109 HR 5293 RH: Senior U.S. House of Representatives 2006-06-08 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

IB Union Calendar No. 275 109th CONGRESS 2d Session H. R. 5293 [Report No. 109–493] IN THE HOUSE OF REPRESENTATIVES May 4, 2006 Mr. Tiberi (for himself and Mr. Hinojosa) introduced the following bill; which was referred to the Committee on Education and the Workforce June 8, 2006 Additional sponsors: Mr. McKeon, Mr. Regula, Mr. Petri, Mr. Porter, Miss McMorris, Mr. Fortuño, Mr. Boustany, Mr. George Miller of California, Mr. Souder, Mr. Wilson of South Carolina, Mr. Davis of Illinois, Mr. Castle, Mr. Sam Johnson of Texas, Mrs. Drake, Mr. Ehlers, Ms. Lee, Ms. Matsui, Mr. Simmons, Mr. Ryan of Ohio, Mr. Doggett, Mr. McCotter, Mrs. Biggert, Mrs. Maloney, Mr. McHugh, Mr. Wu, Mr. LoBiondo, Mr. Holt, Mr. Kind, Mrs. Capito, Mr. Kuhl of New York, Ms. Kilpatrick of Michigan, Mr. Osborne, and Mr. Hall June 8, 2006 Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed Strike out all after the enacting clause and insert the part printed in italic For text of introduced bill, see copy of bill as introduced on May 4, 2006 A BILL To amend the Older Americans Act of 1965 to authorize appropriations for fiscal years 2007 through 2011, and for other purposes.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the Senior Independence Act of 2006. (b)

Table of contents

The table of contents of this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Definitions. Sec. 3. Establishment of Administration on Aging. Sec. 4. Functions of the Assistant Secretary. Sec. 5. Federal agency consultation. Sec. 6. Administration. Sec. 7. Evaluation. Sec. 8. Reports. Sec. 9. Contractual, commercial and private pay relationships; appropriate use of Act funds. Sec. 10. Nutrition education. Sec. 11. Pension counseling and information programs. Sec. 12. Authorization of appropriations. Sec. 13. Purpose; administration. Sec. 14. Authorization of appropriations; uses of funds. Sec. 15. Organization. Sec. 16. Area plans. Sec. 17. State plans. Sec. 18. Payments. Sec. 19. Nutrition services incentive program. Sec. 20. Consumer contributions. Sec. 21. Supportive services and senior centers program. Sec. 22. Nutrition service. Sec. 23. Congregate nutrition program. Sec. 24. Home delivered nutrition services. Sec. 25. Criteria. Sec. 26. Nutrition. Sec. 27. Evaluation of nutrition projects. Sec. 28. Improving indoor air quality to buildings where seniors congregate. Sec. 29. Caregiver support program definitions. Sec. 30. Caregiver support program. Sec. 31. Activities of national significance. Sec. 32. Title IV grant programs. Sec. 33. Career preparation for the field of aging. Sec. 34. Health care service demonstration projects in rural areas. Sec. 35. Demonstration projects for multigenerational activities. Sec. 36. Native American programs. Sec. 37.Responsibilities of Assistant Secretary. Sec. 38. Community service employment-based training for older Americans. Sec. 39. Native Americans caregiver support program. Sec. 40. Vulnerable elder rights protection activities. Sec. 41. Native American organization provisions. Sec. 42. Elder abuse, neglect, and exploitation prevention. Sec. 43. Technical amendments.

2.

