[Congressional Record Volume 152, Number 85 (Tuesday, June 27, 2006)]
[Senate]
[Pages S6561-S6577]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. Enzi (for himself, Mr. Kennedy, Mr. DeWine, and Ms. 
        Mikulski):
  S. 3570. A bill to amend the Older Americans Act of 1965 to authorize 
appropriations for fiscal years 2007 through 2011, and for other 
purposes; to the Committee on Health, Education, Labor, and Pensions.
  Mr. ENZI. Mr. President, I rise today to join Senator DeWine, Senator 
Kennedy and Senator Mikulski in introducing the Older Americans Act 
Amendments of 2006.
  The Older Americans Act Amendments of 2006 is the primary source for 
the delivery of social and nutrition services for older individuals. 
Enacted in 1965, the act's programs include supportive services, 
congregate and home-delivered nutrition services, community service 
employment, the long-term care ombudsman program, and services to 
prevent the abuse, neglect and exploitation of older individuals. The 
act also provides grants to Native Americans and research, training, 
and demonstration activities.
  The 2000 amendments to the act authorized the National Family 
Caregiver Support Program; allowed State agencies on aging to impose 
cost-sharing for certain supportive services for older persons; revised 
the State funding formulas; and required the Department of Labor to 
establish performance measures for the community service employment 
program.
  Title I of the Older Americans Act set broad social policy objective 
to improve the lives of all older Americans. It recognized the need for 
an adequate income in retirement, and the importance of physical and 
mental health, employment in community services for older individuals 
and long-term care services.
  Title II established the Administration on Aging, AOA, within the 
Department of Health and Human Services to be the primary Federal 
advocate for older individuals and to administer the provisions of the 
Older Americans Act. It also established the National Eldercare Locator 
Service to provide nationwide information with regard to resources for 
older individuals; the National Long-term Care Ombudsman Resource 
Center; the National Center on Elder Abuse; the National Aging 
Information Center; and the Pension Counseling and Information Program. 
The 2006 amendments will establish an Office of Elder Abuse Prevention 
and Services to develop a long-term plan and national response to elder 
abuse prevention, detection, treatment, and intervention. Further, the 
2006 amendments strengthen the leadership of the Department of Health 
and Human Services through an interagency coordinating committee to 
guide policy and program development across the Federal Government with 
respect to aging and demographic changes.

  Title III authorized grants to State and area agencies on aging to 
act as

[[Page S6562]]

advocates on behalf of older individuals. Title III services are 
targeted to those with the greatest economic and social need, 
particularly low-income minority persons and older persons residing in 
rural communities. It funds supportive services, congregate and home-
delivered meals, transportation, home care, adult day care, information 
assistance, and legal assistance. The 2006 amendments will expand the 
Caregiver Support Program to permit the use of volunteers to enhance 
services and increase program authorization levels. In addition, the 
bill contains a new demonstration project that promises to lead to 
changes in our long-term care delivery system, leading to consumer 
driven choices.
  Title IV authorized grants for training, research, and demonstration 
projects in the field of aging. This title supports a wide range of 
projects including those related to income, health, housing, retirement 
and long-term care, as well as career preparation and continuing 
education. The 2006 amendments will expand gerontology training for 
minority students; multigenerational activities, and civic engagement 
activities.
  Title V authorized the community service employment program for older 
Americans known as the Senior Community Service Employment or SCSEP--to 
promote part-time opportunities in community service for unemployed, 
low-income persons who are 55 years or older and who have poor 
employment prospects. It is administered by the Department of Labor. 
The 2006 amendments establish 4-year grant cycles for the competitive 
program and permit poor performing grantees to be terminated from the 
program based on performance measures and establishes a 3 year limit 
for participating in subsidized employment with a 20-percent waiver for 
difficult to place individuals.
  Title VI authorized funds for Supportive and nutrition services for 
older Native Americans. The 2006 amendments will increase the funding 
levels for this program.
  Title VII authorized the long-term care ombudsman program and elder 
abuse, neglect and exploitation prevention programs. The 2006 
amendments will enhance the elder abuse prevention activities by 
awarding grants to States and Indian tribes to enable them to 
strengthen long-term care and provide assistance for elder justice and 
elder abuse prevention programs. It will create grants for prevention, 
detection, assessment, treatment of, intervention in, investigation of, 
and response to elder abuse; safe havens demonstrations for older 
individuals; volunteer programs; multidisciplinary activities; elder 
fatality and serious injury review teams; programs for underserved 
populations; incentives for longterm care facilities to train and 
retain employees; and other collaborative and innovative approaches. 
Further, it will initiate a new incidence and prevalence study and a 
data collection process.
  The proportion of the population aged 60 and over will increase 
dramatically over the next 30 years as more than 78 million baby 
boomers approach retirement. It is essential that in the coming years 
Congress and the Federal Government take a leadership role in assisting 
the states in addressing the needs of older Americans. The bill we 
offer today will ensure that our Nation's older Americans are healthy, 
fed, housed, able to get where they need to go and safe from abuse and 
scams. The No. 1 resolution of the 2005 White House Conference on Aging 
called upon Congress to reauthorize the Older Americans Act during the 
109th Congress. I am pleased that the Senate and the House are well on 
the way to accomplis1ing this goal on behalf of one of our Nation's 
greatest resources--our older Americans.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 3570

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

     SECTION 1. SHORT TITLE.

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

     SEC. 2. DEFINITIONS.

