,i #aaith ,,congress #ast ,session ,h4 ,r4 #cjjj ,,in ,,the ,,house ,,of ,,representatives ,april #bd1 #bjbe,mr4 ,fitzpatrick 7for himself and ,mrs4 ,trahan7 introduced the following bill2 which was referred to the ,committee on ,education and ,workforce1 and in addition to the ,committee on ,energy and ,commerce1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to address the worsening long-term care workforce crisis and increase access to and affordability of long-term care4 #a4 ,short title ,this ,act may be cited as the ,caring for ,seniors ,act4 #b4 ,findings ,congress finds the following3 7#a7 ,the ,united ,states population is aging more rapidly than ever before1 with #aj1jjj ,americans turning #fe each day4 ,in #bjcd1 for the first time1 the ,nation will have more people over the age of #fe than under the age of #ah4 ,the population experiencing the fastest growth are persons #he and older1 which is projected to grow #aih percent by #bjfj4 7#b7 ,the ,department of ,health and ,human ,services estimates that #gj percent of ,americans over the age of #fe will require some form of long-term care in their lifetime4 ,by #bjej1 the number of ,americans requiring paid long-term care services will triple from #h1cjj1jjj to #bg1jjj1jjj4 7#c7 ,according to #bjbj ,census data1 more than #dj percent of baby boomers do not have any retirement savings1 let alone savings for their long-term care needs4 ,a recent report by the ,national ,council on ,aging found that up to #hj percent of older adults would be unable to afford #d years in an assisted living community or more than #b years of nursing home care4 ,put another way1 #dg1jjj1jjj ,americans aged #fj or above do not have the financial resources to cover the future care they may need4 7#d7 ,caring for ,america's aging seniors will be the single most expense domestic priority and is projected to deplete ,federal and ,state ,medicaid budgets4 ,the ,united ,states spent over #djj1jjj1jjj1jjj on long-term care in #bjbj1 nearly #aj percent of all national health care spending4 7#e7 ,according to the ,congressional ,research ,service1 ,state and ,federal programs account for #ga4d percent of all long-term care spending nationwide in #bjba4 ,medicaid and ,medicare are1 respectively1 the first and second-largest public payers1 accounting for a combined #fd4a percent of all spending4 ,medicaid is by far the largest single funding source for long-term care1 spending approximately #ace1hjj1jjj1jjj in #bjbj1 a figure that is projected to reach #dff1jjj1jjj1jjj by #bjej4 7#f7 ,a #bjbc report by ,,aarp1 indicates that at least #i percent of seniors in skilled nursing homes nationwide have low-acuity levels that do not warrant high skilled care1 but are forced into a skilled nursing home where assets can be depleted1 and ,medicaid can become the primary payer4 ,the report by ,,aarp indicated that this number is #bj percent in #e ,states4 7#g7 ,in #bjba1 the ,department of ,veterans ,affairs testified to ,congress that if veterans in need of long-term care services could choose assisted living instead of a nursing home1 #fi1aja per veteran per year would be saved by the ,department of ,veterans ,affairs4 7#h7 ,strengthening cost-effective models of long-term care services1 providing incentives for ,americans to better afford their care costs1 and developing the workforce needed to care for the ,nation's aging population will reduce ,federal and ,state ,medicaid spending4 7#i7 ,congregate care models of long-term care services1 such as assisted living1 are half the cost of nursing homes1 and less than a third of round the clock home health aides4 7#aj7 ,assisted living provides #bd_/g personal care1 chronic disease management1 nutrition1 room and board1 and socialization4 ,if assisted living were not an option1 as many as #fa percent of senior residents may be forced into far-costlier skilled nursing facilities at a cost of #dc1djj1jjj1jjj per year4 7#aa7 ,the senior living industry lost approximately #djj1jjj jobs between #bjbj and #bjbb1 leaving the workforce far below prepandemic employment levels4 ,in order to care for the ,united ,states aging population1 the senior care industry will need to fill more than #bj1bjj1jjj jobs by #bjdj4 #c4 ,addressing the long-term care workforce crisis 7a7 ,workforce programs 7#a7 ,expansion of ,,dol workforce programs ,the ,secretary of ,labor1 acting jointly through the ,assistant ,secretary for ,employment and ,training and the ,national ,director for the ,office of ,job ,corps of the ,employment and ,training ,administration1 shall establish new and expand existing education and training grant programs to support the expansion of the direct care workforce for purposes of caring for a rapidly aging population and providing home and community-based services to older adults and people with disabilities4 ,such programs shall include support for core certification and training requirements for the direct care workforce of assisted living facilities4 7#b7 ,expansion of ,,hrsa workforce programs ,the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall establish new and expand existing workforce education and training grant programs to address shortages in the direct care workforce serving the rapidly aging population and providing home and community-based services to older adults and people with disabilities4 ,such programs shall include support for core certification and training requirements for the direct care workforce of assisted living facilities4 7b7 ,definitions ,in this section3 7#a7 ,assisted living facility ,the term assisted living facility means any licensed1 registered1 certified1 listed1 or ,state-regulated residence1 managed residential community1 building1 or part of a building that provides1 or contracts to