S 697 ISCommentsClose CommentsPermalink

To amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes.CommentsClose CommentsPermalink

March 25, 2009CommentsClose CommentsPermalink

Mr. KENNEDY (for himself, Mr. DODD, Mr. HARKIN, Mr. BROWN, Mr. CASEY, and Mr. WHITEHOUSE) introduced the following bill; which was read twice and referred to the Committee on FinanceCommentsClose CommentsPermalink

To amend the Public Health Service Act to help individuals with functional impairments and their families pay for services and supports that they need to maximize their functionality and independence and have choices about community participation, education, and employment, and for other purposes.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the ‘Community Living Assistance Services and Supports Act’ or the ‘CLASS Act’.CommentsClose CommentsPermalink

SEC. 2. PURPOSES.

The purposes of this Act are as follows:CommentsClose CommentsPermalink





(1) To provide individuals with functional limitations with tools that will allow them to maintain their personal and financial independence and live in the community through a new financing strategy for community living assistance services and supports.CommentsClose CommentsPermalink





(2) To establish an infrastructure that will help address America’s community living assistance services and supports needs.CommentsClose CommentsPermalink





(3) To alleviate burdens on family caregivers.CommentsClose CommentsPermalink

SEC. 3. TABLE OF CONTENTS.

The table of contents for this Act is as follows:CommentsClose CommentsPermalink





Sec. 1. Short title.CommentsClose CommentsPermalink





Sec. 2. Purposes.CommentsClose CommentsPermalink





Sec. 3. Table of contents.CommentsClose CommentsPermalink

TITLE I--COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS

Sec. 101. Establishment of national voluntary insurance program for purchasing community living assistance services and support.CommentsClose CommentsPermalink

TITLE II--AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986

Sec. 201. Above-the-line deduction for premium costs.CommentsClose CommentsPermalink





Sec. 202. Credit for premium costs of CLASS enrollees with low-income.CommentsClose CommentsPermalink





Sec. 203. Credit for costs of employers who elect to automatically enroll employees and withhold class premiums from wages.CommentsClose CommentsPermalink





Sec. 204. Long-term care insurance includible in cafeteria plans.CommentsClose CommentsPermalink

TITLE III--EFFECTIVE DATE

Sec. 301. Effective date.CommentsClose CommentsPermalink

TITLE I--COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTSCommentsClose CommentsPermalink

SEC. 101. ESTABLISHMENT OF NATIONAL VOLUNTARY INSURANCE PROGRAM FOR PURCHASING COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORT.

(a) Establishment of Program-CommentsClose CommentsPermalink





(1) IN GENERAL- The Public Health Service Act (42 U.S.C. 201 et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

‘TITLE XXXI--COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTSCommentsClose CommentsPermalink

‘SEC. 3101. DEFINITIONS.

‘In this title:CommentsClose CommentsPermalink





‘(1) ACTIVE ENROLLEE- The term ‘active enrollee’ means an individual who is enrolled in the CLASS program in accordance with section 3102 and who has paid any premiums due to maintain such enrollment in accordance with section 3103.CommentsClose CommentsPermalink





‘(2) ACTIVELY AT WORK- The term ‘actively at work’ means an individual who--CommentsClose CommentsPermalink





‘(A) is reporting for work at the individual’s usual place of employment or at another location to which the individual’s employer requires the individual to travel (or in the case of an individual who is a member of the uniformed services, is on active duty and is physically able to perform the duties of the individual’s position);CommentsClose CommentsPermalink





‘(B) is able to perform all the usual and customary duties of the individual’s employment on the individual’s regular work schedule; andCommentsClose CommentsPermalink





‘(C) is not absent from work due to sickness, injury, annual leave, sick leave or any other leave.CommentsClose CommentsPermalink





‘(3) ACTIVITIES OF DAILY LIVING- The term ‘activities of daily living’ means each of the following activities specified in section 7702B(c)(2)(B) of the Internal Revenue Code of 1986:CommentsClose CommentsPermalink





‘(A) Eating.CommentsClose CommentsPermalink





‘(B) Toileting.CommentsClose CommentsPermalink





‘(C) Transferring.CommentsClose CommentsPermalink





‘(D) Bathing.CommentsClose CommentsPermalink





‘(E) Dressing.CommentsClose CommentsPermalink





‘(F) Continence.CommentsClose CommentsPermalink





‘(4) CLASS PROGRAM- The term ‘CLASS program’ means the program established under this title.CommentsClose CommentsPermalink





‘(5) DISABILITY DETERMINATION SERVICE- The term ‘Disability Determination Service’ means, with respect to each State, the entity that has an agreement with the Commissioner of Social Security to make disability determinations for purposes of title II or XVI of the Social Security Act (42 U.S.C. 401 et seq., 1381 et seq.).CommentsClose CommentsPermalink





‘(6) ELIGIBLE TIER I BENEFICIARY-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The term ‘eligible tier I beneficiary’ means any individual who is an active enrollee in the CLASS program and, as of the date described in subparagraph (B)--CommentsClose CommentsPermalink





‘(i) has paid premiums for enrollment in such program for at least 60 months; andCommentsClose CommentsPermalink





‘(ii) except as provided in section 3103(e)(2), has paid premiums for enrollment in such program for at least 12 consecutive months if a lapse in premium payments of more than 3 months has occurred during the period that begins on the date of the individual’s enrollment and ends on the date of such determination.CommentsClose CommentsPermalink





‘(B) DATE DESCRIBED- For purpose of subparagraph (A), the date described in this subparagraph is the date on which the individual is determined--CommentsClose CommentsPermalink





‘(i) to be unable to perform at least 2 activities of daily living or to require supervision, cueing, or hands-on assistance to plan or perform at least 2 such activities; orCommentsClose CommentsPermalink





‘(ii) due to a cognitive or psychiatric impairment, to require supervision, cueing, or hands-on assistance to engage in activities that will enable the individual to perform at least 2 of the following critical life functions:CommentsClose CommentsPermalink





‘(I) Communicating.CommentsClose CommentsPermalink





‘(II) Taking medications.CommentsClose CommentsPermalink





‘(III) Household management.CommentsClose CommentsPermalink





‘(IV) Basic money management.CommentsClose CommentsPermalink





‘(7) ELIGIBLE TIER II BENEFICIARY- The term ‘eligible tier II beneficiary’ means any individual who is an eligible tier I beneficiary who has been determined--CommentsClose CommentsPermalink





‘(A) to be unable to perform at least 4 activities of daily living or to require supervision, cueing, or hands-on assistance to plan or perform at least 4 such activities; orCommentsClose CommentsPermalink





‘(B) due to a cognitive or psychiatric impairment, to require supervision, cueing, or hands-on assistance to engage in activities that will enable the individual to perform at least 4 of the following critical life functions:CommentsClose CommentsPermalink





‘(i) Communicating.CommentsClose CommentsPermalink





‘(ii) Taking medications.CommentsClose CommentsPermalink





‘(iii) Household management.CommentsClose CommentsPermalink





‘(iv) Basic money management.CommentsClose CommentsPermalink





‘(8) HOSPITAL; NURSING FACILITY; INTERMEDIATE CARE FACILITY FOR THE MENTALLY RETARDED; INSTITUTION FOR MENTAL DISEASES- The terms ‘hospital’, ‘nursing facility’, ‘intermediate care facility for the mentally retarded’, and ‘institution for mental diseases’ have the meanings given such terms for purposes of Medicaid.CommentsClose CommentsPermalink





‘(9) INDEPENDENCE FUND- The term ‘Independence Fund’ or ‘Fund’ means the fund established under section 3105.CommentsClose CommentsPermalink





‘(10) MEDICAID- The term ‘Medicaid’ means the program established under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).CommentsClose CommentsPermalink





‘(11) POVERTY LINE- The term ‘poverty line’ has the meaning given that term in section 2110(c)(5) of the Social Security Act (42 U.S.C. 1397jj(c)(5)).CommentsClose CommentsPermalink





‘(12) PROTECTION AND ADVOCACY SYSTEM- The term ‘Protection and Advocacy System’ means the system for each State established under section 143 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15043).CommentsClose CommentsPermalink

‘SEC. 3102. AUTOMATIC ENROLLMENT WITH OPT-OUT ELECTION.

