1.This Act may be cited as the
Older Americans Act Amendments of
2006
.
2.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.
.
3.Office of Elder
Abuse Prevention and ServicesSection 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.
.
4.Functions of the
Assistant SecretarySection
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.
.
5.Federal agency
consultationSection 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.
.
6.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
.
7.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.
.
8.Section 207(b)(2) of the Older Americans Act
of 1965 (42 U.S.C. 3018(b)(2)) is amended—
(1)in subparagraph (B), by striking
Labor
and inserting the Workforce
; and
(2)in subparagraph (C), by striking
Labor and Human Resources
and inserting Health,
Education, Labor, and Pensions
.
9.Contractual,
commercial and private pay relationships; appropriate use of Act funds
(a)Private pay relationships;
appropriate use of act fundsSection 212 of the Older Americans
Act (42 U.S.C. 3020c) is amended to read as follows:
212.Contracting and
grant authority; private pay relationships; appropriate use of funds
(a)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 fundsAn 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.
.
10.Section 214 of the
Older Americans Act of 1965 (42 U.S.C. 3020e) is amended to read as
follows:
214.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).
.
11.Pension
counseling and information programsSection 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
.
12.Authorization of
appropriationsSection 216 of
the Older Americans Act of 1965 (42 U.S.C. 3020f) is amended—
(1)in subsection (a) by striking
2001, 2002, 2003, 2004, and 2005
and inserting 2007,
2008, 2009, 2010, and 2011.
; and
(2)in subsections (b) and (c) by striking
year
and all that follows through years
, and
inserting years 2007, 2008, 2009, 2010, and 2011
.
13.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.
.
14.Authorization of
appropriations; uses of fundsSection 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.
.
15.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);
.
16.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.
.
17.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.
.
18.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.
.
19.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)
.
20.Nutrition
services incentive programSection 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
.
21.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)
.
22.Supportive
services and senior centersSection 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
.
23.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:
330.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.
.
24.Congregate
nutrition programSection 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.
.
25.Home delivered
nutrition servicesSection 336
of the Older Americans Act of 1965 (42 U.S.C. 3030f) is amended to read as
follows:
336.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.
.
26.Section 337 of the Older Americans Act of
1965 (42 U.S.C. 3030g) is amended to read as follows:
337.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.
.
27.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.
.
28.Study of
nutrition projects
(a)
(1)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)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)
(1)Report to the assistant
secretaryThe 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)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)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.
29.Improving indoor
air quality in buildings where older individuals congregateSection 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.
.
30.Caregiver
support program definitionsSection 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)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).
.
31.Caregiver
support programSection 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)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
.
32.Activities and
programs of national significanceSection 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:
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).
33.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.
.
34.Career
preparation for the field of agingSection 412(a) of the Older Americans Act of
1965 (42 U.S.C. 3032a(a)) is amended to read as follows:
(a)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.
.
35.Health care
service demonstration projects in rural areasSection 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,
.
36.Technical
assistance and innovation to improve transportation for older
individualsSection 416 of the
Older Americans Act of 1965 (42 U.S.C. 3032e) is amended to read as
follows:
416.Technical
assistance and innovation to improve transportation for older
individuals
(a)The Secretary may award grants or contracts to nonprofit
organizations to improve transportation services for older individuals.
(b)
(1)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)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 transportationIn 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.
.
37.Title IV of the Older
Americans Act of 1965 is amended by inserting after section 416 (42 U.S.C.
3032e) the following:
416A.Community
planning for the aging populationThe 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.
.
38.Demonstration,
support, and research projects for multigenerational activities and civic
engagement activitiesSection
417 of the Older Americans Act of 1965 (42 U.S.C. 3032f) is amended to read as
follows:
417.Demonstration,
support, and research projects for multigenerational activities and civic
engagement activities
(a)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)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)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)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)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)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)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)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)As
used in this section:
(1)Civic engagement
activityThe 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
activityThe 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
coordinatorThe 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.
.
39.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
.
