[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 2179 Introduced in Senate (IS)]
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116th CONGRESS
1st Session
S. 2179
To amend the Older Americans Act of 1965 to provide social service
agencies with the resources to provide services to meet the urgent
needs of Holocaust survivors to age in place with dignity, comfort,
security, and quality of life.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 18, 2019
Mr. Cardin (for himself, Mr. Cramer, and Ms. Rosen) 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 provide social service
agencies with the resources to provide services to meet the urgent
needs of Holocaust survivors to age in place with dignity, comfort,
security, and quality of life.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
(a) Short Title.--This Act may be cited as the ``Trauma-Informed
Modernization of Eldercare for Holocaust Survivors Act'' or the ``TIME
for Holocaust Survivors Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title.
Sec. 2. Findings.
Sec. 3. Purposes.
TITLE I--RESPONDING TO THE NEEDS OF HOLOCAUST SURVIVORS
Subtitle A--Definitions, Grants for State and Community Programs, and
Other Programs
Sec. 101. Definitions.
Sec. 102. Organization.
Sec. 103. Area plans.
Sec. 104. State plans.
Sec. 105. Consumer contributions.
Sec. 106. National Family Caregiver Support Program authorized.
Sec. 107. Prevention of elder abuse, neglect, and exploitation.
Subtitle B--Functions Within Administration for Community Living To
Assist Holocaust Survivors
Sec. 111. Designation of individual within the Administration.
Sec. 112. Annual report to Congress.
Sec. 113. National Resource Center for Older Individuals Experiencing
the Long-Term and Adverse Consequences of
Trauma.
Sec. 114. Definitions.
TITLE II--NUTRITION SERVICES FOR OLDER INDIVIDUALS
Sec. 201. Nutrition services.
TITLE III--TRANSPORTATION
Sec. 301. Transportation services and resources.
SEC. 2. FINDINGS.
Congress finds the following:
(1) During the Holocaust, which took place from 1933
through 1945, an estimated 6,000,000 Jews, as well as millions
of victims from other targeted groups, were murdered by the
Nazis and their collaborators.
(2) More than 200,000 Jews fleeing from Nazi-occupied
territory found refuge in the United States from 1933 through
1945, and approximately 137,000 additional Jewish refugees
settled in the United States from 1945 through 1952.
(3) Hundreds of thousands of additional Jewish refugees
continued to immigrate to the United States from Europe and
countries of the former Soviet Union during the subsequent
decades.
(4) The number of Holocaust survivors living in the United
States at the end of 2018 was approximately 80,000 individuals,
down from an estimated 127,000 in 2010.
(5) Every Holocaust survivor is now at least 74 years old,
most are in at least their mid-to-late eighties, and many are
in their nineties and beyond.
(6) One-third of all Holocaust survivors in the United
States live at or below the official poverty threshold (as
defined by the Bureau of the Census), including more than half
of the Holocaust survivors who emigrated from the countries of
the former Soviet Union.
(7) Holocaust survivors continue to live with the unique
mental and physical scars of the unconscionable trauma caused
by the Holocaust, and while institutionalized settings are
beneficial for some, certain aspects of institutionalization
may have particularly adverse effects on Holocaust survivors.
(8) For many Holocaust survivors, institutionalized
settings produce sights, sounds, smells, emotions, and routines
that can induce panic, anxiety, and re-traumatization as a
result of experiences from the Holocaust.
(9) Holocaust survivors are more economically and socially
vulnerable, report poorer health and more health problems, and
have greater social service needs, than other older
individuals.
(10) In comparison to most other older individuals, low-
income Holocaust survivors are more reliant on social service
programs that provide services such as personal care, provision
of home-delivered and congregate meals, transportation,
counseling, and mental health support to promote health and
quality of life.
(11) Community organizations serving Holocaust survivors
report that approximately one-quarter of Holocaust survivors
live alone, and living alone is a risk factor for
hospitalization and nursing home admission, poverty, falls,
depression, poor nutrition, social isolation, and loneliness,
which have been associated with poor health outcomes and an
increased risk of death.