‘(a) Automatic Enrollment-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Subject to paragraph (2), the Secretary shall establish procedures under which each individual described in subsection (c) shall be automatically enrolled in the CLASS program by an employer of such individual in the same manner as an employer may elect to automatically enroll employees in a plan under section 401(k), 403(b), or 457 of the Internal Revenue Code of 1986.CommentsClose CommentsPermalink





‘(2) ALTERNATIVE ENROLLMENT PROCEDURES- The procedures established under paragraph (1) shall provide for an alternative enrollment process for an individual described in subsection (c) in the case of such an individual--CommentsClose CommentsPermalink





‘(A) who is self-employed;CommentsClose CommentsPermalink





‘(B) who has more than 1 employer;CommentsClose CommentsPermalink





‘(C) whose employer does not elect to participate in the automatic enrollment process established by the Secretary; orCommentsClose CommentsPermalink





‘(D) who is a spouse described in paragraph (2) of such subsection who is not subject to automatic enrollment.CommentsClose CommentsPermalink





‘(3) ADMINISTRATION-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The Secretary shall, by regulation, establish procedures to--CommentsClose CommentsPermalink





‘(i) ensure that an individual is not automatically enrolled in the CLASS program by more than 1 employer; andCommentsClose CommentsPermalink





‘(ii) allow for an individual’s employer to deduct a premium for a spouse described in subsection (c)(1)(B) who is not subject to automatic enrollment.CommentsClose CommentsPermalink





‘(B) FORM- Enrollment in the CLASS program shall be made in such manner as the Secretary may prescribe in order to ensure ease of administration.CommentsClose CommentsPermalink





‘(b) Election To Opt-Out- An individual described in subsection (c) may elect to waive enrollment under the CLASS program at any time in such form and manner as the Secretary shall prescribe.CommentsClose CommentsPermalink





‘(c) Individual Described- For purposes of enrolling in the CLASS program, an individual described in this subsection is--CommentsClose CommentsPermalink





‘(1) an individual--CommentsClose CommentsPermalink





‘(A) who has attained age 18;CommentsClose CommentsPermalink





‘(B) who--CommentsClose CommentsPermalink





‘(i) receives wages on which there is imposed a tax under section 3101(a) of the Internal Revenue Code of 1986; orCommentsClose CommentsPermalink





‘(ii) derives self-employment income on which there is imposed a tax under section 1401(a) of the Internal Revenue Code of 1986;CommentsClose CommentsPermalink





‘(C) who is actively at work; andCommentsClose CommentsPermalink





‘(D) who is not--CommentsClose CommentsPermalink





‘(i) a patient in a hospital or nursing facility, an intermediate care facility for the mentally retarded, or an institution for mental diseases and receiving medical assistance under Medicaid; orCommentsClose CommentsPermalink





‘(ii) confined in a jail, prison, other penal institution or correctional facility, or by court order pursuant to conviction of a criminal offense or in connection with a verdict or finding described in section 202(x)(1)(A)(ii) of the Social Security Act (42 U.S.C. 402(x)(1)(A)(ii)); orCommentsClose CommentsPermalink





‘(2) the spouse of an individual described in paragraph (1) and who would be an individual so described but for subparagraph (B) or (C) of that paragraph.CommentsClose CommentsPermalink





‘(d) Rule of Construction- Nothing in this title shall be construed as requiring an active enrollee to continue to satisfy subparagraph (B) or (C) of subsection (c)(1) in order to maintain enrollment in the CLASS program.CommentsClose CommentsPermalink

‘SEC. 3103. PREMIUMS.

‘(a) Monthly Premiums- Except as provided in subsection (e), each individual who is enrolled in the CLASS program shall pay the Secretary a monthly premium to maintain enrollment in the program.CommentsClose CommentsPermalink





‘(b) Amount of Premium-CommentsClose CommentsPermalink





‘(1) $30 MONTHLY PREMIUM FOR ENROLLMENT IN THE FIRST YEAR OF THE PROGRAM- Subject to the succeeding provisions of this subsection, the monthly premium for enrollment in the CLASS program of any individual who enrolls during the first year in which the program is in effect under this title shall be $30 for every such enrollee, regardless of their age at enrollment.CommentsClose CommentsPermalink





‘(2) INFLATION ADJUSTED PREMIUM FOR ENROLLMENT IN FIRST YEAR IN WHICH AN INDIVIDUAL IS ELIGIBLE TO ENROLL AFTER FIRST YEAR OF THE PROGRAM- The monthly premium for enrollment in the CLASS program of any individual who enrolls during the first year in which the individual is eligible to enroll in the program but that occurs after the first year in which the program is in effect under this title, shall be $30, increased with respect to each year that the program is in effect under this title until the year of such enrollment, by the percentage increase in the consumer price index for all urban consumers (U.S. city average) over each such preceding year.CommentsClose CommentsPermalink





‘(3) AGE-ADJUSTED PREMIUMS FOR ENROLLMENT IN OTHER YEARS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The Secretary shall determine for each year that is not a year described in paragraph (1) or (2), an annual monthly premium for enrollment in the CLASS program of an individual during the year that adjusts the monthly premium that would apply to the individual under paragraph (2) if the individual had enrolled during the first year in which the individual was eligible to enroll in the program based on the following:CommentsClose CommentsPermalink





‘(i) AGE AT ENROLLMENT- Subject to paragraph (4), the age of an individual upon the individual’s initial enrollment in the program.CommentsClose CommentsPermalink





‘(ii) ADMINISTRATIVE EXPENSES- The administrative expenses for the program.CommentsClose CommentsPermalink





‘(B) LIMITATION ON ADMINISTRATIVE EXPENSES-CommentsClose CommentsPermalink





‘(i) START-UP ADMINISTRATIVE EXPENSES- The total amount of annual expenditures incurred for administering the CLASS program during each of the first 5 years in which the program is in effect under this title shall not exceed the sum of an amount equal to 3 percent of all premiums paid during that year.CommentsClose CommentsPermalink





‘(ii) SUBSEQUENT ADMINISTRATIVE EXPENSES- With respect to any year after the first 5 years in which the CLASS program is in effect under this title, the total amount of annual expenditures incurred for administering the CLASS program shall not exceed the lesser of an amount equal to--CommentsClose CommentsPermalink





‘(I) 5 percent of the total amount of all expenditures (including benefits paid) under this title with respect to that year; orCommentsClose CommentsPermalink