Definitions

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended— (1)by amending paragraph (10) to read as follows: (10)The terms assistive device, assistive technology, and assistive technology service have the meanings given such terms in section 3 of the Assistive Technology Act of 1998 (29 U.S.C. 3002). , (2)by amending paragraph (12)(D) to read as follows: (D)evidence-based health promotion programs, including programs related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity, and improved nutrition through the consumption of a healthful diet and multivitamin-mineral supplementation; , (3)in paragraph (29)(E)— (A)in clause (i) by striking and at the end, (B)in clause (ii) by striking the period at the end and inserting ; and , and (C)by adding at the end the following: (iii)older individuals at risk for institutional placement. , (4)by amending paragraph (24) to read as follows: (24)The term exploitation means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual that uses the resources of an older individual for monetary or personal benefit, profit, or gain, or that results in depriving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets. , (5)by amending paragraph (34) to read as follows: (34)The term neglect means— (A)the failure of a caregiver or fiduciary to provide goods or services that are necessary to maintain the health or safety of an elder; or (B)self neglect. , (6)by redesignating paragraphs (1) through (43) as paragraphs (43), (7), (48), (37), (25), (26), (52), (13), (46), (8), (28), (12), (1), (2), (3), (5), (6), (10), (24), (35), (11), (14), (15), (17), (19), (20), (21), (22), (27), (29), (30), (32) (33), (36), (38), (39), (40), (41), (42), (49), (51), (18), and (47), respectively, (7)by transferring such paragraphs so as to arrange them in numerical order as so redesignated, (8)by inserting after paragraph (3), as so redesignated the following: (4)The term Aging and Disability Resource Center means a program established by a State as part of the State’s system of long-term care, to provide a coordinated system for providing— (A)comprehensive information on available public and private long-term care programs, options, and resources; (B)personal counseling to assist individuals in assessing their existing or anticipated long-term care needs, and developing and implementing a plan for long-term care designed to meet their specific needs and circumstances; and (C)consumer access to the range of publicly-supported long-term care programs for which they may be eligible, by serving as a convenient point of entry for such programs. , (9)by inserting after paragraph (8), as so redesignated, the following: (9)The term at risk for institutional placement means, with respect to an older individual, that such individual is unable to perform at least two activities of daily living without substantial human assistance (including verbal reminding, physical cuing, or supervision) and is determined by the State to be in need of placement in a long-term care facility. , (10) by inserting after paragraph (15), as so redesignated, the following: (16)The term elder justice means efforts to prevent, detect, treat, intervene in, and respond to elder abuse, neglect, and exploitation and to protect elders with diminished capacity while maximizing their autonomy. , (11)by inserting after paragraph (22), as so redesignated, the following: (23)The term Hispanic serving institution has the meaning as defined in section 502 of the Higher Education Act of 1965 (20 U.S.C. 1101A). , (12)by inserting after paragraph (30), as so redesignated, the following: (31)The term long-term care means any services, care, or items (including assistive devices), including disease prevention and health promotion services, in-home services, and case management service— (A)intended to assist individuals in coping with, and to the extent practicable compensate for, functional impairments in carrying out activities of daily living; (B)furnished at home, in a community care setting (including a small community care setting as defined in subsection (g)(1), and a large community care setting as defined in subsection (h)(1), of section 1929 of the Social Security Act (42 U.S.C. 1396t)), or in a long-term care facility; and (C)not furnished to prevent, diagnose, treat, or cure a medical disease or condition. , (13)by inserting after paragraph (33), as so redesignated, the following: (34)The term multivitamin-mineral supplement means a dietary supplement that provides at least two-third’s of the essential vitamins and minerals at 100 percent of the daily value levels as determined by the Food and Drug Administration. , (14)by inserting after paragraph (43), as so redesignated, the following: (44)The term self-directed care means an approach to providing services (including programs, benefits, supports, and technology) under this Act intended to an older individual to assist such individual with activities of daily living, in which (A)such services (including the amount, duration, scope, provider, and location of such services) are planned, budgeted, and purchased under the direction and control of such individual; (B)such individual is provided with such information and assistance as necessary and appropriate to enable such individual to make informed decisions about his or her care options; (C)the needs, capabilities, and preferences of such individual with respect to such services, and such individual’s ability to direct and control his or her receipt of such services, are assessed by the area agency on aging (or other agency designated by the area agency on aging); (D)based on the assessment made under subparagraph (C), the area agency on aging (or other agency designated by the area agency on aging) develops together with such individual and his or her family, caregiver, or legal representative— (i)a plan of services for such individual that specifies which services such individual will be responsible for directing; (ii)a determination of the role of family members (and others whose participation is sought by such individual) in providing services under such plan; and (iii)a budget for such services; and (E)the area agency on aging or State agency provides for oversight of such individual’s self-directed receipt of services, including steps to ensure the quality of services provided and the appropriate use of funds under this Act. (45)The term self-neglect means an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including— (A)obtaining essential food, clothing, shelter, and medical care; (B)obtaining goods and services necessary to maintain physical health, mental health, or general safety; or (C)managing one’s own financial affairs. , and (15)by inserting after paragraph (49), as so redesignated, the following: (50)The term State system of long-term care means the Federal, State, and local programs and activities administered by a State that provide, support, or facilitate access to long-term care to individuals in such State. .

3.

Establishment of administration on aging

Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is amended by adding at the end the following: (e)(1)The Assistant Secretary may designate within the Administration responsibility for elder abuse prevention and services. (2)It shall be the duty of the assistant secretary, acting through the person designated with responsibility for elder abuse prevention and services, to develop objectives, priorities, policy, and a long-term plan for— (A) carrying out elder justice programs and activities relating to— (i)elder abuse prevention, detection, treatment, and intervention, and response; (ii)training of individuals regarding the matters described in clause (i); and (iii)the improvement of the elder justice system in the United States; (B)collecting and disseminating data relating to the abuse, neglect, and exploitation of older individuals; (C)disseminating information concerning best practices regarding, and providing training on, carrying out activities related to abuse, neglect, and exploitation of older individuals; (D)conducting research related to abuse, neglect, and exploitation of older individuals; (E)providing technical assistance to States and other eligible entities under title VII; (F)assisting States and other eligible entities under title VII to develop strategic plans to better coordinate elder justice activities, research, and training; and (G)promoting collaborative efforts and diminishing duplicative efforts in the development and carrying out of elder justice programs at the Federal, State, and local levels. .

4.