provide1 housing with supportive services on a continuing basis to individuals who-- 7,a7 are elderly or have a mental health1 developmental1 or physical disability2 and 7,b7 are unrelated by blood or marriage to the owner or operator of the residence1 community1 building1 or part of a building1 if the owner or operator is an individual4 7#b7 ,direct care workforce ,the term direct care workforce means a workforce that is composed of individuals who1 in exchange for compensation1 provide services at an assisted living facility to an individual who is elderly or who has a mental health1 developmental1 or physical disability1 that promote such individual's independence1 including-- 7,a7 services that enhance independence and community inclusion for such individual1 including traveling with such individual1 attending and assisting such individual while visiting friends and family1 shopping1 or socializing2 7,b7 services such as coaching and supporting such individual in communicating needs1 achieving self-expression1 pursuing personal goals1 living independently1 and participating actively in employment or voluntary roles in the community2 7,c7 services such as providing assistance with activities of daily living 7such as feeding1 bathing1 toileting1 and ambulation7 and with tasks such as meal preparation1 shopping1 light housekeeping1 and laundry2 or 7,d7 services that support such individual at home1 work1 school1 or any other community setting4 #d4 ,senior ,care ,cost ,reduction ,program ,part ,a of title ,,iii of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjba et seq47 is amended by adding at the end the following3 #cag4 ,senior ,care ,cost ,reduction ,program 7a7 ,establishment of program ,the ,assistant ,secretary1 acting through the ,administration1 shall establish a ,senior ,care ,cost ,reduction ,program for making allotments to ,states to administer monthly cost reduction amounts to assist low-income seniors to reside and receive services in assisted living facilities located in the ,state as an alternative to more costly institutional care4 7b7 ,state application ,in order to be eligible to receive an allotment under this section1 the ,state shall submit an application to the ,assistant ,secretary at such time1 in such manner1 and accompanied by such information as the ,assistant ,secretary may reasonably require4 7c7 ,cost reduction amount 7#a7 ,initial amount ,upon establishment of the ,program1 the monthly amount provided by the ,state to eligible recipients shall be #a1jjj4 7#b7 ,adjustments in consumer price index ,beginning one year after the establishment of the ,program1 and each subsequent year1 the monthly amount required under paragraph 7#a7 shall be increased by the percentage1 if any1 by which the ,consumer ,price ,index for all urban consumers 7all items2 ,united ,states city average7 for the most recent calendar year exceeds the ,consumer ,price ,index for the previous calendar year1 rounded to the nearest dollar4 7d7 ,eligibility ,in order to be eligible for a cost reduction amount under this section1 the individual must-- 7#a7 submit an application to and be approved by the relevant ,state agency tasked with administering the ,program2 7#b7 be at least #gj years old as of the date of application2 7#c7 be accepted for admission as a resident in1 or currently reside in1 an assisted living facility which has been approved by the relevant ,state agency to participate in this ,program2 7#d7 be either a chronically ill individual 7as defined in section #ggjb;,b7c77#b7 of the ,internal ,revenue ,code of #aihf7 or eligible to receive long-term services and supports under the relevant ,state's ,medicaid program2 and 7#e7 be determined to be financially eligible1 pursuant to subsection 7e74 7e7 ,financial eligibility ,an individual is financially eligible under this section only if the individual's-- 7#a7 net monthly income is less than the approved monthly fees for the services provided at the assisted living facility2 7#b7 net annual income is not higher than #fj percent of the median income for the ,state in which the individual resides1 as determined by the ,secretary of ,housing and ,urban ,development2 and 7#c7 resources are not greater than #ai1jjj if single1 or #be1jjj if married4 7f7 ,implementation ,the ,secretary1 acting through the ,assistant ,secretary1 may issue such regulations as may be necessary to carry out this section4 7g7 ,assisted living facility defined ,as used in this section1 the term assisted living facility means any licensed1 registered1 certified1 listed1 or ,state-regulated residence1 managed residential community1 building1 or part of a building that provides1 or contracts to provide1 housing with supportive services on a continuing basis to individuals who-- 7#a7 are elderly or have a mental health1 developmental1 or physical disability2 and 7#b7 are unrelated by blood or marriage to the owner or operator of the residence1 community1 building1 or part of a building1 if the owner or operator is an individual4 4 #e4 ,authorization of appropriations ,amounts that have been returned to or recovered by the ,health ,resources and ,services ,administration or the ,department of the ,treasury1 including all amounts returned or recovered after the date of enactment of this ,act1 from amounts made available and disbursed to eligible health care providers for health care-related expenses or lost revenues attributable to coronavirus under the heading ,public ,health and ,social ,services ,emergency ,fund in title ,,viii of division ,b of ,public ,law #aaf-acf1 title ,i of division ,b of ,public ,law #aaf-aci1 and title ,,iii of division ,m of ,public ,law #aaf-bfj1 are authorized to be appropriated to carry out this ,act and the amendment made by this ,act4