‘(II) the percentage of expenditures incurred under the medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) for that year that is attributable to administering that program.CommentsClose CommentsPermalink





‘(4) NOMINAL PREMIUM FOR INDIVIDUAL’S WITH INCOME THAT DOES NOT EXCEED 150 PERCENT OF THE POVERTY LINE-CommentsClose CommentsPermalink





‘(A) IN GENERAL- In the case of an individual whose income does not exceed 150 percent of the poverty line, the monthly premium for enrollment in the CLASS program shall be the applicable amount under subparagraph (B).CommentsClose CommentsPermalink





‘(B) APPLICABLE AMOUNT- The Secretary shall establish premium amounts which shall apply to an individual described in subparagraph (A) in lieu of the premium amount which would otherwise apply to the individual under paragraph (1), (2), or (3) (whichever is applicable). Such amounts shall be nominal and, in the case of an individual who, but for this paragraph, would be subject to the premium imposed under paragraph (3), may be adjusted in accordance with the factors described in that paragraph.CommentsClose CommentsPermalink





‘(C) SELF-ATTESTATION AND VERIFICATION OF INCOME- The Secretary shall establish procedures to--CommentsClose CommentsPermalink





‘(i) permit an individual, as part of their automatic enrollment in the CLASS program, to self-attest that their income does not exceed 150 percent of the poverty line; andCommentsClose CommentsPermalink





‘(ii) verify the validity of such self-attestation.CommentsClose CommentsPermalink





‘(5) ADJUSTMENT OF PREMIUMS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Except as provided in subparagraphs (C) and (D), the amount of the monthly premium determined for an individual upon such individual’s enrollment in the CLASS program shall remain the same for as long as the individual is an active enrollee in the program.CommentsClose CommentsPermalink





‘(B) PROGRAM SOLVENCY PROJECTIONS- Beginning with 2012 and every year thereafter, the Secretary shall determine with respect to the 20-year period that begins with that year, the amount of funds held (or projected to be held) in the Independence Fund established under section 3105 that are required to pay tier I and tier II benefits under section 3104 during each year of that period.CommentsClose CommentsPermalink





‘(C) RECALCULATED PREMIUM IF REQUIRED FOR PROGRAM SOLVENCY-CommentsClose CommentsPermalink





‘(i) IN GENERAL- Subject to clauses (ii) and (iii), beginning with 2017 and every year thereafter, if the Secretary determines as a result of making the program solvency projections required under subparagraph (B) that, with respect to the 20-year period that begins with that year, more than 40 percent of the amount of funds held (or projected to be held) in the Independence Fund established under section 3105 are required to pay tier I and tier II benefits under section 3104 during each year of that period, the Secretary shall adjust the monthly premiums for individuals enrolled in the CLASS program.CommentsClose CommentsPermalink





‘(ii) REQUIREMENTS- In adjusting monthly premiums under clause (i), the Secretary shall increase the premiums by such an amount as will ensure that--CommentsClose CommentsPermalink





‘(I) the aggregate amount of such premiums collected will result in not more than 20 percent of the amounts held in the Independence Fund being required to pay tier I and tier II benefits for any one year occurring during the applicable 20-year period;CommentsClose CommentsPermalink





‘(II) with respect to any individual enrolled in the program--CommentsClose CommentsPermalink

‘(aa) the amount of the increase in the individual’s monthly premium does not exceed the amount equal to 50 percent of the premium prior to such increase; andCommentsClose CommentsPermalink

‘(bb) the individual’s monthly premium does not exceed the amount equal to 200 percent of the initial premium amount paid by the individual during their first year of enrollment in the program; andCommentsClose CommentsPermalink

‘(III) the requirements of clause (iii) are met.CommentsClose CommentsPermalink





The Secretary shall immediately notify Congress if the Secretary determines that the requirements of this clause cannot be satisfied and shall include in such notification recommendations for such legislative action as the Secretary determines to be appropriate.CommentsClose CommentsPermalink





‘(iii) EXEMPTION FROM INCREASE- Any increase in a monthly premium imposed as result of a determination described in clause (i) shall not apply with respect to the monthly premium of any active enrollee who--CommentsClose CommentsPermalink





‘(I) has attained age 65;CommentsClose CommentsPermalink





‘(II) has paid premiums for enrollment in the program for at least 20 years; andCommentsClose CommentsPermalink





‘(III) is not actively at work.CommentsClose CommentsPermalink





‘(D) RECALCULATED PREMIUM IF REENROLLMENT AFTER MORE THAN A 3-MONTH LAPSE-CommentsClose CommentsPermalink





‘(i) IN GENERAL- Except as provided in subsection (e)(2), the reenrollment of an individual after a 90-day period during which the individual failed to pay the monthly premium required to maintain the individual’s enrollment in the CLASS program shall be treated as an initial enrollment for purposes of age-adjusting the premium for enrollment in the program.CommentsClose CommentsPermalink





‘(ii) CREDIT FOR PRIOR MONTHS- An individual who reenrolls in the CLASS program after such a 90-day period shall be--CommentsClose CommentsPermalink





‘(I) credited with any months of paid premiums that accrued prior to the individual’s lapse in enrollment; andCommentsClose CommentsPermalink





‘(II) notwithstanding the total amount of any such credited months, required to satisfy section 3101(6)(B)(ii) before being eligible to receive a tier I or tier II benefit.CommentsClose CommentsPermalink





‘(6) NO UNDERWRITING REQUIREMENTS- No underwriting shall be used to--CommentsClose CommentsPermalink





‘(A) determine the monthly premium for enrollment in the CLASS program; orCommentsClose CommentsPermalink





‘(B) prevent an individual from enrolling in the program.CommentsClose CommentsPermalink





‘(c) Payment-CommentsClose CommentsPermalink





‘(1) PAYROLL DEDUCTION- An amount equal to the monthly premium for the enrollment in the CLASS program of an individual shall be deducted from the wages or self-employment income of such individual in accordance with such procedures as the Secretary, in consultation with the Secretary of the Treasury, shall establish for employers who elect to deduct and withhold such premiums on behalf of enrolled employees.CommentsClose CommentsPermalink





‘(2) ALTERNATIVE PAYMENT MECHANISM- The Secretary shall establish alternative procedures for the payment of monthly premiums by an individual enrolled in the CLASS program--CommentsClose CommentsPermalink





‘(A) who does not have an employer who elects to deduct and withhold premiums in accordance with paragraph (1); orCommentsClose CommentsPermalink





‘(B) who does not earn wages or derive self-employment income.CommentsClose CommentsPermalink





‘(d) Transfer of Premiums Collected-CommentsClose CommentsPermalink





‘(1) IN GENERAL- During each calendar year the Secretary of the Treasury shall deposit into the Independence Fund a total amount equal, in the aggregate, to 100 percent of the premiums collected during that year.CommentsClose CommentsPermalink





‘(2) TRANSFERS BASED ON ESTIMATES- The amount deposited pursuant to paragraph (1) shall be transferred in at least monthly payments to the Independence Fund on the basis of estimates by the Secretary and certified to the Secretary of the Treasury of the amounts collected in accordance with paragraphs (1) and (2) of subsection (c). Proper adjustments shall be made in amounts subsequently transferred to the Fund to the extent prior estimates were in excess of, or were less than, actual amounts collected.CommentsClose CommentsPermalink





‘(e) Contribution Period-CommentsClose CommentsPermalink





‘(1) IN GENERAL- An individual shall not be required to pay a monthly premium to maintain the individual’s enrollment in the CLASS program during the following periods:CommentsClose CommentsPermalink





‘(A) RECEIVING BENEFITS WHILE UNEMPLOYED- Any period during which the individual is--CommentsClose CommentsPermalink





‘(i) receiving tier I or tier II benefits; andCommentsClose CommentsPermalink





‘(ii) the individual does not have wages or income derived from self-employment.CommentsClose CommentsPermalink





‘(B) FULL-TIME STUDENT WHO IS ACTIVELY AT WORK- Any period during which the individual is a full-time student (as determined by the Secretary) who has not attained age 22 and is actively at work.CommentsClose CommentsPermalink





‘(2) APPLICATION OF PREMIUM AMOUNT PRIOR TO START OF PERIOD- Upon the conclusion of a period described in paragraph (1) for an individual, the individual shall resume paying the monthly premium amount that applied to the individual immediately prior to the start of such period in order to maintain enrollment in the program.CommentsClose CommentsPermalink

‘SEC. 3104. BENEFITS.