(12) Community organizations serving Holocaust survivors
report that transportation is vital to help Holocaust survivors
attend medical appointments, shop and purchase necessary items,
visit family and friends, and participate in cultural,
recreational, or social events, such as congregate meals or
religious services.
(13) As the general population of older individuals
increases in the United States and many public or philanthropic
resources remain constant, providers serving Holocaust
survivors need additional capacity to cover needed services.
(14) The Administration for Community Living in the
Department of Health and Human Services serves as the Federal
agency responsible for increasing access to community supports
for, focusing attention and resources on the unique needs of,
older individuals and individuals with disabilities across
their lifespans.
(15) The mission of the Administration for Community Living
is to maximize the independence, well-being, and health of
older individuals, individuals with disabilities, and their
families and caregivers.
(16) The Administration for Community Living in 2017 issued
guidance entitled ``ACL Guidance for Outreach and Providing
Services for Holocaust Survivors'' in accordance with a
requirement of the Older Americans Act Reauthorization Act of
2016 which states that the Assistant Secretary for Aging shall
``issue guidance to States, that shall be applicable to States,
area agencies on aging, and providers of services for older
individuals, with respect to serving Holocaust survivors,
including guidance on promising practices for conducting
outreach to that population.''.
(17) Many social service agencies that receive funding
under the Older Americans Act of 1965 for home-delivered or
congregate meals serve diverse seniors, including Holocaust
survivors, with specialized dietary needs based on religious,
cultural, or ethnic requirements, and the necessary special
meals often cost more than other meals.
SEC. 3. PURPOSES.
The purposes of this Act are--
(1) to include ``older individuals who are Holocaust
survivors'' in the list of groups that receive preference, as
specified in section 305(a)(2)(E) of the Older Americans Act of
1965, for services provided under that Act;
(2) to require the designation within the Administration
for Community Living of an individual to have responsibility
for the provision of services to older individuals who are
Holocaust survivors;
(3) to promote technical assistance and training for
agencies that serve older individuals experiencing the long-
term and adverse consequences of trauma;
(4) to ensure that the providers of nutrition services
through the Older Americans Act of 1965 can meet the special
health-related or other dietary needs of program participants;
and
(5) to help meet the urgent transportation needs of
Holocaust survivors.
TITLE I--RESPONDING TO THE NEEDS OF HOLOCAUST SURVIVORS
Subtitle A--Definitions, Grants for State and Community Programs, and
Other Programs
SEC. 101. DEFINITIONS.
Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is
amended--
(1) in paragraph (24)--
(A) in subparagraph (B), by striking ``and'';
(B) in subparagraph (C)(ii), by striking the period
at the end and inserting ``; and''; and
(C) by adding at the end the following:
``(D) status as a Holocaust survivor.'';
(2) by redesignating paragraphs (26) through (40) and
paragraphs (41) through (54) as paragraphs (27) through (41)
and paragraphs (43) through (56), respectively;
(3) by inserting after paragraph (25) the following:
``(26) The term `Holocaust survivor' means an individual
who--
``(A)(i) lived in a country in a year not earlier
than 1933 and not later than 1945 under a Nazi regime,
under Nazi occupation, or under the control of Nazi
collaborators; or
``(ii) fled from a country in a year described in
clause (i) under a Nazi regime, under Nazi occupation,
or under the control of Nazi collaborators;
``(B) was persecuted in a year described in clause
(i) on the basis of race, religion, physical or mental
disability, sexual orientation, political affiliation,
ethnicity, or other basis; and
``(C) was a member of a group that was persecuted
by the Nazis.''; and
(4) by inserting after paragraph (41) the following:
``(42) The term `person-centered, trauma-informed', used
with respect to care, means care provided through an aging
program, policy, or procedure, that uses a holistic approach to
service provision that promotes the dignity, strength, and
empowerment of trauma victims by incorporating knowledge about
the role of trauma in trauma victims' lives.''.
