[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3271 Introduced in Senate (IS)]
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119th CONGRESS
1st Session
S. 3271
To authorize grants for the support of family caregivers.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
November 20, 2025
Mr. Booker (for himself and Mr. Kim) introduced the following bill;
which was read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To authorize grants for the support of family caregivers.
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 ``In-Home Caregiver Assessment
Resources and Education Act'' or the ``In-Home CARE Act''.
SEC. 2. PURPOSES.
The purposes of this Act are--
(1) to improve the ability of family caregivers to care for
individuals in the home; and
(2) 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
hospital.
SEC. 3. FAMILY CAREGIVER GRANTS.
Subpart IV of part D of title III of the Public Health Service Act
(42 U.S.C. 255 et seq.) is amended by adding at the end the following:
``SEC. 339A. FAMILY CAREGIVER GRANTS.
``(a) In General.--The Secretary, acting through the Administrator
of the Administration for Community Living, shall award 3-year grants,
on a competitive basis, to eligible organizations to carry out home
visiting programs for family caregivers.
``(b) Definitions.--In this section:
``(1) Caregiver assessment.--The term `caregiver
assessment' means a defined process of gathering information
from a family caregiver, through direct contact, which may
include contact through a home visit, the internet, telephone
or teleconference, or in-person interaction, to identify the
specific needs, barriers to carrying out caregiving
responsibilities, and existing supports of the family
caregiver, to appropriately target recommendations for support
services for the family caregiver.
``(2) Eligible organization.--The term `eligible
organization' means any of the following that has experience
providing the services described in subsection (f):
``(A) A local government agency.
``(B) A health care entity.
``(C) Any other nonprofit or community
organization.
``(3) Family caregiver.--The term `family caregiver' means
an adult family member or other individual who has a
significant relationship with, and who provides in-home
assistance with monitoring, management, supervision, or
treatment of an individual with a chronic or other health
condition, disability, or functional limitation.
``(c) Coordination.--In carrying out this section, the Secretary
shall coordinate with--
``(1) 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 (such as the
Lifespan Respite Care Program) and the Secretary of Veterans
Affairs, to ensure coordination of caregiver services for
family caregivers; and
``(2) the Administrator of the Centers for Medicare &
Medicaid Services, to avoid duplicative services and payments.
``(d) Application.--An eligible organization that desires a grant
under this section shall submit an application at such time, in such
manner, and containing such information as the Secretary may require,
including, at a minimum--
``(1) an outreach plan that identifies how the eligible
organization will ascertain which family caregivers in the
community--
``(A) are most in need of support and education,
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 living;
``(B) are caring for individuals who are at the
greatest risk of needing institutional care; and
``(C) desire to participate in the family caregiver
home visiting program;
``(2) a description of the services that the eligible
organization will provide directly using grant funds, and a
description of the services that the eligible organization will
use grant funds to provide through contracts or referrals;
``(3) a description of how the eligible organization will
identify gaps in the services that family caregivers and
individuals with a chronic or other health condition,
disability, or functional limitation who receive care from a
family caregiver in the community are receiving;
``(4) a description of how the eligible organization can
provide--
``(A) an initial visit to family caregivers in
order to complete a caregiver assessment, including a
description of the eligible organization's expertise in
conducting caregiver assessments;
``(B) education and training, based on evidence-
based models, to help the family caregiver learn how to
best care for an individual with a chronic or other
health condition, disability, or functional limitation,
by an individual with expertise in the tasks for which
the caregiver requires education and training,
including education and training regarding, as
applicable--
``(i) medication management;
``(ii) wound care;
``(iii) nutrition and food preparation for
special diets;
``(iv) fall prevention;
``(v) management of depression, anxiety,
stress, trauma, and other behavioral health
conditions, including ways to minimize negative
mental health effects;
``(vi) assistance with activities of daily
living;
``(vii) ways to engage other family members
in providing care;
``(viii) ways to identify and utilize
available community resources; and
``(ix) self-care; and
``(C) 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 condition, disability, or
functional limitation who is receiving care from a
family caregiver;
``(5) a description of the eligible organization's ability
to provide, 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--
``(A) physical and mental health care, including
home health care and long-term support services;
``(B) transportation;
``(C) home modification services;
``(D) respite care;
``(E) adult day services;
``(F) support groups; and
``(G) legal assistance;
``(6) a description of the eligible organization's ability
to coordinate with other State and community-based agencies;
``(7) a description of the eligible organization's
understanding of family caregiver issues--
``(A) across demographic groups, including age,
gender, race and ethnicity, socioeconomic status,
sexual orientation, military status, and geographical
region; and
``(B) including disabilities and chronic conditions
that affect the populations that the eligible
organization will serve;
``(8) a description of the capacity of the eligible
organization to engage family caregivers, family members, and
individuals with a chronic or other health condition,
disability, or functional limitation who receive care from a
family caregiver; and
``(9) with respect to the population of family caregivers
to whom caregiver visits or services will be provided, or for
whom workers and volunteers will be recruited and trained, a
description of--
``(A) the population of family caregivers;
``(B) the extent and nature of the needs of that
population; and
``(C) existing caregiver services for that
population, including the number of caregivers served
and the extent of unmet need.