‘(a) Determination of Eligibility-CommentsClose CommentsPermalink





‘(1) APPLICATION FOR RECEIPT OF BENEFITS- The Secretary shall establish procedures under which an active enrollee shall apply for receipt of tier I or tier II benefits.CommentsClose CommentsPermalink





‘(2) ELIGIBILITY ASSESSMENTS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Not later than October 1, 2012, the Secretary shall enter into agreements with--CommentsClose CommentsPermalink





‘(i) the Disability Determination Service for each State to provide for eligibility assessments of active enrollees who apply for receipt of benefits;CommentsClose CommentsPermalink





‘(ii) the Protection and Advocacy System for each State to provide advocacy services in accordance with subsection (e); andCommentsClose CommentsPermalink





‘(iii) public and private entities to provide advice and assistance counseling in accordance with subsection (f).CommentsClose CommentsPermalink





‘(B) 30-day PERIOD FOR APPROVAL OR DISAPPROVAL- An agreement under subparagraph (A) shall require that a Disability Determination Service determine within 30 days of the receipt of an application for benefits under the CLASS program whether an applicant is an eligible tier I beneficiary or an eligible tier II beneficiary. An application that is pending after 45 days shall be deemed approved.CommentsClose CommentsPermalink





‘(C) PRESUMPTIVE ELIGIBILITY FOR CERTAIN INSTITUTIONALIZED ENROLLEES PLANNING TO DISCHARGE- An active enrollee shall be deemed presumptively eligible if the enrollee--CommentsClose CommentsPermalink





‘(i) has applied for receipt of tier II benefits;CommentsClose CommentsPermalink





‘(ii) is a patient in a hospital, nursing facility, intermediate care facility for the mentally retarded, or an institution for mental diseases; andCommentsClose CommentsPermalink





‘(iii) is in the process of, or about to begin the process of, planning to discharge from the hospital, facility, or institution.CommentsClose CommentsPermalink





‘(D) APPEALS- The Secretary shall establish procedures under which an applicant for benefits under the CLASS program shall be guaranteed the right to appeal an adverse determination.CommentsClose CommentsPermalink





‘(b) Tier I Benefits- An eligible tier I beneficiary shall receive the following tier I benefits:CommentsClose CommentsPermalink





‘(1) DAILY CASH BENEFIT- A daily cash benefit in the amount of $50 per day.CommentsClose CommentsPermalink





‘(2) ANNUAL BENEFIT- An annual benefit in an amount not to exceed the amount equal to the daily benefit applicable under paragraph (1) (after the application of subsection (g)) multiplied by 365.CommentsClose CommentsPermalink





‘(3) ADVOCACY SERVICES- Advocacy services in accordance with subsection (e).CommentsClose CommentsPermalink





‘(4) ADVICE AND ASSISTANCE COUNSELING- Advice and assistance counseling in accordance with subsection (f).CommentsClose CommentsPermalink





‘(5) NO LIFETIME LIMIT- There shall be no lifetime limit on the aggregate tier I benefits that an eligible tier I beneficiary may receive.CommentsClose CommentsPermalink





‘(c) Tier II Benefits- An eligible tier II beneficiary shall receive the following tier II benefits:CommentsClose CommentsPermalink





‘(1) DAILY CASH BENEFIT- A daily cash benefit in the amount of $100 per day.CommentsClose CommentsPermalink





‘(2) ANNUAL BENEFIT- An annual benefit in an amount not to exceed the amount equal to the daily benefit applicable under paragraph (1) (after the application of subsection (g)) multiplied by 365.CommentsClose CommentsPermalink





‘(3) ADVOCACY SERVICES- Advocacy services in accordance with subsection (e).CommentsClose CommentsPermalink





‘(4) ADVICE AND ASSISTANCE COUNSELING- Advice and assistance counseling in accordance with subsection (f).CommentsClose CommentsPermalink





‘(5) NO LIFETIME LIMIT- There shall be no lifetime limit on the aggregate tier II benefits that an eligible tier II beneficiary may receive.CommentsClose CommentsPermalink





‘(d) Payment of Benefits-CommentsClose CommentsPermalink





‘(1) LIFE INDEPENDENCE ACCOUNTS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The Secretary shall establish procedures under which tier I daily cash benefits and tier II daily cash benefits shall be paid on a monthly basis into a Life Independence Account established by the Secretary on behalf of each eligible tier I beneficiary or eligible tier II beneficiary.CommentsClose CommentsPermalink





‘(B) USE OF CASH BENEFITS- Daily cash benefits paid into a Life Independence Account of an eligible tier I beneficiary or an eligible tier II beneficiary shall be used to purchase nonmedical services and supports that the beneficiary needs to maintain his or her independence at home or in another residential setting of their choice in the community, such as home modifications, assistive technology, accessible transportation, homemaker services, respite care, personal assistance services, and home care aides.CommentsClose CommentsPermalink





‘(C) ELECTRONIC MANAGEMENT OF FUNDS- The procedures established in accordance with subparagraph (A) shall provide for--CommentsClose CommentsPermalink





‘(i) crediting an account established on behalf of a beneficiary with the beneficiary’s cash daily benefit;CommentsClose CommentsPermalink





‘(ii) accessing such account through debit cards; andCommentsClose CommentsPermalink





‘(iii) accounting for withdrawals by the beneficiary from such account.CommentsClose CommentsPermalink





‘(D) PRIMARY PAYOR RULES FOR BENEFICIARIES WHO ARE ENROLLED IN MEDICAID- In the case of an eligible tier I beneficiary or an eligible tier II beneficiary who is enrolled in Medicaid, the following payment rules shall apply:CommentsClose CommentsPermalink





‘(i) INSTITUTIONALIZED BENEFICIARY- If the beneficiary is a patient in a hospital, nursing facility, intermediate care facility for the mentally retarded, or an institution for mental diseases, the beneficiary shall retain an amount equal to 5 percent of the beneficiary’s daily cash benefit (which shall be in addition to the amount of the beneficiary’s personal needs allowance provided under Medicaid), and the remainder of such benefit shall be applied toward the facility’s cost of providing the beneficiary’s care, and Medicaid shall provide secondary coverage for such care.CommentsClose CommentsPermalink





‘(ii) BENEFICIARIES RECEIVING HOME AND COMMUNITY-BASED SERVICES-CommentsClose CommentsPermalink





