,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #cjjj  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,april #bd1 #bjbe,mr4 
,fitzpatrick 7= himself & ,mrs4 ,trahan7
 introduc$ ! foll[+ bill2 :i* 0 ref]r$  
to ! ,committee on ,education &         
,work=ce1 & 9 addition to ! ,committee  
on ,en]gy & ,comm]ce1 = a p]iod to be   
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to address ! wors5+
 long-t]m c>e work=ce crisis & increase 
access to & af=dability ( long-t]m c>e4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,c>+ = ,s5iors ,act4  #b4 ,f9d+s      
,congress f9ds ! foll[+3 7#a7 ,! ,unit$ 
,/ates population is ag+ m rapidly ?an  
ev] be=e1 ) #aj1jjj ,am]icans turn+ #fe 
ea* day4 ,9 #bjcd1 = ! fir/ "t1 !       
,nation w h m p ov] ! age ( #fe ?an "u !
 age ( #ah4 ,! population exp]i5c+ !    
fa/e/ gr[? are p]sons #he & old]1 :i* is
 project$ to gr[ #aih p]c5t by #bjfj4   
7#b7 ,! ,dep>tm5t ( ,heal? & ,human     

,s]vices e/imates t #gj p]c5t (         
,am]icans ov] ! age ( #fe w require "s  
=m ( long-t]m c>e 9 _! lifetime4 ,by    
#bjej1 ! numb] ( ,am]icans requir+ paid 
long-t]m c>e s]vices w triple f         
#h1cjj1jjj to #bg1jjj1jjj4  7#c7        
,accord+ to #bjbj ,c5sus data1 m ?an #dj
 p]c5t ( baby boom]s d n h any retirem5t
 sav+s1 let alone sav+s = _! long-t]m   
c>e ne$s4 ,a rec5t report by ! ,national
 ,c\ncil on ,ag+ f\nd t up to #hj p]c5t 
( old] adults w\ld be unable to af=d #d 
ye>s 9 an assi/$ liv+ community or m ?an
 #b ye>s ( nurs+ home c>e4 ,put ano!r   
way1 #dg1jjj1jjj ,am]icans ag$ #fj or   
above d n h ! f9ancial res\rces to cov] 
! future c>e !y may ne$4  7#d7 ,c>+ =   
,am]ica's ag+ s5iors w be ! s+le mo/    
exp5se dome/ic priority & is project$ to
 deplete ,f$]al & ,/ate ,m$icaid        
budgets4 ,! ,unit$ ,/ates sp5t ov]      
#djj1jjj1jjj1jjj on long-t]m c>e 9      
#bjbj1 ne>ly #aj p]c5t ( all national   
heal? c>e sp5d+4  7#e7 ,accord+ to !    
,congressional ,rese>* ,s]vice1 ,/ate & 

,f$]al programs acc\nt = #ga4d p]c5t (  
all long-t]m c>e sp5d+ nationwide 9     
#bjba4 ,m$icaid & ,m$ic>e are1          
respectively1 ! fir/ & second-l>ge/     
public pay]s1 acc\nt+ = a comb9$ #fd4a  
p]c5t ( all sp5d+4 ,m$icaid is by f> !  
l>ge/ s+le fund+ s\rce = long-t]m c>e1  
sp5d+ approximately #ace1hjj1jjj1jjj 9  
#bjbj1 a figure t is project$ to rea*   
#dff1jjj1jjj1jjj by #bjej4  7#f7 ,a     
#bjbc report by ,,a>p1 indicates t at   
lea/ #i p]c5t ( s5iors 9 skill$ nurs+   
homes nationwide h l[-acuity levels t d 
n w>rant high skill$ c>e1 b are =c$ into
 a skill$ nurs+ home :]e assets c be    
deplet$1 & ,m$icaid c become ! prim>y   
pay]4 ,! report by ,,a>p indicat$ t ?is 
numb] is #bj p]c5t 9 #e ,/ates4  7#g7 ,9
 #bjba1 ! ,dep>tm5t ( ,vet]ans ,affairs 
te/ifi$ to ,congress t if vet]ans 9 ne$ 
( long-t]m c>e s]vices c\ld *oose assi/$
 liv+ in/ead ( a nurs+ home1 #fi1aja p] 
vet]an p] ye> w\ld be sav$ by !         
,dep>tm5t ( ,vet]ans ,affairs4  7#h7    
,/r5g!n+ co/-effective models ( long-t]m