``(e) Priority.--In awarding grants under this section, the
Secretary shall give priority to eligible organizations that--
``(1) the Secretary determines show the greatest likelihood
of implementing or enhancing family caregiver home visiting
services that best meet the needs of the community;
``(2) will allow family caregivers to contact the eligible
organization by phone, email, or 2-way interactive video for up
to 6 months after home visits have ended, or to otherwise
contact the organization at any time if a caregiver has
questions or concerns;
``(3) have a proven record of family caregiver support;
``(4) will use evidence-based programs; or
``(5) 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 provided.
``(f) Authorized Activities.--An eligible organization receiving a
grant under this section shall use grant funds to--
``(1) conduct an initial home visit for each family
caregiver participating in the program, 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 condition, disability, or functional limitation
who receives care from the family caregiver;
``(2) conduct home visits for the purpose of family
caregiver education and training;
``(3) provide, or provide referrals for, the services
described in subsection (d)(5);
``(4) 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 condition,
disability, or functional limitation who receives care from the
family caregiver, as needed; and
``(5) carry out any other activities that are described in
the grant application submitted under subsection (d).
``(g) Technical Assistance Center.--The Secretary shall establish,
or contract to establish, a technical assistance center, to be carried
out by the National Caregiver Support Collaborative Technical
Assistance and Coordinating Center, through which the Secretary shall--
``(1) provide evidence-based models for programs funded by
grants under this section;
``(2) provide training for grantees;
``(3) answer questions from grantees; and
``(4) facilitate an exchange of information among grantees,
and between grantees and other programs within the Department
of Health and Human Services, in order to maximize the use of
existing resources and services for family caregivers and to
avoid the duplication of such services.
``(h) Evaluation.--
``(1) In general.--Not later than 2 years after the date of
enactment of this section, and annually thereafter, the
Secretary shall evaluate the success of the grant program
carried out under this section, based on criteria that the
Secretary may develop for such evaluation.
``(2) Optional contents of evaluation.--The evaluation
described in paragraph (1) may include an evaluation of--
``(A) the extent to which individuals with a
chronic or other health condition, disability, or
functional limitation who are cared for by a
participating family caregiver have--
``(i) a reduction in the potential number
of hospitalizations;
``(ii) a reduction in the potential number
of institutionalizations;
``(iii) cost reductions across the health
care system;
``(iv) improved connection to community
resources;
``(v) improved care; and
``(vi) improved quality of life (including
a reduction of stress and anxiety and improved
relationships and mood); and
``(B) the extent to which participating family
caregivers have improved quality of life (including a
reduction of stress and anxiety and improved health,
relationships, mood, and connection to community
resources).
``(i) Reports and Recommendations.--Not later than 1 year before
the expiration of the grants awarded under this section, the Secretary
shall prepare and submit a report to Congress that includes
recommendations, based on the evaluation described in subsection (h),
about--
``(1) changes to the grant program under this section;
``(2) the potential for expanding the number and scope of
family caregiver home visiting program grants distributed by
the Secretary; and
``(3) extending the length of the grant program.
``(j) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be
necessary.''.
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