‘(I) 50 PERCENT OF DAILY BENEFIT RETAINED BY BENEFICIARY- If a beneficiary is receiving medical assistance under Medicaid for home and community-based services, the beneficiary shall retain an amount equal to 50 percent of the beneficiary’s daily cash benefit, subject to subclause (II), and the remainder of the daily cash benefit shall be applied toward the cost to the State of providing such assistance (and shall not be used to claim Federal matching funds under Medicaid), and Medicaid shall provide secondary coverage for the remainder of any costs incurred in providing such assistance.CommentsClose CommentsPermalink





‘(II) REQUIREMENT FOR STATE OFFSET- A State shall be paid the remainder of a beneficiary’s daily cash benefit under subclause (I) only if the State home and community-based waiver under section 1115 of the Social Security Act (42 U.S.C. 1315) or subsection (c) or (d) of section 1915 of such Act (42 U.S.C. 1396n) does not include a waiver of the requirements of section 1902(a)(1) of the Social Security Act (relating to statewideness) or of section 1902(a)(10)(B) of such Act (relating to comparability) and the State offers at a minimum case management services, personal care services, habilitation services, and respite care under such a waiver.CommentsClose CommentsPermalink





‘(III) DEFINITION OF HOME AND COMMUNITY-BASED SERVICES- In this clause, the term ‘home and community-based services’ means any services which may be offered under a home and community-based waiver authorized for a State under section 1115 of the Social Security Act (42 U.S.C. 1315) or subsection (c) or (d) of section 1915 of such Act (42 U.S.C. 1396n).CommentsClose CommentsPermalink





‘(2) AUTHORIZED REPRESENTATIVES-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The procedures established under paragraph (1)(A) shall allow for access to tier I daily benefits or tier II daily benefits by an authorized representative of the eligible tier I beneficiary or eligible tier II beneficiary on whose behalf such benefits are paid.CommentsClose CommentsPermalink





‘(B) QUALITY ASSURANCE AND PROTECTION AGAINST FRAUD AND ABUSE- The Secretary shall include in the procedures established under paragraph (1) standards of conduct for authorized representatives of eligible tier I beneficiaries and eligible tier II beneficiaries to ensure that authorized representatives provide quality services on behalf of such beneficiaries, do not have conflicts of interest, and do not misuse benefits paid on behalf of such beneficiaries or otherwise engage in fraud or abuse.CommentsClose CommentsPermalink





‘(3) COMMENCEMENT OF BENEFITS- Tier I benefits or tier II benefits, as applicable, shall be paid to, or on behalf of, an eligible tier I beneficiary or an eligible tier II beneficiary, respectively, beginning with the first month in which an application for such benefits is approved.CommentsClose CommentsPermalink





‘(4) ROLLOVER OPTION FOR LUMP-SUM PAYMENT- An eligible tier I beneficiary or an eligible tier II beneficiary may elect to--CommentsClose CommentsPermalink





‘(A) defer payment of their daily benefit and to rollover any such deferred benefits from month-to-month, but not from year-to-year; andCommentsClose CommentsPermalink





‘(B) receive a lump-sum payment of such deferred benefits in an amount that may not exceed the lesser of--CommentsClose CommentsPermalink





‘(i) the total amount of the accrued deferred benefits; orCommentsClose CommentsPermalink





‘(ii) the applicable annual benefit.CommentsClose CommentsPermalink





‘(5) PERIOD FOR DETERMINATION OF ANNUAL BENEFITS-CommentsClose CommentsPermalink





‘(A) IN GENERAL- The applicable period for determining with respect to an eligible tier I beneficiary or an eligible tier II beneficiary the applicable annual benefit and the amount of any accrued deferred benefits is the 12-month period that commences with the first month in which the beneficiary began to receive such benefits, and each 12-month period thereafter.CommentsClose CommentsPermalink





‘(B) INCLUSION OF TIER I BENEFITS- The Secretary shall establish procedures under which benefits paid to an eligible tier I beneficiary who becomes an eligible tier II beneficiary before the end of a 12-month benefit period shall be included in the determination of the applicable annual benefit paid to the eligible tier II beneficiary.CommentsClose CommentsPermalink





‘(C) RECOUPMENT OF UNPAID, ACCRUED BENEFITS-CommentsClose CommentsPermalink





‘(i) IN GENERAL- The Secretary shall recoup any accrued benefits in the event of--CommentsClose CommentsPermalink





‘(I) the death of a beneficiary; orCommentsClose CommentsPermalink





‘(II) the failure of a beneficiary to elect under paragraph (4)(B) to receive such benefits as a lump-sum payment before the end of the 12-month period in which such benefits accrued.CommentsClose CommentsPermalink





‘(ii) PAYMENT INTO INDEPENDENCE FUND- Any benefits recouped in accordance with clause (i) shall be paid into the Independence Fund and used in accordance with section 3105.CommentsClose CommentsPermalink





‘(6) REQUIREMENT TO RECERTIFY ELIGIBILITY FOR RECEIPT OF BENEFITS AND TO NOTIFY THE SECRETARY IF NOT EARNING WAGES OR INCOME- The procedures established under paragraph (1)(A) shall provide for an eligible tier I beneficiary or an eligible tier II beneficiary to--CommentsClose CommentsPermalink





‘(A) annually--CommentsClose CommentsPermalink





‘(i) recertify by submission of medical evidence the beneficiary’s continued eligibility for receipt of tier I or tier II benefits (as applicable); andCommentsClose CommentsPermalink





‘(ii) submit records of expenditures attributable to the aggregate daily cash benefit received by the beneficiary during the preceding year; andCommentsClose CommentsPermalink





‘(B) notify the Secretary if the beneficiary is not earning wages or deriving self-employment income and should not have to pay a monthly premium to maintain enrollment in the CLASS program in accordance with section 3103(e)(2).CommentsClose CommentsPermalink





‘(7) SUPPLEMENT, NOT SUPPLANT OTHER HEALTH CARE BENEFITS- Subject to the Medicaid payment rules under paragraph (1)(C), benefits received by an eligible tier I beneficiary or an eligible tier II beneficiary shall supplement, but not supplant, other health care benefits for which the beneficiary is eligible under Medicaid or any other federally funded program that provides health care benefits or assistance.CommentsClose CommentsPermalink





‘(e) Advocacy Services- An agreement entered into under subsection (a)(2)(A)(ii) shall require the Protection and Advocacy System for the State to--CommentsClose CommentsPermalink





‘(1) assign, as needed, an advocacy counselor to each eligible tier I beneficiary or eligible tier II beneficiary that is covered by such agreement and who provides an eligible tier I beneficiary or an eligible tier II beneficiary with--CommentsClose CommentsPermalink





‘(A) information regarding how to access the appeals process established for the program;CommentsClose CommentsPermalink





‘(B) assistance with respect to the annual recertification and notification required under subsection (d)(6); andCommentsClose CommentsPermalink





‘(C) such other services as the Secretary, by regulation, shall require; andCommentsClose CommentsPermalink





‘(2) ensure that the System and such counselors comply with the requirements of subsection (i).CommentsClose CommentsPermalink





‘(f) Advice and Assistance Counseling- An agreement entered into under subsection (a)(2)(A)(iii) shall require the entity to assign, as requested by an eligible tier I beneficiary or an eligible tier II beneficiary that is covered by such agreement, an advice and assistance counselor who provides an eligible tier I beneficiary or an eligible tier II beneficiary with information regarding--CommentsClose CommentsPermalink