       Section 102 of the Older Americans Act of 1965 (42 U.S.C. 
     3002) is amended--
       (1) in paragraph (12)(D), to read as follows:
       ``(D) evidence-based health promotion programs, including 
     programs related to the prevention and mitigation of the 
     effects of chronic disease (including osteoporosis, 
     hypertension, obesity, diabetes, and cardiovascular disease), 
     alcohol and substance abuse reduction, smoking cessation, 
     weight loss and control, stress management, falls prevention, 
     physical activity, and improved nutrition;'';
       (2) by striking paragraph (24) and inserting the following:
       ``(24) The term `exploitation' means the fraudulent or 
     otherwise illegal, unauthorized, or improper act or process 
     of an individual, including a caregiver or fiduciary (as such 
     terms are defined in section 751), that uses the resources of 
     an older individual for monetary or personal benefit, profit, 
     or gain, or that results in depriving an older individual of 
     rightful access to, or use of, benefits, resources, 
     belongings, or assets.'';
       (3) in paragraph (29)(E)--
       (A) in clause (i), by striking ``and'' at the end;
       (B) in clause (ii), by striking the period at the end and 
     inserting ``; and''; and
       (C) by adding at the end the following:
       ``(iii) older individuals at risk for institutional 
     placement.'';
       (4) in paragraph (32)(D), by inserting ``, including an 
     assisted living facility,'' after ``home'';
       (5) by striking paragraph (34) and inserting the following:
       ``(5)(A) The term `neglect' means--
       ``(i) the failure of a caregiver or fiduciary (as such 
     terms are defined in section 751) to provide the goods or 
     services that are necessary to maintain the health or safety 
     of an older individual; or
       ``(ii) self-neglect.
       ``(B) The term `self-neglect' means an adult's inability, 
     due to physical or mental impairment or diminished capacity, 
     to perform essential self-care tasks including--
       ``(i) obtaining essential food, clothing, shelter, and 
     medical care;
       ``(ii) obtaining goods and services necessary to maintain 
     physical health, mental health, or general safety; or
       ``(iii) managing one's own financial affairs.''; and
       (6) by adding at the end the following:
       ``(44) The term `Aging and Disability Resource Center' 
     means a center established by a State as part of the State's 
     system of long-term care, to provide a coordinated system for 
     providing--
       ``(A) comprehensive information on available public and 
     private long-term care programs, options, and resources;
       ``(B) personal counseling to assist individuals in 
     assessing their existing or anticipated long-term care needs, 
     and developing and implementing a plan for long-term care 
     designed to meet their specific needs and circumstances; and
       ``(C) consumer access to the range of publicly-supported 
     long-term care programs for which consumers may be eligible, 
     by serving as a convenient point of entry for such programs.
       ``(45) The term `at risk for institutional placement' 
     means, with respect to an older individual, that such 
     individual is unable to perform at least two activities of 
     daily living without substantial assistance (including verbal 
     reminding, physical cuing, or supervision), including such an 
     older individual that is determined by the State involved to 
     be in need of placement in a long-term care facility.
       ``(46) The term `Hispanic-serving institution' has the 
     meaning given the term in section 502 of the Higher Education 
     Act of 1965 (20 U.S.C. 1101a).
       ``(47) The term `long-term care' means any services, care, 
     or items (including assistive devices) that are--
       ``(A) intended to assist individuals in coping with, and to 
     the extent practicable compensating for, functional 
     impairments in carrying out activities of daily living;
       ``(B) furnished at home, in a community care setting 
     (including a small community care setting as defined in 
     subsection (g)(1), and a large community care setting as 
     defined in subsection (h)(1), of section 1929 of the Social 
     Security Act (42 U.S.C. 1396t)), or in a long-term care 
     facility; and
       ``(C) not furnished to diagnose, treat, or cure a medical 
     disease or condition.
       ``(48) The term `self-directed care' means an approach to 
     providing services (including programs, benefits, supports, 
     and technology) under this Act intended to assist an older 
     individual with activities of daily living, in which--
       ``(A) such services (including the amount, duration, scope, 
     provider, and location of such services) are planned, 
     budgeted, and purchased under the direction and control of 
     such individual;
       ``(B) such individual is provided with such information and 
     assistance as is necessary and appropriate to enable such 
     individual to make informed decisions about the individual's 
     service options;
       ``(C) the needs, capabilities, and preferences of such 
     individual with respect to such services, and such 
     individual's ability to direct and control the individual's 
     receipt of such services, are assessed by the area agency on 
     aging involved or the local provider agency;
       ``(D) based on the assessment made under subparagraph (C), 
     upon request, the area agency on aging assists such 
     individual and the individual's family, caregiver, or legal 
     representative in developing--

[[Page S6563]]

       ``(i) a plan of services for such individual that specifies 
     which services such individual will be responsible for 
     directing;
       ``(ii) a determination of the role of family members (and 
     others whose participation is sought by such individual) in 
     providing services under such plan; and
       ``(iii) a budget for such services; and
       ``(E) the area agency on aging or State agency involved 
     provides for oversight of such individual's self-directed 
     receipt of services, including steps to ensure the quality of 
     services provided and the appropriate use of funds under this 
     Act.
       ``(49) The term `State system of long-term care' means the 
     Federal, State, and local programs and activities 
     administered by a State that provide, support, or facilitate 
     access to long-term care to individuals in such State.''.

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

       Section 201 of the Older Americans Act of 1965 (42 U.S.C. 
     3011) is amended by adding at the end the following:
       ``(e)(1) In this subsection, the terms defined in section 
     751 shall have the meanings given those terms in that 
     section.
       ``(2) The Secretary is authorized to establish or designate 
     within the Administration (as defined in section 102) an 
     Office of Elder Abuse Prevention and Services.
       ``(3) It shall be the duty of the Assistant Secretary, 
     acting through the head of the Office of Elder Abuse 
     Prevention and Services to--
       ``(A) develop objectives, priorities, policy, and a long-
     term plan for--
       ``(i) carrying out elder justice programs and activities 
     relating to--
       ``(I) elder abuse prevention, detection, treatment, and 
     intervention, and response;
       ``(II) training of individuals regarding the matters 
     described in subclause (I); and
       ``(III) the improvement of the elder justice system in the 
     United States;
       ``(ii) annually collecting, maintaining, and disseminating 
     data relating to the abuse, neglect, and exploitation of 
     elders (and, in the discretion of the Secretary, vulnerable 
     adults), including collecting, maintaining, and disseminating 
     such data under section 753 after consultation with the 
     Attorney General and working with experts from the Department 
     of Justice described in section 753(b)(1);
       ``(iii) disseminating information concerning best practices 
     regarding, and providing training on, carrying out activities 
     related to abuse, neglect, and exploitation of elders (and, 
     in the discretion of the Secretary, vulnerable adults);
       ``(iv) in conjunction with the necessary experts, 
     conducting research related to abuse, neglect, and 
     exploitation of elders (and, in the discretion of the 
     Secretary, vulnerable adults);
       ``(v) providing technical assistance to States and other 
     eligible entities that provide or fund the provision of the 
     services described in subtitle B of title VII; and
       ``(vi) carrying out a study to determine the national 
     incidence and prevalence of elder abuse, neglect, and 
     exploitation in all settings;
       ``(B) implement the overall policy and a strategy to carry 
     out the plan described in subparagraph (A); and
       ``(C) provide advice to the Secretary on elder justice 
     issues and administer such programs relating to elder abuse, 
     neglect, and exploitation as the Secretary determines to be 
     appropriate.
       ``(4) The Secretary, acting through the Assistant 
     Secretary, may issue such regulations as may be necessary to 
     carry out this subsection and subtitle B of title VII.''.

     SEC. 4. FUNCTIONS OF THE ASSISTANT SECRETARY.