40.Multidisciplinary
centers and multidisciplinary systemsSection 419 of the Older Americans Act of
1965 (42 U.S.C. 3032h) is amended—
(1)by striking the title and inserting
the following:
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)The
;
(5)in subsection
(b)—
(A)by striking the following:
(b)
and inserting the
following:
(2)
;
and
(B)by striking
subsection (a)
each place it appears and inserting
paragraph (1)
;
(6)in subsection
(c)—
(A)by striking the following:
(c)
and inserting the following:
(3)
;
(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)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)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 prioritiesA 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 providersIn 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 sourcesFunds 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)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.
.
41.Community
innovations for aging in placePart 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:
422.Community
innovations for aging in place
(a)In this section:
(1)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 CommunityThe 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)
(1)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)The Assistant Secretary shall make the
grants for periods of 3 years.
(c)
(1)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)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)
(1)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)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)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)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)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)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)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)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.
.
42.Choices for
independence demonstration projectsPart 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:
423.Choices for
independence demonstration projects
(a)In
this section:
(1)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)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)The term qualified expenditures means
reported expenditures of a State under this section that have been reviewed and
approved by the Assistant Secretary.
(4)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)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)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)
(1)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)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)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)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 choicesThe 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)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)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 budgetsThe 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 careThe 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)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 centersA
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
carePayments 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 StatesThe 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)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.
.
43.Responsibilities
of Assistant SecretarySection
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
.
44.Older American
community service employment programSection 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.
.
45.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 measuresThe 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)
(A)Establishment
and implementationThe 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
competitionThe 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)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).
.
46.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)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)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
StateIn
;
(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)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)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
granteesThe 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.
.
47.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)
;
(3)by striking
individuals
and inserting individual
; and
(4)by adding at the
end the following:
(B)Determination
of low incomeFor 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.).
.
48.Clarification of
maintenance requirement
(a)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)
(1)In
this subsection, the term covered year means fiscal year 2006 or a
subsequent fiscal year.
(2)Consortia of
tribal organizationsIf 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)Subsection (a) takes effect on October 1, 2005.
49.Native Americans
caregiver support programSection 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.
.
50.Vulnerable elder
rights protection activitiesSection 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
.
51.Elder abuse,
neglect, and exploitation prevention amendmentSection 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)
.
52.Native American
organization provisionsSection 751(d) of the Older Americans Act of
1965 (42 U.S.C. 3058aa(d)) is amended by striking 2001
and
inserting 2007
.
53.
(a)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)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:
B
751.In this subtitle:
(1)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)The term direct care means care by an employee
or contractor who provides assistance or long-term care services to a
recipient.
(3)The
term elder means an older individual, as defined in section
102.
(4)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)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)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)The
term grant includes a contract, cooperative agreement, or other
mechanism for providing financial assistance.
(8)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)
(A)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-careFor 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)The term long-term care facility means a
residential care provider that arranges for, or directly provides, long-term
care.
(11)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 developerThe term State legal assistance
developer means an individual described in section 731.
(13)State long-term
care ombudsmanThe term State Long-Term Care
Ombudsman means the State Long-Term Care Ombudsman described in section
712(a)(2).
752.State and
tribal grants to strengthen long-term care and provide assistance for elder
justice programs
(a)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)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)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)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)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)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)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)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 lawsIn order to receive funds under this section, an
entity shall comply with all applicable laws, regulations, and
guidelines.
(j)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
appropriationsThere are authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2005
through 2008.
753.Collection of
uniform national data on elder abuse, neglect, and exploitation
(a)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)
(1)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)
(A)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)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)
(1)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
methodsThe 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)
(1)Distribution of
national data reporting formsAfter 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)
(A)The
Secretary is authorized to award grants to States to improve data collection
activities relating to elder abuse, neglect, and exploitation.
(B)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)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)
(i)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)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)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)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
appropriationsThere 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.
.
54.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:
765.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.
.
1.This Act may be cited as the
Older Americans Act Amendments of
2006
.
2.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:
(34)(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 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 2 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)Except as provided in
section 751, 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.
.
3.Office of Elder Abuse
Prevention and ServicesSection 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, 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.
.
