Summary: S.2809 — 96th Congress (1979-1980)All Information (Except Text)

There is one summary for S.2809. Bill summaries are authored by CRS.

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Introduced in Senate (06/10/1980)

Noninstitutional Long-Term Care Services for the Elderly and Disabled Act - Amends the Social Security Act by adding a new title, title XXI (Noninstitutional Long-Term Care Services for the Elderly and the Disabled), to provide a comprehensive system of noninstitutional medical and social services for individuals aged 65 or over and individuals with chronic disabilities.

Entitles an eligible individual to the following benefits: (1) home health services; (2) homemaker-home health aid services; (3) adult day services; and (4) respite care services for up to 14 days, or 336 hours in any year. Sets forth definitions of such benefits.

Provides benefits to every individual who: (1) has attained age 65; (2) is disabled and eligible for benefits under titles II (Old-Age, Survivors and Disability Insurance), XVI (Supplemental Security Income), XVIII (Medicare), and XIX (Medicaid) of the Act; (3) was eligible for such benefits but ceased to be so eligible, but only if loss of benefits would seriously jeopardize such individuals ability to continue to live in a noninstitutional community residence and such individual's income is not sufficient to allow such individual to provide a reasonable equivalent of the services available under this Act; and (4) has been certified as eligible by the Secretary of Health and Human Services.

States that no eligible individual shall be eligible to receive any benefits under title XXI or any long-term care benefits under titles XIX or XX (Grants to States for Services) of the Act unless such individual has a plan of care, as specified in this Act, and has been screened and assessed by a preadmission assessment and screening team (PAT) in order to determine the types and frequency of services required by such individual and in order to assure the maximum level of independence for such individual.

Provides for at least one PAT to serve each unit of general purpose local government in a State. Permits the appropriate State agency to designate a Professional Standards Review Organization (PSRO), an area agency on aging, a hospital, a local government's department of health, a rural health clinic, a health maintenance organization (HMO), a center or agency for the handicapped, or any qualified similar entity as the PAT. Prohibits any hospital with a hospital-based home health agency and any free standing home health agency from being designated as a PAT, except in a rural area in which no other entity can provide PAT services. Directs the Secretary to reimburse any PAT and any State for the reasonable costs incurred in performing duties under this Act.

Requires beneficiaries under title XXI to make copayments as follows: (1) 10 percent of the reimbursable amount with respect to home health services for visits in excess of 50 visits in a calendar year; (2) 10 percent of the reimbursable amount with respect to homemaker-home health aide services for visits in excess of 50 visits in a calendar year; and (3) 10 percent of the reimbursable amount with respect to adult day services for visits to an adult day center in excess of 50 visits in a calendar year. Sets limits based on income, on such copayments, with the highest copayments being limited to five percent of an individual's income for individuals with an annual income of over $10,000. Includes SSI and OASDI benefits, unemployment compensation, and pensions as income.

Directs the Secretary to pay amounts for benefits incurred by an eligible individual in accordance with specified guidelines.

Creates the Federal Long-Term Care Trust Fund into which specified funds will be deposited in order to make the payments required by this Act.

Coordinates the provisions of this Act with titles XVIII, XIX, and XX of the Act by providing that no payment shall be made under such titles for services, as defined in title XXI, to or on behalf of an individual who is eligible under title XXI.

States that extended care services under titles XVIII, XIX, and XX shall not be covered unless the individual seeking coverage first undergoes a preadmission screening and assessment as provided in title XXI, and the need for such services has been approved under the individual's plan of care.

Amends the Internal Revenue Code to allow an annual credit of $100 to a taxpayer caring for an elderly dependent.

Directs the Secretary to monitor ten designated States with respect to their PAT's and to report to Congress concerning the utilization of services under titles XVIII, XIX, XX, and XXI of the Act and the effects of implementing a copayment requirement beginning with the first visit as compared to a copayment requirement beginning after 50 visits. Directs the Comptroller General to also conduct an ongoing evaluation of the effect of the use of PAT's with respect to utilization of services. Requires the reports to include a recommended strategy for implementing title XXI on a national basis. Directs the Office of Management and Budget to prepare an analysis of the budgetary impact of the implementation of title XXI on a national basis.

States that the provisions of titles XVIII, XIX, XX, and XXI of the Act relating to PAT's shall not become effective until one year after Congress has received evaluations from the Department of Health and Human Services, the Comptroller General, and the OMB.