       Section 202 of the Older Americans Act of 1965 (42 U.S.C. 
     3012) is amended--
       (1) in subsection (a)--
       (A) in paragraph (12)--
       (i) by striking ``carry on'' and inserting the following:
       ``(B) carry on''; and
       (ii) by striking ``(12)'' and inserting the following:
       ``(12)(A) consult and coordinate activities with the 
     Administrator of the Centers for Medicare & Medicaid Services 
     to implement and build awareness of programs providing new 
     benefits affecting older individuals; and'';
       (B) by striking paragraph (20) and inserting the following:
       ``(20)(A) provide technical assistance and support for 
     outreach and benefits enrollment assistance to support 
     efforts--
       ``(i) to inform older individuals with greatest economic 
     need, who may be eligible to participate, but who are not 
     participating, in Federal and State programs for which the 
     individuals are eligible, about the programs; and
       ``(ii) to enroll the individuals in the programs;
       ``(B) in cooperation with related Federal agency partners 
     administering the Federal programs, make a grant to or enter 
     into a contract with a qualified, experienced entity to 
     establish a National Center on Senior Benefits Outreach and 
     Enrollment, which shall--
       ``(i) maintain and update web-based decision support and 
     enrollment tools, and integrated, person-centered systems, 
     designed to inform older individuals about the full range of 
     benefits for which the individuals may be eligible under 
     Federal and State programs;
       ``(ii) utilize cost-effective strategies to find older 
     individuals with greatest economic need and enroll the 
     individuals in the programs;
       ``(iii) create and support efforts for Aging and Disability 
     Resource Centers, and other public and private State and 
     community-based organizations, including faith-based 
     organizations and coalitions, to serve as benefits enrollment 
     centers for the programs;
       ``(iv) develop and maintain an information clearinghouse on 
     best practices and the most cost-effective methods for 
     finding and enrolling older individuals with greatest 
     economic need in the programs; and
       ``(v) provide, in collaboration with related Federal agency 
     partners administering the Federal programs, training and 
     technical assistance on the most effective outreach, 
     screening, enrollment, and follow-up strategies for the 
     Federal and State programs.'';
       (C) in paragraph (26)(D)--
       (i) by striking ``gaps in'';
       (ii) by inserting ``(including services that would permit 
     such individuals to receive long-term care in home and 
     community-based settings)'' after ``individuals''; and
       (iii) by striking ``and'' at the end;
       (D) in paragraph (27), by striking the period at the end 
     and inserting ``; and''; and
       (E) by adding at the end the following:
       ``(28) make available to States information and technical 
     assistance to support the provision of evidence-based disease 
     prevention and health promotion services.''; and
       (2) by striking subsection (b) and inserting the following:
       ``(b) To promote the development and implementation of 
     comprehensive, coordinated systems at Federal, State, and 
     local levels for providing long-term care in home and 
     community-based settings, in a manner responsive to the needs 
     and preferences of older individuals and their family 
     caregivers, the Assistant Secretary shall, consistent with 
     the applicable provisions of this title--
       ``(1) collaborate, coordinate, and consult with other 
     Federal agencies and departments (other than the 
     Administration on Aging) responsible for formulating and 
     implementing programs, benefits, and services related to 
     providing long-term care, and may make grants, contracts, and 
     cooperative agreements with funds received from those other 
     Federal agencies and departments;
       ``(2) conduct research and demonstration projects to 
     identify innovative, cost-effective strategies for modifying 
     State systems of long-term care to--
       ``(A) respond to the needs and preferences of older 
     individuals and family caregivers;
       ``(B) target services to individuals at risk for 
     institutional placement, to permit such individuals to remain 
     in home and community-based settings; and
       ``(C) establish criteria for and promote the implementation 
     (through area agencies on aging, service providers, and such 
     other entities as the Assistant Secretary determines to be 
     appropriate) of evidence-based programs to assist older 
     individuals and their family caregivers in learning about and 
     making behavioral changes intended to reduce the risk of 
     injury, disease, and disability among older individuals;
       ``(3) facilitate, in coordination with the Administrator of 
     the Centers for Medicare & Medicaid Services, including the 
     provision of such care through self-directed care models 
     that--
       ``(A) provide for the assessment of the needs and 
     preferences of an individual at risk for institutional 
     placement to help such individual avoid unnecessary 
     institutional placement and depletion of income and assets to 
     qualify for benefits under the Medicaid program under title 
     XIX of the Social Security Act (42 U.S.C. 1396 et seq.);
       ``(B) respond to the needs and preferences of such 
     individual and provide the option--
       ``(i) for the individual to direct and control the receipt 
     of supportive services provided; or
       ``(ii) as appropriate, for a person who was appointed by 
     the individual, or is legally acting on the individual's 
     behalf, in order to represent or advise the individual in 
     financial or service coordination matters (referred to in 
     this paragraph as a `representative' of the individual), to 
     direct and control the receipt of those services; and
       ``(C) assist an older individual (or, as appropriate, a 
     representative of the individual) to develop a plan for long-
     term support, including selecting, budgeting for, and 
     purchasing home and community-based long-term care and 
     supportive services;
       ``(4) provide for the Administration to play a lead role 
     with respect to issues concerning home and community-based 
     long-term care, including--
       ``(A) directing (as the Secretary or the President 
     determines to be appropriate) or otherwise participating in 
     departmental and interdepartmental activities concerning 
     long-term care; and
       ``(B) reviewing and commenting on departmental rules, 
     regulations, and policies related to providing long-term 
     care; and
       ``(C) making recommendations to the Secretary with respect 
     to home and community-based long-term care, including 
     recommendations based on findings made through projects 
     conducted under paragraph (2);
       ``(5) promote, in coordination with other appropriate 
     Federal agencies--
       ``(A) enhanced awareness by the public of the importance of 
     planning in advance for long-term care; and
       ``(B) the availability of information and resources to 
     assist in such planning;

[[Page S6564]]

       ``(6) establish, either directly or through grants or 
     contracts, a national technical assistance program to assist 
     State agencies, area agencies on aging, and community-based 
     service providers funded under this Act in implementing home 
     and community-based long-term care systems, including 
     evidence-based programs;
       ``(7) develop, in collaboration with the Administrator of 
     the Centers for Medicare & Medicaid Services, performance 
     standards and measures for use by States to determine the 
     extent to which their systems of long-term care fulfill the 
     objectives described in this subsection; and
       ``(8) conduct such other activities as the Assistant 
     Secretary determines to be appropriate.
       ``(c) The Assistant Secretary, after consultation with the 
     Chief Executive Officer of the Corporation for National and 
     Community Service, shall--
       ``(1) encourage and permit volunteer groups (including 
     organizations carrying out national service programs and 
     including organizations of youth in secondary or 
     postsecondary school) that are active in supportive services 
     and civic engagement to participate and be involved 
     individually or through representative groups in supportive 
     service and civic engagement programs or activities to the 
     maximum extent feasible;
       ``(2) develop a comprehensive strategy for utilizing older 
     individuals to address critical local needs of national 
     concern; and
       ``(3) encourage other community capacity-building 
     initiatives involving older individuals.''.

     SEC. 5. FEDERAL AGENCY CONSULTATION.