4.Functions of the
Assistant SecretarySection
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)—
(i)in subparagraph
(D)—
(I)by
striking gaps in
; and
(II)by
inserting (including services that would permit such individuals to
receive long-term care in home and community-based settings)
after
individuals
; and
(ii)in subparagraph (E), 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 subsections
(b) and (c) and inserting the following:
(b)To promote the development and
implementation of comprehensive, coordinated systems at Federal, State, and
local levels that enable older individuals to receive long-term care in home
and community-based settings, in a manner responsive to the needs and
preferences of the 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, 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)implement in each State
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;
(7)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;
(8)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 State systems of long-term care fulfill the objectives described in
this subsection; and
(9)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.
.
5.Federal agency
consultationSection 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)—
(A)in paragraph (17), by striking
and
at the end;
(B)in paragraph (18), by striking the
period and inserting , and
; and
(C)by adding at the end the
following:
(19)sections
4 and 5 of the Assistive Technology Act of 1998 (29 U.S.C. 3003,
3004).
;
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 1 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.
.
6.Section 205(a) of the Older Americans Act of
1965 (42 U.S.C. 3016(a)) is amended—
(1)in paragraph (1)—
(A)in
subparagraph (C), by adding and
at the end;
(B)in
subparagraph (D), by striking ; and
at the end and inserting a
period; and
(C)by
striking subparagraph (E); and
(2)in paragraph (2)—
(A)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
(B)by amending subparagraph
(C)(i) to read as follows:
(i)have expertise in nutrition and meal
planning;
and
.
7.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.
.
8.Section 207(b)(2) of the Older Americans Act
of 1965 (42 U.S.C. 3018(b)(2)) is amended—
(1)in
subparagraph (B), by striking Labor
and inserting the
Workforce
; and
(2)in
subparagraph (C), by striking Labor and Human Resources
and
inserting Health, Education, Labor, and Pensions
.
9.Contractual, commercial,
and private pay relationships; appropriate use of Act funds
(a)Private pay relationships;
appropriate use of act fundsSection 212 of the Older Americans
Act (42 U.S.C. 3020c) is amended to read as follows:
212.Contracting
and grant authority; private pay relationships; appropriate use of
funds
(a)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, such
individual's own private expense, to receive such services based on the fair
market value of such services.
(b)Ensuring
appropriate use of fundsAn 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.
.
10.Section 214 of the
Older Americans Act of 1965 (42 U.S.C. 3020e) is amended to read as
follows:
214.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).
.
11.Pension counseling and
information programsSection
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
.
12.Authorization of
appropriationsSection 216 of
the Older Americans Act of 1965 (42 U.S.C. 3020f) is amended—
(1)in
subsection (a) by striking 2001, 2002, 2003, 2004, and 2005
and
inserting 2007, 2008, 2009, 2010, and 2011.
; and
(2)in subsections (b) and (c) by striking
year
and all that follows through years
, and
inserting years 2007, 2008, 2009, 2010, and 2011
.
13.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.
.
14.Authorization of
appropriations; uses of fundsSection 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.
.
15.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);
.
16.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 State system of
long-term care that is a comprehensive, coordinated system that enables older
individuals to receive long-term care in home and community-based settings, in
a manner responsive to the needs and preferences of the 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 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.
.
17.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 that enables older
individuals to receive long-term care in home and community-based settings, in
a manner responsive to the needs and preferences of the 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);
(17)provide, to the extent
feasible, for the furnishing of services under this Act, consistent with
self-directed care; and
(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 on 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.
.
18.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, State
agencies responsible for emergency preparedness, 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.
.
19.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)
.
20.Nutrition services
incentive programSection 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
.
21.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)
.
22.Supportive services and
senior centersSection 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
.
23.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:
330.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.
.
24.Congregate nutrition
programSection 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.
.
25.Home delivered
nutrition servicesSection 336
of the Older Americans Act of 1965 (42 U.S.C. 3030f) is amended to read as
follows:
336.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.
.
26.Section 337 of the Older Americans Act of
1965 (42 U.S.C. 3030g) is amended to read as follows:
337.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.
.
27.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
;
(B)in subparagraph (D), by
inserting joint
after encourages
;
(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,
;
(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.
.
