Short title

This Act may be cited as the

Care Coordination for Older Americans Act of 2014

Declaration of objectives

Section 101(4) of the Older Americans Act of 1965 (42 U.S.C. 3001(4)) is amended by inserting care coordination and after including.

Definitions

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended by adding at the end the following:

(55) (A)The term care coordination means a person- and family-centered, assessment-based, and interdisciplinary approach to meet the needs and preferences of an older individual and a family caregiver while enhancing the capabilities of the older individual (including the ability to self-direct services). (B)The term care coordination means coordination that— (i)integrates health care, long-term services and supports, housing, and social support services in a high-quality and cost-effective manner in which an individual’s needs, preferences, and capabilities are assessed, along with the needs and preferences of a family caregiver; (ii)includes, as a core element, the active involvement of the older individual, the family, or a representative appointed by the older individual or legally acting on the individual’s behalf, community-based service professionals, and health care professionals providing care to the older individual, in the design and implementation of an individualized, individual-centered service and support plan, through which the services and supports will be provided in a manner free from conflicts of interest; (iii)integrates services and interventions that are implemented, monitored, and evaluated for effectiveness using an evidence-based process, which typically involves a designated lead care coordinator and involves feedback from the older individual; (iv)includes activities that aim simultaneously at meeting individual and family needs and preferences, building on individual capabilities, and improving outcomes and systems of care; (v)includes provision of some or all of the services and activities described in clauses (i) through (iv) by trained professionals employed by or under a contract with— (I)area agencies on aging; (II)Aging and Disability Resource Centers; or (III)other service providers, including in-home service providers; and (vi)is not furnished to directly diagnose, treat, or cure a medical disease or condition.

Functions of the Assistant Secretary

Section 202(a) of the Older Americans Act of 1965 (42 U.S.C. 3012(a)) is amended— (1)in paragraph (27), by striking and at the end; (2)in paragraph (28), by striking the period and inserting ; and; and (3)by adding at the end the following:

(29) (A)encourage, provide technical assistance to, and share best practices with, States, area agencies on aging, Aging and Disability Resource Centers, and service providers to carry out outreach and coordinate activities with health care entities in order to assure better care coordination for individuals with multiple chronic illnesses; and (B)coordinate activities with other Federal agencies that are working to improve care coordination and developing new models and best practices.

Organization

Section 305(a) of the Older Americans Act of 1965 (42 U.S.C. 3025(g)) is amended— (1)in paragraph (2), by striking and at the end; (2)in paragraph (3), by striking the period and inserting ; and; and (3)by adding at the end the following:

(4)the State agency shall promote the development and implementation of a State system to address the care coordination needs of older individuals with multiple chronic illnesses, and shall work with acute care providers, area agencies on aging, service providers, and Federal agencies to ensure that the system uses best practices and is evaluated on its provision of care coordination.

Area plans

Section 306(a) of the Older Americans Act of 1965 (42 U.S.C. 3026(a)) is amended— (1)in paragraph (4)(B)(i)(VII) by inserting with multiple chronic illnesses or after older individuals; (2)in paragraph (6)(D), by inserting (including acute care providers) after service providers; (3)in paragraph (16), by striking and at the end; (4)in paragraph (17) by striking the period and inserting ; and; and (5)by adding at the end the following:

(18)provide assurances that the area agency on aging will— (A)identify existing (as of the date of submission of the plan) care coordination programs and systems; (B)identify unmet community need for care coordination; (C)facilitate the development and implementation of an area-wide system to address the care coordination needs of older individuals with multiple chronic illnesses; and (D)work with acute care providers, service providers, and Federal and State agencies to ensure that the system uses best practices in its provision of care coordination.

State plans

Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 3027(a)) is amended— (1)in paragraph (2)(A), by inserting care coordination, after information and assistance,; (2)in paragraph (17), by striking and develop collaborative programs, where appropriate, and inserting , ensure care coordination, and (where appropriate) develop collaborative programs,; (3)in paragraph (18), in the matter preceding subparagraph (A), by inserting and ensure care coordination that integrates long-term care services and other care services, before for older; (4)in paragraph (23), by striking with other State services and inserting with other Federal and State health care programs and services; and (5)by adding at the end the following:

(31)The plan shall provide assurances that the area agencies on aging in the State will facilitate the area-wide development and implementation of an area-wide system to address the care coordination needs of older individuals with multiple chronic illnesses, and work with acute care providers, service providers, and other Federal and State agencies to ensure that the system uses best practices and is evaluated on its provision of care coordination.