       Section 203 of the Older Americans Act of 1965 (42 U.S.C. 
     3013) is amended--
       (1) in subsection (a)(3)(A)--
       (A) by striking ``(with particular attention to low-income 
     minority older individuals and older individuals residing in 
     rural areas)'' and inserting ``(with particular attention to 
     low-income older individuals, including low-income minority 
     older individuals, older individuals with limited English 
     proficiency, and older individuals residing in rural 
     areas)''; and
       (B) by striking ``section 507'' and inserting ``section 
     516'';
       (2) in subsection (b), by adding at the end the following:
       ``(19) Sections 4 and 5 of the Assistive Technology Act of 
     1998 (29 U.S.C. 3003, 3004).''; and
       (3) by adding at the end the following:
       ``(c)(1) The Secretary, in collaboration with the Secretary 
     of Housing and Urban Development and with the other Federal 
     officials specified in paragraph (2), shall establish an 
     interagency coordinating committee (referred to in this 
     subsection as the `Committee') focusing on the coordination 
     of agencies with respect to aging issues, particularly issues 
     related to demographic changes and housing needs among older 
     individuals.
       ``(2) The officials referred to in paragraph (1) are the 
     Secretary of Labor, the Secretary of Housing and Urban 
     Development, the Attorney General, the Secretary of 
     Transportation, the Secretary of the Treasury, the Secretary 
     of Agriculture, the Commissioner of Social Security, the 
     Surgeon General, the Administrator of the Centers for 
     Medicare & Medicaid Services, the Director of the Centers for 
     Disease Control and Prevention, the Director of the National 
     Institutes of Health, the Assistant Secretary for Children 
     and Families, the Administrator of the National Highway 
     Traffic Safety Administration, and such other Federal 
     officials as the Secretary of Health and Human Services 
     determines to be appropriate.
       ``(3) The Secretary of Health and Human Services shall 
     serve as the first chairperson of the Committee, for an 
     initial period of 2 years. After that initial period, the 
     Secretary of Housing and Urban Development and the Secretary 
     of Health and Human Services shall alternate as chairpersons 
     of the Committee, each serving as chairperson for a period of 
     2 years.
       ``(4) The Committee shall--
       ``(A) review all Federal programs and services that assist 
     older individuals in finding and affording housing, health 
     care, and other services, including those Federal programs 
     and services that assist older individuals in accessing 
     health care, transportation, supportive services, and 
     assistance with daily activities, at the place or close to 
     the place where the older individuals live;
       ``(B) monitor, evaluate, and recommend improvements in 
     programs and services administered, funded, or financed by 
     Federal, State, and local agencies to assist older 
     individuals in meeting their housing, health care, and other 
     service needs and make any recommendations about how the 
     agencies can better carry out and provide the programs and 
     services to house and serve older individuals;
       ``(C) recommend ways to--
       ``(i) facilitate aging in place of older individuals, by 
     identifying and making available the programs and services 
     necessary to enable older individuals to remain in their 
     homes as the individuals age;
       ``(ii) reduce duplication by Federal agencies of programs 
     and services to assist older individuals in meeting their 
     housing, health care, and other service needs;
       ``(iii) ensure collaboration among and within agencies in 
     providing and making available the programs and services so 
     that older individuals are able to easily access needed 
     programs and services;
       ``(iv) work with States to better provide housing, health 
     care, and other services to older individuals by--
       ``(I) holding individual meetings with State 
     representatives;
       ``(II) providing ongoing technical assistance to States 
     about better meeting the needs of older individuals; and
       ``(III) working with States to designate State liaisons for 
     the Committee;
       ``(v) identify model programs and services to assist older 
     individuals in meeting their housing, health care, and other 
     service needs, including model--
       ``(I) programs linking housing, health care, and other 
     services;
       ``(II) financing products offered by government, quasi-
     government, and private sector entities; and
       ``(III) innovations in technology applications that give 
     older individuals access to information on available services 
     or that help in providing services to older individuals;
       ``(vi) collect and disseminate information about older 
     individuals and the programs and services available to the 
     individuals to ensure that the individuals can access 
     comprehensive information; and
       ``(vii) work with the Federal Interagency Forum on Aging-
     Related Statistics, the Bureau of the Census, and member 
     agencies--
       ``(I) to collect and maintain data relating to the housing, 
     health care, and other service needs of older individuals so 
     that all such data can be accessed in one place on a 
     designated website; and
       ``(II) to identify and address unmet data needs;
       ``(D) make recommendations to guide policy and program 
     development across Federal agencies with respect to 
     demographic changes among older individuals; and
       ``(E) actively seek input from and consult with all 
     appropriate and interested parties, including public health 
     interest and research groups and foundations about the 
     activities described in subparagraphs (A) through (D).
       ``(5) Each year, the Committee shall prepare and submit to 
     the President, the Committee on Financial Services of the 
     House of Representatives, the Committee on Education and the 
     Workforce of the House of Representatives, the Committee on 
     Banking, Housing, and Urban Affairs of the Senate, the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate, and the Special Committee on Aging of the Senate, a 
     report that--
       ``(A) describes the activities and accomplishments of the 
     Committee in working with Federal, State, and local 
     governments, and private organizations, in coordinating 
     programs and services to meet the requirements of paragraph 
     (4);
       ``(B) assesses the level of Federal assistance required to 
     meet the needs described in paragraph (4);
       ``(C) incorporates an analysis from the head of each agency 
     that is a member of the interagency coordinating committee 
     established under paragraph (1) that describes the barriers 
     and impediments, including barriers and impediments in 
     statutory and regulatory law, to the access and use by older 
     individuals of programs and services administered by such 
     agency; and
       ``(D) makes recommendations for appropriate legislative and 
     administrative actions to meet the needs described in 
     paragraph (4) and for coordinating programs and services 
     designed to meet those needs.
       ``(6)(A) The Secretary of Health and Human Services, after 
     consultation with the Secretary of Housing and Urban 
     Development, shall appoint an executive director of the 
     Committee.
       ``(B) On the request of the Committee, any Federal 
     Government employee may be detailed to the Committee without 
     reimbursement, and such detail shall be without interruption 
     or loss of civil service status or privilege.''.

     SEC. 6. ADMINISTRATION.

       Section 205 of the Older Americans Act of 1965 (42 U.S.C. 
     3016) is amended--
       (1) in subsection (a)--
       (A) in paragraph (1)--
       (i) in subparagraph (C), by adding ``and'' at the end;
       (ii) in subparagraph (D), by striking ``; and'' at the end 
     and inserting a period; and
       (iii) by striking subparagraph (E); and
       (B) in paragraph (2)--
       (i) in subparagraph (A)--

       (I) by amending clause (i) to read as follows:

       ``(i) designing, implementing, and evaluating evidence-
     based programs to support improved nutrition and regular 
     physical activity for older individuals;'';

       (II) by amending clause (iii) to read as follows:

       ``(iii) conducting outreach and disseminating evidence-
     based information to nutrition service providers about the 
     benefits of healthful diets and regular physical activity, 
     including information about the most current Dietary 
     Guidelines for Americans published under section 301 of the 
     National Nutrition Monitoring and Related Research Act of 
     1990 (7 U.S.C. 5341), the Food Guide Pyramid published by the 
     Secretary of Agriculture, and advances in nutrition 
     science;'';

       (III) in clause (vii) by striking ``and'' at the end; and
       (IV) by striking clause (viii) and inserting the following:

       ``(viii) disseminating guidance that describes strategies 
     for improving the nutritional quality of meals provided under 
     title III; and

[[Page S6565]]

       ``(ix) providing technical assistance to the regional 
     offices of the Administration with respect to each duty 
     described in clauses (i) through (viii).''; and
       (ii) by amending subparagraph (C)(i) to read as follows:
       ``(i) have expertise in nutrition and meal planning; and''.

     SEC. 7. EVALUATION.

       Section 206(g) of the Older Americans Act of 1965 (42 
     U.S.C. 3017(g)) is amended by striking the first sentence and 
     inserting the following: ``From the total amount appropriated 
     for each fiscal year to carry out title III, the Secretary 
     may use such sums as may be necessary, but not more than \1/
     2\ of 1 percent of such amount, for purposes of conducting 
     evaluations under this section, either directly or by grant 
     or contract.''.

     SEC. 8. REPORTS.

       Section 207(b)(2) of the Older Americans Act of 1965 (42 
     U.S.C. 3018(b)(2)) is amended--
       (1) in subparagraph (B), by striking ``Labor'' and 
     inserting ``the Workforce''; and
       (2) in subparagraph (C), by striking ``Labor and Human 
     Resources'' and inserting ``Health, Education, Labor, and 
     Pensions''.

     SEC. 9. CONTRACTUAL, COMMERCIAL AND PRIVATE PAY 
                   RELATIONSHIPS; APPROPRIATE USE OF ACT FUNDS.

       (a) Private Pay Relationships; Appropriate Use of Act 
     Funds.--Section 212 of the Older Americans Act (42 U.S.C. 
     3020c) is amended to read as follows:

     ``SEC. 212. CONTRACTING AND GRANT AUTHORITY; PRIVATE PAY 
                   RELATIONSHIPS; APPROPRIATE USE OF FUNDS.

