[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 3570 Introduced in Senate (IS)]








109th CONGRESS
  2d Session
                                S. 3570

 To amend the Older Americans Act of 1965 to authorize appropriations 
      for fiscal years 2007 through 2011, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 27, 2006

   Mr. Enzi (for himself, Mr. Kennedy, Mr. DeWine, and Ms. Mikulski) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Older Americans Act of 1965 to authorize appropriations 
      for fiscal years 2007 through 2011, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Older Americans Act Amendments of 
2006''.

SEC. 2. DEFINITIONS.

    Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is 
amended--
            (1) in 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;'';
            (2) by striking paragraph (24) and inserting the following:
            ``(24) The term `exploitation' means the fraudulent or 
        otherwise illegal, unauthorized, or improper act or process of 
        an individual, including a caregiver or fiduciary (as such 
        terms are defined in section 751), 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.'';
            (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) in paragraph (32)(D), by inserting ``, including an 
        assisted living facility,'' after ``home'';
            (5) by striking paragraph (34) and inserting the following:
            ``(5)(A) The term `neglect' means--
                    ``(i) the failure of a caregiver or fiduciary (as 
                such terms are defined in section 751) to provide the 
                goods or services that are necessary to maintain the 
                health or safety of an older individual; or
                    ``(ii) self-neglect.
            ``(B) 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--
                    ``(i) obtaining essential food, clothing, shelter, 
                and medical care;
                    ``(ii) obtaining goods and services necessary to 
                maintain physical health, mental health, or general 
                safety; or
                    ``(iii) managing one's own financial affairs.''; 
                and
            (6) by adding at the end the following:
            ``(44) The term `Aging and Disability Resource Center' 
        means a center 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 consumers 
                may be eligible, by serving as a convenient point of 
                entry for such programs.
            ``(45) 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 assistance (including verbal 
        reminding, physical cuing, or supervision), including such an 
        older individual that is determined by the State involved to be 
        in need of placement in a long-term care facility.
            ``(46) The term `Hispanic-serving institution' has the 
        meaning given the term in section 502 of the Higher Education 
        Act of 1965 (20 U.S.C. 1101a).
            ``(47) The term `long-term care' means any services, care, 
        or items (including assistive devices) that are--
                    ``(A) intended to assist individuals in coping 
                with, and to the extent practicable compensating 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 diagnose, treat, or cure a 
                medical disease or condition.
            ``(48) The term `self-directed care' means an approach to 
        providing services (including programs, benefits, supports, and 
        technology) under this Act intended to assist an older 
        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 is necessary and 
                appropriate to enable such individual to make informed 
                decisions about the individual's service options;
                    ``(C) the needs, capabilities, and preferences of 
                such individual with respect to such services, and such 
                individual's ability to direct and control the 
                individual's receipt of such services, are assessed by 
                the area agency on aging involved or the local provider 
                agency;
                    ``(D) based on the assessment made under 
                subparagraph (C), upon request, the area agency on 
                aging assists such individual and the individual's 
                family, caregiver, or legal representative in 
                developing--
                            ``(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 
                involved 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.
            ``(49) 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.''.

SEC. 3. OFFICE OF ELDER ABUSE PREVENTION AND SERVICES.

    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) In this subsection, the terms defined in section 751 shall 
have the meanings given those terms in that section.
    ``(2) The Secretary is authorized to establish or designate within 
the Administration (as defined in section 102) an Office of Elder Abuse 
Prevention and Services.
    ``(3) It shall be the duty of the Assistant Secretary, acting 
through the head of the Office of Elder Abuse Prevention and Services 
to--
            ``(A) develop objectives, priorities, policy, and a long-
        term plan for--
                    ``(i) 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 subclause (I); and
                            ``(III) the improvement of the elder 
                        justice system in the United States;
                    ``(ii) annually collecting, maintaining, and 
                disseminating data relating to the abuse, neglect, and 
                exploitation of elders (and, in the discretion of the 
                Secretary, vulnerable adults), including collecting, 
                maintaining, and disseminating such data under section 
                753 after consultation with the Attorney General and 
                working with experts from the Department of Justice 
                described in section 753(b)(1);
                    ``(iii) disseminating information concerning best 
                practices regarding, and providing training on, 
                carrying out activities related to abuse, neglect, and 
                exploitation of elders (and, in the discretion of the 
                Secretary, vulnerable adults);
                    ``(iv) in conjunction with the necessary experts, 
                conducting research related to abuse, neglect, and 
                exploitation of elders (and, in the discretion of the 
                Secretary, vulnerable adults);
                    ``(v) providing technical assistance to States and 
                other eligible entities that provide or fund the 
                provision of the services described in subtitle B of 
                title VII; and
                    ``(vi) carrying out a study to determine the 
                national incidence and prevalence of elder abuse, 
                neglect, and exploitation in all settings;
            ``(B) implement the overall policy and a strategy to carry 
        out the plan described in subparagraph (A); and
            ``(C) provide advice to the Secretary on elder justice 
        issues and administer such programs relating to elder abuse, 
        neglect, and exploitation as the Secretary determines to be 
        appropriate.
    ``(4) The Secretary, acting through the Assistant Secretary, may 
issue such regulations as may be necessary to carry out this subsection 
and subtitle B of title VII.''.

SEC. 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 (12)--
                            (i) by striking ``carry on'' and inserting 
                        the following:
            ``(B) carry on''; and
                            (ii) by striking ``(12)'' and inserting the 
                        following:
            ``(12)(A) consult and coordinate activities with the 
        Administrator of the Centers for Medicare & Medicaid Services 
        to implement and build awareness of programs providing new 
        benefits affecting older individuals; and'';
                    (B) by striking paragraph (20) and inserting the 
                following:
            ``(20)(A) provide technical assistance and support for 
        outreach and benefits enrollment assistance to support 
        efforts--
                    ``(i) to inform older individuals with greatest 
                economic need, who may be eligible to participate, but 
                who are not participating, in Federal and State 
                programs for which the individuals are eligible, about 
                the programs; and
                    ``(ii) to enroll the individuals in the programs;
            ``(B) in cooperation with related Federal agency partners 
        administering the Federal programs, make a grant to or enter 
        into a contract with a qualified, experienced entity to 
        establish a National Center on Senior Benefits Outreach and 
        Enrollment, which shall--
                    ``(i) maintain and update web-based decision 
                support and enrollment tools, and integrated, person-
                centered systems, designed to inform older individuals 
                about the full range of benefits for which the 
                individuals may be eligible under Federal and State 
                programs;
                    ``(ii) utilize cost-effective strategies to find 
                older individuals with greatest economic need and 
                enroll the individuals in the programs;
                    ``(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 and coalitions, to 
                serve as benefits enrollment centers for the programs;
                    ``(iv) develop and maintain an information 
                clearinghouse on best practices and the most cost-
                effective methods for finding and enrolling older 
                individuals with greatest economic need in the 
                programs; and
                    ``(v) provide, in collaboration with related 
                Federal agency partners administering the Federal 
                programs, training and technical assistance on the most 
                effective outreach, screening, enrollment, and follow-
                up strategies for the Federal and State programs.'';
                    (C) in paragraph (26)(D)--
                            (i) by striking ``gaps in'';
                            (ii) by inserting ``(including services 
                        that would permit such individuals to receive 
                        long-term care in home and community-based 
                        settings)'' after ``individuals''; and
                            (iii) by striking ``and'' at the end;
                    (D) in paragraph (27), by striking the period at 
                the end and inserting ``; and''; and
                    (E) 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 subsection (b) 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 (other than the Administration 
        on Aging) 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 those other Federal 
        agencies and departments;
            ``(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;
                    ``(B) target services to individuals at risk for 
                institutional placement, to permit such individuals to 
                remain in home and community-based settings; and
                    ``(C) establish criteria for 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;
            ``(3) facilitate, in coordination with the Administrator of 
        the Centers for Medicare & Medicaid Services, including the 
        provision of such care through 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 
                institutional placement and depletion of income and 
                assets to qualify for benefits under the Medicaid 
                program under title XIX of the Social Security Act (42 
                U.S.C. 1396 et seq.);
                    ``(B) respond to the needs and preferences of such 
                individual and provide the option--
                            ``(i) for the individual to direct and 
                        control the receipt of supportive services 
                        provided; or
                            ``(ii) as appropriate, for a person who was 
                        appointed by the individual, or is legally 
                        acting on the individual's behalf, in order to 
                        represent or advise the individual in financial 
                        or service coordination matters (referred to in 
                        this paragraph as a `representative' of the 
                        individual), to direct and control the receipt 
                        of those services; and
                    ``(C) assist an older individual (or, as 
                appropriate, a representative of the individual) to 
                develop a plan for long-term support, including 
                selecting, budgeting for, and purchasing home and 
                community-based long-term care and supportive services;
            ``(4) 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; and
                    ``(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);
            ``(5) promote, in coordination with other appropriate 
        Federal agencies--
                    ``(A) enhanced awareness by the public of the 
                importance of planning in advance for long-term care; 
                and
                    ``(B) the availability of information and resources 
                to assist in such planning;
            ``(6) 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 home 
        and community-based long-term care systems, including evidence-
        based programs;
            ``(7) 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
            ``(8) conduct such other activities as the Assistant 
        Secretary determines to be appropriate.
    ``(c) The Assistant Secretary, after consultation with the Chief 
Executive Officer of the Corporation for National and Community 
Service, shall--
            ``(1) encourage and permit volunteer groups (including 
        organizations carrying out national service programs and 
        including organizations of youth in secondary or postsecondary 
        school) that are active in supportive services and civic 
        engagement to participate and be involved individually or 
        through representative groups in supportive service and civic 
        engagement 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.''.

