[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[S. 1819 Introduced in Senate (IS)]

112th CONGRESS
  1st Session
                                S. 1819

   To amend the Older Americans Act of 1965 to improve programs and 
                               services.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            November 8, 2011

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

_______________________________________________________________________

                                 A BILL


 
   To amend the Older Americans Act of 1965 to improve programs and 
                               services.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Strengthening Services for America's 
Seniors Act''.

SEC. 2. STANDARDIZED ASSESSMENT OF NEEDS OF FAMILY CAREGIVERS.

    (a) In General.--Section 373 (42 U.S.C. 3030s-1) is amended--
            (1) by redesignating subsections (b) through (g) as 
        subsections (c) through (h), respectively;
            (2) in subsection (d), as so redesignated, by striking 
        ``subsection (b)'' and inserting ``subsection (c)'';
            (3) in subsection (e), as so redesignated, by striking 
        ``subsection (b)'' and inserting ``subsection (c)''; and
            (4) by inserting after subsection (a) the following:
    ``(b) Assessment Program of Needs of Family Caregivers.--
            ``(1) In general.--The Assistant Secretary may make grants 
        to States to establish a program, in accordance with the 
        program requirements described in paragraph (5), to assess the 
        needs of family caregivers for targeted support services 
        described in paragraph (5)(C).
            ``(2) Application by states.--Each State seeking a grant 
        under this subsection shall submit an application to the 
        Assistant Secretary at such time, in such manner, and 
        containing such information and assurances as the Assistant 
        Secretary determines appropriate.
            ``(3) Grant amount.--The amount of a grant to a State under 
        this subsection shall be determined according to such 
        methodology as the Assistant Secretary determines appropriate.
            ``(4) Program administration.--A State receiving a grant 
        under this subsection may enter into an agreement with area 
        agencies on aging in the State, or an Aging and Disability 
        Resource Center in the State, to administer the program, using 
        such grant funds.
            ``(5) Program requirements.--
                    ``(A) Standardized assessment.--Assessments under a 
                program established under paragraph (1)--
                            ``(i) shall be conducted by social workers, 
                        care managers, nurses, or other appropriate 
                        professionals; and
                            ``(ii)(I) shall be conducted with a 
                        standardized instrument to identify family 
                        caregiver needs; and
                            ``(II) in a State in which an area agency 
                        on aging or an Aging and Disability Resource 
                        Center is using such an instrument on the date 
                        of enactment of the Strengthening Services for 
                        America's Seniors Act, may continue to be 
                        conducted with that instrument.
                    ``(B) Questionnaire.--
                            ``(i) In general.--Subject to clause (ii), 
                        assessments under a program established as 
                        described in paragraph (1) shall include asking 
                        the family caregiver relevant questions in 
                        order to determine whether the family caregiver 
                        would benefit from any targeted support 
                        services described in subparagraph (C).
                            ``(ii) Completion on a voluntary basis.--
                        The answering of questions under clause (i) by 
                        a family caregiver shall be on a voluntary 
                        basis.
                            ``(iii) Addressing diverse caregiver needs 
                        and preferences.--The questionnaire under this 
                        subparagraph shall be designed in a manner that 
                        accounts for, and aims to ascertain, the 
                        varying needs and preferences of family 
                        caregivers, based on the range of their 
                        capabilities, caregiving experience, and other 
                        relevant personal characteristics and 
                        circumstances.
                    ``(C) Targeted support services described.--The 
                following targeted support services are described in 
                this subparagraph:
                            ``(i) Information and assistance (including 
                        brochures and online resources for researching 
                        a disease or disability or for learning and 
                        managing a regular caregiving role, new 
                        technologies that can assist family caregivers, 
                        and practical assistance for locating 
                        services).
                            ``(ii) Individual counseling (including 
                        advice and consultation sessions to bolster 
                        emotional support for the family caregiver to 
                        make well-informed decisions about how to cope 
                        with caregiver strain).
                            ``(iii) Support groups, including groups 
                        which provide help for family caregivers to--
                                    ``(I) locate a support group either 
                                locally or online to share experiences 
                                and reduce isolation;
                                    ``(II) make well-informed 
                                caregiving decisions; and
                                    ``(III) reduce isolation.
                            ``(iv) Education and training (including 
                        workshops and other resources available with 
                        information about stress management, self-care 
                        to maintain good physical and mental health, 
                        understanding and communicating with 
                        individuals with dementia, medication 
                        management, normal aging processes, change in 
                        disease and disability, the role of assistive 
                        technologies, and other relevant topics).
                            ``(v) Respite care and emergency back-up 
                        services (including short-term in-home care 
                        services that gives the family caregiver a 
                        break from providing such care).