       ``(a) In General.--Subject to subsection (b), this Act 
     shall not be construed to prevent a recipient of a grant or a 
     contract under this Act from entering into an agreement--
       ``(1) with a profitmaking organization;
       ``(2) under which funds provided under such grant or 
     contract are used to pay part or all of a cost (including an 
     administrative cost) incurred by such recipient to carry out 
     a contract or commercial relationship for the benefit of 
     older individuals or their family caregivers, whether such 
     contract or relationship is carried out to implement a 
     provision of this Act or to conduct activities inherently 
     associated with implementing such provision; or
       ``(3) under which any individual, regardless of age or 
     income (including the family caregiver of such individual), 
     who seeks to receive 1 or more services may voluntarily pay, 
     at their own private expense, to receive such services based 
     on the fair market value of such services.
       ``(b) Ensuring Appropriate Use of Funds.--An agreement 
     described in subsection (a) may not--
       ``(1) be made without the prior approval of the State 
     agency (or, in the case of a grantee under title VI, without 
     the prior recommendation of the Director of the Office for 
     American Indian, Alaska Native, and Native Hawaiian Aging and 
     the prior approval of the Assistant Secretary);
       ``(2) directly or indirectly provide for, or have the 
     effect of, paying, reimbursing, or otherwise compensating an 
     entity under such agreement in an amount that exceeds the 
     fair market value of the goods or services furnished by such 
     entity under such agreement;
       ``(3) result in the displacement of services otherwise 
     available to an older individual with greatest social need, 
     an older individual with greatest economic need, or an older 
     individual who is at risk for institutional placement; or
       ``(4) in any other way compromise, undermine, or be 
     inconsistent with the objective of serving the needs of older 
     individuals, as determined by the Assistant Secretary.''.

     SEC. 10. NUTRITION EDUCATION.

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

     ``SEC. 214. NUTRITION EDUCATION.

       ``The Assistant Secretary, in consultation with the 
     Secretary of Agriculture, shall conduct outreach and provide 
     technical assistance to agencies and organizations that serve 
     older individuals to assist such agencies and organizations 
     to carry out integrated health promotion and disease 
     prevention programs that--
       ``(1) are designed for older individuals; and
       ``(2) include--
       ``(A) nutrition education;
       ``(B) physical activity; and
       ``(C) other activities to modify behavior and to improve 
     health literacy, including providing information on optimal 
     nutrient intake, through education and counseling in 
     accordance with section 339(2)(J).''.

     SEC. 11. PENSION COUNSELING AND INFORMATION PROGRAMS.

       Section 215 of the Older Americans Act of 1965 (42 U.S.C. 
     3020e-1) is amended--
       (1) in subsection (e)(1)(J), by striking ``and low income 
     retirees'' and inserting ``, low-income retirees, and older 
     individuals with limited English proficiency'';
       (2) in subsection (f), by amending paragraph (2) to read as 
     follows:
       ``(2) The ability of the entity to perform effective 
     outreach to affected populations, particularly populations 
     with limited English proficiency and other populations that 
     are identified as in need of special outreach.''; and
       (3) in subsection (h)(2), by inserting ``(including 
     individuals with limited English proficiency)'' after 
     ``individuals''.

     SEC. 12. AUTHORIZATION OF APPROPRIATIONS.

       Section 216 of the Older Americans Act of 1965 (42 U.S.C. 
     3020f) is amended--
       (1) in subsection (a) by striking ``2001, 2002, 2003, 2004, 
     and 2005'' and inserting ``2007, 2008, 2009, 2010, and 
     2011.''; and
       (2) in subsections (b) and (c) by striking ``year'' and all 
     that follows through ``years'', and inserting ``years 2007, 
     2008, 2009, 2010, and 2011''.

     SEC. 13. PURPOSE; ADMINISTRATION.

       Section 301(a)(2) of the Older Americans Act of 1965 (42 
     U.S.C. 3021(a)(2)) is amended--
       (1) in subparagraph (D), by striking ``and'' at the end;
       (2) in subparagraph (E), by striking the period at the end 
     and inserting ``; and''; and
       (3) by adding at the end the following:
       ``(F) organizations with experience in providing senior 
     volunteer services, such as Federal volunteer programs 
     administered by the Corporation for National and Community 
     Service and designed to provide training, placement, and 
     stipends for volunteers in community service settings.''.

     SEC. 14. AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS.

       Section 303 of the Older Americans Act of 1965 (42 U.S.C. 
     3023) is amended--
       (1) in subsections (a)(1), (b), and (d), by striking ``year 
     2001'' and all that follows through ``years'' each place it 
     appears, and inserting ``years 2007, 2008, 2009, 2010, and 
     2011''; and
       (2) in subsection (e)--
       (A) in paragraph (1) by striking ``$125,000,000'' and all 
     that follows and inserting ``$160,000,000 for fiscal year 
     2007.''; and
       (B) in paragraph (2), by striking ``such sums'' and all 
     that follows and inserting ``$170,000,000 for fiscal year 
     2008, $180,000,000 for fiscal year 2009, $190,000,000 for 
     fiscal year 2010, and $200,000,000 for fiscal year 2011.''.

     SEC. 15. ALLOTMENTS.

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

     SEC. 16. ORGANIZATION.

       Section 305 of the Older Americans Act of 1965 (42 U.S.C. 
     3025) is amended--
       (1) in subsection (a)--
       (A) in paragraph (1)(E)--
       (i) by striking ``(with particular attention to low-income 
     minority individuals and older individuals residing in rural 
     areas)'' each place it appears and inserting ``(with 
     particular attention to low-income older individuals, 
     including low-income minority older individuals, older 
     individuals with limited English proficiency, and older 
     individuals residing in rural areas)''; and
       (ii) by striking ``and'' at the end;
       (B) in paragraph (2)--
       (i) in subparagraph (E), by striking ``, with particular 
     attention to low-income minority individuals and older 
     individuals residing in rural areas'' and inserting ``(with 
     particular attention to low-income older individuals, 
     including low-income minority older individuals, older 
     individuals with limited English proficiency, and older 
     individuals residing in rural areas)''; and
       (ii) in subparagraph (G), by striking the period and 
     inserting ``; and''; and
       (C) by adding at the end the following:
       ``(3) the State agency shall, consistent with this section, 
     promote the development and implementation of a 
     comprehensive, coordinated system in such State for providing 
     long-term care in home and community-based settings, in a 
     manner responsive to the needs and preferences of older 
     individuals and their family caregivers, by--
       ``(A) collaborating, coordinating, and consulting with 
     other agencies in such State responsible for formulating, 
     implementing, and administering programs, benefits, and 
     services related to providing long-term care;
       ``(B) participating in any State government activities 
     concerning long-term care, including reviewing and commenting 
     on any State rules, regulations, and policies related to 
     long-term care;
       ``(C) conducting analyses and making recommendations with 
     respect to strategies for modifying the State's system of 
     long-term care to better--
       ``(i) respond to the needs and preferences of older 
     individuals and family caregivers;
       ``(ii) facilitate the provision, by service providers, of 
     long-term care in home and community-based settings;
       ``(iii) target services to older individuals at risk for 
     institutional placement, to permit such individuals to remain 
     in home and community-based settings; and
       ``(iv) implement (through area agencies on aging, service 
     providers, and such other entities as the State determines to 
     be appropriate) programs to assist older individuals and 
     their family caregivers in learning about and making 
     behavioral changes intended to reduce the risk of injury, 
     disease, and disability among older individuals; and

[[Page S6566]]

       ``(D) providing for the availability and distribution 
     (through public education campaigns, Aging and Disability 
     Resource Centers, area agencies on aging, and other 
     appropriate means) of information relating to--
       ``(i) the need to plan in advance for long-term care; and
       ``(ii) the range of available public and private long-term 
     care programs, options, and resources.''; and
       (2) in subsection (b), by adding at the end the following:
       ``(6) Nothing in this section shall prevent the 
     Commonwealth of Puerto Rico from designating, with the 
     approval of the Assistant Secretary, a single planning and 
     service area to cover all the older individuals in the 
     Commonwealth.''.