SEC. 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)--
                    (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
                    (B) by striking ``section 507'' and inserting 
                ``section 516'';
            (2) in subsection (b), 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).''; and
            (3) by adding at the end the following:
    ``(c)(1) The Secretary, in collaboration with the Secretary of 
Housing and Urban Development and with the other Federal officials 
specified in paragraph (2), shall establish an interagency coordinating 
committee (referred to in this subsection as the `Committee') focusing 
on the coordination of agencies with respect to aging issues, 
particularly issues related to demographic changes and housing needs 
among older individuals.
    ``(2) The officials referred to in paragraph (1) are the Secretary 
of Labor, the Secretary of Housing and Urban Development, the Attorney 
General, the Secretary of Transportation, the Secretary of the 
Treasury, the Secretary of Agriculture, the Commissioner of Social 
Security, the Surgeon General, the Administrator of the Centers for 
Medicare & Medicaid Services, the Director of the Centers for Disease 
Control and Prevention, the Director of the National Institutes of 
Health, the Assistant Secretary for Children and Families, the 
Administrator of the National Highway Traffic Safety Administration, 
and such other Federal officials as the Secretary of Health and Human 
Services determines to be appropriate.
    ``(3) The Secretary of Health and Human Services shall serve as the 
first chairperson of the Committee, for an initial period of 2 years. 
After that initial period, the Secretary of Housing and Urban 
Development and the Secretary of Health and Human Services shall 
alternate as chairpersons of the Committee, each serving as chairperson 
for a period of 2 years.
    ``(4) The Committee shall--
            ``(A) review all Federal programs and services that assist 
        older individuals in finding and affording housing, health 
        care, and other services, including those Federal programs and 
        services that assist older individuals in accessing health 
        care, transportation, supportive services, and assistance with 
        daily activities, at the place or close to the place where the 
        older individuals live;
            ``(B) monitor, evaluate, and recommend improvements in 
        programs and services administered, funded, or financed by 
        Federal, State, and local agencies to assist older individuals 
        in meeting their housing, health care, and other service needs 
        and make any recommendations about how the agencies can better 
        carry out and provide the programs and services to house and 
        serve older individuals;
            ``(C) recommend ways to--
                    ``(i) facilitate aging in place of older 
                individuals, by identifying and making available the 
                programs and services necessary to enable older 
                individuals to remain in their homes as the individuals 
                age;
                    ``(ii) reduce duplication by Federal agencies of 
                programs and services to assist older individuals in 
                meeting their housing, health care, and other service 
                needs;
                    ``(iii) ensure collaboration among and within 
                agencies in providing and making available the programs 
                and services so that older individuals are able to 
                easily access needed programs and services;
                    ``(iv) work with States to better provide housing, 
                health care, and other services to older individuals 
                by--
                            ``(I) holding individual meetings with 
                        State representatives;
                            ``(II) providing ongoing technical 
                        assistance to States about better meeting the 
                        needs of older individuals; and
                            ``(III) working with States to designate 
                        State liaisons for the Committee;
                    ``(v) identify model programs and services to 
                assist older individuals in meeting their housing, 
                health care, and other service needs, including model--
                            ``(I) programs linking housing, health 
                        care, and other services;
                            ``(II) financing products offered by 
                        government, quasi-government, and private 
                        sector entities; and
                            ``(III) innovations in technology 
                        applications that give older individuals access 
                        to information on available services or that 
                        help in providing services to older 
                        individuals;
                    ``(vi) collect and disseminate information about 
                older individuals and the programs and services 
                available to the individuals to ensure that the 
                individuals can access comprehensive information; and
                    ``(vii) work with the Federal Interagency Forum on 
                Aging-Related Statistics, the Bureau of the Census, and 
                member agencies--
                            ``(I) to collect and maintain data relating 
                        to the housing, health care, and other service 
                        needs of older individuals so that all such 
                        data can be accessed in one place on a 
                        designated website; and
                            ``(II) to identify and address unmet data 
                        needs;
            ``(D) make recommendations to guide policy and program 
        development across Federal agencies with respect to demographic 
        changes among older individuals; and
            ``(E) actively seek input from and consult with all 
        appropriate and interested parties, including public health 
        interest and research groups and foundations about the 
        activities described in subparagraphs (A) through (D).
    ``(5) Each year, the Committee shall prepare and submit to the 
President, the Committee on Financial Services of the House of 
Representatives, the Committee on Education and the Workforce of the 
House of Representatives, the Committee on Banking, Housing, and Urban 
Affairs of the Senate, the Committee on Health, Education, Labor, and 
Pensions of the Senate, and the Special Committee on Aging of the 
Senate, a report that--
            ``(A) describes the activities and accomplishments of the 
        Committee in working with Federal, State, and local 
        governments, and private organizations, in coordinating 
        programs and services to meet the requirements of paragraph 
        (4);
            ``(B) assesses the level of Federal assistance required to 
        meet the needs described in paragraph (4);
            ``(C) incorporates an analysis from the head of each agency 
        that is a member of the interagency coordinating committee 
        established under paragraph (1) that describes the barriers and 
        impediments, including barriers and impediments in statutory 
        and regulatory law, to the access and use by older individuals 
        of programs and services administered by such agency; and
            ``(D) makes recommendations for appropriate legislative and 
        administrative actions to meet the needs described in paragraph 
        (4) and for coordinating programs and services designed to meet 
        those needs.
    ``(6)(A) The Secretary of Health and Human Services, after 
consultation with the Secretary of Housing and Urban Development, shall 
appoint an executive director of the Committee.
    ``(B) On the request of the Committee, any Federal Government 
employee may be detailed to the Committee without reimbursement, and 
such detail shall be without interruption or loss of civil service 
status or privilege.''.

SEC. 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 ``; 
                        and'' 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 by 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; and
            ``(ix) 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 and meal planning; and''.

SEC. 7. EVALUATION.

    Section 206(g) of the Older Americans Act of 1965 (42 U.S.C. 
3017(g)) is amended by striking the first sentence and inserting the 
following: ``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 more than \1/2\ of 1 percent of such amount, for 
purposes of conducting evaluations under this section, either directly 
or by grant or contract.''.

SEC. 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''.

SEC. 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 (42 U.S.C. 3020c) is amended to 
read as follows:

``SEC. 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 under this 
Act 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 contract 
        or 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 may voluntarily pay, 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 in 
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 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.''.

SEC. 10. NUTRITION EDUCATION.

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

``SEC. 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--
            ``(1) are designed for older individuals; and
            ``(2) include--
                    ``(A) nutrition education;
                    ``(B) physical activity; and
                    ``(C) other activities to modify behavior and to 
                improve health literacy, including providing 
                information on optimal nutrient intake, through 
                education and counseling in accordance with section 
                339(2)(J).''.

SEC. 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 as in need of special outreach.''; and
            (3) in subsection (h)(2), by inserting ``(including 
        individuals with limited English proficiency)'' after 
        ``individuals''.

SEC. 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''.

SEC. 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 and designed to provide training, placement, and 
        stipends for volunteers in community service settings.''.

SEC. 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 subsections (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)--
                    (A) in paragraph (1) by striking ``$125,000,000'' 
                and all that follows and inserting ``$160,000,000 for 
                fiscal year 2007.''; and
                    (B) in paragraph (2), by striking ``such sums'' and 
                all that follows and inserting ``$170,000,000 for 
                fiscal year 2008, $180,000,000 for fiscal year 2009, 
                $190,000,000 for fiscal year 2010, and $200,000,000 for 
                fiscal year 2011.''.

SEC. 15. ALLOTMENTS.

    Section 304(d)(1)(A) of the Older Americans Act of 1965 (42 U.S.C. 
3024(d)(1)(A)) is amended to read as follows:
                    ``(A)(i) such amount as the State agency 
                determines, but not more than 10 percent thereof, shall 
                be available for paying such percentage as the agency 
                determines, but not more than 75 percent, of the cost 
                of administration of area plans; and
                    ``(ii) in addition to that amount, for any fiscal 
                year among fiscal years 2007 through 2011 for which the 
                amount appropriated under subsections (a) through (d) 
                of section 303 is not less than 110 percent of that 
                appropriated amount for fiscal year 2006, an amount 
                equal to 1 percent of the State's allotment shall be 
                used by the area agencies on aging in the State to 
                carry out the assessment described in section 
                306(b);''.

SEC. 16. ORGANIZATION.

    Section 305 of the Older Americans Act of 1965 (42 U.S.C. 3025) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)(E)--
                            (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, including low-income 
                        minority older individuals, older individuals 
                        with limited English proficiency, and older 
                        individuals residing in rural areas)''; and
                            (ii) by striking ``and'' at the end;
                    (B) in paragraph (2)--
                            (i) in subparagraph (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
                            (ii) in subparagraph (G), by striking the 
                        period and inserting ``; and''; and
                    (C) 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 to long-term care;
                    ``(C) conducting analyses and making 
                recommendations with respect to strategies for 
                modifying 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, by service 
                        providers, of long-term care in home and 
                        community-based settings;
                            ``(iii) target services to older 
                        individuals at risk for institutional 
                        placement, to permit such individuals to remain 
                        in home and community-based settings; and
                            ``(iv) implement (through area agencies on 
                        aging, service providers, and such other 
                        entities as the State determines to be 
                        appropriate) 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.''; and
            (2) in subsection (b), by adding at the end the following:
    ``(6) Nothing in this section shall prevent the Commonwealth of 
Puerto Rico from designating, with the approval of the Assistant 
Secretary, a single planning and service area to cover all the older 
individuals in the Commonwealth.''.

SEC. 17. 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)'' 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)'';
                            (ii) by striking ``(with particular 
                        attention to low-income minority individuals)'' 
                        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
                            (iii) 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)--
                            (i) by inserting after ``transportation,'' 
                        the following: ``health services (including 
                        mental health services),''; and
                            (ii) by inserting after ``information and 
                        assistance'' the following: ``(which may 
                        include information and assistance to consumers 
                        on availability of services under part B and 
                        how to receive benefits under and participate 
                        in publicly supported programs for which the 
                        consumer may be eligible)'';
                    (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 specific objectives for providing 
                services to low-income minority older individuals, 
                older individuals with limited English proficiency, 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; 
                                and
                                    (II) in clause (i)--
                                            (aa) in subclause (V) by 
                                        striking ``with limited 
                                        English-speaking ability; and'' 
                                        and inserting ``with limited 
                                        English proficiency;''; and
                                            (bb) by adding at the end 
                                        the following:
                            ``(VII) older individuals at risk for 
                        institutional placement; and'';
                    (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 older individuals and 
                individuals with disabilities needing such services 
                and, if possible, work in coordination with entities 
                carrying out volunteer programs (including programs 
                administered by the Corporation for National and 
                Community Services) 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, representatives of the 
                                business community,'' after 
                                ``individuals,''; and
                            (iii) in subparagraph (F), by inserting 
                        ``(including mental health screening)'' before 
                        ``provided'' each place it appears;
                    (F) in 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, by service 
                        providers, of long-term care in home and 
                        community-based settings;
                            ``(iii) target services to older 
                        individuals at risk for institutional 
                        placement, to permit such individuals to remain 
                        in home and community-based settings; and
                            ``(iv) 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
                    ``(C) providing 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 the 2 paragraphs (15);
                    (H) by redesignating paragraph (16) as paragraph 
                (15); and
                    (I) by adding at the end the following:
            ``(16) provide assurances that funds received under this 
        title will be used--
                    ``(A) to provide benefits and services to older 
                individuals giving priority to older individuals 
                identified in paragraph (4)(A)(i); and
                    ``(B) in compliance with the assurances specified 
                in paragraph (13) and the limitations specified in 
                section 212(b); and
            ``(17) provide, to the extent feasible, for the furnishing 
        of services under this Act, consistent with self-directed care.
            ``(18) include information detailing how the area agency on 
        aging will coordinate activities, and develop long-range 
        emergency plans, with local and State emergency response 
        agencies, relief organizations, local and State governments, 
        and any other institutions that have responsibility for 
        disaster relief service delivery.'';
            (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) In any fiscal year, an area agency on aging may include in 
the area plan an assessment of how prepared the area agency on aging 
and service providers in the planning and service area are for a change 
in the number of older individuals during the 10-year period following 
the fiscal year for which the plan is submitted. In a fiscal year 
described in section 304(d)(1)(A)(ii), an area agency or aging shall 
include the assessment in the area plan.
    ``(2) 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 individuals with low incomes, 
        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 by such area agency can be improved, and how 
        resource levels can be adjusted to meet the needs of the 
        changing population of older individuals in the planning and 
        service area; and
            ``(D) an analysis of how the change in the number of 
        individuals age 85 and older in the planning and service area 
        is expected to affect the need for supportive services.
    ``(3) 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;
            ``(J) emergency preparedness; and
            ``(K) any other service as determined by such agency.''.

SEC. 18. STATE PLANS.

    Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)) is amended--
            (1) in paragraph (2)(C), by striking ``section 306(b)'' and 
        inserting ``section 306(c)'';
            (2) in paragraph (4), 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 minority older individuals, 
        older individuals with limited English proficiency, and older 
        individuals residing in rural areas)'';
            (3) by striking paragraph (15);
            (4) by redesignating paragraph (14) as paragraph (15);
            (5) 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 minority older individuals with limited 
                English proficiency; and
                    ``(B) describe the methods used to satisfy the 
                service needs of the low-income minority older 
                individuals described in subparagraph (A), including 
                the plan to meet the needs of low-income minority older 
                individuals with limited English proficiency.'';
            (6) 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, including low-income 
        minority older individuals, older individuals with limited 
        English proficiency, and older individuals residing in rural 
        areas)''; and
            (7) by adding at the end the following:
            ``(27) The plan shall provide assurances that area agencies 
        on aging will provide, to the extent feasible, 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 age 85 and older in the State is 
                expected to affect the need for supportive services.
            ``(29) The plan shall include information detailing how the 
        State will coordinate activities, and develop long-range 
        emergency preparedness plans, with area agencies on aging, 
        local emergency response agencies, relief organizations, local 
        governments, and any other institutions that have 
        responsibility for disaster relief service delivery.
            ``(30) The plan shall include information describing the 
        involvement of the head of the State agency in the development, 
        revision, and implementation of emergency preparedness plans, 
        including the State Public Health Emergency Preparedness and 
        Response Plan.
            ``(31) The plan shall provide that the State shall 
        implement an Aging and Disability Resource Center--
                    ``(A) to serve as a visible and trusted source of 
                information on the full range of options for long-term 
                care, including both institutional and home and 
                community-based care, that are available in the State;
                    ``(B) to provide personalized and consumer-friendly 
                assistance to empower individuals to make informed 
                decisions about their long-term care options;
                    ``(C) to provide coordinated and streamlined access 
                to all publicly funded long-term care options so that 
                consumers can obtain the care they need through a 
                single intake, assessment, and eligibility 
                determination process;
                    ``(D) to help individuals to plan ahead for their 
                long-term care needs; and
                    ``(E) to assist, in coordination with the entity 
                carrying out the health insurance information, 
                counseling, and assistance program (receiving funding 
                under section 4360 of the Omnibus Budget Reconciliation 
                Act of 1990 (42 U.S.C. 1395b-4)) in the State, 
                beneficiaries, and prospective beneficiaries, under the 
                Medicare program established under title XVIII of the 
                Social Security Act (42 U.S.C. 1395 et seq.) in 
                understanding and accessing prescription drug and 
                preventative health benefits under the provisions of, 
                and amendments made by, the Medicare Prescription Drug, 
                Improvement, and Modernization Act of 2003.''.

