[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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