                            ``(vi) Chore services (such as house 
                        cleaning) to assist the individual receiving 
                        care.
                            ``(vii) Personal care (including outside 
                        help) to assist the individual receiving care.
                            ``(viii) Legal and financial planning and 
                        consultation (including advice and counseling 
                        regarding long-term care planning, estate 
                        planning, powers of attorney, community 
                        property laws, tax advice, employment leave 
                        advice, advance directives, and end-of-life 
                        care).
                            ``(ix) Transportation (including 
                        transportation to medical appointments) to 
                        assist the individual receiving care.
                            ``(x) Other targeted support services, as 
                        determined appropriate by the State agency and 
                        approved by the Assistant Secretary.
                    ``(D) Referrals.--In the case where a questionnaire 
                completed by a family caregiver under subparagraph (B) 
                indicates that the family caregiver would benefit from 
                1 or more of the targeted support services described in 
                subparagraph (C), the agency administering the program 
                shall provide referrals to the family caregiver for 
                State, local, and private-sector caregiver programs and 
                other resources that provide such targeted support 
                services to such caregivers.
                    ``(E) Targeting and timing of assessments.--
                Assessments under the program established under 
                paragraph (1) may be conducted--
                            ``(i) when an individual who is being 
                        assisted by a family caregiver transitions from 
                        one care setting to another;
                            ``(ii) upon referral from a social worker, 
                        care manager, nurse, physician, or other 
                        appropriate professional; or
                            ``(iii) according to circumstances 
                        determined by the State and approved by the 
                        Assistant Secretary.
                    ``(F) Coordination with other assessment.--
                Assessments under the program established under 
                paragraph (1) may be conducted separately or as part 
                of, or in conjunction with, eligibility or other 
                routine assessments of an individual who is being (or 
                is going to be) assisted by a family caregiver.
                    ``(G) Followup services.--As the Assistant 
                Secretary determines appropriate, a State with a 
                program described in paragraph (1) shall conduct 
                followup activities with caregivers who have 
                participated in an assessment to determine the status 
                of the caregiver and whether services were provided.
                    ``(H) Reporting requirement.--Each State with a 
                program described in paragraph (1) shall periodically 
                submit to the Assistant Secretary a report containing 
                information on the number of caregivers assessed under 
                the program, information on the number of referrals 
                made for targeted support services under the program 
                (disaggregated by type of service), demographic 
                information on caregivers assessed under the program, 
                and other information required by the Assistant 
                Secretary.''.
    (b) Standardized Assessment of Needs of Informal Caregivers.--
Section 202 (42 U.S.C. 3012) is amended--
            (1) in subsection (b)(8)--
                    (A) in subparagraph (D), by striking ``and'';
                    (B) in subparagraph (E), inserting ``and'' after 
                the semicolon at the end; and
                    (C) by adding at the end the following:
                    ``(F) which may carry out the informal caregiver 
                assessment program described in subsection (g);''; and
            (2) by adding at the end the following:
    ``(g) Standardized Assessment of Needs of Informal Caregivers.--
            ``(1) In general.--Aging and Disability Resource Centers 
        implemented under subsection (b)(8) may carry out an assessment 
        program with respect to informal caregivers and care 
        recipients. Such assessment program shall be modeled on the 
        family caregiver assessment program established under section 
        373(b).
            ``(2) Definitions.--For purposes of an informal caregiver 
        assessment carried out in accordance with paragraph (1), the 
        following definitions shall apply:
                    ``(A) Care recipient.--The term `care recipient' 
                means--
                            ``(i) an older individual;
                            ``(ii) an individual with a disability; or
                            ``(iii) an individual with a special need.
                    ``(B) Individual with a special need.--The term 
                `individual with a special need' means an individual 
                who requires care or supervision to--
                            ``(i) meet the individual's basic needs;
                            ``(ii) prevent physical self-injury or 
                        injury to others; or
                            ``(iii) avoid placement in an institutional 
                        facility.
                    ``(C) Informal caregiver.--
                            ``(i) In general.--Subject to clause (ii), 
                        the term `informal caregiver' means an adult 
                        family member, or another individual, who is an 
                        informal provider of in-home and community care 
                        to a care recipient.
                            ``(ii) Alternate definition.--A State that 
                        has a State law with an alternate definition of 
                        the term `informal caregiver' for purposes of a 
                        program described in paragraph (1) may use that 
                        definition (with respect to caregivers for care 
                        recipients) for purposes of provisions of this 
                        Act that relate to that program, if such 
                        alternative definition is broader than the 
                        definition in clause (i), and subject to 
                        approval by the Assistant Secretary.''.
    (c) Conforming Amendment.--Section 631(b) (42 U.S.C. 3057k-11(b)) 
is amended by striking ``subsections (c), (d), and (e)'' and inserting 
``subsections (d), (e), and (f)''.