SEC. 19. 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 section 304(d)(1)(D)''.

SEC. 20. NUTRITION SERVICES INCENTIVE PROGRAM.

    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 and grantee under title VI 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 ``agricultural 
                commodities'';
                    (B) in paragraph (2), by inserting ``, including 
                bonus commodities,'' after ``food commodities''; and
                    (C) in paragraph (3), by inserting ``, including 
                bonus commodities,'' after ``Dairy products'';
            (3) in subsection (d)(4), by inserting ``and grantee under 
        title VI'' after ``State agency''; and
            (4) in subsection (e), by striking ``2001'' and inserting 
        ``2007''.

SEC. 21. 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)--
                            (i) by striking ``provided that'' and 
                        inserting ``if''; and
                            (ii) by adding at the end the following: 
                        ``Such contributions shall be encouraged for 
                        individuals whose self-declared income is at or 
                        above 200 percent of the poverty line, at 
                        contribution levels based on the actual cost of 
                        services.''; 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 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)''.

SEC. 22. SUPPORTIVE SERVICES AND SENIOR CENTERS.

    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 striking ``services'' and 
        inserting ``provision of devices and services (including 
        provision of assistive technology devices and assistive 
        technology 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 in carrying out and 
        coordinating activities for older individuals with respect to 
        mental health services, including outreach for, education 
        concerning, and screening for such services, and referral to 
        such services for treatment; and''.

SEC. 23. NUTRITION SERVICES.

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

``SEC. 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 nutrition services to delay the onset of 
adverse health conditions.''.

SEC. 24. 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'' the first place 
        it appears;
            (3) in paragraph (2), by striking ``which''; 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.''.

SEC. 25. HOME DELIVERED NUTRITION SERVICES.

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

``SEC. 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 that provide--
            ``(1) 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) at least 1 home delivered meal per day, 
        which may consist 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.''.

SEC. 26. CRITERIA.

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

``SEC. 337. CRITERIA.

    ``The Assistant Secretary, in consultation with recognized experts 
in the fields 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.''.

SEC. 27. NUTRITION.

    Section 339 of the Older Americans Act of 1965 (42 U.S.C. 3030g-21) 
is amended--
            (1) in paragraph (1), to read as follows:
            ``(1) solicit the advice and expertise of a dietitian or 
        other individual with 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), 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
                    (B) in subparagraph (D), by inserting ``joint'' 
                after ``encourages''; and
                    (C) in subparagraph (G), to read as follows:
                    ``(G) ensures that meal providers solicit the 
                advice and expertise of--
                            ``(i) a dietitian or other individual 
                        described in paragraph (1),
                            ``(ii) meal participants, and
                            ``(iii) other individuals knowledgeable 
                        with regard to the needs of older 
                        individuals,''; and
                    (D) in subparagraph (I), by striking ``and'' at the 
                end; and
                    (E) in subparagraph (J), to read as follows:
                    ``(J) provides for nutrition screening and 
                nutrition education, and nutrition assessment and 
                counseling if appropriate; and
                    ``(K) encourages individuals who distribute 
                nutrition services under subpart 2 to provide, to 
                homebound older individuals, available medical 
                information approved by health care professionals, such 
                as informational brochures and information on how to 
                get vaccines, including vaccines for influenza, 
                pneumonia, and shingles, in the individuals' 
                communities.''.

SEC. 28. STUDY OF NUTRITION PROJECTS.

    (a) Study.--
            (1) In general.--The Assistant Secretary for Aging shall 
        use funds allocated in section 206(g) of the Older Americans 
        Act of 1965 (42 U.S.C. 3017(g)) to enter into a contract with 
        the Food and Nutrition Board of the Institute of Medicine of 
        the National Academy of Sciences, for the purpose of 
        establishing an independent panel of experts that will conduct 
        an evidence-based study of the nutrition projects authorized 
        under such Act.
            (2) Study.--Such study shall, to the extent data are 
        available, include--
                    (A) an evaluation of the effect of the nutrition 
                projects authorized by such Act on--
                            (i) improvement of the health status, 
                        including nutritional status, of participants 
                        in the projects;
                            (ii) prevention of hunger and food 
                        insecurity of the participants; and
                            (iii) continuation of the ability of the 
                        participants to live independently;
                    (B) a cost-benefit analysis of nutrition projects 
                authorized by such Act, including the potential to 
                affect costs of the Medicaid program under title XIX of 
                the Social Security Act (42 U.S.C. 1396 et seq.); and
                    (C) an analysis of how nutrition projects 
                authorized by such Act may be modified to improve the 
                outcomes described in subparagraph (A), including by 
                improving the nutritional quality of the meals provided 
                through the projects and undertaking other potential 
                strategies to improve the nutritional status of the 
                participants.
    (b) Reports.--
            (1) Report to the assistant secretary.--The panel described 
        in subsection (a) shall submit to the Assistant Secretary a 
        report containing the results of the evidence-based study 
        described in subsection (a), including any recommendations 
        resulting from the analysis described in subsection (a)(2)(C).
            (2) Report to congress.--The Assistant Secretary shall 
        submit a report containing the results described in paragraph 
        (1) 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.
    (c) Timing.--The Food and Nutrition Board shall establish the 
independent panel of experts described in subsection (a) not later than 
90 days after the date of the enactment of this Act. The panel shall 
submit the report described in subsection (b)(1) to the Assistant 
Secretary not later than 24 months after the date of the enactment of 
this Act.

SEC. 29. IMPROVING INDOOR AIR QUALITY IN BUILDINGS WHERE OLDER 
              INDIVIDUALS 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 older individuals congregate.''.

SEC. 30. CAREGIVER SUPPORT PROGRAM DEFINITIONS.

    Section 372 of the Older Americans Act of 1965 (42 U.S.C. 3030s) is 
amended--
            (1) in paragraph (1), by inserting ``or an adult child with 
        mental retardation or a related developmental disability'' 
        after ``age'';
            (2) in paragraph (2), by inserting before the period the 
        following: ``or an individual with Alzheimer's disease or a 
        related disorder with neurological and organic brain 
        dysfunction who is 50 years of age or older'';
            (3) in paragraph (3)--
                    (A) by striking ``child'' the first place it 
                appears and inserting ``child (including an adult child 
                with mental retardation or a related developmental 
                disability)'';
                    (B) by striking ``a child by blood or marriage'' 
                and inserting ``such a child by blood, marriage, or 
                adoption''; and
                    (C) by striking ``60'' and inserting ``55'';
            (4) by redesignating paragraphs (2) and (3) as paragraphs 
        (3) and (4), respectively; and
            (5) by inserting after paragraph (1) the following:
            ``(2) Developmental disability.--The term `developmental 
        disability' has the meaning given the term in section 102 of 
        the Developmental Disabilities Assistance and Bill of Rights 
        Act of 2000 (42 U.S.C. 15002).''.

SEC. 31. CAREGIVER SUPPORT PROGRAM.

    Section 373 of the National Family Support Caregiver Act (42 U.S.C. 
3030s-1) is amended--
            (1) in subsection (b)(3), by striking ``caregivers to 
        assist'' and all that follows through the end and inserting the 
        following: ``assist the caregivers in the areas of health, 
        nutrition, and financial literacy, and in making decisions and 
        solving problems relating to their caregiving roles;'';
            (2) in subsection (c)(2)--
                    (A) by striking ``(as defined'' and all that 
                follows and inserting a period; and
                    (B) by adding at the end the following: ``In 
                providing services for family caregivers under this 
                subpart, the State shall give priority for services to 
                family caregivers who provide care for older 
                individuals.''; and
            (3) in subsection (d), to read as follows:
    ``(d) Use of Volunteers.--In carrying out this subpart, each area 
agency on aging shall make use of trained volunteers to expand the 
provision of the available services described in subsection (b) and 
shall, if possible, work in coordination with entities carrying out 
volunteer programs (including programs administered by the Corporation 
for National and Community Service) designed to provide training, 
placement, and stipends for volunteers in community service 
settings.''; and
            (4) in subsection (e)(3), by adding at the end the 
        following: ``The reports shall describe any mechanisms used in 
        the State to provide to persons who are family caregivers, or 
        grandparents or older individuals who are relative caregivers, 
        information about and access to various services so that the 
        persons can better carry out their care responsibilities.''; 
        and
            (5) in subsection (f)(1), by striking ``2001 through 2005'' 
        and inserting ``2007, 2008, 2009, 2010, and 2011''.

SEC. 32. ACTIVITIES AND PROGRAMS OF NATIONAL SIGNIFICANCE.

    Section 376(a) of the National Family Support Caregiver Act (42 
U.S.C. 3030s-12(a)) is amended--
            (1) by striking the title heading and inserting the 
        following:

``SEC. 376. ACTIVITIES AND PROGRAMS OF NATIONAL SIGNIFICANCE.'';

            (2) by striking ``(a) In General.--'';
            (3) by striking ``shall'' and inserting ``may'';
            (4) by striking ``program'' and inserting ``activities that 
        include'';
            (5) by striking ``research.'' and inserting ``research, and 
        programs that include--
            ``(1) multigenerational programs, including programs that 
        provide supports for grandparents and other older individuals 
        who are relative caregivers (as defined in section 372) raising 
        children (such as kinship navigator programs), and programs 
        that sustain and replicate innovative multigenerational family 
        support programs involving volunteers who are older 
        individuals;
            ``(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 family support programs;
            ``(3) programs addressing unique issues faced by rural 
        caregivers;
            ``(4) programs focusing on the needs of older individuals 
        with Alzheimer's disease and related dementia and their 
        caregivers; and
            ``(5) programs supporting caregivers in the roles the 
        caregivers carry out in health promotion and disease 
        prevention.''; and
            (6) by striking subsection (b).

SEC. 33. 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 activities may include--
                    ``(A) efforts to assess the aging population;
                    ``(B) activities to coordinate the activities of 
                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 grants under part A of title 
                VI, in engaging 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 older individuals residing in home and 
        community-based settings or rural areas.''.

SEC. 34. 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 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, Hispanic Centers of 
Excellence in Applied Gerontology, and other educational institutions 
that serve the needs of minority students, to provide education and 
training that prepare students for careers in the field of aging.''.

SEC. 35. HEALTH CARE SERVICE DEMONSTRATION PROJECTS IN RURAL AREAS.

    Section 414 of the Older Americans Act of 1965 (42 U.S.C. 3032c) is 
amended--
            (1) in subsection (a), by inserting ``mental health care,'' 
        after ``adult day health care,''; and
            (2) in subsection (b)(1)(B)(i), by inserting ``mental 
        health,'' after ``public health,''.

SEC. 36. TECHNICAL ASSISTANCE AND INNOVATION TO IMPROVE TRANSPORTATION 
              FOR OLDER INDIVIDUALS.