     SEC. 17. AREA PLANS.

       Section 306 of the Older Americans Act of 1965 (42 U.S.C. 
     3026) is amended--
       (1) in subsection (a)--
       (A) in paragraph (1)--
       (i) by striking ``(with particular attention to low-income 
     minority individuals and older individuals residing in rural 
     areas)'' and inserting ``(with particular attention to low-
     income older individuals, including low-income minority older 
     individuals, older individuals with limited English 
     proficiency, and older individuals residing in rural 
     areas)'';
       (ii) by striking ``(with particular attention to low-income 
     minority individuals)'' and inserting ``(with particular 
     attention to low-income older individuals, including low-
     income minority older individuals, older individuals with 
     limited English proficiency, and older individuals residing 
     in rural areas)''; and
       (iii) by inserting ``the number of older individuals at 
     risk for institutional placement residing in such area,'' 
     after ``individuals) residing in such area,'';
       (B) in paragraph (2)(A)--
       (i) by inserting after ``transportation,'' the following: 
     ``health services (including mental health services),''; and
       (ii) by inserting after ``information and assistance'' the 
     following: ``(which may include information and assistance to 
     consumers on availability of services under part B and how to 
     receive benefits under and participate in publicly supported 
     programs for which the consumer may be eligible)'';
       (C) in paragraph (4)--
       (i) in subparagraph (A)--

       (I) by amending clause (i) to read as follows:

       ``(i) provide assurances that the area agency on aging 
     will--
       ``(I) set specific objectives, consistent with State 
     policy, for providing services to older individuals with 
     greatest economic need, older individuals with greatest 
     social need, and older individuals at risk for institutional 
     placement;
       ``(II) include specific objectives for providing services 
     to low-income minority older individuals, older individuals 
     with limited English proficiency, and older individuals 
     residing in rural areas; and
       ``(III) include in the area plan proposed methods to 
     achieve such objectives;''; and

       (II) in clause (ii) by inserting ``(including older 
     individuals with limited English proficiency)'' after ``low 
     income minority individuals'' each place it appears; and

       (ii) in subparagraph (B)--

       (I) by moving the left margin of each of subparagraph (B), 
     clauses (i) and (ii), and subclauses (I) through (VI) of 
     clause (i), 2 ems to the left; and
       (II) in clause (i)--

       (aa) in subclause (V) by striking ``with limited English-
     speaking ability; and'' and inserting ``with limited English 
     proficiency;''; and
       (bb) by adding at the end the following:
       ``(VII) older individuals at risk for institutional 
     placement; and'';
       (D) in paragraph (5), by inserting ``and individuals at 
     risk for institutional placement'' after ``severe 
     disabilities'';
       (E) in paragraph (6)--
       (i) in subparagraph (C)--

       (I) in clause (i), by striking ``and'' at the end;
       (II) in clause (ii), by adding ``and'' at the end; and
       (III) by inserting after clause (ii) the following:

       ``(iii) make use of trained volunteers in providing direct 
     services delivered to older individuals and individuals with 
     disabilities needing such services and, if possible, work in 
     coordination with entities carrying out volunteer programs 
     (including programs administered by the Corporation for 
     National and Community Services) designed to provide 
     training, placement, and stipends for volunteers in community 
     service settings.'';
       (ii) in subparagraph (D)--

       (I) by inserting ``family caregivers of such individuals,'' 
     after ``Act,''; and
       (II) by inserting ``service providers, representatives of 
     the business community,'' after ``individuals,''; and

       (iii) in subparagraph (F), by inserting ``(including mental 
     health screening)'' before ``provided'' each place it 
     appears;
       (F) in paragraph (7), to read as follows:
       ``(7) provide that the area agency on aging shall, 
     consistent with this section, facilitate the area-wide 
     development and implementation of a comprehensive, 
     coordinated system for providing long-term care in home and 
     community-based settings, in a manner responsive to the needs 
     and preferences of older individuals and their family 
     caregivers, by--
       ``(A) collaborating, coordinating, and consulting with 
     other local public and private agencies and organizations 
     responsible for administering programs, benefits, and 
     services related to providing long-term care;
       ``(B) conducting analyses and making recommendations with 
     respect to strategies for modifying the local system of long-
     term care to better--
       ``(i) respond to the needs and preferences of older 
     individuals and family caregivers;
       ``(ii) facilitate the provision, by service providers, of 
     long-term care in home and community-based settings;
       ``(iii) target services to older individuals at risk for 
     institutional placement, to permit such individuals to remain 
     in home and community-based settings; and
       ``(iv) implement (through the agency or service providers), 
     evidence-based programs to assist older individuals and their 
     family caregivers in learning about and making behavioral 
     changes intended to reduce the risk of injury, disease, and 
     disability among older individuals; and
       ``(C) providing for the availability and distribution 
     (through public education campaigns, Aging and Disability 
     Resource Centers, and other appropriate means) of information 
     relating to--
       ``(i) the need to plan in advance for long-term care; and
       ``(ii) the range of available public and private long-term 
     care programs, options, and resources.'';
       (G) by striking the 2 paragraphs (15);
       (H) by redesignating paragraph (16) as paragraph (15); and
       (I) by adding at the end the following:
       ``(16) provide assurances that funds received under this 
     title will be used--
       ``(A) to provide benefits and services to older individuals 
     giving priority to older individuals identified in paragraph 
     (4)(A)(i); and
       ``(B) in compliance with the assurances specified in 
     paragraph (13) and the limitations specified in section 
     212(b); and
       ``(17) provide, to the extent feasible, for the furnishing 
     of services under this Act, consistent with self-directed 
     care.
       ``(18) include information detailing how the area agency on 
     aging will coordinate activities, and develop long-range 
     emergency plans, with local and State emergency response 
     agencies, relief organizations, local and State governments, 
     and any other institutions that have responsibility for 
     disaster relief service delivery.'';
       (2) by redesignating subsections (b), (c), (d), and (e) as 
     subsections (c), (d), (e), and (f); and
       (3) by inserting after subsection (a) the following:
       ``(b)(1) In any fiscal year, an area agency on aging may 
     include in the area plan an assessment of how prepared the 
     area agency on aging and service providers in the planning 
     and service area are for a change in the number of older 
     individuals during the 10-year period following the fiscal 
     year for which the plan is submitted. In a fiscal year 
     described in section 304(d)(1)(A)(ii), an area agency or 
     aging shall include the assessment in the area plan.
       ``(2) Such assessment may include--
       ``(A) the projected change in the number of older 
     individuals in the planning and service area;
       ``(B) an analysis of how such change may affect such 
     individuals, including individuals with low incomes, 
     individuals with greatest economic need, minority older 
     individuals, older individuals residing in rural areas, and 
     older individuals with limited English proficiency;
       ``(C) an analysis of how the programs, policies, and 
     services provided by such area agency can be improved, and 
     how resource levels can be adjusted to meet the needs of the 
     changing population of older individuals in the planning and 
     service area; and
       ``(D) an analysis of how the change in the number of 
     individuals age 85 and older in the planning and service area 
     is expected to affect the need for supportive services.
       ``(3) An area agency on aging, in cooperation with 
     government officials, State agencies, tribal organizations, 
     or local entities, may make recommendations to government 
     officials in the planning and service area and the State, on 
     actions determined by the area agency to build the capacity 
     in the planning and service area to meet the needs of older 
     individuals for--
       ``(A) health and human services;
       ``(B) land use;
       ``(C) housing;
       ``(D) transportation;
       ``(E) public safety;
       ``(F) workforce and economic development;
       ``(G) recreation;
       ``(H) education;
       ``(I) civic engagement;
       ``(J) emergency preparedness; and
       ``(K) any other service as determined by such agency.''.