 c>e s]vices1 provid+ inc5tives =       
,am]icans to bett] af=d _! c>e co/s1 &  
develop+ ! work=ce ne$$ to c>e = !      
,nation's ag+ population w r$uce ,f$]al 
& ,/ate ,m$icaid sp5d+4  7#i7           
,congregate c>e models ( long-t]m c>e   
s]vices1 su* z assi/$ liv+1 are half !  
co/ ( nurs+ homes1 & less ?an a ?ird (  
r\nd ! clock home heal? aides4  7#aj7   
,assi/$ liv+ provides #bd_/g p]sonal    
c>e1 *ronic disease managem5t1          
nutrition1 room & bo>d1 & socialization4
 ,if assi/$ liv+ 7 n an option1 z _m z  
#fa p]c5t ( s5ior resid5ts may be =c$   
into f>-co/li] skill$ nurs+ facilities  
at a co/ ( #dc1djj1jjj1jjj p] ye>4      
7#aa7 ,! s5ior liv+ indu/ry lo/         
approximately #djj1jjj jobs betwe5 #bjbj
 & #bjbb1 leav+ ! work=ce f> bel[       
prep&emic employm5t levels4 ,9 ord] to  
c>e = ! ,unit$ ,/ates ag+ population1 ! 
s5ior c>e indu/ry w ne$ to fill m ?an   
#bj1bjj1jjj jobs by #bjdj4  #c4         
,address+ ! long-t]m c>e work=ce crisis 
7a7 ,work=ce programs  7#a7 ,expansion (

 ,,dol work=ce programs ,! ,secret>y (  
,labor1 act+ jo9tly ?r\gh ! ,assi/ant   
,secret>y = ,employm5t & ,tra9+ & !     
,national ,director = ! ,(fice ( ,job   
,corps ( ! ,employm5t & ,tra9+          
,adm9i/ration1 %all e/abli% new & exp&  
exi/+ education & tra9+ grant programs  
to support ! expansion ( ! direct c>e   
work=ce = purposes ( c>+ = a rapidly ag+
 population & provid+ home &            
community-bas$ s]vices to old] adults & 
p ) disabilities4 ,su* programs %all    
include support = core c]tification &   
tra9+ requirem5ts = ! direct c>e work=ce
 ( assi/$ liv+ facilities4  7#b7        
,expansion ( ,,hrsa work=ce programs ,! 
,secret>y ( ,heal? & ,human ,s]vices1   
act+ ?r\gh ! ,adm9i/rator ( ! ,heal?    
,res\rces & ,s]vices ,adm9i/ration1 %all
 e/abli% new & exp& exi/+ work=ce       
education & tra9+ grant programs to     
address %ortages 9 ! direct c>e work=ce 
s]v+ ! rapidly ag+ population & provid+ 
home & community-bas$ s]vices to old]   
adults & p ) disabilities4 ,su* programs

 %all include support = core            
c]tification & tra9+ requirem5ts = !    
direct c>e work=ce ( assi/$ liv+        
facilities4  7b7 ,def9itions ,9 ?is     
section3 7#a7 ,assi/$ liv+ facility ,!  
t]m assi/$ liv+ facility means any      
lic5s$1 regi/]$1 c]tifi$1 li/$1 or      
,/ate-regulat$ resid5ce1 manag$         
resid5tial community1 build+1 or "p ( a 
build+ t provides1 or contracts to      
provide1 h\s+ ) supportive s]vices on a 
cont9u+ basis to individuals :o-- 7,a7  
are eld]ly or h a m5tal heal?1          
developm5tal1 or physical disability2 & 
7,b7 are unrelat$ by blood or m>riage to
 ! own] or op]ator ( ! resid5ce1        
community1 build+1 or "p ( a build+1 if 
! own] or op]ator is an individual4     
7#b7 ,direct c>e work=ce ,! t]m direct  
c>e work=ce means a work=ce t is compos$
 ( individuals :o1 9 ex*ange =          
comp5sation1 provide s]vices at an      
assi/$ liv+ facility to an individual :o
 is eld]ly or :o has a m5tal heal?1     
developm5tal1 or physical disability1 t 

promote su* individual's indep5d5ce1    
includ+-- 7,a7 s]vices t enhance        
indep5d5ce & community inclusion = su*  
individual1 includ+ travel+ ) su*       
individual1 att5d+ & assi/+ su*         
individual :ile visit+ fri5ds & family1 
%opp+1 or socializ+2  7,b7 s]vices su* z
 coa*+ & support+ su* individual 9      
communicat+ ne$s1 a*iev+                
self-expression1 pursu+ p]sonal goals1  
liv+ indep5d5tly1 & p>ticipat+ actively 
9 employm5t or volunt>y roles 9 !       
community2  7,c7 s]vices su* z provid+  
assi/ance ) activities ( daily liv+ 7su*
 z fe$+1 ba?+1 toilet+1 & ambulation7 & 
) tasks su* z meal prep>ation1 %opp+1   
light h\sekeep+1 & laundry2 or  7,d7    
s]vices t support su* individual at     
home1 "w1 s*ool1 or any o!r community   
sett+4  #d4 ,s5ior ,c>e ,co/ ,r$uction  
,program ,"p ,a ( title ,,iii ( ! ,old] 
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjba et seq47 is am5d$ by add+ at ! end
 ! foll[+3  #cag4 ,s5ior ,c>e ,co/      
,r$uction ,program  7a7 ,e/abli%m5t (   

