriz$ to be appropriat$1 & to
 rema9 available until exp5d$1 ! foll[+3
  7#a7 #a1jjj1jjj = fiscal ye> #bjai4   
7#b7 #c1jjj1jjj = fiscal ye> #bjbj4     
7#c7 #f1jjj1jjj = fiscal ye> #bjba4     

7#d7 #h1jjj1jjj = fiscal ye> #bjbb4     
7#e7 #aj1jjj1jjj = fiscal ye> #bjbc4