Functions of the assistant secretary

Section 202 of the Older Americans Act of 1965 (42 U.S.C. 3012) is amended— (1)in subsection (a)— (A)in paragraph (5) by inserting assistive technology, after housing,, (B)in paragraph (12)— (i)by striking (12) and inserting the following: (12)(A) consult and coordinate activities with the Centers for Medicare & Medicaid Services and other federal entities to implement and build awareness of programs providing benefits affecting older individuals; and (B) , (C)in paragraph (20)— (i)by striking and area agencies on aging and inserting , area agencies on aging, and service providers, (ii)by striking and benefits and inserting benefits, (iii)by inserting benefits under any other applicable Federal program, or any other service (including technology and internet-based decision support tools) to assist consumers to learn about, to receive benefits under, and to participate in programs for which they may be eligible after (7 U.S.C. 2011 et seq.),, (iv)by inserting (A) after (20), and (v)by adding at the end the following: (B)provide technical assistance and support for benefits enrollment assistance and outreach to support existing efforts to inform and enroll older individuals who may be eligible to participate, but who are not participating, in programs for which they are eligible, and may in cooperation with Federal partners, establish a National Center on Senior Benefits Outreach and Enrollment, which shall— (i)develop, maintain, and update web-based decision supports and enrollment tools and integrated, person-centered systems designed to inform older individuals about the full range of benefits for which they may be eligible; (ii)utilize strategies to find and enroll those with greatest economic need; (iii)create and support efforts for Aging and Disability Resource Centers, and other public and private state and community-based organizations, including faith-based organizations, to serve as enrollment benefit centers; (iv)develop and maintain an information clearinghouse on best practices and cost-effective methods for enrolling limited income older Americans in benefits for which they are eligible; and (v)provide, in collaboration with Federal partners administering programs, training and technical assistance on effective outreach, screening, enrollment and follow-up strategies. , (D)in paragraph (26)— (i)in subsection (D)— (I)by striking gaps in, and (II)by inserting (including services that would permit such individuals to receive long-term care in home and community-based settings) after individuals, and (ii)in subsection (E) by striking and at the end, (E)in paragraph (27)— (i)in subparagraph (B) by adding and at the end, (ii)in subparagraph (C) by striking the semicolon and inserting a period, and (iii)by striking subparagraph (D), and (F)by adding at the end the following: (28)make available to States information and technical assistance to support the provision of evidence-based disease prevention and health promotion services. , and (2)by striking subsections (b) and (c), and inserting the following: (b)To promote the development and implementation of comprehensive, coordinated systems at Federal, State, and local levels for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers, the Assistant Secretary shall, consistent with the applicable provisions of this title— (1)collaborate, coordinate, and consult with other Federal agencies and departments responsible for formulating and implementing programs, benefits, and services related to providing long-term care, and may make grants, contracts, and cooperative agreements with funds received from other Federal entities; (2)conduct research and demonstration projects to identify innovative, cost-effective strategies for modifying State systems of long-term care to— (A)respond to the needs and preferences of older individuals and family caregivers; and (B)target services to individuals at risk for institutional placement, to permit such individuals to remain in home and community-based care settings; (3)establish criteria and promote the implementation (through area agencies on aging, service providers, and such other entities as the Assistant Secretary determines to be appropriate) of evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; (4)facilitate, in coordination with the Centers for Medicare & Medicaid Services, the provision of long-term care in home and community-based settings, including the provision of self-directed care models that— (A)provide for the assessment of the needs and preferences of an individual at risk for institutional placement to help such individual avoid unnecessary nursing home placement and depletion of income and assets to qualify for Medicaid eligibility; (B)respond to the needs and preferences of such individual and provide the option for the individual (or representative, as appropriate) to direct and control the receipt of support services provided; (C)assist an older individual (or a representative, as appropriate) develop a plan for long-term support, including the selecting, budgeting, and purchasing of home and community-based long-term care and supportive services; (for purposes of this paragraph, the term representative means a person appointed by the eligible individual, or legally acting on the individual's behalf, to represent or advise the individual in financial or service coordination matters);(5)provide for the Administration to play a lead role with respect to issues concerning home and community-based long-term care, including— (A)directing (as the Secretary or the President determines to be appropriate) or otherwise participating in departmental and interdepartmental activities concerning long-term care; (B)reviewing and commenting on departmental rules, regulations, and policies related to providing long-term care; and (C)making recommendations to the Secretary with respect to home and community-based long-term care, including recommendations based on findings made through projects conducted under paragraph (2); (6)promote, in coordination with other appropriate Federal agencies, enhanced awareness by the public of the importance of planning in advance for long-term care and the availability of information and resources to assist in such planning; (7)implement in all states Aging and Disability Resource Centers— (A)to serve as visible and trusted sources of information on the full range of long-term care options that are available in the community, including both institutional and home and community-based care; (B)to provide personalized and consumer friendly assistance to empower people to make informed decisions about their care options; (C)to provide coordinated and streamlined access to all publicly supported long-term care options so that consumers can obtain the care they need though a single intake, assessment and eligibility determination process; (D)to help people to plan ahead for their future long-term care needs; and (E)to assist, in coordination with the State Health Insurance Assistance Program, Medicare beneficiaries in understanding and accessing the Prescription Drug Coverage and preventative health benefits available under the Medicare Modernization Act; (8)establish, either directly or through grants or contracts, a national technical assistance program to assist State agencies, area agencies on aging, and community-based service providers funded under this Act in implementing such home and community-based long-term care systems including evidence-based programs; (9)develop, in collaboration with the Administrator of the Centers for Medicare & Medicaid Services, performance standards and measures for use by States to determine the extent to which their systems of long-term care fulfill the objectives described in this subsection; and (10)conduct such other activities as the Assistant Secretary determines to be appropriate. (c)The Assistant Secretary, in consultation with the Corporation for National and Community Service, shall— (1)encourage and permit voluntary groups active in supportive services, including youth organizations active at the secondary or postsecondary levels, to participate and be involved individually or through representative groups, in such programs or activities to the maximum extent feasible; (2)develop a comprehensive strategy for utilizing older individuals to address critical local needs of national concern; and (3)encourage other community capacity building initiatives involving older individuals. .

5.

Federal agency consultation

Section 203 of the Older Americans Act of 1965 (42 U.S.C. 3013) is amended— (1)in subsection (a)(3)(A) by striking (with particular attention to low-income minority older individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas), and (2)in subsection (b)— (A)in paragraph (17) by striking and at the end, (B)in paragraph (18) by striking the period at the end and inserting ; and, and (C)by adding at the end the following: (19)sections 4 and 5 of the Assistive Technology Act of 1998 (29 U.S.C. 3003–3004). .

6.