     SEC. 18. STATE PLANS.

       Section 307(a) of the Older Americans Act of 1965 (42 
     U.S.C. 3027(a)) is amended--
       (1) in paragraph (2)(C), by striking ``section 306(b)'' and 
     inserting ``section 306(c)'';
       (2) in paragraph (4), by striking ``, with particular 
     attention to low-income minority individuals and older 
     individuals residing in rural areas'' and inserting ``(with 
     particular attention to low-income minority older 
     individuals, older individuals with limited English 
     proficiency, and older individuals residing in rural 
     areas)'';

[[Page S6567]]

       (3) by striking paragraph (15);
       (4) by redesignating paragraph (14) as paragraph (15);
       (5) by inserting after paragraph (13) the following:
       ``(14) The plan shall, with respect to the fiscal year 
     preceding the fiscal year for which such plan is prepared--
       ``(A) identify the number of low-income minority older 
     individuals in the State, including the number of low-income 
     minority older individuals with limited English proficiency; 
     and
       ``(B) describe the methods used to satisfy the service 
     needs of the low-income minority older individuals described 
     in subparagraph (A), including the plan to meet the needs of 
     low-income minority older individuals with limited English 
     proficiency.'';
       (6) in clauses (ii) and (iii) of paragraph (16)(A) by 
     striking ``(with particular attention to low-income minority 
     individuals and older individuals residing in rural areas)'' 
     each place it appears and inserting ``(with particular 
     attention to low-income older individuals, including low-
     income minority older individuals, older individuals with 
     limited English proficiency, and older individuals residing 
     in rural areas)''; and
       (7) by adding at the end the following:
       ``(27) The plan shall provide assurances that area agencies 
     on aging will provide, to the extent feasible, for the 
     furnishing of services under this Act, consistent with self-
     directed care.
       ``(28)(A) The plan shall include, at the election of the 
     State, an assessment of how prepared the State is, under the 
     State's statewide service delivery model, for a change in the 
     number of older individuals during the 10-year period 
     following the fiscal year for which the plan is submitted.
       ``(B) Such assessment may include--
       ``(i) the projected change in the number of older 
     individuals in the State;
       ``(ii) an analysis of how such change may affect such 
     individuals, including individuals with low incomes, 
     individuals with great economic need, minority older 
     individuals, older individuals residing in rural areas, and 
     older individuals with limited English proficiency;
       ``(iii) an analysis of how the programs, policies, and 
     services provided by the State can be improved, including 
     coordinating with area agencies on aging, and how resource 
     levels can be adjusted to meet the needs of the changing 
     population of older individuals in the State; and
       ``(iv) an analysis of how the change in the number of 
     individuals age 85 and older in the State is expected to 
     affect the need for supportive services.
       ``(29) The plan shall include information detailing how the 
     State will coordinate activities, and develop long-range 
     emergency preparedness plans, with area agencies on aging, 
     local emergency response agencies, relief organizations, 
     local governments, and any other institutions that have 
     responsibility for disaster relief service delivery.
       ``(30) The plan shall include information describing the 
     involvement of the head of the State agency in the 
     development, revision, and implementation of emergency 
     preparedness plans, including the State Public Health 
     Emergency Preparedness and Response Plan.
       ``(31) The plan shall provide that the State shall 
     implement an Aging and Disability Resource Center--
       ``(A) to serve as a visible and trusted source of 
     information on the full range of options for long-term care, 
     including both institutional and home and community-based 
     care, that are available in the State;
       ``(B) to provide personalized and consumer-friendly 
     assistance to empower individuals to make informed decisions 
     about their long-term care options;
       ``(C) to provide coordinated and streamlined access to all 
     publicly funded long-term care options so that consumers can 
     obtain the care they need through a single intake, 
     assessment, and eligibility determination process;
       ``(D) to help individuals to plan ahead for their long-term 
     care needs; and
       ``(E) to assist, in coordination with the entity carrying 
     out the health insurance information, counseling, and 
     assistance program (receiving funding under section 4360 of 
     the Omnibus Budget Reconciliation Act of 1990 (42 U.S.C. 
     1395b-4)) in the State, beneficiaries, and prospective 
     beneficiaries, under the Medicare program established under 
     title XVIII of the Social Security Act (42 U.S.C. 1395 et 
     seq.) in understanding and accessing prescription drug and 
     preventative health benefits under the provisions of, and 
     amendments made by, the Medicare Prescription Drug, 
     Improvement, and Modernization Act of 2003.''.

     SEC. 19. PAYMENTS.

       Section 309(b)(2) of the Older Americans Act of 1965 (42 
     U.S.C. 3029(b)(2)) is amended by striking ``the non-Federal 
     share required prior to fiscal year 1981'' and inserting ``10 
     percent of the cost of the services specified in section 
     304(d)(1)(D)''.

     SEC. 20. NUTRITION SERVICES INCENTIVE PROGRAM.

       Section 311 of the Older Americans Act of 1965 (42 U.S.C. 
     3030a) is amended--
       (1) in subsection (b), by adding at the end the following:
       ``(3) Each State agency and grantee under title VI shall 
     promptly and equitably disburse amounts received under this 
     subsection to recipients of grants and contracts.'';
       (2) in subsection (c)--
       (A) in paragraph (1), by inserting ``, including bonus 
     commodities,'' after ``agricultural commodities'';
       (B) in paragraph (2), by inserting ``, including bonus 
     commodities,'' after ``food commodities''; and
       (C) in paragraph (3), by inserting ``, including bonus 
     commodities,'' after ``Dairy products'';
       (3) in subsection (d)(4), by inserting ``and grantee under 
     title VI'' after ``State agency''; and
       (4) in subsection (e), by striking ``2001'' and inserting 
     ``2007''.

     SEC. 21. CONSUMER CONTRIBUTIONS.

       Section 315 of the Older Americans Act of 1965 (42 U.S.C. 
     3030c-2) is amended--
       (1) in subsection (b)--
       (A) in paragraph (1)--
       (i) by striking ``provided that'' and inserting ``if''; and
       (ii) by adding at the end the following: ``Such 
     contributions shall be encouraged for individuals whose self-
     declared income is at or above 200 percent of the poverty 
     line, at contribution levels based on the actual cost of 
     services.''; and
       (B) in paragraph (4)(E), by inserting ``and to supplement 
     (not supplant) funds received under this Act'' after 
     ``given'';
       (2) in subsection (c)(2), by striking ``(with particular 
     attention to low-income minority individuals and older 
     individuals residing in rural areas)'' and inserting ``(with 
     particular attention to low-income older individuals, 
     including low-income minority older individuals, older 
     individuals with limited English proficiency, and older 
     individuals residing in rural areas)''; and
       (3) in subsection (d), by striking ``with particular 
     attention to low-income and minority older individuals and 
     older individuals residing in rural areas'' and inserting 
     ``(with particular attention to low-income older individuals, 
     including low-income minority older individuals, older 
     individuals with limited English proficiency, and older 
     individuals residing in rural areas)''.

     SEC. 22. SUPPORTIVE SERVICES AND SENIOR CENTERS.