    Section 416 of the Older Americans Act of 1965 (42 U.S.C. 3032e) is 
amended to read as follows:

``SEC. 416. TECHNICAL ASSISTANCE AND INNOVATION TO IMPROVE 
              TRANSPORTATION FOR OLDER INDIVIDUALS.

    ``(a) In General.--The Secretary may award grants or contracts to 
nonprofit organizations to improve transportation services for older 
individuals.
    ``(b) Use of Funds.--
            ``(1) In general.--A nonprofit organization receiving a 
        grant or contract under subsection (a) shall use the funds 
        received through such grant or contract to carry out a 
        demonstration project, or to provide technical assistance to 
        assist local transit providers, area agencies on aging, senior 
        centers, and local senior support groups, to encourage and 
        facilitate coordination of Federal, State, and local 
        transportation services and resources for older individuals. 
        The organization may use the funds to develop and carry out an 
        innovative transportation demonstration project to create 
        transportation services for older individuals.
            ``(2) Specific activities.--In carrying out a demonstration 
        project or providing technical assistance under paragraph (1) 
        the organization may carry out activities that include--
                    ``(A) developing innovative approaches for 
                improving access by older individuals to transportation 
                services, including volunteer driver programs, 
                economically sustainable transportation programs, and 
                programs that allow older individuals to transfer their 
                automobiles to a provider of transportation services in 
                exchange for the services;
                    ``(B) preparing information on transportation 
                options and resources for older individuals and 
                organizations serving such individuals, and 
                disseminating the information by establishing and 
                operating a toll-free telephone number;
                    ``(C) developing models and best practices for 
                providing comprehensive integrated transportation 
                services for older individuals, including services 
                administered by the Secretary of Transportation, by 
                providing ongoing technical assistance to agencies 
                providing services under title III and by assisting in 
                coordination of public and community transportation 
                services; and
                    ``(D) providing special services to link seniors to 
                transportation services not provided under title III.
    ``(c) Economically Sustainable Transportation.--In this section, 
the term `economically sustainable transportation' means demand 
responsive transportation for older individuals--
            ``(1) that may be provided through volunteers; and
            ``(2) that the provider will provide without receiving 
        Federal or other public financial assistance, after a period of 
        not more than 5 years of providing the services under this 
        section.''.

SEC. 37. COMMUNITY PLANNING.

    Title IV of the Older Americans Act of 1965 is amended by inserting 
after section 416 (42 U.S.C. 3032e) the following:

``SEC. 416A. COMMUNITY PLANNING FOR THE AGING POPULATION.

    ``The Secretary may establish, either directly or through grants or 
contracts, a national technical assistance program to assist States and 
area agencies on aging funded under this Act in planning efforts to 
prepare communities for the aging of the population.''.

SEC. 38. DEMONSTRATION, SUPPORT, AND RESEARCH PROJECTS FOR 
              MULTIGENERATIONAL ACTIVITIES AND CIVIC ENGAGEMENT 
              ACTIVITIES.

    Section 417 of the Older Americans Act of 1965 (42 U.S.C. 3032f) is 
amended to read as follows:

``SEC. 417. DEMONSTRATION, SUPPORT, AND RESEARCH PROJECTS FOR 
              MULTIGENERATIONAL ACTIVITIES AND CIVIC ENGAGEMENT 
              ACTIVITIES.

    ``(a) Grants and Contracts.--The Assistant Secretary shall award 
grants and enter into contracts with eligible organizations to--
            ``(1) conduct productivity and cost-benefit research to 
        determine the effectiveness of engaging older individuals in 
        paid and unpaid positions with public and nonprofit 
        organizations;
            ``(2) develop a national agenda and blueprint for creating 
        paid and unpaid positions for older individuals with public and 
        nonprofit organizations to increase the capacity of the 
        organizations to provide needed services to communities;
            ``(3) carry out demonstration and support projects to 
        provide older individuals with multigenerational activities, 
        and civic engagement activities, designed to meet critical 
        community needs; and
            ``(4) carry out demonstration projects to coordinate 
        multigenerational activities and civic engagement activities, 
        and facilitate development of and participation in 
        multigenerational activities.
    ``(b) Use of Funds.--An eligible organization shall use funds made 
available under a grant awarded, or a contract entered into, under 
subsection (a)--
            ``(1)(A) to conduct the research described in subsection 
        (a)(1);
            ``(B) to develop the national agenda and blueprint 
        described in subsection (a)(2); or
            ``(C) to carry out a demonstration or support project 
        described in subsection (a)(3);
            ``(D) to carry out a demonstration project described in 
        subsection (a)(4); and
            ``(2) to evaluate the project involved in accordance with 
        subsection (f).
    ``(c) Preference.--In awarding grants and entering into contracts 
under subsection (a) to carry out a demonstration or support project 
described in subsection (a)(3), the Assistant Secretary shall give 
preference to--
            ``(1) eligible organizations with a demonstrated record of 
        carrying out multigenerational activities or civic engagement 
        activities;
            ``(2) eligible organizations proposing multigenerational 
        activity service projects that will serve older individuals and 
        communities with the greatest need (with particular attention 
        to low-income minority older individuals, older individuals 
        with limited English proficiency, older individuals residing in 
        rural areas, and low-income minority communities);
            ``(3) eligible organizations proposing civic engagement 
        activity service projects that will serve communities with the 
        greatest need; and
            ``(4) eligible organizations with the capacity to develop 
        meaningful roles and assignments that use the time, skills, and 
        experience of older individuals to serve public and nonprofit 
        organizations.
    ``(d) Application.--To be eligible to receive a grant or a contract 
under subsection (a), an organization shall submit an application to 
the Assistant Secretary at such time, in such manner, and accompanied 
by such information as the Assistant Secretary may reasonably require.
    ``(e) Eligible Organizations.--Organizations eligible to receive a 
grant or enter into a contract under subsection (a)--
            ``(1) to carry out activities described in subsection 
        (a)(1) shall be research or academic organizations with the 
        capacity to conduct productivity and cost-benefit research 
        described in subsection (a)(1);
            ``(2) to carry out activities described in subsection 
        (a)(2) shall be organizations with the capacity to develop the 
        national agenda and blueprint described in subsection (a)(2);
            ``(3) to carry out activities described in subsection 
        (a)(3) shall be organizations that provide paid or unpaid 
        positions for older individuals to serve in multigenerational 
        activities, or civic engagement activities, designed to meet 
        critical community needs and use the full range of time, 
        skills, and experience of older individuals; and
            ``(4) to carry out activities described in subsection 
        (a)(4) shall be organizations with the capacity to facilitate 
        and coordinate activities as described in subsection (a)(4), 
        through the use of multigenerational coordinators.
    ``(f) Local Evaluation and Report.--
            ``(1) Evaluation.--Each organization receiving a grant or a 
        contract under subsection (a) to carry out a demonstration or 
        support project under subsection (a)(3) shall evaluate the 
        multigenerational activities or civic engagement activities 
        assisted under the project to determine the effectiveness of 
        the activities involved, the impact of such activities on the 
        community being served and the organization providing the 
        activities, and the impact of such activities on older 
        individuals involved in such project.
            ``(2) Report.--The organization shall submit a report to 
        the Assistant Secretary containing the evaluation not later 
        than 6 months after the expiration of the period for which the 
        grant or contract is in effect.
    ``(g) Report to Congress.--Not later than 6 months after the 
Assistant Secretary receives the reports described in subsection 
(f)(2), the Assistant Secretary shall prepare and submit to the Speaker 
of the House of Representatives and the President pro tempore of the 
Senate a report that assesses the evaluations and includes, at a 
minimum--
            ``(1) the names or descriptive titles of the demonstration, 
        support, and research projects funded under subsection (a);
            ``(2) a description of the nature and operation of the 
        projects;
            ``(3) the names and addresses of organizations that 
        conducted the projects;
            ``(4) in the case of demonstration and support projects 
        carried out under subsection (a)(3), a description of the 
        methods and success of the projects in recruiting older 
        individuals as employees and volunteers to participate in the 
        projects;
            ``(5) in the case of demonstration and support projects 
        carried out under subsection (a)(3), a description of the 
        success of the projects in retaining older individuals involved 
        in the projects as employees and as volunteers;
            ``(6) in the case of demonstration and support projects 
        carried out under subsection (a)(3), the rate of turnover of 
        older individual employees and volunteers in the projects;
            ``(7) a strategy for disseminating the findings resulting 
        from the projects described in paragraph (1); and
            ``(8) any policy change recommendations relating to the 
        projects.
    ``(h) Definitions.--As used in this section:
            ``(1) Civic engagement activity.--The term `civic 
        engagement activity' includes an opportunity that uses the 
        time, skills, and experience of older individuals, in paid or 
        unpaid positions with a public or nonprofit organization, to 
        help address the unmet human, educational, health care, 
        environmental, and public safety needs and nurture and sustain 
        active participation in community affairs.
            ``(2) Multigenerational activity.--The term 
        `multigenerational activity' includes an opportunity that uses 
        the time, skills, and experience of older individuals, in paid 
        or unpaid positions with a public or nonprofit organization, to 
        serve as a mentor or adviser in a child care program, a youth 
        day care program, an educational assistance program, an at-risk 
        youth intervention program, a juvenile delinquency treatment 
        program, a before- or after-school program, or a family support 
        program.
            ``(3) Multigenerational coordinator.--The term 
        `multigenerational coordinator' means a person who--
                    ``(A) builds the capacity of public and nonprofit 
                organizations to develop meaningful roles and 
                assignments, that use the time, skill, and experience 
                of older individuals to serve those organizations; and
                    ``(B) nurtures productive, sustainable working 
                relationships between--
                            ``(i) individuals from the generations with 
                        older individuals; and
                            ``(ii) individuals in younger 
                        generations.''.

SEC. 39. 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 ``health''.

SEC. 40. MULTIDISCIPLINARY CENTERS AND MULTIDISCIPLINARY SYSTEMS.

    Section 419 of the Older Americans Act of 1965 (42 U.S.C. 3032h) is 
amended--
            (1) by striking the title and inserting the following:

``SEC. 419. MULTIDISCIPLINARY CENTERS AND MULTIDISCIPLINARY SYSTEMS.'';