Administration

Section 205 of the Older Americans Act of 1965 (42 U.S.C. 3016) is amended— (1)in subsection (a)— (A)in paragraph (1)— (i)in subparagraph (C) by adding and at the end, (ii)in subparagraph (D) by striking the semicolon at the end and inserting a period, and (iii)by striking subparagraph (E), and (B)in paragraph (2)— (i)in subparagraph (A)— (I)by amending clause (i) to read as follows: (i)designing, implementing, and evaluating evidence-based programs to support improved nutrition and regular physical activity for older individuals; , (II)by amending clause (iii) to read as follows: (iii)conducting outreach and disseminating evidence-based information to nutrition service providers about the benefits of healthful diets and regular physical activity, including information about the most current Dietary Guidelines for Americans published under section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341), the Food Guide Pyramid published jointly by the Secretary and the Secretary of Agriculture, and advances in nutrition science; , (III)in clause (vii) by striking and at the end, and (IV)by striking clause (viii) and inserting the following: (viii)disseminating guidance that describes strategies for improving the nutritional quality of meals provided under title III, particularly strategies for increasing the consumption of whole grains, lowfat dairy products, fruits and vegetables; (ix)developing and disseminating guidelines for conducting nutrient analyses of meals provided in subparts 1 and 2 of part C, including guidelines for averaging key nutrients over an appropriate period of time; and (x)providing technical assistance to the regional offices of the Administration with respect to each duty described in clauses (i) through (viii). , and (ii)by amending subparagraph (C)(i) to read as follows: (i)have expertise in nutrition, energy balance, and meal planning; and .

7.

Evaluation

The 1st sentence of section 206(g) of the Older Americans Act of 1965 (42 U.S.C. 3017(g)) is amended to read as follows: From the total amount appropriated for each fiscal year to carry out title III, the Secretary may use such sums as may be necessary, but not to exceed ½ of 1 percent of such amount, for purposes of conducting evaluations under this section, either directly or through grants or contracts..

8.

Reports

Section 207(b)(2) of the Older Americans Act of 1965 (42 U.S.C. 3018(b)(2)) is amended— (1)in subparagraph (B) by striking Labor and inserting the Workforce, and (2)in subparagraph (C) by striking Labor and Human Resources and inserting Health, Education, Labor, and Pensions.

9.

Contractual, commercial and private pay relationships; appropriate use of act funds

(a)

Private pay relationships; appropriate use of act funds

Section 212 of the Older Americans Act of 1965 (42 U.S.C. 3020c) is amended to read as follows:

212.

Contracting and grant authority; private pay relationships; appropriate use of funds

(a)

In general

Subject to subsection (b), this Act shall not be construed to prevent a recipient of a grant or a contract from entering into an agreement— (1)with a profitmaking organization; (2)under which funds provided under such grant or contract are used to pay part or all of a cost (including an administrative cost) incurred by such recipient to carry out a contract or commercial relationship for the benefit of older individuals or their family caregivers, whether such relationship is carried out to implement a provision of this Act or to conduct activities inherently associated with implementing such provision; or (3)under which any individual, regardless of age or income (including the family caregiver of such individual), who seeks to receive 1 or more services pays, at their own private expense, to receive such services based on the fair market value of such services. (b)

Ensuring appropriate use of funds

An agreement described under subsection (a) may not— (1)be made without the prior approval of the State agency (or, in the case of a grantee under title VI, without the prior recommendation of the Director of the Office for American Indian, Alaska Native, and Native Hawaiian Aging and the prior approval of the Assistant Secretary); (2)directly or indirectly provide for, or have the effect of, paying, reimbursing, or otherwise compensating an entity under such agreement in an amount that exceeds the fair market value of the goods or services furnished by such entity under such agreement; (3)result in the displacement of services otherwise available to an older individual with the greatest social need, an older individual with greatest economic need, or an older individual who is at risk for institutional placement; or (4)in any other way compromise, undermine, or be inconsistent with the objective of serving the needs of older individuals, as determined by the Assistant Secretary.

.

10.

Nutrition education

Section 214 of the Older Americans Act of 1965 (42 U.S.C. 3020e) is amended to read as follows:

214.

Nutrition education

The Assistant Secretary, in consultation with the Secretary of Agriculture, shall conduct outreach and provide technical assistance to agencies and organizations that serve older individuals to assist such agencies and organizations to carry out integrated health promotion and disease prevention programs that are designed for older individuals and that include nutrition education, physical activity, and other activities to modify behavior and to improve health literacy (including information on optimal nutrient intake) through education and counseling in accordance with section 339(2)(J).

.

11.

Pension counseling and information programs

Section 215 of the Older Americans Act of 1965 (42 U.S.C. 3020e–1) is amended— (1)in subsection (e)(1)(J) by striking and low-income retirees and inserting , low income retirees, and older individuals with limited English proficiency, (2)in subsection (f) by amending paragraph (2) to read as follows: (2)The ability of the entity to perform effective outreach to affected populations, particularly populations with limited English proficiency and other populations that are identified in need of special outreach. , and (3)in subsection (h)(2) by inserting (including individuals with limited English proficiency) after individuals.

12.

Authorization of appropriations

Section 216 of the Older Americans Act of 1965 (42 U.S.C. 3020f) is amended— (1)in subsection (a) by striking 2001, 2002, 2003, 2004, and 2005 and inserting 2007, 2008, 2009, 2010, and 2011., and (2)in subsections (b) and (c) by striking year and all that follows through years, and inserting years 2007, 2008, 2009, 2010, and 2011.

13.

Purpose; administration

Section 301(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 3021(a)(2)) is amended— (1)in subparagraph (D) by striking and at the end, (2)in subparagraph (E) by striking the period at the end and inserting ; and, and (3)by adding at the end the following: (F)organizations with experience in providing senior volunteer services, such as Federal volunteer programs administered by the Corporation for National and Community Service designed to provide training, placement, and stipends for volunteers in community service settings. .

14.

Authorization of appropriations; uses of funds

Section 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) is amended— (1)in subsection (a)(1), (b), and (d) by striking year 2001 and all that follows through years each place it appears, and inserting years 2007, 2008, 2009, 2010, and 2011, and (2)in subsection (e)(1) by striking 2001 each place it appears and inserting 2007.

