Health Care

HOUSE BILL 1443
By Jones R

SENATE BILL 1777
By Crowe
SB1777
009151
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AN ACT to amend Tennessee Code Annotated, Title 9;
Title 33; Title 52; Title 67 and Title 68, relative to
relief for caregivers of individuals with Alzheimer's
disease or related dementia.

WHEREAS, one in three senior citizens will die from dementia; and
WHEREAS, the caregivers of family members with Alzheimer's disease incur
replacement costs and forgone wages estimated to be $36,667 per person; and
WHEREAS, financial relief is positively related to the level of service and support
provided by informal caregivers; and
WHEREAS, it is fitting and proper that the State create a financial relief program to
benefit Alzheimer's caregivers; now, therefore,
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 52, is amended by adding the following
as a new chapter:
52-9-101. Short title.
This chapter is known and may be cited as the "Caring for Caregivers Act."
52-9-102. Chapter definitions.
As used in this chapter:
(1) "Activities of daily living" or "ADL" means:
(A) Ambulating, which is the extent of an individual's ability to
move from one position to another and walk independently;
(B) Feeding, which is the ability of an individual to feed oneself;
(C) Dressing, which is the ability to select appropriate clothes and
to put the clothes on without aid;

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(D) Personal hygiene, which is the ability to bathe and groom
oneself and maintain dental hygiene and nail and hair care;
(E) Continence, which is the ability to control bladder and bowel
function; and
(F) Toileting, which is the ability to get to and from the toilet
without aid, using it appropriately, and cleaning oneself;
(2) "Adjusted income" means household income minus fifty percent
(50%) of the cost of total eligible expenditures for the year;
(3) "Alzheimer's disease or related dementia" has the same meaning as
defined in § 52-8-203;
(4) "Eligible expenditures":
(A) Means uncompensated expenses paid or incurred by a family
caregiver that are directly related to assisting the family caregiver in
providing care to an eligible family member;
(B) Includes expenses paid or incurred for:
(i) The improvement or alteration to the family caregiver's
or eligible family member's primary residence to permit the eligible
family member to live in the residence and to remain mobile, safe,
and independent;
(ii) The family caregiver's purchase or lease of equipment,
including healthcare equipment, durable medical equipment, or
technology that is necessary to assist an eligible family member in
carrying out one (1) or more ADLs; or
(iii) Respite care; and

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(C) Does not include the carrying out of general household
maintenance activities such as painting, plumbing, electrical repairs, or
exterior maintenance;
(5) "Eligible family member" means an individual who:
(A) Requires assistance with at least two (2) ADLs and is
diagnosed with Alzheimer's disease or related dementia and qualifies as
an adult child, spouse, parent, or other relative by blood or marriage to a
family caregiver; and
(B) Lives in a private residential home and not in an assisted
living center, nursing facility, or residential care home;
(6) "Family caregiver" means an individual who:
(A) Provides care and support for an eligible family member;
(B) Has incurred eligible expenditures; and
(C) For calendar year 2027, and each subsequent year, has an
annual adjusted income from all sources that does not exceed the area or
state median income, whichever is greater, adjusted for family size;
(7) "Low income household" has the same meaning as defined in § 13-
23-103;
(8) "Respite care" has the same meaning as defined in § 52-8-203; and
(9) "Very low income household" has the same meaning as defined in §
13-23-103.
52-9-103. Family caregiver grant pilot program.
(a) The department shall establish and administer a family caregiver grant pilot
program to provide grants to family caregivers of eligible family members in each of the

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three (3) grand divisions to offset eligible expenditures incurred by the family caregivers.
The pilot program must be operated from July 1, 2026, to December 31, 2029.
(b) There is created a separate fund within the general fund to be known as the
family caregiver grant fund. The fund is composed of:
(1) Funds appropriated by the general assembly for the fund; and
(2) Gifts, grants, and other donations received by the department for the
fund.
(c) Subject to the availability of funds, the department shall allocate and disperse
grants each fiscal year of the pilot program period to family caregivers of eligible family
members giving primary priority to very low income households and secondary priority to
low income households. A grant awarded under this chapter is limited to six thousand
dollars ($6,000) per family caregiver in a fiscal year.
(d) Family caregivers must continue to qualify for a grant while the eligible family
member is temporarily relocated for health care to a hospital or skilled or intermediate
care facility if the eligible family member indicates an intent to return to the private
residential home when recovered sufficiently.
(e) The state treasurer shall invest moneys in the fund for the benefit of the fund
in accordance with § 9-4-603. Interest accruing on investments and deposits of the fund
must be returned to the fund and remain part of the fund. Any unencumbered moneys
and any unexpended balance of the fund remaining at the end of a fiscal year do not
revert to the general fund, but must be carried forward until expended in accordance with
this section.
52-9-104. Annual adjusted income limit.
The annual adjusted income limit in § 52-9-102(6)(C) must be adjusted by the
department on July 1, 2027, and July 1, 2028, to reflect the cost-of-living adjustment for

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social security recipients as determined by the social security administration and must
be rounded to the nearest ten dollars ($10.00). The income attributable to the family
caregiver applying for a grant is the income of the family caregiver and the income of the
family caregiver's spouse, if applicable.
52-9-105. Rules.
The commissioner may promulgate rules to effectuate this chapter in accordance
with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
52-9-106. Report.
On or before October 1, 2027, and by October 1 of each subsequent year, until
the close of the pilot program period, the department shall submit a report to the chair of
the health and welfare committee of the senate and the chair of the committee in the
house of representatives having jurisdiction over health-related matters on the status of
the program and on the funds received and payments made by the family caregiver
grant fund.
SECTION 2. It is the legislative intent that an initial appropriation in the amount of six
hundred thousand dollars ($600,000) be appropriated in fiscal year 2026-2027 in the general
appropriations act for awarding grants from the fund.
SECTION 3. This act is not an appropriation of funds, and funds must not be obligated
or expended pursuant to this act unless the funds are specifically appropriated by the general
appropriations act.
SECTION 4. The headings in this act are for reference purposes only and do not
constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
requested to include the headings in any compilation or publication containing this act.

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SECTION 5. For the purpose of promulgating rules, this act takes effect upon becoming
a law, the public welfare requiring it. For all other purposes, this act takes effect July 1, 2026,
the public welfare requiring it.