28.Study of nutrition
projects
(a)
(1)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)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)
(1)Report to the assistant
secretaryThe 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)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)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.
29.Improving indoor air
quality in buildings where older individuals congregateSection 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.
.
30.Caregiver support
program definitionsSection
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)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).
.
31.Caregiver support
programSection 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.
;
(3)in subsection (d), to
read as follows:
(d)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.
;
(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
.
32.Activities and programs
of national significanceSection 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:
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).
33.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;
(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;
and
.
34.Career preparation for
the field of agingSection
412(a) of the Older Americans Act of 1965 (42 U.S.C. 3032a(a)) is amended to
read as follows:
(a)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.
.
35.Health care service
demonstration projects in rural areasSection 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,
.
36.Technical assistance
and innovation to improve transportation for older individualsSection 416 of the Older Americans Act of
1965 (42 U.S.C. 3032e) is amended to read as follows:
416.Technical
assistance and innovation to improve transportation for older
individuals
(a)The Secretary may award grants or contracts to nonprofit
organizations to improve transportation services for older individuals.
(b)
(1)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)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 transportationIn 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.
.
37.Title IV of the Older
Americans Act of 1965 is amended by inserting after section 416 (42 U.S.C.
3032e) the following:
416A.Community planning
for the aging populationThe
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.
.
38.Demonstration, support,
and research projects for multigenerational activities and civic engagement
activitiesSection 417 of the
Older Americans Act of 1965 (42 U.S.C. 3032f) is amended to read as
follows:
417.Demonstration,
support, and research projects for multigenerational activities and civic
engagement activities
(a)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)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);
(C)to
carry out a demonstration or support project described in subsection (a)(3);
or
(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)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)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)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)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)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)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)As
used in this section:
(1)Civic engagement
activityThe 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
activityThe 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
coordinatorThe 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.
.
39.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
.
40.Multidisciplinary
centers and multidisciplinary systemsSection 419 of the Older Americans Act of
1965 (42 U.S.C. 3032h) is amended—
(1)by
striking the title and inserting the following:
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)The
;
(5)in subsection (b)—
(A)by
striking the following:
(b)
and inserting the
following:
(2)
;
and
(B)by striking
subsection (a)
each place it appears and inserting
paragraph (1)
;
(6)in subsection (c)—
(A)by
striking the following:
(c)
and inserting the following:
(3)
;
(B)by striking
subsection (a)
and inserting paragraph
(1)
;
(C)by striking such
subsection
and inserting such paragraph
;
(D)by striking
paragraph (1)
and inserting subparagraph (A)
;
and
(E)by striking this
section
and inserting this subsection
; and
(7)by adding at the end the
following:
(b)
Multidisciplinary health services in communities
(1)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)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
prioritiesA 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 large numbers of
older individuals.
(4)Area coordination of
services with other providersIn 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 sourcesFunds 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)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.
.
41.Community innovations
for aging in placePart 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:
422.Community
innovations for aging in place
(a)In this section:
(1)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 CommunityThe 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)
(1)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)The Assistant Secretary shall make the
grants for periods of 3 years.
(c)
(1)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)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)
(1)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)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)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)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)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)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)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)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.
.
42.Choices for
independence demonstration projectsPart 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:
423.Choices
for independence demonstration projects
(a)In
this section:
(1)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)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)The term qualified expenditures means
reported expenditures of a State under this section that have been reviewed and
approved by the Assistant Secretary.
(4)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)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 State 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)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)
(1)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
system of long-term care the component strategies described in paragraphs (2)
through (5).
(2)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)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 clause (iii), 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)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
choicesThe 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)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)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 budgetsThe 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 careThe 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)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 centersA 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 carePayments
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
StatesThe 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)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.
.
43.Responsibilities of
Assistant SecretarySection
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
.
44.Older American
community service employment program
(a)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.
.
(b)Section
506(g)(2) of the Older Americans Act of 1965 (42 U.S.C. 3056d(g)(2)) is
amended—
(1)in
subparagraph (A), by striking , or the amount remaining after the
application of section 514(e)
; and
(2)in
subparagraph (B), by striking , or the amount remaining after the
application of section 514(f)
.