15.

Organization

Section 305(a) of the Older Americans Act of 1965 (42 U.S.C. 3025(a)) is amended— (1)in paragraph (1)(E) by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas), (2)in paragraph (2)(E) by striking with particular attention to low-income minority individuals and older individuals residing in rural areas and inserting with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas, and (3)by adding at the end the following: (3)the State agency shall, consistent with this section, promote the development and implementation of a comprehensive, coordinated system in such State for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers, by— (A)collaborating, coordinating, and consulting with other agencies in such State responsible for formulating, implementing, and administering programs, benefits, and services related to providing long-term care; (B)participating in any State government activities concerning long-term care, including reviewing and commenting on any State rules, regulations, and policies related thereto; (C)conducting analyses, making recommendations, and implementing programs and strategies to modify the State’s system of long-term care to better— (i)respond to the needs and preferences of older individuals and family caregivers; (ii)facilitate the provision of long-term care in home and community-based settings through service providers; (iii)target services to individuals at risk for institutional placement, to permit such individuals to remain in home and community-based care settings; and (iv)implement (through area agencies on aging, service providers, and such other entities as the State determines to be appropriate) evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; and (D)providing for the availability and distribution (through public education campaigns, aging and disability resource centers, area agencies on aging, and other appropriate means) of information relating to— (i)the need to plan in advance for long-term care; and (ii)the range of available public and private long-term care programs, options, and resources. .

16.

Area plans

Section 306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is amended— (1)in subsection (a)— (A)in paragraph (1)— (i)by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas), and (ii)by inserting the number of older individuals at risk for institutional placement residing in such area, after individuals) residing in such area,, (B)in paragraph (2)(A) by inserting health services (including mental health services), after transportation, (C)in paragraph (4)— (i)in subparagraph (A)— (I)by amending clause (i) to read as follows: (i)provide assurances that the area agency on aging will— (I)set specific objectives, consistent with State policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement; (II)include in the area plan specific objectives for providing services to low-income minority older individuals and older individuals residing in rural areas; and (III)include in the area plan proposed methods to achieve such objectives; , and (II)in clause (ii) by inserting (including older individuals with limited English proficiency) after low income minority individuals each place it appears; and (ii)in subparagraph (B)— (I)by moving the left margin of each of subparagraph (B), clauses (i) and (ii), and subclauses (I) through (VI) of clause (i), 2 ems to the left, (II)in clause (i)— (aa)in subclause (V) by striking and at the end; and (bb)by adding at the end the following: (VI)older individuals at risk for institutional placement; and , and (III)by striking (VI) and inserting (VII), (D)in paragraph (5) by inserting and individuals at risk for institutional placement after severe disabilities, (E)in paragraph (6)— (i)in subparagraph (C)— (I)in clause (i) by striking and at the end, (II)in clause (ii) by adding and at the end, and (III)by inserting after clause (ii) the following: (iii)make use of trained volunteers in providing direct services delivered to elderly and disabled individuals needing such care and, if possible, work in coordination with volunteer programs (including programs administered by the Corporation for National Service) designed to provide training, placement, and stipends for volunteers in community service settings. , (ii)in subparagraph (D)— (I)by inserting family caregivers of such individuals, after Act,, and (II)by inserting service providers, the business community, after individuals,, and (iii)in subparagraph (F) by inserting (including mental health screening) after provided the 1st place it appears, (F)by amending paragraph (7) to read as follows: (7)provide that the area agency on aging shall, consistent with this section, facilitate the area-wide development and implementation of a comprehensive, coordinated system for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers, by— (A)collaborating, coordinating, and consulting with other local public and private agencies and organizations responsible for administering programs, benefits, and services related to providing long-term care; (B)conducting analyses and making recommendations with respect to strategies for modifying the local system of long-term care to better— (i)respond to the needs and preferences of older individuals and family caregivers; (ii)facilitate the provision, through service providers, of long-term care in home and community-based settings; and (iii)target services to older individuals at risk for institutional placement, to permit such individuals to remain in home and community-based care settings; (C)implement, through the agency or service providers, evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; and (D)provide for the availability and distribution (through public education campaigns, aging and disability resource centers, and other appropriate means) of information relating to— (i)the need to plan in advance for long-term care; and (ii)the range of available public and private long-term care programs, options, and resources; , (G)by striking paragraph (14) and the 2 paragraphs (15), (H)by redesignating paragraph (16) as paragraph (14), and (I)by adding at the end the following: (15)provide assurances that funds received under this title will be used— (A)in a manner, consistent with paragraph (4), that gives priority in furnishing benefits and services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement; and (B)in compliance with the assurances specified in paragraph (13) and the limitations specified in section 212(b); and (16)provide, to the maximum extent feasible, for the furnishing of services under this Act consistent with self-directed care. , (2)by redesignating subsections (b), (c), (d), and (e) as subsections (c), (d), (e), and (f), and (3)by inserting after subsection (a) the following: (b)(1)An area agency on aging may include in the area plan an assessment of how prepared the planning and service area is for any anticipated change in the number of older individual during the 10-year period following the fiscal year for which the plan is submitted. Such assessment may include— (A)the projected change in the number of older individuals in the planning and service area; (B)an analysis of how such change may affect such individuals, including such individuals with low incomes, such individuals with greatest economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency; (C)an analysis of how the programs, policies, and services provided in the planning and service area can be improved, and how resource levels can be adjusted, to meet the needs of the changing population of older individuals in such area; and (D)an analysis of how the change in the number of individuals 85 years of age and older is expected to affect the need for supportive services. (2)An area agency on aging, in cooperation with government officials, State agencies, tribal organizations, or local entities, may make recommendations to government officials in the planning and service area and the State, on actions determined by the area agency to build the capacity in the planning and service area to meet the needs of older individuals for— (A)health and human services; (B)land use; (C)housing; (D)transportation; (E)public safety; (F)workforce and economic development; (G)recreation; (H)education; (I)civic engagement; and (J)any other service as determined by such agency. .