SEC. 102. ORGANIZATION.
Section 305(a) of the Older Americans Act of 1965 (42 U.S.C.
3025(a)) is amended--
(1) in paragraph (1)(E), by inserting ``older individuals
who are Holocaust survivors,'' after ``proficiency,'' each
place it appears; and
(2) in paragraph (2)(E), by inserting ``older individuals
who are Holocaust survivors,'' after ``proficiency,''.
SEC. 103. AREA PLANS.
Section 306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is
amended--
(1) in subsection (a)--
(A) in paragraph (1), by inserting ``older
individuals who are Holocaust survivors,'' after
``proficiency,'' each place it appears;
(B) in paragraph (4)--
(i) in subparagraph (A)--
(I) in clause (i)(I)(bb), by
inserting ``older individuals who are
Holocaust survivors,'' after
``proficiency,''; and
(II) in clause (ii), by inserting
``older individuals who are Holocaust
survivors,'' after ``proficiency,''
each place it appears;
(ii) in subparagraph (B)(i)--
(I) in subclause (VI), by striking
``and'' at the end; and
(II) by inserting after subclause
(VII) the following:
``(VIII) older individuals who are
Holocaust survivors; and''; and
(iii) in subparagraph (B)(ii), by striking
``subclauses (I) through (VI)'' and inserting
``subclauses (I) through (VIII)''; and
(C) in paragraph (7)(B)(iii), by inserting ``, in
particular, older individuals who are Holocaust
survivors,'' after ``placement''; and
(2) in subsection (b)(2)(B), by inserting ``older
individuals who are Holocaust survivors,'' after ``areas,''.
SEC. 104. STATE PLANS.
Section 307(a) of the Older Americans Act of 1965 (42 U.S.C.
3027(a)) is amended--
(1) in paragraph (4), by inserting ``older individuals who
are Holocaust survivors,'' after ``proficiency,'';
(2) in paragraph (16)--
(A) in subparagraph (A)--
(i) in clause (v), by striking ``and'' at
the end; and
(ii) by adding at the end the following:
``(vii) older individuals who are Holocaust
survivors; and''; and
(B) in subparagraph (B), by striking ``clauses (i)
through (vi)'' and inserting ``clauses (i) through
(vii)''; and
(3) in paragraph (28)(B)(ii), by inserting ``older
individuals who are Holocaust survivors,'' after ``areas,''.
SEC. 105. CONSUMER CONTRIBUTIONS.
Section 315 of the Older Americans Act of 1965 (42 U.S.C. 3030c-2)
is amended--
(1) in subsection (c)(2), by inserting ``older individuals
who are Holocaust survivors,'' after ``proficiency,''; and
(2) in subsection (d), by inserting ``older individuals who
are Holocaust survivors,'' after ``proficiency,''.
SEC. 106. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM AUTHORIZED.
Section 373(c)(2)(A) of the Older Americans Act of 1965 (42 U.S.C.
3030s-1(c)(2)(A)) is amended by striking ``individuals)'' and inserting
``individuals and older individuals who are Holocaust survivors)''.
SEC. 107. PREVENTION OF ELDER ABUSE, NEGLECT, AND EXPLOITATION.
Section 721(b)(13) of the Older Americans Act of 1965 (42 U.S.C.
3058i(b)(13)) is amended--
(1) in subparagraph (B), by striking ``or'' at the end;
(2) in subparagraph (C), by striking the period at the end
and inserting ``; or''; and
(3) by adding at the end the following:
``(D) older individuals who are Holocaust
survivors.''.
Subtitle B--Functions Within Administration for Community Living To
Assist Holocaust Survivors
SEC. 111. DESIGNATION OF INDIVIDUAL WITHIN THE ADMINISTRATION.
The Administrator of the Administration for Community Living is
authorized to designate, within the Administration for Community
Living, a person who has specialized training, background, or
experience with Holocaust survivor issues--
(1) to have responsibility within the Administration for
Community Living for implementing and coordinating services for
older individuals who are Holocaust survivors; and
(2) to serve as a liaison on those issues, and the
provision of services for those individuals, with other
relevant agencies of the Federal Government.