program ,! ,assi/ant ,secret>y1 act+    
?r\gh ! ,adm9i/ration1 %all e/abli% a   
,s5ior ,c>e ,co/ ,r$uction ,program =   
mak+ allotm5ts to ,/ates to adm9i/]     
mon?ly co/ r$uction am\nts to assi/     
l[-income s5iors to reside & receive    
s]vices 9 assi/$ liv+ facilities locat$ 
9 ! ,/ate z an alt]native to m co/ly    
in/itutional c>e4  7b7 ,/ate application
 ,9 ord] to be eligible to receive an   
allotm5t "u ?is section1 ! ,/ate %all   
submit an application to ! ,assi/ant    
,secret>y at su* "t1 9 su* mann]1 &     
accompani$ by su* in=mation z !         
,assi/ant ,secret>y may reasonably      
require4  7c7 ,co/ r$uction am\nt  7#a7 
,initial am\nt ,^u e/abli%m5t ( !       
,program1 ! mon?ly am\nt provid$ by !   
,/ate to eligible recipi5ts %all be     
#a1jjj4  7#b7 ,adju/m5ts 9 consum] price
 index ,beg9n+ "o ye> aft] ! e/abli%m5t 
( ! ,program1 & ea* subsequ5t ye>1 !    
mon?ly am\nt requir$ "u p>agraph 7#a7   
%all be increas$ by ! p]c5tage1 if any1 
by :i* ! ,consum] ,price ,index = all   

urban consum]s 7all items2 ,unit$ ,/ates
 city av]age7 = ! mo/ rec5t cal5d> ye>  
exce$s ! ,consum] ,price ,index = !     
previ\s cal5d> ye>1 r\nd$ to ! ne>e/    
doll>4  7d7 ,eligibility ,9 ord] to be  
eligible = a co/ r$uction am\nt "u ?is  
section1 ! individual mu/-- 7#a7 submit 
an application to & be approv$ by !     
relevant ,/ate ag5cy task$ ) adm9i/]+ ! 
,program2  7#b7 be at lea/ #gj ye>s old 
z ( ! date ( application2  7#c7 be      
accept$ = admission z a resid5t 91 or   
curr5tly reside 91 an assi/$ liv+       
facility :i* has be5 approv$ by !       
relevant ,/ate ag5cy to p>ticipate 9 ?is
 ,program2  7#d7 be ei!r a *ronically   
ill individual 7z def9$ 9 section       
#ggjb;,b7c77#b7 ( ! ,int]nal ,rev5ue    
,code ( #aihf7 or eligible to receive   
long-t]m s]vices & supports "u !        
relevant ,/ate's ,m$icaid program2 &    
7#e7 be det]m9$ to be f9ancially        
eligible1 pursuant to subsection 7e74   
7e7 ,f9ancial eligibility ,an individual
 is f9ancially eligible "u ?is section  

only if ! individual's-- 7#a7 net mon?ly
 income is less ?an ! approv$ mon?ly    
fees = ! s]vices provid$ at ! assi/$    
liv+ facility2  7#b7 net annual income  
is n high] ?an #fj p]c5t ( ! m$ian      
income = ! ,/ate 9 :i* ! individual     
resides1 z det]m9$ by ! ,secret>y (     
,h\s+ & ,urban ,developm5t2 &  7#c7     
res\rces are n great] ?an #ai1jjj if    
s+le1 or #be1jjj if m>ri$4  7f7         
,implem5tation ,! ,secret>y1 act+ ?r\gh 
! ,assi/ant ,secret>y1 may issue su*    
regulations z may be necess>y to c>ry   
out ?is section4  7g7 ,assi/$ liv+      
facility def9$ ,z us$ 9 ?is section1 !  
t]m assi/$ liv+ facility means any      
lic5s$1 regi/]$1 c]tifi$1 li/$1 or      
,/ate-regulat$ resid5ce1 manag$         
resid5tial community1 build+1 or "p ( a 
build+ t provides1 or contracts to      
provide1 h\s+ ) supportive s]vices on a 
cont9u+ basis to individuals :o-- 7#a7  
are eld]ly or h a m5tal heal?1          
developm5tal1 or physical disability2 & 
7#b7 are unrelat$ by blood or m>riage to

 ! own] or op]ator ( ! resid5ce1        
community1 build+1 or "p ( a build+1 if 
! own] or op]ator is an individual4  4  
#e4 ,au?orization ( appropriations      
,am\nts t h be5 return$ to or recov]$ by
 ! ,heal? ,res\rces & ,s]vices          
,adm9i/ration or ! ,dep>tm5t ( !        
,treasury1 includ+ all am\nts return$ or
 recov]$ aft] ! date ( enactm5t ( ?is   
,act1 f am\nts made available & disburs$
 to eligible heal? c>e provid]s = heal? 
c>e-relat$ exp5ses or lo/ rev5ues       
attributable to coronavirus "u ! head+  
,public ,heal? & ,social ,s]vices       
,em]g5cy ,fund 9 title ,,viii ( division
 ,b ( ,public ,law #aaf-acf1 title ,i ( 
division ,b ( ,public ,law #aaf-aci1 &  
title ,,iii ( division ,m ( ,public ,law
 #aaf-bfj1 are au?oriz$ to be           
appropriat$ to c>ry out ?is ,act & !    
am5dm5t made by ?is ,act4