17.

State plans

Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 3027(a)) is amended— (1)in paragraph (4) by striking with particular attention to low-income minority individuals and older individuals residing in rural areas and inserting low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas, (2)by striking paragraph (15), (3)by redesignating paragraph (14) as paragraph (15), (4)by inserting after paragraph (13) the following: (14)The plan shall, with respect to the fiscal year preceding the fiscal year for which such plan is prepared— (A)identify the number of low-income minority older individuals in the State, including the number of low-income older individuals with limited English proficiency; and (B)describe the methods used to satisfy the service needs of such minority older individuals, including the plan to service the needs of older individuals with limited English proficiency. , (5)in clauses (ii) and (iii) of paragraph (16)(A) by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas), and (6)by adding at the end the following: (27) The plan shall provide assurances that area agencies on aging will, to the maximum extent feasible, provide for the furnishing of services under this Act consistent with self-directed care. (28)(A)The plan shall include, at the election of the State, an assessment of how prepared the State is, under the State’s statewide service delivery model, for a change in the number of older individuals during the 10-year period following the fiscal year for which the plan is submitted. (B)Such assessment may include— (i)the projected change in the number of older individuals in the State; (ii)an analysis of how such change may affect such individuals, including individuals with low incomes, individuals with great economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency; (iii)an analysis of how the programs, policies, and services provided by the State can be improved, including coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the State; and (iv)an analysis of how the change in the number of individuals 85 years of age and older in the State is expected to affect the need for supportive services. .

18.

Payments

Section 309(b)(2) of the Older Americans Act of 1965 (42 U.S.C. 3029(b)(2)) is amended by striking the non-Federal share required prior to fiscal year 1981 and inserting 10 percent of the cost of the services specified in such section 304(d)(1)(D).

19.

Nutrition services incentive program

(a)

Cash Only Program; Authority To Use Program Funds To Purchase Food Through School Food Authorities

Section 311 of the Older Americans Act of 1965 (42 U.S.C. 3030a) is amended-— (1)in subsection (b) by adding at the end the following: (3)Each State agency shall promptly and equitably disburse amounts received under this subsection to recipients of grants and contracts. , (2)in subsection (c)— (A)in paragraph (1) by inserting (including bonus commodities) after commodities, (B)in paragraph (2) by inserting (including bonus commodities) after commodities, (C)in paragraph (3) by inserting (including bonus commodities) after products, and (D)by adding at the end the following: (4)Among the commodities delivered under this subsection, the Secretary of Agriculture shall give special emphasis to high protein foods. The Secretary of Agriculture, in consultation with the Assistant Secretary, is authorized to prescribe the terms and conditions respecting the donation of commodities under this subsection. , (3)by amending subsection (d) to read as follows: (d)(1)Amounts provided under subsection (b) to State grantees and contractors, and to title VI grantees, shall be available only for the purchase by such entities of United States agricultural commodities and other foods for their respective nutrition projects, subject to paragraph (2). (2)Part or all of the amounts received by an entity specified in paragraph (1) may be used to pay a school food authority (as referred to under the Richard B. Russell National School Lunch Act (42 U.S.C.1751 et seq.) to obtain United States agricultural commodities for such entity’s nutrition projects, in accordance with an agreement between the entity and the school food authority, under which such payments— (A)shall cover the cost of such commodities; and (B)may cover related expenses incurred by the school food authority, including the cost of transporting, distributing, processing, storing, and handling such commodities. , (4)in subsection (e) by striking 2001 and inserting 2007, (5)in subsection (f)— (A)in the matter preceding paragraph (1) by striking the Secretary of Agriculture and the Secretary of Health and Human Services and inserting the Assistant Secretary and the Secretary of Agriculture, and (B)by amending paragraphs (1) and (2) to read as follows: (1) school food authorities participating in programs authorized under the Richard B. Russell National School Lunch Act within the geographic area served by each such State agency; and (2)the donated foods available to such State agencies, area agencies on aging, and providers under subsection (c). .

20.

Consumer contributions

Section 315 of the Older Americans Act of 1965 (42 U.S.C. 3030c–2) is amended-— (1)in subsection (b)— (A)in paragraph (1) by striking provided that and inserting , and such contributions shall be encouraged for individuals whose self-declared income is at or above 125 percent of the poverty line and may be requested at contribution levels based on the actual cost of services, if, and (B)in paragraph (4)(E) by inserting and to supplement (not supplant) funds received under this Act after given, (2)in subsection (c)(2) by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas), and (3)in subsection (d) by striking with particular attention to low-income and minority individuals and older individuals residing in rural areas and inserting , with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas.

21.

Supportive services and senior centers program

Section 321(a) of the Older Americans Act of 1965 (42 U.S.C. 3030d(a)) is amended— (1)in paragraph (8) by inserting (including mental health screening) after screening, (2)in paragraph (11) by inserting (including assistive technology devices and assistive technology services) after services, (3)in paragraph (14)(B) by inserting (including mental health) after health, (4)in paragraph (22) by striking the period at the end and inserting a semicolon, (5)by redesignating paragraph (23) as paragraph (24), and (6)by inserting after paragraph (22) the following: (23)services designed to support States, area agencies on aging, and local service providers carry out and coordinate, with respect to mental health services, activities including outreach, education, screening, and referral for treatment of older individuals; and .