‘(1) accessing and coordinating long-term services and supports in the most integrated setting;CommentsClose CommentsPermalink





‘(2) possible eligibility for other benefits and services;CommentsClose CommentsPermalink





‘(3) development of a service and support plan;CommentsClose CommentsPermalink





‘(4) information about programs established under the Assistive Technology Act of 1998 and the services offered under such programs; andCommentsClose CommentsPermalink





‘(5) such other services as the Secretary, by regulation, may require.CommentsClose CommentsPermalink





‘(g) No Effect on Eligibility for Other Benefits- Benefits paid to an eligible tier I beneficiary or an eligible tier II beneficiary under the CLASS program shall be disregarded for purposes of determining or continuing the beneficiary’s eligibility for receipt of benefits under any other Federal, State, or locally funded assistance program, including benefits paid under titles II, XVI, XVIII, XIX, or XXI of the Social Security Act (42 U.S.C. 401 et seq., 1381 et seq., 1395 et seq., 1396 et seq., 1397aa et seq.), under the laws administered by the Secretary of Veterans Affairs, under low-income housing assistance programs, or under the food stamp program established under the Food Stamp Act of 1977 (7 U.S.C. 2011).CommentsClose CommentsPermalink





‘(h) Cost-of-Living and Other Adjustments-CommentsClose CommentsPermalink





‘(1) IN GENERAL- Beginning with 2011, the dollar amounts specified in subsections (b)(1) and (c)(1) shall be annually increased by the percentage increase in the consumer price index for all urban consumers (U.S. city average) over the previous year.CommentsClose CommentsPermalink





‘(2) ADDITIONAL ADJUSTMENT- With respect to any year for which the Secretary has determined under section 3103(b)(4)(C) that an adjustment to the monthly premium amounts is necessary to ensure program solvency, the Secretary shall decrease the increase in the dollar amounts specified in subsections (b)(1) and (c)(1) that would otherwise be applicable under paragraph (1) for that year, by such amount as the Secretary determines is appropriate for that year (but shall ensure that there is an increase in such dollar amounts for that year).CommentsClose CommentsPermalink





‘(i) Rule of Construction- Nothing in this title shall be construed as prohibiting tier I or tier II benefits paid under the CLASS program from being used to compensate a family caregiver for providing community living assistance services and supports to an eligible tier I beneficiary or an eligible tier II beneficiary.CommentsClose CommentsPermalink





‘(j) Protection Against Conflict of Interests- The Secretary shall establish procedures to ensure that the Disability Determination Service and Protection and Advocacy System for a State, advocacy counselors for eligible tier I or eligible tier II beneficiaries, and any other entities that provide services to active enrollees and eligible tier I or eligible tier II beneficiaries under the CLASS program comply with the following:CommentsClose CommentsPermalink





‘(1) If the entity provides counseling or planning services, such services are provided in a manner that fosters the best interests of the active enrollee or beneficiary.CommentsClose CommentsPermalink





‘(2) The entity has established operating procedures that are designed to avoid or minimize conflicts of interest between the entity and an active enrollee or beneficiary.CommentsClose CommentsPermalink





‘(3) The entity provides information about all services and options available to the active enrollee or beneficiary, to the best of its knowledge, including services available through other entities or providers.CommentsClose CommentsPermalink





‘(4) The entity assists the active enrollee or beneficiary to access desired services, regardless of the provider.CommentsClose CommentsPermalink





‘(5) The entity reports the number of active enrollees and beneficiaries provided with assistance by age, disability, and whether such enrollees and beneficiaries received services from the entity or another entity.CommentsClose CommentsPermalink





‘(6) If the entity provides counseling or planning services, the entity ensures that an active enrollee or beneficiary is informed of any financial interest that the entity has in a service provider.CommentsClose CommentsPermalink





‘(7) The entity provides an active enrollee or beneficiary with a list of available service providers that can meet the needs of the active enrollee or beneficiary.CommentsClose CommentsPermalink

‘SEC. 3105. INDEPENDENCE FUND.

‘(a) Establishment of Independence Fund- There is established in the Treasury of the United States a trust fund to be known as the ‘Independence Fund’. The Secretary shall serve as Managing Trustee of such Fund. The Fund shall consist of all amounts derived from payments into the Fund under sections 3103(d) and 3104(d)(5)(C)(ii), and remaining after investment of such amounts under subsection (b), including additional amounts derived as income from such investments. The amounts held in the Fund are appropriated and shall remain available without fiscal year limitation--CommentsClose CommentsPermalink





‘(1) to be held for investment on behalf of individuals enrolled in the CLASS program;CommentsClose CommentsPermalink





‘(2) to pay the administrative expenses related to the Fund and to investment under subsection (b); andCommentsClose CommentsPermalink





‘(3) to pay tier I and tier II benefits under section 3104.CommentsClose CommentsPermalink





‘(b) Investment of Fund Balance- The Secretary, through the Secretary of the Treasury, shall invest the Independence Fund in the same manner, and to the same extent, as the Federal Old-Age and Survivors Trust Fund and the Federal Disability Insurance Trust Fund may be invested under section 201(d) of the Social Security Act (42 U.S.C. 401(d)).CommentsClose CommentsPermalink





‘(c) Off-Budget Status; Lock-Box Protection-CommentsClose CommentsPermalink





‘(1) EXCLUSION OF TRUST FUNDS FROM ALL BUDGETS- Notwithstanding any other provision of law, the amounts derived from payments into the Fund and amounts paid from the Fund shall not be counted as new budget authority, outlays, receipts, or deficit or surplus for purposes of--CommentsClose CommentsPermalink





‘(A) the budget of the United States Government, as submitted by the President;CommentsClose CommentsPermalink





‘(B) the congressional budget; orCommentsClose CommentsPermalink





‘(C) the Balanced Budget and Emergency Deficit Control Act of 1985.CommentsClose CommentsPermalink





‘(2) LOCK-BOX PROTECTION-CommentsClose CommentsPermalink





‘(A) IN GENERAL- Notwithstanding any other provision of law, it shall not be in order in the Senate or the House of Representatives to consider any measure that would authorize the payment or use of amounts in the Fund for any purpose other than a purpose authorized under this title.CommentsClose CommentsPermalink





‘(B) 60-vote WAIVER REQUIRED IN THE SENATE-CommentsClose CommentsPermalink





‘(i) IN GENERAL- Subparagraph (A) may be waived or suspended in the Senate only by the affirmative vote of 3/5 of the Members, duly chosen and sworn.CommentsClose CommentsPermalink





‘(ii) APPEALS-CommentsClose CommentsPermalink





‘(I) PROCEDURE- Appeals in the Senate from the decisions of the Chair relating to clause (i) shall be limited to 1 hour, to be equally divided between, and controlled by, the mover and the manager of the measure that would authorize the payment or use of amounts in the Fund for a purpose other than a purpose authorized under this title.CommentsClose CommentsPermalink





‘(II) 60-votes REQUIRED- An affirmative vote of 3/5 of the Members, duly chosen and sworn, shall be required in the Senate to sustain an appeal of the ruling of the Chair on a point of order raised in relation to clause (i).CommentsClose CommentsPermalink