SEC. 3. ADVISORY COMMITTEE TO ASSESS, COORDINATE, AND IMPROVE LEGAL 
              ASSISTANCE ACTIVITIES.

    (a) In General.--Title II of the Older Americans Act of 1965 is 
amended--
            (1) in section 215(j) (42 U.S.C. 3020e-1(j)), by striking 
        ``section 216'' and inserting ``section 217'';
            (2) by redesignating section 216 (42 U.S.C. 3020f) as 
        section 217; and
            (3) by inserting after section 215 (42 U.S.C. 3020e-1) the 
        following:

``SEC. 216. ADVISORY COMMITTEE TO ASSESS, COORDINATE, AND IMPROVE LEGAL 
              ASSISTANCE ACTIVITIES.

    ``(a) Establishment.--There is established an Advisory Committee to 
Assess, Coordinate, and Improve Legal Assistance Activities (referred 
to in this section as the `Committee').
    ``(b) Membership.--
            ``(1) Composition.--The Committee shall be composed of 9 
        members--
                    ``(A) with expertise with existing State legal 
                assistance development programs carried out under 
                section 731 and providers of State legal assistance 
                under subtitle B of title III and title IV; and
                    ``(B) of whom--
                            ``(i) 6 individuals shall be appointed by 
                        the Assistant Secretary--
                                    ``(I) 1 of whom shall be a consumer 
                                advocate;
                                    ``(II) 1 of whom shall be a 
                                professional advocate from a State 
                                agency or State Legal Services 
                                Developer; and
                                    ``(III) 4 of whom shall be 
                                representatives from collaborating 
                                organizations under the National Legal 
                                Resource Center of the Administration; 
                                and
                            ``(ii) 3 individuals shall be appointed by 
                        the Comptroller General of the United States.
            ``(2) Date.--The appointments of the members of the 
        Committee shall be made not later than 9 months after the date 
        of enactment of the Strengthening Services for America's 
        Seniors Act.
            ``(3) Period of appointment; vacancies.--Members shall be 
        appointed for the life of the Committee. Any vacancy in the 
        Committee shall not affect its powers, but shall be filled in 
        the same manner as the original appointment.
            ``(4) Chairperson and vice chairperson.--The Committee 
        shall select a Chairperson and Vice Chairperson from among its 
        members.
    ``(c) Initial Meeting.--The Committee shall hold its first meeting 
not later than 9 months after the date of enactment of the 
Strengthening Services for America's Seniors Act.
    ``(d) Duties of the Committee.--
            ``(1) Definition.--In this subsection, the term `assistance 
        activities' includes--
                    ``(A) legal assistance made available to older 
                individuals in social or economic need under this Act;
                    ``(B) activities of the National Legal Resource 
                Center carried out under section 420(a);
                    ``(C) State legal assistance developer activities 
                carried out under section 731; and
                    ``(D) any other directly related activity or 
                program as determined appropriate by the Assistant 
                Secretary.
            ``(2) Study.--
                    ``(A) In general.--The Committee shall design, 
                implement, and analyze results of a study of--
                            ``(i) the extent to which State leadership 
                        is provided through the State legal assistance 
                        developer in States to enhance the coordination 
                        and effectiveness of legal assistance 
                        activities across the State;
                            ``(ii) the extent to which--
                                    ``(I) there is data collection and 
                                reporting of information by legal 
                                assistance providers in States;
                                    ``(II) there is uniform statewide 
                                reporting among States; and
                                    ``(III) the value and impact of 
                                services provided is being captured at 
                                the State or local level; and
                            ``(iii) the mechanisms to organize and 
                        promote legal assistance development and 
                        services to best meet the needs of older 
                        individuals with greatest social and economic 
                        need.