45.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 measuresThe 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)
(A)Establishment and
implementationThe 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
competitionThe 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)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).
.
46.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)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)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);
(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
StateIn
;
(ii)by striking
subparagraphs (B) through (D); and
(iii)by striking take
corrective action
and inserting provide technical
assistance
; and
(C)in paragraph (4)—
(i)in
the first sentence, by striking paragraph (3)(A)
and inserting
paragraph (3)
; and
(ii)by
striking the second sentence;
(5)in subsection (f), by
striking paragraph (4); and
(6)by adding at the end the
following:
(g)Grantees serving
individuals with barriers to employment
(1)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)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
granteesThe 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.
.
47.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)
;
(3)by striking
individuals
and inserting individual
; and
(4)by adding at the end the
following:
(B)Determination
of low incomeFor 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.).
.
48.Clarification of
maintenance requirement
(a)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)
(1)In
this subsection, the term covered year means fiscal year 2006 or a
subsequent fiscal year.
(2)Consortia of tribal
organizationsIf 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)Subsection (a) takes effect on October 1, 2005.
49.Native Americans
caregiver support programSection 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.
.
50.Vulnerable elder rights
protection activitiesSection
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
.
51.Elder abuse, neglect,
and exploitation prevention amendmentSection 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)
.
52.Native American
organization provisionsSection 751(d) of the Older Americans Act of
1965 (42 U.S.C. 3058aa(d)) is amended by striking 2001
and
inserting 2007
.
53.
(a)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)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:
B
751.In this subtitle:
(1)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)The term direct care means care by an employee
or contractor who provides assistance or long-term care services to a
recipient.
(3)The
term elder means an older individual, as defined in section
102.
(4)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)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)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)The
term grant includes a contract, cooperative agreement, or other
mechanism for providing financial assistance.
(8)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)
(A)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-careFor 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)The term long-term care facility means a
residential care provider that arranges for, or directly provides, long-term
care.
(11)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
developerThe term State legal assistance developer
means an individual described in section 731.
(13)State long-term care
ombudsmanThe term State Long-Term Care Ombudsman
means the State Long-Term Care Ombudsman described in section 712(a)(2).
752.State and tribal
grants to strengthen long-term care and provide assistance for elder justice
programs
(a)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)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)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)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)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)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)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)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 lawsIn order to receive funds under this section, an
entity shall comply with all applicable laws, regulations, and
guidelines.
(j)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
appropriationsThere are authorized to be appropriated to carry
out this section such sums as may be necessary for each of fiscal years 2005
through 2008.
753.Collection of uniform
national data on elder abuse, neglect, and exploitation
(a)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)
(1)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)
(A)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)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)
(1)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
methodsThe 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)
(1)Distribution of
national data reporting formsAfter 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)
(A)The
Secretary is authorized to award grants to States to improve data collection
activities relating to elder abuse, neglect, and exploitation.
(B)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)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)
(i)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)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)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)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
appropriationsThere 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.
.
54.Subtitle D of
title VII of the Older Americans Act of 1965 (42 U.S.C. 3058bb et seq.), as
redesignated by section 53(b)(1), is amended by adding at the end the
following:
775.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.
.
55.The Older Americans
Act of 1965 (42 U.S.C. 3001 et seq.) is amended—
(1)in
section 202(e)(1)(A) by striking the semicolon at the end and inserting a
period; and
(2)by
inserting before section 401 the following:
<enum>IV</enum><header>Activities for health,
independence, and
longevity</header>
.
56.Conforming amendments
to other Acts
(a)Older Americans Act Amendments of
1987Section 205(1) of the Older Americans Act Amendments of 1987
(42 U.S.C. 3001 note) is amended by striking section 102(17) of the
Older Americans Act of 1965 (42 U.S.C. 3002(17))
and inserting
section 102 of the Older Americans Act of 1965 (42 U.S.C.
3002)
.
(b)Energy Conservation and
Production ActSection 412(6) of the Energy Conservation and
Production Act (42 U.S.C. 6862(6)) is amended by striking paragraphs
(4), (5), and (6), respectively, of section 102
and inserting
section 102
.
September 19, 2006
Reported with an amendment