‘(C) RULES OF THE SENATE AND HOUSE OF REPRESENTATIVES- This section is enacted by Congress--CommentsClose CommentsPermalink





‘(i) as an exercise of the rulemaking power of the Senate and House of Representatives, respectively, and is deemed to be part of the rules of each House, respectively, but applicable only with respect to the procedure to be followed in that House in the case of a measure described in subparagraph (A), and it supersedes other rules only to the extent that it is inconsistent with such rules; andCommentsClose CommentsPermalink





‘(ii) with full recognition of the constitutional right of either House to change the rules (so far as they relate to the procedure of that House) at any time, in the same manner, and to the same extent as in the case of any other rule of that House.CommentsClose CommentsPermalink





‘(d) Additional Appropriations To Ensure Solvency During Initial Benefit Years- In addition to the amounts appropriated to the Fund under subsection (a), out of any money in the Treasury of the United States not otherwise appropriated, there are appropriated to the Fund, for each of fiscal years 2013 through 2017, such sums as are necessary for each such fiscal year (and which, in the case of each of fiscal years 2014 through 2017, shall be less than the amount appropriated for the preceding fiscal year) to ensure the solvency of the Fund during the first 5 years in which tier I or tier II benefits are paid from the Fund. Amounts appropriated under this subsection shall remain available without fiscal year limitation for the purposes specified in paragraphs (1), (2), and (3) of subsection (a).CommentsClose CommentsPermalink

‘SEC. 3106. REGULATIONS; ANNUAL REPORT.

‘(a) Regulations- The Secretary shall promulgate such regulations as are necessary to carry out the CLASS program in accordance with this title. Such regulations shall include provisions to prevent fraud and abuse under the program.CommentsClose CommentsPermalink





‘(b) Annual Report- Beginning with fiscal year 2013, the Secretary shall submit an annual report to Congress on the CLASS program. Each report shall include the following:CommentsClose CommentsPermalink





‘(1) The total amount of enrollees in the program.CommentsClose CommentsPermalink





‘(2) The total number of eligible tier I beneficiaries and eligible tier II beneficiaries during the fiscal year.CommentsClose CommentsPermalink





‘(3) The total amount of tier I and tier II benefits provided during the fiscal year.CommentsClose CommentsPermalink





‘(4) A description of instances of fraud or abuse identified during the fiscal year.CommentsClose CommentsPermalink





‘(5) Recommendations for such administrative or legislative action as the Secretary determines is necessary to improve the program or to prevent the occurrence of fraud or abuse.CommentsClose CommentsPermalink

‘SEC. 3107. TAX TREATMENT OF PROGRAM.

‘The CLASS program shall be treated for purposes of the Internal Revenue Code of 1986 in the same manner as a qualified long-term care insurance contract for qualified long-term care services.’.CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENTS TO MEDICAID- Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by section 5006(e)(2)(A) of division B of Public Law 111-5, is amended--CommentsClose CommentsPermalink





(A) in paragraph (72), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(B) in paragraph (73)(B), by striking the period and inserting ‘; and’; andCommentsClose CommentsPermalink





(C) by inserting after paragraph (73) the following:CommentsClose CommentsPermalink





‘(74) provide that the State will comply with such regulations regarding the application of primary and secondary payor rules with respect to individuals who are eligible for medical assistance under this title and are eligible tier I beneficiaries or eligible tier II beneficiaries under the CLASS program established under title XXIX of the Public Health Service Act as the Secretary shall establish.’.CommentsClose CommentsPermalink





(b) Assurance of Adequate Infrastructure for the Provision of Personal Care Attendant Workers- Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by subsection (a)(2), is amended--CommentsClose CommentsPermalink





(1) in paragraph (73)(B), by striking ‘and’ at the end;CommentsClose CommentsPermalink





(2) in paragraph (74), by striking the period at the end and inserting ‘; and’; andCommentsClose CommentsPermalink





(3) by inserting after paragraph (74), the following:CommentsClose CommentsPermalink





‘(75) provide that, not later than 2 years after the date of enactment of the Community Living Assistance Services and Supports Act, each State shall--CommentsClose CommentsPermalink





‘(A) assess the extent to which entities such as providers of home care, home health services, home and community service providers, public authorities created to provide personal care services to individuals eligible for medical assistance under the State plan, and nonprofit organizations, are serving or have the capacity to serve as fiscal agents for, employers of, and providers of employment-related benefits for, personal care attendant workers who provide personal care services to individuals receiving benefits under the CLASS program established under title XXIX of the Public Health Service Act, including in rural and underserved areas;CommentsClose CommentsPermalink





‘(B) designate or create such entities to serve as fiscal agents for, employers of, and providers of employment-related benefits for, such workers to ensure an adequate supply of the workers for individuals receiving benefits under the CLASS program, including in rural and underserved areas; andCommentsClose CommentsPermalink





‘(C) ensure that the designation or creation of such entities will not negatively alter or impede existing programs, models, methods, or administration of service delivery that provide for consumer controlled or self-directed home and community services and further ensure that such entities will not impede the ability of individuals to direct and control their home and community services, including the ability to select, manage, dismiss, co-employ, or employ such workers or inhibit such individuals from relying on family members for the provision of personal care services.’.CommentsClose CommentsPermalink





(c) Personal Care Attendants Workforce Advisory Panel-CommentsClose CommentsPermalink





(1) ESTABLISHMENT- Not later than 90 days after the date of enactment of this Act, the Secretary of Health and Human Services shall establish a Personal Care Attendants Workforce Advisory Panel for the purpose of examining and advising the Secretary and Congress on workforce issues related to personal care attendant workers, including with respect to the adequacy of the number of such workers, the salaries, wages, and benefits of such workers, and access to the services provided by such workers.CommentsClose CommentsPermalink





(2) MEMBERSHIP- In appointing members to the Personal Care Attendants Workforce Advisory Panel, the Secretary shall ensure that such members include the following:CommentsClose CommentsPermalink





(A) Individuals with disabilities of all ages.CommentsClose CommentsPermalink





(B) Senior individuals.CommentsClose CommentsPermalink





(C) Representatives of individuals with disabilities.CommentsClose CommentsPermalink





(D) Representatives of senior individuals.CommentsClose CommentsPermalink





(E) Representatives of workforce and labor organizations.CommentsClose CommentsPermalink





(F) Representatives of home and community-based service providers.CommentsClose CommentsPermalink





(G) Representatives of assisted living providers.CommentsClose CommentsPermalink

TITLE II--AMENDMENTS TO THE INTERNAL REVENUE CODE OF 1986CommentsClose CommentsPermalink

SEC. 201. ABOVE-THE-LINE DEDUCTION FOR PREMIUM COSTS.

(a) In General- Section 62(a) of the Internal Revenue Code of 1986 (defining adjusted gross income) is amended by inserting after paragraph (21) the following new paragraph:CommentsClose CommentsPermalink





‘(22) CLASS PROGRAM PREMIUMS- The deduction allowed by section 213 (determined without regard to any adjusted gross income limitation) which consists of amounts paid by the taxpayer for enrollment in the CLASS program (as defined in section 36B(d)) for eligible enrollment months (as defined in section 36(b)) beginning in the taxable year.’.CommentsClose CommentsPermalink





(b) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2009.CommentsClose CommentsPermalink

SEC. 202. CREDIT FOR PREMIUM COSTS OF CLASS ENROLLEES WITH LOW-INCOME.