                    ``(B) Considerations.--In carrying out subparagraph 
                (A)(i), particular attention shall be given to--
                            ``(i) State leadership on targeting limited 
                        legal resources to older individuals in 
                        greatest social and economic need; and
                            ``(ii) State leadership on establishing 
                        priority legal issue areas in accordance with 
                        section 307(a)(11)(E).
            ``(3) Recommendations.--After completion and analysis of 
        study results under paragraph (2), the Committee shall develop 
        recommendations for the establishment of guidelines for--
                    ``(A) enhancing the leadership capacity of the 
                State legal assistance developers to carry out 
                statewide coordinated legal assistance service 
                delivery, with particular focus on enhancing leadership 
                capacity to--
                            ``(i) target limited legal resources to 
                        older individuals in greatest social and 
                        economic need; and
                            ``(ii) establish priority legal issue areas 
                        in accord with priorities set forth in section 
                        307(a)(11)(E);
                    ``(B) developing a uniform national data collection 
                system to be implemented in all States on legal 
                assistance development and services; and
                    ``(C) identifying mechanisms for organizing and 
                promoting legal assistance activities to provide the 
                highest quality, impact, and effectiveness to older 
                individuals with the greatest social and economic need.
            ``(4) Report.--Not later than 1 years after the date of the 
        establishment of the Committee, the Committee shall submit to 
        the President, Congress, and the Assistant Secretary a report 
        that contains a detailed statement of the findings and 
        conclusions of the Committee, together with the recommendations 
        described in paragraph (3).
    ``(e) Duties of the Assistant Secretary.--Not later than 180 days 
after receiving the report described in subsection (d)(4), the 
Assistant Secretary shall issue regulations or guidance, taking into 
consideration the recommendations described in subsection (d)(3).
    ``(f) Powers.--
            ``(1) Information from federal agencies.--The Committee may 
        secure directly from any Federal department or agency such 
        information as the Committee considers necessary to carry out 
        the provisions of this section. Upon request of the Committee, 
        the head of such department or agency shall furnish such 
        information to the Committee.
            ``(2) Postal services.--The Committee may use the United 
        States mails in the same manner and under the same conditions 
        as other departments and agencies of the Federal Government.
    ``(g) Personnel and Administration.--
            ``(1) Travel expenses.--The members of the Committee shall 
        not receive compensation for the performance of services for 
        the Committee, but shall be allowed travel expenses, including 
        per diem in lieu of subsistence, at rates authorized for 
        employees of agencies under subchapter I of chapter 57 of title 
        5, United States Code, while away from their homes or regular 
        places of business in the performance of services for the 
        Committee. Notwithstanding section 1342 of title 31, United 
        States Code, the Secretary may accept the voluntary and 
        uncompensated services of members of the Committee.
            ``(2) Detail of government employees.--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.
            ``(3) Administrative and support services.--The Assistant 
        Secretary shall provide administrative and support services to 
        the Committee.
            ``(4) Procurement of temporary and intermittent services.--
        The Chairman of the Committee may procure temporary and 
        intermittent services under section 3109(b) of title 5, United 
        States Code, at rates for individuals that do not exceed the 
        daily equivalent of the annual rate of basic pay prescribed for 
        level V of the Executive Schedule under section 5316 of such 
        title.
    ``(h) Exemption From Termination Requirements.--Section 14 of the 
Federal Advisory Committee Act shall not apply to the Committee.''.
    (b) Authorization of Appropriations.--Section 217 of the Older 
Americans Act of 1965, as redesignated by subsection (a), is amended by 
adding at the end the following:
    ``(d) Advisory Committee To Assess, Coordinate, and Improve Legal 
Assistance Activities.--There is authorized to be appropriated to carry 
out section 216, $300,000 for fiscal year 2012.''.