            (2)(A) in subsection (b)(2), by redesignating subparagraphs 
        (A) through (G) as clauses (i) through (vii), respectively;
            (B) in subsection (c)(2), by redesignating subparagraphs 
        (A) through (D) as clauses (i) through (iv), respectively; and
            (C) by aligning the margins of the clauses described in 
        subparagraphs (A) and (B) with the margins of clause (iv) of 
        section 418(a)(2)(A) of such Act;
            (3)(A) in subsection (b), by redesignating paragraphs (1) 
        and (2) as subparagraphs (A) and (B), respectively;
            (B) in subsection (c), by redesignating paragraphs (1) and 
        (2) as subparagraphs (A) and (B), respectively; and
            (C) by aligning the margins of the subparagraphs described 
        in subparagraphs (A) and (B) with the margins of subparagraph 
        (D) of section 420(a)(1) of such Act;
            (4) in subsection (a), by striking ``(a)'' and all that 
        follows through ``The'' and inserting the following:
    ``(a) Multidisciplinary Centers.--
            ``(1) Program authorized.--The'';
            (5) in subsection (b)--
                    (A) by striking the following:
    ``(b) Use of Funds.--'' and inserting the following:
            ``(2) Use of funds.--''; and
                    (B) by striking ``subsection (a)'' each place it 
                appears and inserting ``paragraph (1)'';
            (6) in subsection (c)--
                    (A) by striking the following:
    ``(c) Data.--'' and inserting the following:
            ``(3) Data.--'';
                    (B) by striking ``subsection (a)'' and inserting 
                ``paragraph (1)'';
                    (C) by striking ``such subsection'' and inserting 
                ``such paragraph''; and
                    (D) by striking ``paragraph (1)'' and inserting 
                ``subparagraph (A)''; and
            (7) by adding at the end the following:
    ``(b)  Multidisciplinary Health Services in Communities.--
            ``(1) Program authorized.--The Assistant Secretary shall 
        make grants to States, on a competitive basis, for the 
        development and operation of--
                    ``(A) systems for the delivery of mental health 
                screening and treatment services for older individuals 
                who lack access to such services; and
                    ``(B) programs to--
                            ``(i) increase public awareness regarding 
                        the benefits of prevention and treatment of 
                        mental disorders in older individuals;
                            ``(ii) reduce the stigma associated with 
                        mental disorders in older individuals and other 
                        barriers to the diagnosis and treatment of the 
                        disorders; and
                            ``(iii) reduce age-related prejudice and 
                        discrimination regarding mental disorders in 
                        older individuals.
            ``(2) Application.--To be eligible to receive a grant under 
        this subsection for a State, a State agency shall submit an 
        application to the Assistant Secretary at such time, in such 
        manner, and containing such information as the Assistant 
        Secretary may require.
            ``(3) State allocation and priorities.--A State agency that 
        receives funds through a grant made under this subsection shall 
        allocate the funds to area agencies on aging to carry out this 
        subsection in planning and service areas in the State. In 
        allocating the funds, the State agency shall give priority to 
        planning and service areas in the State--
                    ``(A) that are medically underserved; and
                    ``(B) in which there are a large number of older 
                individuals.
            ``(4) Area coordination of services with other providers.--
        In carrying out this part, to more efficiently and effectively 
        deliver services to older individuals, each area agency on 
        aging shall--
                    ``(A) coordinate services described in paragraph 
                (1) with other community agencies, and voluntary 
                organizations, providing similar or related services; 
                and
                    ``(B) to the greatest extent practicable, integrate 
                outreach and educational activities with existing (as 
                of the date of the integration) health care and social 
                service providers serving older individuals in the 
                planning and service area involved.
            ``(5) Relationship to other funding sources.--Funds made 
        available under this part shall supplement, and not supplant, 
        any Federal, State, and local funds expended by a State or unit 
        of general purpose local government (including an area agency 
        on aging) to provide the services described in paragraph (1).
            ``(6) Definition.--In this subsection, the term `mental 
        health screening and treatment services' means patient 
        screening, diagnostic services, care planning and oversight, 
        therapeutic interventions, and referrals, that are--
                    ``(A) provided pursuant to evidence-based 
                intervention and treatment protocols (to the extent 
                such protocols are available) for mental disorders 
                prevalent in older individuals; and
                    ``(B) coordinated and integrated with the services 
                of social service, mental health, and health care 
                providers in an area in order to--
                            ``(i) improve patient outcomes; and
                            ``(ii) ensure, to the maximum extent 
                        feasible, the continuing independence of older 
                        individuals who are residing in the area.''.

SEC. 41. COMMUNITY INNOVATIONS FOR AGING IN PLACE.

    Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 
3031 et seq.) is amended by adding at the end the following:

``SEC. 422. COMMUNITY INNOVATIONS FOR AGING IN PLACE.

    ``(a) Definitions.--In this section:
            ``(1) Eligible entity.--The term `eligible entity'--
                    ``(A) means a nonprofit health or social service 
                organization, a community-based nonprofit organization, 
                an area agency on aging or other local government 
                agency, a tribal organization, or another entity that--
                            ``(i) the Assistant Secretary determines to 
                        be appropriate to carry out a project under 
                        this part; and
                            ``(ii) demonstrates a record of, and 
                        experience in, providing or administering group 
                        and individual health and social services for 
                        older individuals; and
                    ``(B) does not include an entity providing housing 
                under the congregate housing services program carried 
                out under section 802 of the Cranston-Gonzalez National 
                Affordable Housing Act (42 U.S.C. 8011) or the 
                multifamily service coordinator program carried out 
                under section 202(g) of the Housing Act of 1959 (12 
                U.S.C. 1701q(g)).
            ``(2) Naturally occurring retirement community.--The term 
        `Naturally Occurring Retirement Community' means a residential 
        building, a housing complex, an area (including a rural area) 
        of single family residences, or a neighborhood composed of age-
        integrated housing--
                    ``(A) where--
                            ``(i) 40 percent of the heads of households 
                        are older individuals; or
                            ``(ii) a critical mass of older individuals 
                        exists, based on local factors which, taken in 
                        total, allow an organization to achieve 
                        efficiencies in the provision of health and 
                        social services to older individuals living in 
                        the community; and
                    ``(B) that is not an institutional care or assisted 
                living setting.
    ``(b) Grants.--
            ``(1) In general.--The Assistant Secretary shall make 
        grants to eligible entities to enable the entities to pay for 
        developing or carrying out model aging in place projects. The 
        projects shall permit aging in place for older individuals, 
        including such individuals who reside in Naturally Occurring 
        Retirement Communities, which help to sustain the independence 
        of older individuals in communities where the individuals have 
        established personal, family, and professional supportive 
        networks. The entities shall provide comprehensive and 
        coordinated health and social services through the projects.
            ``(2) Grant periods.--The Assistant Secretary shall make 
        the grants for periods of 3 years.
    ``(c) Applications.--
            ``(1) In general.--To be eligible to receive a grant under 
        subsection (b) for a project, an entity shall submit an 
        application to the Assistant Secretary at such time, in such 
        manner, and containing such information as the Assistant 
        Secretary may require.
            ``(2) Contents.--The application shall include--
                    ``(A) a detailed description of the entity's 
                experience in providing services to older individuals 
                in age-integrated settings;
                    ``(B) a definition of the contiguous service area 
                and a description of the project boundaries in which 
                the older individuals reside or carry out activities to 
                sustain their well-being;
                    ``(C) a description of how the entity will 
                cooperate and coordinate planning and services, with 
                agencies and organizations that provide publicly 
                supported services for older individuals within the 
                project boundaries, including the State agency and area 
                agencies on aging with planning and service areas 
                within the project boundaries;
                    ``(D) an assurance that the entity will seek to 
                establish cooperative relationships with interested 
                local entities, including private agencies and 
                businesses that provide health and social services, 
                housing entities, community development organizations, 
                philanthropic organizations, foundations, and other 
                non-Federal entities;
                    ``(E) a description of the entity's protocol for 
                referral of residents who may require long-term care 
                services, including coordination with local information 
                and referral agencies and Aging and Disability Resource 
                Centers who serve as single points of entry to public 
                services;
                    ``(F) a description of how the entity will offer 
                opportunities for older individuals to be involved in 
                the governance, oversight, and operation of the 
                project;
                    ``(G) an assurance that the entity will submit to 
                the Assistant Secretary such evaluations and reports as 
                the Assistant Secretary may require; and
                    ``(H) a plan for long-term sustainability of the 
                project.
    ``(d) Use of Funds.--
            ``(1) In general.--An eligible entity that receives a grant 
        under subsection (b) shall use the funds made available through 
        the grant to provide and coordinate, through aging in place 
        projects described in subsection (b), services that include a 
        comprehensive and coordinated array of community-based health 
        and social services, which may include mental health services, 
        for eligible older individuals.
            ``(2) Services.--The services described in paragraph (1) 
        shall include--
                    ``(A) providing--
                            ``(i) case management, case assistance, and 
                        social work services;
                            ``(ii) health care management and health 
                        care assistance, including disease prevention 
                        and health promotion services;
                            ``(iii) education, socialization, and 
                        recreational activities; and
                            ``(iv) volunteer opportunities for project 
                        participants; and
                    ``(B) coordinating the services provided under 
                title III for eligible older individuals served by the 
                project.
            ``(3) Preference.--In carrying out an aging in place 
        project, an eligible entity shall, to the extent practicable, 
        serve communities of low-income individuals and operate or 
        locate projects and services in or in close proximity to 
        locations where large concentrations of older individuals have 
        aged in place and resided, such as Naturally Occurring 
        Retirement Communities.
            ``(4) Supplement not supplant.--Funds made available to an 
        eligible entity under this section shall be used to supplement, 
        not supplant, any Federal, State, or other funds otherwise 
        available to the entity to provide health and social services 
        to eligible older individuals.
    ``(e) Competitive Grants for Technical Assistance.--
            ``(1) Grants.--The Assistant Secretary shall (or shall make 
        a grant, on a competitive basis, to an eligible nonprofit 
        organization, to enable the organization to)--
                    ``(A) provide technical assistance to recipients of 
                grants under subsection (b); and
                    ``(B) carry out other duties, as determined by the 
                Assistant Secretary.
            ``(2) Eligible organization.--To be eligible to receive a 
        grant under this subsection, an organization shall be a 
        nonprofit organization (including a partnership of nonprofit 
        organizations), that--
                    ``(A) has experience and expertise in providing 
                technical assistance to a range of entities serving 
                older individuals and experience evaluating and 
                reporting on programs; and
                    ``(B) has demonstrated knowledge of and expertise 
                in community-based health and social services.
            ``(3) Application.--To be eligible to receive a grant under 
        this subsection, an organization (including a partnership of 
        nonprofit organizations) shall submit an application to the 
        Assistant Secretary at such time, in such manner, and 
        containing such information as the Assistant Secretary may 
        require, including an assurance that the organization will 
        submit to the Assistant Secretary such evaluations and reports 
        as the Assistant Secretary may require.
    ``(f) Report.--The Assistant Secretary shall annually prepare and 
submit a report to Congress that shall include--
            ``(1) the findings resulting from the evaluations of the 
        model projects conducted under this section;
            ``(2) a description of recommended best practices regarding 
        carrying out health and social service projects for older 
        individuals aging in place; and
            ``(3) recommendations for legislative or administrative 
        action, as the Assistant Secretary determines appropriate.''.

SEC. 42. CHOICES FOR INDEPENDENCE DEMONSTRATION PROJECTS.

    Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 
3031 et seq.), as amended by section 41, is further amended by adding 
at the end the following:

``SEC. 423. CHOICES FOR INDEPENDENCE DEMONSTRATION PROJECTS.