(a) In General- Subpart C of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 (relating to refundable credits) is amended by inserting after section 36A the following new section:CommentsClose CommentsPermalink

‘SEC. 36B. PREMIUM COSTS OF CLASS ENROLLEES WITH LOW-INCOME.

‘(a) In General- In the case of a CLASS enrollee with low-income, there shall be allowed as a credit against the tax imposed by subtitle A an amount equal to 50 percent of the amount paid by the taxpayer for enrollment of the taxpayer and the taxpayer’s spouse in the CLASS program for eligible enrollment months beginning in the taxable year.CommentsClose CommentsPermalink





‘(b) Eligible Enrollment Month- For purposes of this section--CommentsClose CommentsPermalink





‘(1) IN GENERAL- The term ‘eligible enrollment month’ means any month if, as of the first day of such month, the taxpayer is a CLASS enrollee with low-income enrolled in the CLASS program, the premium for which is paid by the taxpayer.CommentsClose CommentsPermalink





‘(2) JOINT RETURNS- In the case of a joint return, the requirements of paragraph (1) shall be treated as met with respect to any month if at least 1 spouse satisfies such requirements.CommentsClose CommentsPermalink





‘(c) CLASS Enrollee With Low-Income- For purposes of this section, the term ‘CLASS enrollee with low-income’ means an individual--CommentsClose CommentsPermalink





‘(1) who is an active enrollee in the CLASS program (as defined in section 3101(1) of the Public Health Service Act); andCommentsClose CommentsPermalink





‘(2) whose gross income does not exceed 250 percent of the poverty line.CommentsClose CommentsPermalink





‘(d) CLASS Program- For purposes of this section, the term ‘CLASS program’ means the program for community living assistance services and supports established under title XXIX of the Public Health Service Act.CommentsClose CommentsPermalink





‘(e) Special Rules-CommentsClose CommentsPermalink





‘(1) COORDINATION WITH OTHER DEDUCTIONS- Amounts taken into account under subsection (a) shall not be taken into account in determining any deduction allowed under section 62(a)(22), 162(l), or 213.CommentsClose CommentsPermalink





‘(2) MSA DISTRIBUTIONS- Amounts distributed from an Archer MSA (as defined in section 220(d)) shall not be taken into account under subsection (a).CommentsClose CommentsPermalink





‘(3) DENIAL OF CREDIT TO DEPENDENTS- No credit shall be allowed under this section to any individual with respect to whom a deduction under section 151 is allowable to another taxpayer for a taxable year beginning in the calendar year in which such individual’s taxable year begins.CommentsClose CommentsPermalink





‘(4) BOTH SPOUSES ELIGIBLE INDIVIDUALS- For purposes of subsection (a), the amount paid for enrollment of the taxpayer’s spouse shall be disregarded if--CommentsClose CommentsPermalink





‘(A) the taxpayer is married at the close of the taxable year,CommentsClose CommentsPermalink





‘(B) the taxpayer and the taxpayer’s spouse are both CLASS enrollee with low-income during the taxable year, andCommentsClose CommentsPermalink





‘(C) the taxpayer files a separate return for the taxable year.CommentsClose CommentsPermalink





‘(5) MARITAL STATUS; CERTAIN MARRIED INDIVIDUALS LIVING APART- Rules similar to the rules of paragraph (3) and (4) of section 21(e) shall apply for purposes of this section.CommentsClose CommentsPermalink





‘(f) Regulations- The Secretary may prescribe such regulations and guidance as may be necessary or appropriate to carry out this section.’.CommentsClose CommentsPermalink





(b) Conforming Amendments-CommentsClose CommentsPermalink





(1) Paragraph (2) of section 1324(b) of title 31, United States Code, is amended by striking ‘section 35’ and all that follows through ‘53(e)’ and inserting ‘section 35, 36, 36A, 36B, 53(e), or 6428’.CommentsClose CommentsPermalink





(2) Section 6211(b)(4)(A) is amended by inserting ‘36B,’ after ‘36A,’.CommentsClose CommentsPermalink





(3) The table of sections for subpart C of part IV of chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after the item relating to section 36A the following new item:CommentsClose CommentsPermalink





‘Sec. 36B. Premiums costs of CLASS enrollees with low-income.’.CommentsClose CommentsPermalink





(c) Effective Date- The amendments made by this section shall apply to taxable years beginning after December 31, 2009.CommentsClose CommentsPermalink

SEC. 203. CREDIT FOR COSTS OF EMPLOYERS WHO ELECT TO AUTOMATICALLY ENROLL EMPLOYEES AND WITHHOLD CLASS PREMIUMS FROM WAGES.

(a) In General- Subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 (relating to business credits) is amended by inserting after section 45Q the following:CommentsClose CommentsPermalink

‘SEC. 45R. CREDIT FOR COSTS OF AUTOMATICALLY ENROLLING EMPLOYEES AND WITHHOLDING CLASS PREMIUMS FROM WAGES.

‘(a) General Rule- For purposes of section 38, the CLASS automatic enrollment and premium withholding credit determined under this section for the taxable year is an amount equal to 25 percent of the total amount paid or incurred by the taxpayer during the taxable year to--CommentsClose CommentsPermalink





‘(1) automatically enroll employees in the CLASS program established under title XXIX of the Public Health Service Act, andCommentsClose CommentsPermalink





‘(2) withhold monthly CLASS premiums on behalf of an employee who is enrolled in that program.CommentsClose CommentsPermalink





‘(b) Denial of Double Benefit- No deduction shall be allowed under this chapter for any amount taken into account in determining the credit under this section.CommentsClose CommentsPermalink





‘(c) Election Not To Claim Credit- This section shall not apply to a taxpayer for any taxable year if such taxpayer elects to have this section not apply for such taxable year.’.CommentsClose CommentsPermalink





(b) Credit Made Part of General Business Credit- Subsection (b) of section 38 of the Internal Revenue Code of 1986 (relating to general business credit) is amended by striking ‘plus’ at the end of paragraph (34), by striking the period at the end of paragraph (35) and inserting ‘, plus’, and by inserting after paragraph (35) the following new paragraph:CommentsClose CommentsPermalink





‘(36) the CLASS automatic enrollment and premium withholding credit determined under section 45R(a).’.CommentsClose CommentsPermalink





(c) Clerical Amendment- The table of sections for subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after the item relating to section 45Q the following new item:CommentsClose CommentsPermalink





‘Sec. 45R. Credit for costs of automatically enrolling employees and withholding CLASS premiums from wages.’.CommentsClose CommentsPermalink





(d) Effective Date- The amendments made by this section shall apply to expenses paid or incurred after December 31, 2009, in taxable years ending after such date.CommentsClose CommentsPermalink

SEC. 204. LONG-TERM CARE INSURANCE INCLUDIBLE IN CAFETERIA PLANS.

(a) In General- Section 125(f) of the Internal Revenue Code of 1986 is amended by striking the last sentence.CommentsClose CommentsPermalink





(b) Effective Date- The amendment made by subsection (a) shall apply to taxable years beginning after December 31, 2009.CommentsClose CommentsPermalink

TITLE III--EFFECTIVE DATECommentsClose CommentsPermalink

SEC. 301. EFFECTIVE DATE.

Except as provided in sections 201(b), 202(c), 203(d), and 204(b), this Act and the amendments made by this Act take effect on January 1, 2010.CommentsClose CommentsPermalink