22.

Nutrition service

After the heading of part C of title III of the Older Americans Act of 1965 (42 U.S.C. 3030e–3030g–22), insert the following:

330.

Purpose

It is the purpose of this part to promote socialization and the health and well-being of older individuals by assisting such individuals to gain access to disease prevention and health promotion services (including information, nutrition services, and programs of physical activity) to delay the onset of health conditions resulting from poor nutritional health or sedentary behavior.

.

23.

Congregate nutrition program

Section 331 of the Older Americans Act of 1965 (42 U.S.C. 3030e) is amended— (1)by striking projects— and inserting projects that—, (2)in paragraph (1) by striking which,, (3)in paragraph (2)— (A)by striking which the last place it appears, and (B)by striking and at the end, and (4)by striking paragraph (3) and inserting the following: (3)provide nutrition education, nutrition counseling, and other nutrition services, as appropriate, based on the needs of meal participants; and (4)may provide along with a meal described in (1), a multivitamin-mineral supplement as an addition to such meal. .

24.

Home delivered nutrition services

Section 336 of the Older Americans Act of 1965 (42 U.S.C. 3030f) is amended to read as follows:

336.

Program authorized

The Assistant Secretary shall establish and carry out a program to make grants to States under State plans approved under section 307 for the establishment and operation of nutrition projects for older individuals which provide, on 5 or more days a week (except in a rural area where such frequency is not feasible (as defined by the Assistant Secretary by rule) and a lesser frequency is approved by the State agency)— (1)at least 1 home delivered meal per day consisting of hot, cold, frozen, dried, canned, fresh, or supplemental foods and any additional meals that the recipient of a grant or contract under this subpart elects to provide; and (2)nutrition education, nutrition counseling, and other nutrition services as appropriate, based on the needs of meal recipients.

.

25.

Criteria

Section 337 of the Older Americans Act of 1965 (42 U.S.C. 3030g) is amended to read as follows:

337.

Criteria

The Assistant Secretary, in consultation with experts in the field of nutrition science, dietetics, meal planning and food service management, and aging, shall develop minimum criteria of efficiency and quality for the furnishing of home delivered meal services for projects described in section 336.

.

26.

Nutrition

Section 339 of the Older Americans Act of 1965 (42 U.S.C. 3030g–21) is amended— (1)by amending paragraph (1) to read as follows: (1)solicit the expertise of a dietitian or other individual with equivalent education and training in nutrition science, or if such an individual is not available, an individual with comparable expertise in the planning of nutritional services, and , and (2)in paragraph (2)— (A)in subparagraph (A)— (i)by amending clause (i) to read as follows: (i)comply with the most recent Dietary Guidelines for Americans, published by the Secretary and the Secretary of Agriculture, and , and (ii)in clause (ii) by striking daily recommended dietary allowances as and inserting dietary reference intakes, (B)in subparagraph (D)— (i)by inserting joint after encourages, and (ii)by inserting shared after promote, (C)by amending subparagraph (G) to read as follows: (G)ensures that local meal providers solicit the advice and expertise of— (i)a dietitian or, if a dietitian is not available, an individual with comparable expertise in the planning of nutrition and food services, (ii)meal participants, and (iii)other individuals knowledgeable with regard to the needs of older individuals, , (D)in subparagraph (H) by striking and accompany, (E)by amending subparagraph (J) to read as follows: (J)provides for nutrition screening and nutrition education, and nutrition assessment and counseling if appropriate, and , and (F)by adding at the end the following: (K)encourages professionals who distribute nutrition assistance under subpart 2 to provide information to homebound seniors on how to get an influenza vaccination in their local areas. .

27.

Evaluation of nutrition projects

(a)

Study

The Assistant Secretary for Aging shall use funds allocated in section 206(g) of the Older Americans Act of 1965 to enter into a contract with the Food and Nutrition Board of the Institute of Medicine, for the purpose of establishing an independent panel of experts that will conduct an evidence-based evaluation of the nutrition projects authorized in such Act. Such study shall, to the extent data are available, include— (1)an evaluation of the effect of nutrition projects authorized by such Act on— (A)health status of participants, including nutritional status, (B)prevention of participant hunger and food insecurity, and (C)ability of participants to remain living independently, (2)a cost-benefit analysis of nutrition projects authorized by such Act, including the potential to affect costs of Federal programs under title XIX of the Social Security Act, and (3)recommendations for how nutrition projects authorized by such Act may be modified to improve the outcomes described in paragraph (1), including recommendations for improving the nutritional quality of meals and other potential strategies to improve the nutritional status of participants, including vitamin-mineral supplementation. (b)

Timing

The Institute of Medicine shall establish an independent panel of experts not later than 90 days after the date of the enactment of this Act. The panel shall submit to the Assistant Secretary the report described in subsection (a) not later than 24 months after the date of the enactment of this Act. The Assistant Secretary shall submit a report on the findings of the evidence-based study described in such subsection to the Committee on Education and the Workforce of the House of Representatives and the Committee on Health, Education, Labor and Pensions of the Senate.

28.

Improving indoor air quality in buildings where seniors congregate

Section 361 of the Older Americans Act of 1965 (42 U.S.C. 3030m) is amended by adding at the end the following: (c) The Assistant Secretary shall work in consultation with qualified experts to provide information on methods of improving indoor air quality in buildings where seniors congregate. .

29.

Caregiver support program definitions

Section 372 of the National Family Caregiver Support Act (42 U.S.C. 3030s) is amended— (1)in paragraph (1) by inserting or who is an individual with a disability after age, (2)in paragraph (2) by inserting or an individual with Alzheimer’s disease or a related disorder with neurological and organic brain dysfunction before the period at the end, and (3)in paragraph (3) by striking 60 and inserting 55.