    ``(a) Definitions.--In this section:
            ``(1) Consumer.--The term `consumer' means an older 
        individual, a family member of such individual, and any other 
        person seeking information or assistance with respect to long-
        term care.
            ``(2) High-risk individual.--The term `high-risk 
        individual' means an older individual who--
                    ``(A) has a functional impairment affecting the 
                individual's activities of daily living;
                    ``(B) is ineligible for the Medicaid program under 
                title XIX of the Social Security Act (42 U.S.C. 1396 et 
                seq.); and
                    ``(C) meets such income and functional status 
                criteria as are determined to be appropriate by the 
                State involved and approved by the Assistant Secretary.
            ``(3) Qualified expenditures.--The term `qualified 
        expenditures' means reported expenditures of a State under this 
        section that have been reviewed and approved by the Assistant 
        Secretary.
            ``(4) Service coordination.--The term `service 
        coordination' means a coordinated approach taken on behalf of 
        high-risk older individuals to facilitate the development and 
        implementation of a long-term care plan and the choice and 
        independence of the individuals in securing long-term care.
    ``(b) Authority.--The Assistant Secretary shall make grants on a 
competitive basis, in accordance with this section, to States to enable 
the States to pay for the Federal share of the cost of modifying their 
systems of long-term care in order to promote and facilitate--
            ``(1) the choice and control of older individuals and their 
        families in securing long-term care;
            ``(2) the coordination and cost-effectiveness of State 
        systems of long-term care;
            ``(3) the provision of long-term care in home and 
        community-based settings; and
            ``(4) the ability of individuals receiving long-term care 
        to remain as independent and self-sufficient as possible.
    ``(c) Applications by States.--For a State to be eligible to 
receive a grant under this section, the Governor of such State shall 
submit an application to the Assistant Secretary, at such time, in such 
manner, and containing such information as the Assistant Secretary may 
specify, containing a plan for implementation of the component 
strategies described in subsection (d) and such other information and 
assurances as the Secretary determines to be appropriate.
    ``(d) Use of Funds by States.--
            ``(1) Component strategies.--A State that receives funds 
        through a grant made under subsection (b) shall use the funds 
        to carry out a demonstration project under this section 
        (directly or by grant or contract) by integrating into the 
        State's system of long-term care the component strategies 
        described in paragraphs (2) through (5).
            ``(2) Public education.--In carrying out the demonstration 
        project, the State shall conduct activities that shall include 
        media campaigns, targeted mailings, and related activities, to 
        help ensure that consumers are aware of--
                    ``(A) the need to plan in advance for long-term 
                care;
                    ``(B) available public and private long-term care 
                options, including private long-term care insurance; 
                and
                    ``(C) sources of information and resources related 
                to long-term care, including the resource centers 
                described in paragraph (3).
            ``(3) Aging and disability resource centers.--
                    ``(A) In general.--The State shall provide for 
                community-level Aging and Disability Resource Centers, 
                which, consistent with section 102(47) and subsection 
                (f), shall provide--
                            ``(i) comprehensive information on 
                        available public and private long-term care 
                        programs, options, and resources;
                            ``(ii) personal counseling and service 
                        coordination to assist consumers in assessing 
                        their existing or anticipated long-term care 
                        needs and circumstances, and developing and 
                        implementing a plan for long-term care designed 
                        to meet their specific needs and circumstances;
                            ``(iii) a convenient point of entry to the 
                        range of publicly-supported long-term care 
                        programs for which an individual may be 
                        eligible, including the Medicaid program under 
                        title XIX of the Social Security Act (42 U.S.C. 
                        1396 et seq.), and to such other public benefit 
                        programs as the State determines to be 
                        appropriate;
                            ``(iv) a single process for consumer 
                        intake, assessment, and application for 
                        benefits under the programs described in 
                        subparagraph (C), including, where appropriate 
                        and feasible, facilitating the determination of 
                        an individual's eligibility (including 
                        facilitating that determination in compliance 
                        with the requirements of title XIX of the 
                        Social Security Act) under such programs by 
                        collaborating with the appropriate programmatic 
                        office; and
                            ``(v) the ability--
                                    ``(I) to respond immediately to a 
                                request for assistance from an 
                                individual or a family member of the 
                                individual, in the event of a crisis 
                                situation that could result in 
                                placement of such individual in an 
                                institutional care setting; and
                                    ``(II) to provide (or coordinate 
                                the provision of), such available 
                                short-term assistance as would be 
                                necessary and appropriate to 
                                temporarily preclude the need for such 
                                institutional placement, until a plan 
                                for home and community-based long-term 
                                care can be developed and implemented.
                    ``(B) Training.--In providing for the Centers, the 
                State shall ensure that the staff of the Centers is 
                appropriately trained to understand the interactions 
                between private long-term care insurance (especially 
                insurance through long-term care partnership policies) 
                and eligibility for benefits under the Medicaid program 
                under title XIX of the Social Security Act (42 U.S.C. 
                1396 et seq.).
            ``(4) Healthy lifestyle choices.--The State shall, in 
        accordance with standards established by the Assistant 
        Secretary, provide for low-cost, community-level, evidence-
        based prevention programs and related tools 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.
            ``(5) Community living incentives.--
                    ``(A) In general.--The State shall provide funding 
                toward and otherwise assist with the provision of home 
                and community-based long-term care to individuals at 
                high risk for placement in institutional care (referred 
                to in this paragraph as `high-risk individuals'). The 
                State shall ensure that individuals at greatest risk 
                for becoming eligible for benefits under the Medicaid 
                program receive priority for the home and community-
                based long-term care.
                    ``(B) Long-term care plan.--The State shall provide 
                for assessments of the needs and preferences of high-
                risk individuals with respect to long-term care, and 
                based on such assessments, shall develop with such 
                individuals and their family members, caregivers, or 
                legal representatives a plan for long-term care for 
                such individuals, specifying the types of support, 
                providers, budget, and, if the State elects, cost-
                sharing contributions involved.
                    ``(C) Allocation of funds based on individual 
                budgets.--The State shall ensure that the funding 
                described in subparagraph (A) will be allocated among, 
                and disbursed for, the budgets of high-risk individuals 
                under long-term care plans developed for such 
                individuals.
                    ``(D) Option to provide consumer-directed care.--
                The State shall provide high-risk individuals with the 
                option to receive home and community-based long-term 
                care under this paragraph in a manner that permits such 
                individuals to direct and control, in conjunction with 
                a service coordinator, the selection, planning, 
                budgeting, and purchasing of such care (including the 
                amount, duration, scope, providers, and location of 
                such care), to the extent determined appropriate and 
                feasible under the long-term care plan developed under 
                subparagraph (B). The service coordinator shall assist 
                the high-risk individuals in purchasing a range of 
                long-term care services or supplies, not otherwise 
                available or eligible for payment through an entity 
                carrying out a Federal or State program or a similar 
                third party, from a qualified provider that are 
                delivered in home and community-based settings and in a 
                manner that best meets the individuals' needs and 
                respects the individuals' preferences to remain in the 
                least restrictive setting possible.
    ``(e) Federal Share.--The Federal share of the cost of modifying 
systems of long-term systems care as described in subsection (b) shall 
be not more than 75 percent of such cost (calculated on an annual basis 
as the State's qualified expenditures for such modifications for such 
year).
    ``(f) Special Provisions Relating to Aging and Disability Resource 
Centers.--A State shall ensure that any Aging and Disability Resource 
Center shall--
            ``(1) fully coordinate its activities with any health 
        insurance information, counseling, and assistance (receiving 
        funding under section 4360 of the Omnibus Budget Reconciliation 
        Act of 1990 (42 U.S.C. 1395b-4)) in the State;
            ``(2) be subject to such controls as the Assistant 
        Secretary determines to be appropriate to ensure there is no 
        conflict of interest with respect to any referrals, for 
        information or otherwise, made by the Center for individuals 
        receiving services through the Center; and
            ``(3) provide no long-term care services or supplies, with 
        the exception of case management services provided through area 
        agencies on aging as described in section 306(a)(8).
    ``(g) Special Provisions Relating to Option to Provide Consumer-
Directed Care.--Payments made for a high-risk individual under 
subsection (d)(5)(D) shall not be included in the gross income of the 
high-risk individual for purposes of the Internal Revenue Code of 1986 
or be treated as income, be treated as assets or benefits, or otherwise 
be taken into account, for purposes of determining the individual's 
eligibility for, the amount of benefits for the individual under, or 
the amount of cost-sharing required of the individual by, any other 
Federal or State program, other than the program carried out under this 
section.
    ``(h) Technical Assistance to States.--The Assistant Secretary, 
directly or by grant or contract, shall provide for technical 
assistance to and oversight of States carrying out demonstration 
projects under this section, for purposes of administration, quality 
assurance, and quality improvement.
    ``(i) Evaluation and Report.--The Assistant Secretary, directly or 
by grant or contract, shall provide for an evaluation of the 
demonstration projects carried out under this section. The Assistant 
Secretary shall submit to the President a report containing the 
findings resulting from such evaluation not later than 6 months after 
the termination of the demonstration projects.''.

SEC. 43. 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 before the period the 
following: ``, 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''.

SEC. 44. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT PROGRAM.

    Section 502 of the Older Americans Act of 1965 (42 U.S.C. 3056) is 
amended--
            (1) in subsection (a)(1), by adding at the end the 
        following: ``For purposes of this paragraph, an underemployed 
        person shall be considered to be an unemployed person.'';
            (2) in subsection (b)(1)(M), by striking ``minority, 
        limited English-speaking, and Indian eligible individuals, and 
        eligible individuals who have the greatest economic need,'' and 
        inserting ``minority and Indian eligible individuals, eligible 
        individuals with limited English proficiency, and eligible 
        individuals with greatest economic need,''; and
            (3) by adding at the end the following:
    ``(g)(1) Except as provided in paragraphs (2) and (3), an eligible 
individual may participate in projects carried out under this title for 
a period of not more than 36 months (whether or not consecutive) in the 
aggregate.
    ``(2) A grantee for a project may extend the period of 
participation for not more than 20 percent of the project participants. 
In selecting participants for the extended period of participation, the 
grantee shall give priority to--
            ``(A) participants who are 65 years old or older or frail 
        older individuals; and
            ``(B) individuals who have more than 1 of the following 
        barriers to employment:
                    ``(i) A disability.
                    ``(ii) Limited English proficiency or low literacy 
                skills.
                    ``(iii) A residence in a rural area.
                    ``(iv) A residence in an area of high unemployment.
                    ``(v) Homelessness or a situation that puts the 
                individual at risk for homelessness.
                    ``(vi) A failure to find employment after utilizing 
                services under title I of the Workforce Investment Act 
                of 1998 (29 U.S.C. 2801 et seq.).
    ``(3) A grantee may petition for a waiver of the 36-month limit 
described in paragraph (1) if the grantee serves a high concentration 
of individuals who are hard-to-serve individuals because they have more 
than 1 barrier to employment as described in paragraph (2)(B), 
including a grantee who operates a project in an area in which at least 
60 percent of the counties are rural counties, as defined by the 
Economic Research Service of the Department of Agriculture.
    ``(h) It is the sense of the Senate that--
            ``(1) the older American community service employment 
        program was created with the intent of placing older 
        individuals in community service positions to provide job 
        training placements; and
            ``(2) placing older individuals in community service 
        positions strengthens the ability of the individuals to become 
        self-sufficient, provides much-needed volunteer support to 
        organizations who benefit significantly from increased civic 
        engagement, and strengthens the communities that are served by 
        such organizations.''.

SEC. 45. PERFORMANCE.

    Section 513 of the Older Americans Act of 1965 (42 U.S.C. 3056k) is 
amended--
            (1) in subsection (a)--
                    (A) in paragraph (1)--
                            (i) by striking the paragraph designation 
                        and all that follows through ``grantees'' and 
                        inserting the following:
            ``(1) Establishment and implementation of measures.--The 
        Secretary shall establish and implement, after consultation 
        with the Assistant Secretary, grantees''; and
                            (ii) by adding at the end the following: 
                        ``The Assistant Secretary shall provide 
                        recommendations to the Secretary on the 
                        establishment and implementation of the 
                        performance measures.'';
                    (B) in paragraph (2)(B), by adding at the end the 
                following:
                            ``(iv) Not less than 60 percent of the 
                        counties, in the areas served by the grantee, 
                        being rural counties as defined by the Economic 
                        Research Service of the Department of 
                        Agriculture.
                            ``(v) The areas served by the grantee 
                        comprising a difficult to serve territory due 
                        to limited economies of scale.''; and
                    (C) by adding at the end the following:
            ``(6) Special rules.--
                    ``(A) Establishment and implementation.--The 
                Secretary shall establish and implement the performance 
                measures described in this section, including all 
                required indicators described in subsection (b), not 
                later than 1 year after the date of enactment of the 
                Older Americans Act Amendments of 2006.
                    ``(B) Impact on grant competition.--The Secretary 
                may not publish a notice announcing a grant competition 
                under this title, and soliciting proposals for grants, 
                until the day that is the later of--
                            ``(i) the date on which the Secretary 
                        implements all required indicators described in 
                        subsection (b); and
                            ``(ii) January 1, 2010.''; and
            (2) by adding at the end the following:
    ``(e) Effect of Exemption.--In implementing a performance measure 
under this section, the Secretary shall not reduce a score on the 
performance measure of--
            ``(1) a grantee that receives a waiver under section 
        502(g)(3) on the basis that the grantee is extending the period 
        of participation for project participants under that section; 
        and
            ``(2) a grantee on the basis that the grantee is extending 
        the period of participation for project participants under 
        section 502(g)(2).''.

SEC. 46. COMPETITIVE REQUIREMENTS.