SEC. 112. ANNUAL REPORT TO CONGRESS.
The Administrator, with assistance from the individual designated
under section 111, shall prepare and submit to Congress an annual
report on--
(1) the status and needs, including the priority areas of
concern, of older individuals who are Holocaust survivors; and
(2) how the aging network is identifying and serving older
individuals experiencing the long-term and adverse consequences
of trauma and how agencies within the aging network are
promoting and advancing person-centered, trauma-informed care
to older individuals experiencing the long-term and adverse
consequences of trauma.
SEC. 113. NATIONAL RESOURCE CENTER FOR OLDER INDIVIDUALS EXPERIENCING
THE LONG-TERM AND ADVERSE CONSEQUENCES OF TRAUMA.
(a) Program Authorized.--
(1) Center.--The Administrator shall establish and operate
a National Resource Center on Innovative Services and Supports
for Older Individuals Experiencing the Long-Term and Adverse
Consequences of Trauma (referred to in this section as the
``Center'').
(2) Functions.--The Center shall--
(A) provide training and technical assistance to
agencies in the aging network delivering services to
older individuals experiencing the long-term and
adverse consequences of trauma;
(B) share best practices with the aging network;
and
(C) make subgrants to the agencies best positioned
to advance and improve the delivery of services for
older individuals experiencing the long-term and
adverse consequences of trauma.
(b) Assistance.--To carry out subsection (a), the Administrator
shall make grants to or enter into contracts with one or more nonprofit
organization that are experienced--
(1) in providing person-centered, trauma-informed care; and
(2) in providing support and technical assistance on a
nationwide basis to agencies within the aging network that
offer services to older individuals experiencing the long-term
and adverse consequences of trauma.
SEC. 114. DEFINITIONS.
In this subtitle:
(1) Administrator.--The term ``Administrator'' means the
Administrator of the Administration for Community Living.
(2) Other terms.--The terms ``Holocaust survivor'', ``older
individual'', and ``person-centered, trauma-informed'' have the
meanings given the terms in section 102 of the Older Americans
Act of 1965 (42 U.S.C. 3002).
TITLE II--NUTRITION SERVICES FOR OLDER INDIVIDUALS
SEC. 201. NUTRITION SERVICES.
(a) In General.--Section 339(2) of the Older Americans Act of 1065
(42 U.S.C. 3030g-21(2)) is amended--
(1) in subparagraph (A), by amending clause (iii) to read
as follows:
``(iii) to the maximum extent practicable,
are adjusted and appropriately funded to meet
any special health-related dietary needs, and
other dietary needs of program participants
(including needs based on religious, cultural,
or ethnic requirements) if for the special
health-related or other dietary needs involved
there is sufficient demand in a community to
warrant special meals;'';
(2) in subparagraph (K), by striking ``, and'' and
inserting a comma;
(3) in subparagraph (L), by striking the period and
inserting ``, and''; and
(4) by adding at the end the following:
``(M) encourages and educates individuals utilizing
methodology that promotes person-centered, trauma-
informed care who distribute nutrition services under
subpart 2 to engage in conversation with homebound
older individuals and to be aware of the warning signs
of medical emergencies, injury, or abuse in order to
reduce isolation and promote well-being.''.
TITLE III--TRANSPORTATION
SEC. 301. TRANSPORTATION SERVICES AND RESOURCES.
Section 411(a) of the Older Americans Act of 1965 (42 U.S.C.
3032(a)) is amended--
(1) by redesignating paragraph (14) as paragraph (15);
(2) in paragraph (13), by striking ``; and'' and inserting
a semicolon; and
(3) by inserting after paragraph (13) the following:
``(14) conducting programs that enable the mobility and
self-sufficiency of older individuals with greatest economic
need and older individuals with greatest social need by
providing transportation services and resources; and''.
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