,,ii #aaith ,,congress #ast ,session ,s4 #cbga ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,november #bj1 #bjbe,mr4 ,booker 7for himself and ,mr4 ,kim7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to authorize grants for the support of family caregivers4 #a4 ,short title ,this ,act may be cited as the ,in-,home ,caregiver ,assessment ,resources and ,education ,act or the ,in-,home ,,care ,act4 #b4 ,purposes ,the purposes of this ,act are-- 7#a7 to improve the ability of family caregivers to care for individuals in the home2 and 7#b7 to increase opportunities for individuals who are in need of care to remain at home and reduce or postpone the need for such individuals to receive care at an institution or hospital4 #c4 ,family caregiver grants ,subpart ,,iv of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bee et seq47 is amended by adding at the end the following3 #cci;,a4 ,family caregiver grants 7a7 ,in ,general ,the ,secretary1 acting through the ,administrator of the ,administration for ,community ,living1 shall award #c-year grants1 on a competitive basis1 to eligible organizations to carry out home visiting programs for family caregivers4 7b7 ,definitions ,in this section3 7#a7 ,caregiver assessment ,the term caregiver assessment means a defined process of gathering information from a family caregiver1 through direct contact1 which may include contact through a home visit1 the internet1 telephone or teleconference1 or in-person interaction1 to identify the specific needs1 barriers to carrying out caregiving responsibilities1 and existing supports of the family caregiver1 to appropriately target recommendations for support services for the family caregiver4 7#b7 ,eligible organization ,the term eligible organization means any of the following that has experience providing the services described in subsection 7f73 7,a7 ,a local government agency4 7,b7 ,a health care entity4 7,c7 ,any other nonprofit or community organization4 7#c7 ,family caregiver ,the term family caregiver means an adult family member or other individual who has a significant relationship with1 and who provides in-home assistance with monitoring1 management1 supervision1 or treatment of an individual with a chronic or other health condition1 disability1 or functional limitation4 7c7 ,coordination ,in carrying out this section1 the ,secretary shall coordinate with-- 7#a7 the heads of the ,national ,family ,caregiver ,support ,program of the ,administration on ,aging and other programs within the ,department of ,health and ,human ,services 7such as the ,lifespan ,respite ,care ,program7 and the ,secretary of ,veterans ,affairs1 to ensure coordination of caregiver services for family caregivers2 and 7#b7 the ,administrator of the ,centers for ,medicare ,medicaid ,services1 to avoid duplicative services and payments4 7d7 ,application ,an eligible organization that desires a grant under this section shall submit an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including1 at a minimum-- 7#a7 an outreach plan that identifies how the eligible organization will ascertain which family caregivers in the community-- 7,a7 are most in need of support and education1 particularly caregivers who have had no training and provide complex chronic care activities or perform medical or nursing tasks in addition to assisting with activities of daily living2 7,b7 are caring for individuals who are at the greatest risk of needing institutional care2 and 7,c7 desire to participate in the family caregiver home visiting program2 7#b7 a description of the services that the eligible organization will provide directly using grant funds1 and a description of the services that the eligible organization will use grant funds to provide through contracts or referrals2 7#c7 a description of how the eligible organization will identify gaps in the services that family caregivers and individuals with a chronic or other health condition1 disability1 or functional limitation who receive care from a family caregiver in the community are receiving2 7#d7 a description of how the eligible organization can provide-- 7,a7 an initial visit to family caregivers in order to complete a caregiver assessment1 including a description of the eligible organization's expertise in conducting caregiver assessments2 7,b7 education and training1 based on evidence-based models1 to help the family caregiver learn how to best care for an individual with a chronic or other health condition1 disability1 or functional limitation1 by an individual with expertise in the tasks for which the caregiver requires education and training1 including education and training regarding1 as applicable-- 7i7 medication management2 7ii7 wound care2 7iii7 nutrition and food preparation for special diets2 7iv7 fall prevention2 7v7 management of depression1 anxiety1 stress1 trauma1 and other behavioral health conditions1 including ways to minimize negative mental health effects2 7vi7 assistance with activities of daily living2 7vii7 ways to engage other family members in providing care2 7viii7 ways to identify and utilize available community resources2 and 7ix7 self-care2 and 7,c7 recommendations for home modifications or physical environmental changes that could improve the health or quality of life of an individual with a chronic or other health condition1 disability1 or functional limitation who is receiving care from a family caregiver2 7#e7 a description of the eligible organization's ability to provide1 or refer family caregivers to local resources or appropriate programs of the ,department of ,health and ,human ,services or the ,department of ,veterans ,affairs that will provide-- 7,a7 physical and mental health care1 including home health care and long-term support services2 7,b7 transportation2 7,c7 home modification services2 7,d7 respite care2 7,e7 adult day services2 7,f7 support groups2 and 7,g7 legal assistance2 7#f7 a description of the eligible organization's ability to coordinate with other ,state and community-based agencies2 7#g7 a description of the eligible organization's understanding of family caregiver issues-- 7,a7 across demographic groups1 including age1 gender1 race and ethnicity1 socioeconomic status1 sexual orientation1 military status1 and geographical region2 and 7,b7 including disabilities and chronic conditions that affect the populations that the eligible organization will serve2 7#h7 a description of the capacity of the eligible organization to engage family caregivers1 family members1 and individuals with a chronic or other health condition1 disability1 or functional limitation who receive care from a family caregiver2 and 7#i7 with respect to the population of family caregivers to whom caregiver visits or services will be provided1 or for whom workers and volunteers will be recruited and trained1 a description of-- 7,a7 the population of family caregivers2 7,b7 the extent and nature of the needs of that population2 and 7,c7 existing caregiver services for that population1 including the number of caregivers served and the extent of unmet need4 7e7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to eligible organizations that-- 7#a7 the ,secretary determines show the greatest likelihood of implementing or enhancing family caregiver home visiting services that best meet the needs of the community2 7#b7 will allow family caregivers to contact the eligible organization by phone1 email1 or #b-way interactive video for up to #f months after home visits have ended1 or to otherwise contact the organization at any time if a caregiver has questions or concerns2 7#c7 have a proven record of family caregiver support2 7#d7 will use evidence-based programs2 or 7#e7 will provide matching funds or can demonstrate that the program funded by a grant under this section will be sustainable after grant funds are no longer provided4 7f7 ,authorized activities ,an eligible organization receiving a grant under this section shall use grant funds to-- 7#a7 conduct an initial home visit for each family caregiver participating in the program1 during which a representative from the eligible organization who has expertise in care management in the home and caregiving will perform a caregiver assessment and determine what follow-up services may benefit the caregiver and the individual with a chronic or other health condition1 disability1 or functional limitation who receives care from the family caregiver2 7#b7 conduct home visits for the purpose of family caregiver education and training2 7#c7 provide1 or provide referrals for1 the services described in subsection 7d77#e72 7#d7 provide an assessment and referral for physical and mental health services for the family caregiver and for the individual with a chronic or other health condition1 disability1 or functional limitation who receives care from the family caregiver1 as needed2 and 7#e7 carry out any other activities that are described in the grant application submitted under subsection 7d74 7g7 ,technical assistance center ,the ,secretary shall establish1 or contract to establish1 a technical assistance center1 to be carried out by the ,national ,caregiver ,support ,collaborative ,technical ,assistance and ,coordinating ,center1 through which the ,secretary shall-- 7#a7 provide evidence-based models for programs funded by grants under this section2 7#b7 provide training for grantees2 7#c7 answer questions from grantees2 and 7#d7 facilitate an exchange of information among grantees1 and between grantees and other programs within the ,department of ,health and ,human ,services1 in order to maximize the use of existing resources and services for family caregivers and to avoid the duplication of such services4 7h7 ,evaluation 7#a7 ,in general ,not later than #b years after the date of enactment of this section1 and annually thereafter1 the ,secretary shall evaluate the success of the grant program carried out under this section1 based on criteria that the ,secretary may develop for such evaluation4 7#b7 ,optional contents of evaluation ,the evaluation described in paragraph 7#a7 may include an evaluation of-- 7,a7 the extent to which individuals with a chronic or other health condition1 disability1 or functional limitation who are cared for by a participating family caregiver have-- 7i7 a reduction in the potential number of hospitalizations2 7ii7 a reduction in the potential number of institutionalizations2 7iii7 cost reductions across the health care system2 7iv7 improved connection to community resources2 7v7 improved care2 and 7vi7 improved quality of life 7including a reduction of stress and anxiety and improved relationships and mood72 and 7,b7 the extent to which participating family caregivers have improved quality of life 7including a reduction of stress and anxiety and improved health1 relationships1 mood1 and connection to community resources74 7i7 ,reports and recommendations ,not later than #a year before the expiration of the grants awarded under this section1 the ,secretary shall prepare and submit a report to ,congress that includes recommendations1 based on the evaluation described in subsection 7h71 about-- 7#a7 changes to the grant program under this section2 7#b7 the potential for expanding the number and scope of family caregiver home visiting program grants distributed by the ,secretary2 and 7#c7 extending the length of the grant program4 7j7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section such sums as may be necessary4 4