    Section 514 of the Older Americans Act of 1965 (42 U.S.C. 3056l) is 
amended--
            (1) by striking subsection (a) and inserting the following:
    ``(a) Program Authorized.--In accordance with section 502(b), the 
Secretary shall award grants to eligible applicants, through a 
competitive process that emphasizes meeting performance measures, to 
carry out projects under this title for a 4-year period. The Secretary 
may not conduct a grant competition under this title until the day 
described in section 513(a)(6)(B).'';
            (2) by striking subsection (b) and inserting the following:
    ``(b) Eligible Applicants.--An applicant shall be eligible to 
receive a grant as described in subsection (a) if the applicant meets 
the requirements and criteria described in section 502(b)(1), 
subsections (c) and (d), and paragraphs (2) and (3) of subsection 
(e).'';
            (3) in subsection (c)--
                    (A) by redesignating paragraphs (2) through (7) as 
                paragraphs (4) through (9), respectively;
                    (B) by inserting after paragraph (1) the following:
            ``(2) The applicant's performance on the required 
        indicators described in section 513(b), in the case of an 
        applicant that has previously received a grant under this 
        title, and the applicant's ability to meet the required 
        indicators, in the case of any other applicant.
            ``(3) The applicant's ability to administer a program that 
        provides community service.''; and
                    (C) by striking paragraph (9) and inserting the 
                following:
            ``(9) The applicant's ability to minimize disruption in 
        services for project participants and the entities employing 
        the participants.
            ``(10) Any additional criteria that the Secretary may 
        determine to be appropriate.'';
            (4) in subsection (e)--
                    (A) in paragraph (2), by striking subparagraphs (C) 
                and (D); and
                    (B) in paragraph (3)--
                            (i) by striking ``(3)'' and all that 
                        follows through ``In'' and inserting the 
                        following:
            ``(3) Competition requirements for public and private 
        nonprofit agencies and organizations in a state.--In'';
                            (ii) by striking subparagraphs (B) through 
                        (D); and
                            (iii) by striking ``take corrective 
                        action'' and inserting ``provide technical 
                        assistance'';
                    (C) in paragraph (4), by striking ``paragraph 
                (3)(A)'' and inserting ``paragraph (3)'';
            (5) in subsection (f), by striking paragraph (4);
            (6) by adding at the end the following:
    ``(g) Grantees Serving Individuals With Barriers to Employment.--
            ``(1) Definition.--In this subsection, the term 
        `individuals with barriers to employment' means minority and 
        Indian individuals, individuals with limited English 
        proficiency, and individuals with greatest economic need.
            ``(2) Special consideration.--In areas where a substantial 
        population of individuals with barriers to employment exists, a 
        grantee that receives a national grant under this section 
        shall, in selecting subgrantees, give special consideration to 
        organizations (including former recipients of such national 
        grants) with demonstrated expertise in serving individuals with 
        barriers to employment.
    ``(h) Minority-Serving Grantees.--The Secretary may not promulgate 
rules or regulations, affecting grantees in areas where a substantial 
population of minority individuals exists, that would significantly 
compromise the ability of the grantees to serve their targeted 
population of minority older individuals.''.

SEC. 47. DEFINITIONS.

    Section 516(2) of the Older Americans Act of 1965 (42 U.S.C. 
3056n(2)) is amended--
            (1) in the header, by striking ``individuals'' and 
        inserting ``individual'' ;
            (2) by inserting before ``The term'' the following:
                    ``(A) In general.--'';
            (3) by striking ``individuals'' and inserting 
        ``individual''; and
            (4) by adding at the end the following:
                    ``(B) Determination of low income.--For purposes of 
                determining income eligibility under subparagraph (A), 
                the Secretary shall not include as income--
                            ``(i) unemployment compensation;
                            ``(ii) benefits received under title XVI of 
                        the Social Security Act (42 U.S.C. 1381 et 
                        seq.);
                            ``(iii) payments made to or on behalf of 
                        veterans or former members of the Armed Forces 
                        under the laws administered by the Secretary of 
                        Veterans Affairs; or
                            ``(iv) 25 percent of the old-age and 
                        survivors insurance benefits received under 
                        title II of the Social Security Act (42 U.S.C. 
                        401 et seq.).''.

SEC. 48. CLARIFICATION OF MAINTENANCE REQUIREMENT.

    (a) In General.--Section 614A of the Older Americans Act of 1965 
(42 U.S.C. 3057e-1) is amended by adding at the end the following:
    ``(c) Clarification.--
            ``(1) Definition.--In this subsection, the term `covered 
        year' means fiscal year 2006 or a subsequent fiscal year.
            ``(2) Consortia of tribal organizations.--If a tribal 
        organization received a grant under this part for fiscal year 
        1991 as part of a consortium, the Assistant Secretary shall 
        consider the tribal organization to have received a grant under 
        this part for fiscal year 1991 for purposes of subsections (a) 
        and (b), and shall apply the provisions of subsections (a) and 
        (b)(1) (under the conditions described in subsection (b)) to 
        the tribal organization for each covered year for which the 
        tribal organization submits an application under this part, 
        even if the tribal organization submits--
                    ``(A) a separate application from the remaining 
                members of the consortium; or
                    ``(B) an application as 1 of the remaining members 
                of the consortium.''.
    (b) Effective Date.--Subsection (a) takes effect on October 1, 
2005.

SEC. 49. NATIVE AMERICANS CAREGIVER SUPPORT PROGRAM.

    Section 643 of the Older Americans Act of 1965 (42 U.S.C. 3057n) is 
amended--
            (1) in paragraph (1), by striking ``2001'' and inserting 
        ``2007''; and
            (2) in paragraph (2), by striking ``$5,000,000'' and all 
        that follows and inserting ``$6,500,000 for fiscal year 2007, 
        $7,000,000 for fiscal year 2008, $7,500,000 for fiscal year 
        2009, $8,000,000 for fiscal year 2010, and $8,500,000 for 
        fiscal year 2011.''.

SEC. 50. 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''.

SEC. 51. ELDER ABUSE, NEGLECT, AND EXPLOITATION PREVENTION AMENDMENT.

    Section 721 of the Older Americans Act of 1965 (42 U.S.C. 3058i) is 
amended--
            (1) in subsection (b)--
                    (A) by redesignating paragraphs (2) through (8) as 
                paragraphs (3) through (9), respectively; and
                    (B) 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) in subsection (e)(2)--
                    (A) by striking ``subsection (b)(8)(B)(i)'' and 
                inserting ``subsection (b)(9)(B)(i)''; and
                    (B) by striking ``subsection (b)(8)(B)(ii)'' and 
                inserting ``subsection (b)(9)(B)(ii)''.

SEC. 52. NATIVE AMERICAN ORGANIZATION PROVISIONS.

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

SEC. 53. ELDER JUSTICE PROGRAMS.

    (a) Purposes.--The purposes of this section are as follows:
            (1) To assist States and Indian tribes in developing a 
        comprehensive multi-disciplinary approach to elder justice.
            (2) To promote research and data collection that will fill 
        gaps in knowledge about elder abuse, neglect, and exploitation.
            (3) To support innovative and effective activities of 
        service providers and programs that are designed to address 
        issues relating to elder abuse, neglect, and exploitation.
            (4) To assist States, Indian tribes, and local service 
        providers in the development of short- and long-term strategic 
        plans for the development and coordination of elder justice 
        research, programs, studies, training, and other efforts.
            (5) To promote collaborative efforts and diminish overlap 
        and gaps in efforts in developing the important field of elder 
        justice.
    (b) Elder Justice.--Title VII of the Older Americans Act of 1965 
(42 U.S.C. 3058 et seq.) is amended--
            (1) by redesignating subtitles B and C as subtitles C and 
        D, respectively;
            (2) by redesignating sections 751, and 761 through 764, as 
        sections 761, and 771 through 774, respectively; and
            (3) by inserting after subtitle A the following:

                  ``Subtitle B--Elder Justice Programs

``SEC. 751. DEFINITIONS.

    ``In this subtitle:
            ``(1) Caregiver.--The term `caregiver' means an individual 
        who has the responsibility for the care of an elder, either 
        voluntarily, by contract, by receipt of payment for care, or as 
        a result of the operation of law and means a family member or 
        other individual who provides (on behalf of such individual or 
        of a public or private agency, organization, or institution) 
        compensated or uncompensated care to an elder.
            ``(2) Direct care.--The term `direct care' means care by an 
        employee or contractor who provides assistance or long-term 
        care services to a recipient.
            ``(3) Elder.--The term `elder' means an older individual, 
        as defined in section 102.
            ``(4) Elder justice.--The term `elder justice' means--
                    ``(A) 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; and
                    ``(B) from an individual perspective, the 
                recognition of an elder's rights, including the right 
                to be free of abuse, neglect, and exploitation.
            ``(5) Eligible entity.--The term `eligible entity' means a 
        State or local government agency, Indian tribe, or any other 
        public or private entity, that is engaged in and has expertise 
        in issues relating to elder justice.
            ``(6) Fiduciary.--The term `fiduciary'--
                    ``(A) means a person or entity with the legal 
                responsibility--
                            ``(i) to make decisions on behalf of and 
                        for the benefit of another person; and
                            ``(ii) to act in good faith and with 
                        fairness; and
                    ``(B) includes a trustee, a guardian, a 
                conservator, an executor, an agent under a financial 
                power of attorney or health care power of attorney, or 
                a representative payee.
            ``(7) Grant.--The term `grant' includes a contract, 
        cooperative agreement, or other mechanism for providing 
        financial assistance.
            ``(8) Law enforcement.--The term `law enforcement' means 
        the full range of potential responders to elder abuse, neglect, 
        and exploitation including--
                    ``(A) police, sheriffs, detectives, public safety 
                officers, and corrections personnel;
                    ``(B) prosecutors;
                    ``(C) medical examiners;
                    ``(D) investigators; and
                    ``(E) coroners.
            ``(9) Long-term care.--
                    ``(A) In general.--The term `long-term care' means 
                supportive and health services specified by the 
                Secretary for individuals who need assistance because 
                the individuals have a loss of capacity for self-care 
                due to illness, disability, or vulnerability.
                    ``(B) Loss of capacity for self-care.--For purposes 
                of subparagraph (A), the term `loss of capacity for 
                self-care' means an inability to engage effectively in 
                activities of daily living, including eating, dressing, 
                bathing, and management of one's financial affairs.
            ``(10) Long-term care facility.--The term `long-term care 
        facility' means a residential care provider that arranges for, 
        or directly provides, long-term care.
            ``(11) Nursing facility.--The term `nursing facility' has 
        the meaning given such term under section 1919(a) of the Social 
        Security Act (42 U.S.C. 1396r(a)).
            ``(12) State legal assistance developer.--The term `State 
        legal assistance developer' means an individual described in 
        section 731.
            ``(13) State long-term care ombudsman.--The term `State 
        Long-Term Care Ombudsman' means the State Long-Term Care 
        Ombudsman described in section 712(a)(2).

``SEC. 752. STATE AND TRIBAL GRANTS TO STRENGTHEN LONG-TERM CARE AND 
              PROVIDE ASSISTANCE FOR ELDER JUSTICE PROGRAMS.

    ``(a) Grants.--The Assistant Secretary may award grants to States 
and Indian tribes to enable the States and tribes to strengthen long-
term care and provide assistance for elder justice programs.
    ``(b) Application.--To be eligible to receive a grant under this 
subtitle, a State or Indian tribe shall submit an application to the 
Assistant Secretary at such time, in such manner, and containing such 
information as the Assistant Secretary may require.
    ``(c) Use of Funds.--A State or Indian tribe that receives a grant 
under this subtitle may use the funds made available through the grant 
to award grants--
            ``(1) to eligible entities for the prevention, detection, 
        assessment, and treatment of, intervention in, investigation 
        of, and response to elder abuse, neglect, and exploitation;
            ``(2) to eligible entities to examine various types of 
        elder shelters (in this paragraph referred to as `safe 
        havens'), and to test various safe haven models for 
        establishing safe havens (at home or elsewhere), that--
                    ``(A) recognize autonomy and self-determination, 
                and fully protect the due process rights of elders; and
                    ``(B)(i) provide a comprehensive, culturally 
                sensitive, and multidisciplinary team response to 
                allegations of elder abuse, neglect, or exploitation;
                    ``(ii) provide a dedicated, elder-friendly setting;
                    ``(iii) have the capacity to meet the needs of 
                elders for care; and
                    ``(iv) provide various services including--
                            ``(I) nursing and forensic evaluation;
                            ``(II) therapeutic intervention;
                            ``(III) victim support and advocacy; and
                            ``(IV) case review and assistance to make 
                        the elders safer at home or to find appropriate 
                        placement in safer environments, including 
                        shelters, and, in some circumstances long-term 
                        care facilities, other residential care 
                        facilities, and hospitals;
            ``(3) to eligible entities to establish or continue 
        volunteer programs that focus on the issues of elder abuse, 
        neglect, and exploitation, or to provide related services;
            ``(4) to eligible entities to support multidisciplinary 
        elder justice activities, such as--
                    ``(A) supporting and studying team approaches for 
                bringing a coordinated multidisciplinary or 
                interdisciplinary response to elder abuse, neglect, and 
                exploitation, including a response from individuals in 
                social service, health care, public safety, and legal 
                disciplines;
                    ``(B) establishing a State or tribal coordinating 
                council, which shall identify the individual State's or 
                Indian tribe's needs and provide the Secretary with 
                information and recommendations relating to efforts by 
                the State or Indian tribe to combat elder abuse, 
                neglect, and exploitation;
                    ``(C) providing training, technical assistance, and 
                other methods of support to groups carrying out 
                multidisciplinary efforts at the State or Indian tribe 
                level (referred to in some States as `State Working 
                Groups');
                    ``(D) broadening and studying various models for 
                elder fatality and serious injury review teams, to make 
                recommendations about their composition, protocols, 
                functions, timing, roles, and responsibilities, with a 
                goal of producing models and information that will 
                allow for replication based on the needs of other 
                States, Indian tribes, and communities; or
                    ``(E) carrying out such other interdisciplinary or 
                multidisciplinary efforts as the Assistant Secretary 
                determines to be appropriate;
            ``(5) to eligible entities to provide training for 
        individuals with respect to issues of elder abuse, neglect, and 
        exploitation, consisting of--
                    ``(A) training within a discipline; or
                    ``(B) cross-training activities that permit 
                individuals in multiple disciplines to train together, 
                fostering communication, coordinating efforts, and 
                ensuring collaboration;
            ``(6) to eligible entities to address underserved 
        populations of elders, such as--
                    ``(A) elders living in rural locations;
                    ``(B) elders in minority populations; or
                    ``(C) low-income elders;
            ``(7) to eligible entities to provide incentives for 
        individuals to train for, seek, and maintain employment 
        providing direct care in a long-term care facility, such as--
                    ``(A) to eligible entities to provide incentives to 
                participants in programs carried out under part A of 
                title IV, and section 403(a)(5), of the Social Security 
                Act (42 U.S.C. 601 et seq., 603(a)(5)) to train for and 
                seek employment providing direct care in a long-term 
                care facility;
                    ``(B) to long-term care facilities to carry out 
                programs through which the facilities--
                            ``(i) offer, to employees who provide 
                        direct care to residents of a long-term care 
                        facility, continuing training and varying 
                        levels of professional certification, based on 
                        observed clinical care practices and the amount 
                        of time the employees spend providing direct 
                        care; and
                            ``(ii) provide, or make arrangements with 
                        employers to provide, bonuses or other 
                        increased compensation or benefits to employees 
                        who achieve professional certification under 
                        such a program; or
                    ``(C) to long-term care facilities to enable the 
                facilities to provide training and technical assistance 
                to eligible employees regarding management practices 
                using methods that are demonstrated to promote 
                retention of employees of the facilities, such as--
                            ``(i) the establishment of basic human 
                        resource policies that reward high performance, 
                        including policies that provide for improved 
                        wages and benefits on the basis of job reviews; 
                        or
                            ``(ii) the establishment of other programs 
                        that promote the provision of high quality 
                        care, such as a continuing education program 
                        that provides additional hours of training, 
                        including on-the-job training, for employees 
                        who are certified nurse aides;
            ``(8) to encourage the establishment of eligible 
        partnerships to develop collaborative and innovative approaches 
        to improve the quality of, including preventing abuse, neglect, 
        and exploitation in, long-term care; or
            ``(9) to eligible entities to establish multidisciplinary 
        panels to address and develop best practices concerning methods 
        of--
                    ``(A) improving the quality of long-term care; and
                    ``(B) addressing abuse, including resident-to-
                resident abuse, in long-term care.
    ``(d) Administrative Expenses.--A State or Indian tribe that 
receives a grant under this section shall not use more than 5 percent 
of the funds made available through the grant to pay for administrative 
expenses.
    ``(e) Supplement Not Supplant.--Funds made available pursuant to 
this section shall be used to supplement and not supplant other 
Federal, State, and local (including tribal) funds expended to provide 
activities described in subsection (c).
    ``(f) Maintenance of Effort.--The State or Indian tribe, in using 
the proceeds of a grant received under this section, shall maintain the 
expenditures of the State or tribe for activities described in 
subsection (c) at a level equal to not less than the level of such 
expenditures maintained by the State or tribe for the fiscal year 
preceding the fiscal year for which the grant is received.
    ``(g) Accountability Measures.--The Assistant Secretary shall 
develop accountability measures to ensure the effectiveness of the 
activities conducted using funds made available under this section, 
including accountability measures to ensure that the activities 
described in subsection (c)(7) benefit eligible employees and increase 
the stability of the long-term care workforce.
    ``(h) Evaluating Programs.--The Assistant Secretary shall evaluate 
the activities conducted using funds made available under this section 
and shall use the results of such evaluation to determine the 
activities for which funds made available under this section may be 
used.
    ``(i) Compliance With Applicable Laws.--In order to receive funds 
under this section, an entity shall comply with all applicable laws, 
regulations, and guidelines.
    ``(j) Eligible Partnerships.--In subsection (c)(8), the term 
`eligible partnership' means a multidisciplinary community partnership 
consisting of eligible entities or appropriate individuals, such as a 
partnership consisting of representatives in a community of nursing 
facility providers, State legal assistance developers, advocates for 
residents of long-term care facilities, State Long-Term Care Ombudsmen, 
surveyors, the State agency with responsibility for adult protective 
services, the State agency with responsibility for licensing long-term 
care facilities, law enforcement agencies, courts, family councils, 
residents, certified nurse aides, registered nurses, physicians, and 
other eligible entities and appropriate individuals.
    ``(k) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2005 through 2008.

``SEC. 753. COLLECTION OF UNIFORM NATIONAL DATA ON ELDER ABUSE, 
              NEGLECT, AND EXPLOITATION.

    ``(a) Purpose.--The purpose of this section is to improve, 
streamline, and promote uniform collection, maintenance, and 
dissemination of national data relating to the various types of elder 
abuse, neglect, and exploitation.
    ``(b) Phase I.--
            ``(1) In general.--Not later than the date that is 1 year 
        after the date of enactment of the Older Americans Act 
        Amendments of 2006, the Assistant Secretary, acting through the 
        head of the Office of Elder Abuse Prevention and Services, 
        after consultation with the Attorney General and working with 
        experts in relevant disciplines from the Bureau of Justice 
        Statistics of the Office of Justice Programs of the Department 
        of Justice, shall--
                    ``(A) develop a method for collecting national data 
                regarding elder abuse, neglect, and exploitation; and
                    ``(B) develop uniform national data reporting forms 
                adapted to each relevant entity or discipline (such as 
                health, public safety, social and protective services, 
                and law enforcement) reflecting--
                            ``(i) the distinct manner in which each 
                        entity or discipline receives and maintains 
                        information; and
                            ``(ii) the sequence and history of reports 
                        to or involvement of different entities or 
                        disciplines, independently, or the sequence and 
                        history of reports from 1 entity or discipline 
                        to another over time.
            ``(2) Forms.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                national data reporting forms described in paragraph 
                (1)(B) shall incorporate the definitions of section 
                751, for use in determining whether an event is 
                reportable.
                    ``(B) Protection of privacy.--In pursuing 
                activities under this paragraph, the Secretary shall 
                ensure the protection of individual health privacy 
                consistent with the regulations promulgated under 
                section 264(c) of the Health Insurance Portability and 
                Accountability Act of 1996 and State and local privacy 
                regulations (as applicable).
    ``(c) Phase II.--
            ``(1) In general.--Not later than the date that is 1 year 
        after the date on which the activities described in subsection 
        (b)(1) are completed, the Secretary (or the Secretary's 
        designee) shall ensure that the national data reporting forms 
        and data collection methods developed in accordance with such 
        subsection are pilot tested in 6 States selected by the 
        Secretary.
            ``(2) Adjustments to the form and methods.--The Secretary, 
        after considering the results of the pilot testing described in 
        paragraph (1) and consultation with the Attorney General and 
        relevant experts, shall adjust the national data reporting 
        forms and data collection methods as necessary.
    ``(d) Phase III.--
            ``(1) Distribution of national data reporting forms.--After 
        completion of the adjustment to the national data reporting 
        forms under subsection (c)(2), the Secretary shall submit the 
        national data reporting forms along with instructions to--
                    ``(A) the heads of the relevant components of the 
                Department of Health and Human Services, the Department 
                of Justice, and the Department of the Treasury, and 
                such other Federal entities as may be appropriate; and
                    ``(B) the Governor's office of each State for 
                collection from all relevant State entities of data, 
                including health care, social services, and law 
                enforcement data.
            ``(2) Data collection grants.--
                    ``(A) Authorization.--The Secretary is authorized 
                to award grants to States to improve data collection 
                activities relating to elder abuse, neglect, and 
                exploitation.
                    ``(B) Application.--To be eligible to receive a 
                grant under this paragraph, a State shall submit an 
                application to the Secretary at such time, in such 
                manner, and containing such information as the 
                Secretary may require.
                    ``(C) Requirements.--Each State receiving a grant 
                under this paragraph for a fiscal year shall report 
                data for the calendar year that begins during that 
                fiscal year, using the national data reporting forms 
                described in paragraph (1).
                    ``(D) Funding.--
                            ``(i) First year.--For the first fiscal 
                        year for which a State receives grant funds 
                        under this subsection the Secretary shall 
                        initially distribute 50 percent of such funds. 
                        The Secretary shall distribute the remaining 
                        funds at the end of the calendar year that 
                        begins during that fiscal year, if the 
                        Secretary determines that the State has 
                        properly reported data required under this 
                        subsection for the calendar year.
                            ``(ii) Subsequent years.--Except as 
                        provided in clause (i), the Secretary shall 
                        distribute grant funds to a State under this 
                        subsection for a fiscal year if the Secretary 
                        determines that the State properly reported 
                        data required under this subsection for the 
                        calendar year that ends during that fiscal 
                        year.
            ``(3) Required information.--Each report submitted under 
        this subsection shall--
                    ``(A) indicate the State and year in which each 
                event occurred; and
                    ``(B) identify the total number of events that 
                occurred in each State during the year and the type of 
                each event.
    ``(e) Report.--Not later than 1 year after the date of enactment of 
the Older Americans Act Amendments of 2006 and annually thereafter, the 
Secretary shall prepare and submit to the appropriate committees of 
Congress, including to the Committee on Health Education, Labor, and 
Pensions and the Special Committee on Aging of the Senate, a report 
regarding activities conducted under this section.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2007, 2008, 2009, 2010, and 2011.''.

SEC. 54. RULE OF CONSTRUCTION.

    Subtitle C of title VII of the Older Americans Act of 1965 (42 
U.S.C. 3058 et seq.) is amended by adding at the end the following:

``SEC. 765. RULE OF CONSTRUCTION.

    ``Nothing in this title shall be construed to interfere with or 
abridge the right of an older individual to practice the individual's 
religion through reliance on prayer alone for healing, in a case in 
which a decision to so practice the religion--
            ``(1) is contemporaneously expressed by the older 
        individual--
                    ``(A) either orally or in writing;
                    ``(B) with respect to a specific illness or injury 
                that the older individual has at the time of the 
                decision; and
                    ``(C) when the older individual is competent to 
                make the decision;
            ``(2) is set forth prior to the occurrence of the illness 
        or injury in a living will, health care proxy, or other advance 
        directive document that is validly executed and applied under 
        State law; or
            ``(3) may be unambiguously deduced from the older 
        individual's life history.''.
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