SEC. 4. IMPROVING THE STATE LONG-TERM CARE OMBUDSMAN PROGRAMS.

    (a) National Ombudsman Resource Center.--Section 202(a)(18)(B) of 
the Older Americans Act of 1965 (42 U.S.C. 3012(a)(18)(B)) is amended 
by striking ``make available'' and all that follows and inserting 
``reserve and provide, for the funding of the National Ombudsman 
Resource Center (which may include enabling the center to collaborate 
and participate with the Centers for Medicare & Medicaid Services in 
providing training for State survey agencies with an agreement in 
effect under section 1864 of the Social Security Act (42 U.S.C. 1395aa) 
or, in the case of States without such an agency, work with the 
Administrator for the Centers for Medicare & Medicaid Services to 
improve the investigative processes used by the center to address 
complaints by residents of long-term care facilities)--
                            ``(i) for fiscal year 2012, not less than 
                        $2,000,000; and
                            ``(ii) for each subsequent fiscal year, not 
                        less than the sum of--
                                    ``(I) $100,000; and
                                    ``(II) the amount made available 
                                under this subparagraph for the fiscal 
                                year preceding the year for which the 
                                sum is determined;''.
    (b) Functions of Program.--
            (1) Private and unimpeded access to ombudsman services.--
        Section 712(b)(1)(A) of the Older Americans Act of 1965 (42 
        U.S.C. 3058g(b)(1)(A)) is amended by striking ``access'' and 
        inserting ``private and unimpeded access''.
            (2) Ombudsman development of resident and family 
        councils.--Section 712(a)(3)(H)(iii) of such Act (42 U.S.C. 
        3058g(a)(3)(H)(iii)) is amended by striking ``provide technical 
        support for'' and inserting ``actively encourage and assist 
        in''.
            (3) Local entity development of resident and family 
        councils.--Section 712(a)(5)(B)(vi) of such Act (42 U.S.C. 
        3058g(a)(5)(B)(vi)) is amended by striking ``support'' and 
        inserting ``actively encourage and assist in''.
    (c) Ombudsman Authority With Respect to HIPAA.--Section 712(b) of 
the Older Americans Act of 1965 (42 U.S.C. 3058g(b)) is amended--
            (1) in paragraph (1)(B)(i) by striking ``the medical and 
        social records of a'' and inserting ``all records concerning 
        a''; and
            (2) by adding at the end the following:
    ``(3) For purposes of section 264(c) of the Health Insurance 
Portability and Accountability Act of 1996 (including regulations 
issued under that section) (42 U.S.C. 1320d-2 note), the Ombudsman and 
a representative of the Office shall be considered a `health oversight 
agency,' so that release of residents' individually identifiable health 
information to the Ombudsman or representative is not precluded in 
cases in which the requirements of clause (i) or (ii) of paragraph 
(1)(B) are otherwise met.''.
    (d) Disclosure and Confidentiality.--Section 712(d) of the Older 
Americans Act of 1965 (42 U.S.C. 3058g(d)) is amended--
            (1) in paragraph (1), by striking ``files'' and inserting 
        ``information''; and
            (2) in paragraph (2)--
                    (A) in the paragraph heading, by striking 
                ``Identity of complainant or resident'' and inserting 
                ``Procedures'';
                    (B) in subparagraph (A)--
                            (i) by striking ``files or records'' the 
                        first place it appears and inserting 
                        ``information (including files or records)''; 
                        and
                            (ii) by striking ``disclose'' and all that 
                        follows and inserting ``disclose such 
                        information);'';
                    (C) in subparagraph (B)--
                            (i) in the matter preceding clause (i), by 
                        striking ``files or records'' and inserting 
                        ``information''; and
                            (ii) in clause (iii), by striking the 
                        period and inserting ``; and''; and
                    (D) by adding at the end the following:
                    ``(C) require that the Ombudsman and each 
                representative of the Office hold in strict confidence 
                all communications with individuals seeking assistance 
                under this Act, and take all reasonable steps to 
                safeguard the confidentiality of information provided 
                to the Ombudsman or a representative of the Office 
                under this title by a complainant or resident.''.
                                 <all>