30.

Caregiver support program

Section 373 of the National Family Caregiver Support Act (42 U.S.C. 3030s–1) is amended— (1)in subsection by (b)(3) by striking caregivers to assist and all that follows through the end and inserting the following: assist the caregivers in addressing caregiver issues related to the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles;, (2)by amending subsection (d) to read as follows: (d)

Use of volunteers

In carrying out this subpart, each area agency on aging shall encourage the use of trained volunteers to expand the available services described in subsection (b) and shall, if possible, coordinate with volunteer programs (including programs administered by the Corporation for National Service) designed to provide training, placement, and stipends for volunteers in community service settings. , (3)in subsection (e)(3) by adding at the end the following: The reports shall describe any mechanisms used in the State to provide family caregivers of an older individual and relative caregivers of a child or an adult child with a disability, information about and access to various services so that caregivers can better carry out their care responsibilities., and (4)in subsection (f)(1) by striking 2001 through 2005 and inserting 2007, 2008, 2009, 2010, and 2011.

31.

Activities of national significance

Section 376(a) of the National Family Caregiver Support Act (42 U.S.C. 3030s–12(a)) is amended— (1)by striking (a) In General.—, (2)by striking shall and inserting may, (3)by striking program and inserting programs that include, (4)by striking research. and inserting research, including—(1)intergenerational programs, including supports for grandparents and other older relatives raising children (such as kinship navigator programs), and sustaining and replicating innovative intergenerational family support programs that involve senior volunteers; (2)Programs providing support and information to families who have a child with a disability or chronic illness and to other families in need of such family support programs; (3)programs addressing unique issues faced by rural caregivers; (4)programs focusing on the needs of older persons with Alzheimer’s disease and related dementia and their caregivers; and (5)programs supporting caregivers in the role they play in health promotion and disease prevention. , and (5)by striking subsection (b).

32.

Title IV grant programs

Section 411 of the Older Americans Act of 1965 (42 U.S.C. 3032) is amended— (1)in subsection (a)— (A)in paragraph (8) by striking and at the end, (B)by redesignating paragraph (9) as paragraph (11), and (C)by inserting after paragraph (8) the following: (9)planning activities to prepare communities for the aging of the population, which include— (A)efforts to assess the aging population; (B)activities to coordinate State and local agencies in order to meet the needs of older individuals; and (C)training and technical assistance to support States, area agencies on aging, and tribal organizations receiving a grant under title VI, engage in community planning activities; and (10)the development, implementation, and assessment of technology-based service models and best practices, to support the use of health monitoring and assessment technologies, communication devices, assistive technologies, and other technologies that may remotely connect family and professional caregivers to frail elderly residing in home- and community-based settings or rural areas; and , and (2)in subsection (b) by striking year and all that follows through years, and inserting years 2007, 2008, 2009, 2010, and 2011.

33.

Career preparation for the field of aging

Section 412(a) of the Older Americans Act of 1965 (42 U.S.C. 3032a(a)) is amended by amending subsection (a) to read as follows: (a)

Grants

The Assistant Secretary shall make grants to institutions of higher education, including historically Black colleges or universities, Hispanic serving institutions, and Hispanic Centers of Excellence in Applied Gerontology, to provide education and training that prepares students for careers in the field of aging. .

34.

Health care service demonstration projects in rural areas

Section 414 of the Older Americans Act of 1965 (42 U.S.C. 3032d) is amended— (1)in subsection (a) by inserting mental health services, after care,, and (2)in subsection (b)(1)(B)(i) by inserting mental health, after health,.

35.

Demonstration projects for multigenerational activities

Section 417(c)(2) of the Older Americans Act of 1965 (42 U.S.C. 3032f(c)(2)) is amended by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas).

36.

Native american programs

Section 418(a)(2)(B)(i) of the Older Americans Act of 1965 (42 U.S.C. 3032g(a)(2)(B)(i)) is amended by inserting (including mental health) after problems.

37.

Responsibilities of assistant secretary

Section 432(c)(2)(B) of the Older Americans Act of 1965 (42 U.S.C. 3033a(c)(2)(B)) is amended by inserting , including preparing an analysis of such services, projects, and programs, and of how the evaluation relates to improvements in such services, projects, and programs and in the strategic plan of the Administration before the period at the end.

38.

Community service employment-based training for older americans

Title V of the Older Americans Act of 1965 (42 U.S.C. 3056 et seq.) is amended to read as follows: .

39.

Native americans caregiver support program

Section 643 of the Older Americans Act of 1965 (42 U.S.C. 3057n) is amended by striking 2001 each place it appears and inserting 2007.

40.

Vulnerable elder rights protection activities

Section 702 of the Older Americans Act of 1965 (42 U.S.C. 3058a) is amended by striking 2001 each place it appears and inserting 2007.

41.

Native american organization provisions

Section 751(d) of the Older Americans Act of 1965 (42 U.S.C. 3058aa(b)) is amended by striking 2001 and inserting 2007.

42.

Elder abuse, neglect, and exploitation prevention

Section 721 (b) of the Older Americans Act of 1965 (42 U.S.C. 3058i(b)) is amended— (1)by inserting after paragraph (1) the following new paragraph: (2)providing for public education and outreach to promote financial literacy and prevent identity theft and financial exploitation of older individuals; ; and (2)by redesignating paragraphs (2) through (8) as paragraphs (3) through (9), respectively.

43.

Technical amendments

The Older Americans Act of 1965 (42 U.S.C. 2001 et seq.) is amended— (1)in section 202(e)(1)(A) by striking the semicolon at the end and inserting a period, and (2)by inserting before section 401 the following: .

June 8, 2006 Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed