[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6530 Introduced in House (IH)]
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117th CONGRESS
2d Session
H. R. 6530
To amend the Public Health Service Act to sustain senior congregate
care operations in the wake of ongoing COVID-19 financial burdens, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
January 28, 2022
Mrs. Trahan (for herself and Mr. Fitzpatrick) introduced the following
bill; which was referred to the Committee on Energy and Commerce, and
in addition to the Committee on Ways and Means, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to sustain senior congregate
care operations in the wake of ongoing COVID-19 financial burdens, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Safeguarding Elderly Needs for
Infrastructure and Occupational Resources Act of 2022'' or the ``SENIOR
Act of 2022''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Long-term care facilities and senior congregate care
homes provide direct and personalized care, where social
distancing is not possible, 24 hours a day, 7 days a week.
(2) Assisted living, memory care, independent living, and
other senior congregate care settings are the homes of
America's seniors and critical options on the long-term care
continuum; these senior residences provide safety and security
for our Nation's most vulnerable population.
(3) Sixty percent of a senior's health is based on social
determinants of health which include the need for adequate
nutrition, housing, and social activities; thus supporting
caregivers and home- and community-based care models that
prioritize the social determinants of senior health should be a
priority of the Congress.
(4) Investing in senior care and the caregiving workforce
prevents hospitalization and skilled nursing expenses,
preserving Medicare and Medicaid budgets.
(5) Since March of 2020, senior care facilities have lost
over 380,000 caregivers and are experiencing a workforce crisis
as America's population rapidly ages.
(6) By 2030, the entire Baby Boomer Generation will be 65
years of age or older.
(7) By 2060, nearly 95 million Americans will be 65 years
of age or older and the portion of the population over 85 years
of age will have tripled to nearly 20 million persons.
(8) Fifty-two percent of individuals require long-term care
by age 65. Individuals over 65 years of age are 70 percent more
likely to need long-term care, with half of those seniors
requiring an even higher level of care.
(9) The average duration of long-term care is nearly 4
years, and 14 percent of individuals need long-term care for 5
or more years.
(10) Twenty-seven percent of seniors over 65 years of age
will spend at least $100,000 on long-term care, and 15 percent
will have costs for long-term care surpassing $250,000.
(11) The average cost for long-term care for a 65-year old
today is $138,000.
(12) Long-term care infrastructure must address the
availability of cost-effective care and housing options to meet
the growing needs of the Nation's aging population.
(13) On average, assisted living costs $4,300 per month,
which equals $5.91 per hour of available care (based on 24/7
care). Nursing homes cost $8,821 per month (or $13.13 per hour
based on 24/7 care). In-home care costs $4,576 per month (or
$26 per hour based on 44 hours per week care).
(14) An individual 85 years of age or older is 630 percent
more likely to die of COVID-19.
(15) Sixty-three percent of residents of long-term care
facilities need assistance with bathing; 48 percent need
assistance with dressing; and 40 percent need assistance with
toileting.
(16) More than 42 percent of residents of long-term care
facilities suffer from Alzheimer's disease or some other form
of dementia.
(17) The people of the United States are a compassionate
people who are committed to protecting the most vulnerable in
our society, and we should not jeopardize the financial
underpinnings of the long-term care communities our Nation's
senior citizens depend on day-in and day-out.
SEC. 3. SENIOR CAREGIVER RELIEF ASSISTANCE.
Part K of title III of the Public Health Service Act (42 U.S.C.
280c et seq.) is amended by adding at the end the following new
subpart:
``Subpart IV--Senior Caregiver Relief Assistance
``SEC. 399A-1. SENIOR CAREGIVER RELIEF ASSISTANCE.
``(a) Authority.--The Secretary shall provide assistance under this
section to eligible entities to stabilize and preserve senior
congregate care operations.
``(b) Eligible Entities.--
``(1) In general.--The Secretary may provide assistance
under this section only to an entity that--
``(A) is an assisted living facility;
``(B) demonstrates, by providing such documentation
as the Secretary shall require, financial need by
having--
``(i) incurred uncompensated losses because
of the public health emergency declared under
section 319 with respect to COVID-19; and
``(ii) consistently maintained ongoing
operations during the period from March 13,
2020, to December 31, 2020; and
``(C) makes a good-faith certification to the
Secretary--
``(i) that the uncertainty of existing
economic conditions makes the application for
assistance under this section necessary to
support ongoing operations of the entity; and
``(ii) that all amounts of such assistance
will be used to promote the health and well-
being of the facility's population of seniors,
to retain workers, to maintain the facility,
and for other eligible uses under the relevant
provisions of this section.
``(2) Basis of determinations.--Any individual
determination of qualification of an entity as an eligible
entity for purposes of this section shall be based on review of
the entity's existing versus recent historic financials,
including--
``(A) profit-loss statements;
``(B) account receivables;
``(C) Federal tax filings; and
``(D) such other materials that the Secretary deems
relevant to meet the purposes of this section.
``(c) Applications.--The Secretary shall--
``(1) provide for eligible entities to submit applications
for assistance under this section; and
``(2) require such applications--
``(A) to set forth the proposed uses of such
assistance; and
``(B) to contain such other assurances and
information as the Secretary may require.
``(d) Formula Grants for Health Care-Related Expenses and Lost
Revenue Attributable to COVID-19.--
``(1) In general.--To the extent and in the amount of
appropriations made in advance to carry out this section, the
Secretary shall--
``(A) make grants to eligible entities for health
care-related expenses attributable to COVID-19 or to
supplant lost revenue attributable to COVID-19; and
``(B) distribute such amounts among eligible
entities in an equitable and timely manner, but not
later than December 31, 2022, based on the order in
which approvable applications from such entities are
received by the Secretary.
``(2) Limitation on administrative expenses.--As a
condition on receipt of a grant under this section, an eligible
entity shall agree to use not more than 5 percent of the
amounts received through the grant for administrative expenses.
``(3) Amount.--The amount of assistance distributed to an
eligible entity pursuant to this subsection shall be--
``(A) based on the number of beds in the facility
to be assisted; and
``(B) proportional to the uncompensated losses of
the eligible entity referred to in subsection
(b)(1)(B)(i).
``(4) Rule of construction.--Nothing in this subsection
shall be construed as preventing the Secretary from making
assistance available to eligible entities at any time before
the date specified in paragraph (1)(B).
``(e) Senior Caregiver Relief Grants.--
``(1) In general.--To the extent and in the amount of
appropriations made in advance to carry out this section, the
Secretary shall make grants to eligible entities for use
(subject to paragraph (2)) only for the following purposes:
``(A) Enhanced broadband connectivity and
telehealth support.--To ensure regular and reliable
communications connections between seniors residing in
the assisted living facility of the entity and their
physicians and medical support personnel.
``(B) Caregiver sustainability.--For costs of
operating and maintaining the assisted living facility
of the entity, including--
``(i) for payments of principal or interest
on any mortgage obligation in connection with
the facility, but not including any prepayment
of principal on such a mortgage obligation;
``(ii) for payments of rent for a facility,
including rent under a lease agreement, but not
including any prepayment of rent;
``(iii) for costs of activities to prevent,
prepare for, and mitigate the presence of
COVID-19 on facility premises, including costs
of purchasing and installing equipment and
supplies to disinfect the premises, support
emergency management operations, and provide
for associated staff-related expenses;
``(iv) for maintenance expenses for the
facility for the purposes of COVID-19
mitigation and infection control, including
construction to accommodate social distancing
and other preventive measures, such as
plexiglass barriers;
``(v) for costs of supplies for the
facility, including protective equipment and
cleaning materials; and
``(vi) for any other expenses that the
Secretary determines to be essential to
maintaining the facility.
``(2) Other activities.--Nothing in this subsection may be
construed to prevent the Secretary from approving applications
providing for use of funds for other costs, purposes, and
activities not specifically identified in paragraph (1) that
the Secretary deems appropriate and consistent with the
purposes of this section.
``(f) Reporting.--Each recipient of a grant under subsection (d) or
(e) shall submit reports and maintain documentation by such deadlines,
in such form, and containing such content as the Secretary determines
necessary to ensure compliance with the conditions of the grant.
``(g) Tax Treatment.--
``(1) Exclusion from gross income.--For purposes of the
Internal Revenue Code of 1986, amounts received by an eligible
entity from the Secretary under a grant under subsection (d) or
(e) shall not be included in the gross income of such eligible
entity.
``(2) Effect of exclusion.--An eligible entity shall not
have a tax deduction denied, a tax attribute reduced, or any
basis increased by reason of the exclusion from gross income
pursuant to paragraph (1).
``(h) GAO Report to Congress.--Not later than 2 years after the
date of enactment of this Act, the Comptroller General of the United
States shall submit to the Congress a report assessing the efficacy of
assistance made available under this section and the activities
supported with such assistance.
``(i) Definitions.--In this section:
``(1) The term `assisted living facility' means a licensed,
registered, certified, listed, or State-regulated residence,
managed residential community, building, or part of a building
that provides, or contracts to provide, housing with supportive
services on a continuing basis to individuals who--
``(A) are elderly or have a mental health,
developmental, or physical disability; and
``(B) are unrelated by blood or marriage to the
owner or operator of the residence, community,
building, or part of a building if the owner or
operator is an individual.
``(2) The term `eligible entity' means an entity that is
eligible under subsection (b) to be provided assistance under
this section.
``(3) The term `health care-related expenses attributable
to COVID-19' means health care-related expenses to prevent,
prepare for, and respond to COVID-19, including the building or
construction of a temporary structure, the leasing of a
property, the purchase of medical supplies and equipment
(including personal protective equipment and testing supplies),
providing for an expanded workforce (including by training
staff, maintaining staff, and hiring additional staff), the
operation of an emergency operation center, retrofitting a
facility, providing for surge capacity, and other expenses
determined appropriate by the Secretary.
``(4) The term `lost revenue attributable to COVID-19'
means the cost of services that were received, building
modifications made, and tangible property ordered for
mitigation and prevention of COVID-19, including the difference
between such provider's budgeted and actual revenue if such
budget was established and approved before March 27, 2020, for
the purposes of preventing, preparing for, and responding to
COVID-19.
``(j) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $10,000,000,000 for fiscal year
2022, to remain available until expended.''.
SEC. 4. SENIOR CAREGIVING WORKFORCE DEVELOPMENT SUSTAINMENT GRANTS.
Part K of title III of the Public Health Service Act (42 U.S.C.
280c et seq.) is amended by inserting after section 399A-1, as added by
section 3 of this Act, the following:
``SEC. 399A-2. SENIOR CAREGIVING WORKFORCE DEVELOPMENT SUSTAINMENT
GRANTS.
``(a) In General.--The Secretary may award grants to eligible
entities to establish or expand a senior caregiver workforce training
and recruitment program on the campus of the respective eligible
entity.
``(b) Amount; Duration.--A grant under this section shall be for--
``(1) an amount of not more than $1,000,000; and
``(2) a term of not more than 4 years.
``(c) Use of Funds.--Amounts provided to an eligible entity through
a grant under this section shall be used to cover the costs of--
``(1) establishing or expanding a senior caregiver
workforce training and recruitment program described in
subsection (a), including costs associated with recruitment,
training, and retention of senior caregivers; and
``(2) technical assistance provided by the eligible entity
in connection with such program.
``(d) Application.--An eligible entity seeking a grant under this
section shall submit an application to the Secretary at such time, in
such manner, and containing such information as the Secretary may
require.
``(e) Reports.--Each recipient of a grant under this section shall
submit reports and maintain documentation by such deadlines, in such
form, and containing such content as the Secretary determines necessary
to ensure compliance with the conditions of the grant.
``(f) Tax Treatment.--
``(1) Exclusion from gross income.--For purposes of the
Internal Revenue Code of 1986, amounts received by an eligible
entity from the Secretary under a grant under this section
shall not be included in the gross income of such eligible
entity.
``(2) Effect of exclusion.--An eligible entity shall not
have a tax deduction denied, a tax attribute reduced, or any
basis increased by reason of the exclusion from gross income
pursuant to paragraph (1).
``(g) Definitions.--
``(1) The term `eligible entity'--
``(A) means an assisted living facility as defined
in section 399A-1; and
``(B) excludes any skilled nursing facility as
defined in section 1819(a) of the Social Security Act.
``(2) The term `senior caregiver' means an individual who
furnishes direct personal care, assistance with activities of
daily living, or any other related service for older adults
located on a campus of an eligible entity.
``(h) Authorization of Appropriations.--To carry out this section,
there is authorized to be appropriated $1,250,000,000 for fiscal year
2022, to remain available until expended.''.
SEC. 5. NATIONAL HEALTH CARE WORKFORCE COMMISSION.
The National Health Care Workforce Commission established under
section 5101 of the Patient Protection and Affordable Care Act (42
U.S.C. 294q) shall--
(1) not later than 180 days after the date of enactment of
this Act, pursuant to subsection (d)(4) of such section 5101,
designate as a ``high priority area'' the current and projected
workforce needs of assisted living and other senior care
settings that attend to the care of the senior population; and
(2) not later than 1 year after finalizing such
designation, submit a report pursuant to subsection (d)(2)(D)
of such section 5101 to the Congress and the Administration
containing a review of, and recommendations on, such high
priority area.
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