       Section 321(a) of the Older Americans Act of 1965 (42 
     U.S.C. 3030d(a)) is amended--
       (1) in paragraph (8), by inserting ``(including mental 
     health screening)'' after ``screening'';
       (2) in paragraph (11) by striking ``services'' and 
     inserting ``provision of devices and services (including 
     provision of assistive technology devices and assistive 
     technology services)'';
       (3) in paragraph (14)(B) by inserting ``(including mental 
     health)'' after ``health'';
       (4) in paragraph (22) by striking the period at the end and 
     inserting a semicolon;
       (5) by redesignating paragraph (23) as paragraph (24); and
       (6) by inserting after paragraph (22) the following:
       ``(23) services designed to support States, area agencies 
     on aging, and local service providers in carrying out and 
     coordinating activities for older individuals with respect to 
     mental health services, including outreach for, education 
     concerning, and screening for such services, and referral to 
     such services for treatment; and''.

     SEC. 23. NUTRITION SERVICES.

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

     ``SEC. 330. PURPOSE.

       ``It is the purpose of this part to promote socialization 
     and the health and well-being of older individuals by 
     assisting such individuals to gain access to nutrition 
     services to delay the onset of adverse health conditions.''.

     SEC. 24. CONGREGATE NUTRITION PROGRAM.

       Section 331 of the Older Americans Act of 1965 (42 U.S.C. 
     3030e) is amended--
       (1) by striking ``projects--'' and inserting ``projects 
     that--'';
       (2) in paragraph (1) by striking ``which'' the first place 
     it appears;
       (3) in paragraph (2), by striking ``which''; and
       (4) by striking paragraph (3) and inserting the following:
       ``(3) provide nutrition education, nutrition counseling, 
     and other nutrition services, as appropriate, based on the 
     needs of meal participants.''.

     SEC. 25. HOME DELIVERED NUTRITION SERVICES.

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

     ``SEC. 336. PROGRAM AUTHORIZED.

       ``The Assistant Secretary shall establish and carry out a 
     program to make grants to States under State plans approved 
     under section 307 for the establishment and operation of 
     nutrition projects for older individuals that provide--
       ``(1) on 5 or more days a week (except in a rural area 
     where such frequency is not feasible (as defined by the 
     Assistant Secretary by rule) and a lesser frequency is 
     approved by the State agency) at least 1 home delivered meal 
     per day, which may consist of hot, cold, frozen, dried, 
     canned, fresh, or supplemental foods and any additional meals 
     that the recipient of a grant or contract under this subpart 
     elects to provide; and
       ``(2) nutrition education, nutrition counseling, and other 
     nutrition services as appropriate, based on the needs of meal 
     recipients.''.

[[Page S6568]]

     SEC. 26. CRITERIA.

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

     ``SEC. 337. CRITERIA.

       ``The Assistant Secretary, in consultation with recognized 
     experts in the fields of nutrition science, dietetics, meal 
     planning and food service management, and aging, shall 
     develop minimum criteria of efficiency and quality for the 
     furnishing of home delivered meal services for projects 
     described in section 336.''.

     SEC. 27. NUTRITION.

       Section 339 of the Older Americans Act of 1965 (42 U.S.C. 
     3030g-21) is amended--
       (1) in paragraph (1), to read as follows:
       ``(1) solicit the advice and expertise of a dietitian or 
     other individual with education and training in nutrition 
     science or, if such an individual is not available, an 
     individual with comparable expertise in the planning of 
     nutritional services, and''; and
       (2) in paragraph (2)--
       (A) in subparagraph (A)(i), to read as follows:
       ``(i) comply with the most recent Dietary Guidelines for 
     Americans, published by the Secretary and the Secretary of 
     Agriculture, and''; and
       (B) in subparagraph (D), by inserting ``joint'' after 
     ``encourages''; and
       (C) in subparagraph (G), to read as follows:
       ``(G) ensures that meal providers solicit the advice and 
     expertise of--
       ``(i) a dietitian or other individual described in 
     paragraph (1),
       ``(ii) meal participants, and
       ``(iii) other individuals knowledgeable with regard to the 
     needs of older individuals,''; and
       (D) in subparagraph (I), by striking ``and'' at the end; 
     and
       (E) in subparagraph (J), to read as follows:
       ``(J) provides for nutrition screening and nutrition 
     education, and nutrition assessment and counseling if 
     appropriate; and
       ``(K) encourages individuals who distribute nutrition 
     services under subpart 2 to provide, to homebound older 
     individuals, available medical information approved by health 
     care professionals, such as informational brochures and 
     information on how to get vaccines, including vaccines for 
     influenza, pneumonia, and shingles, in the individuals' 
     communities.''.

     SEC. 28. STUDY OF NUTRITION PROJECTS.

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

     SEC. 29. IMPROVING INDOOR AIR QUALITY IN BUILDINGS WHERE 
                   OLDER INDIVIDUALS CONGREGATE.

       Section 361 of the Older Americans Act of 1965 (42 U.S.C. 
     3030m) is amended by adding at the end the following:
       ``(c) The Assistant Secretary shall work in consultation 
     with qualified experts to provide information on methods of 
     improving indoor air quality in buildings where older 
     individuals congregate.''.

     SEC. 30. CAREGIVER SUPPORT PROGRAM DEFINITIONS.

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

     SEC. 31. CAREGIVER SUPPORT PROGRAM.

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

     SEC. 32. ACTIVITIES AND PROGRAMS OF NATIONAL SIGNIFICANCE.

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

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

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

     SEC. 33. GRANT PROGRAMS.

       Section 411 of the Older Americans Act of 1965 (42 U.S.C. 
     3032) is amended--
       (1) in subsection (a)--
       (A) in paragraph (8), by striking ``and'' at the end;
       (B) by redesignating paragraph (9) as paragraph (11); and
       (C) by inserting after paragraph (8) the following:
       ``(9) planning activities to prepare communities for the 
     aging of the population, which activities may include--
       ``(A) efforts to assess the aging population;
       ``(B) activities to coordinate the activities of State and 
     local agencies in order to meet the needs of older 
     individuals; and
       ``(C) training and technical assistance to support States, 
     area agencies on aging, and tribal organizations receiving 
     grants under part A of title VI, in engaging in community 
     planning activities; and
       ``(10) the development, implementation, and assessment of 
     technology-based service

[[Page S6569]]

     models and best practices, to support the use of health 
     monitoring and assessment technologies, communication 
     devices, assistive technologies, and other technologies that 
     may remotely connect family and professional caregivers to 
     frail older individuals residing in home and community-based 
     settings or rural areas.''.

     SEC. 34. CAREER PREPARATION FOR THE FIELD OF AGING.

       Section 412(a) of the Older Americans Act of 1965 (42 
     U.S.C. 3032a(a)) is amended to read as follows:
       ``(a) Grants.--The Assistant Secretary shall make grants to 
     institutions of higher education, including historically 
     Black colleges or universities, Hispanic-serving 
     institutions, Hispanic Centers of Excellence in Applied 
     Gerontology, and other educational institutions that serve 
     the needs of minority students, to provide education and 
     training that prepare students for careers in the field of 
     aging.''.

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

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

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

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

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

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

     SEC. 37. COMMUNITY PLANNING.

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

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

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

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

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

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

       ``(a) Grants and Contracts.--The Assistant Secretary shall 
     award grants and enter into contracts with eligible 
     organizations to--
       ``(1) conduct productivity and cost-benefit research to 
     determine the effectiveness of engaging older individuals in 
     paid and unpaid positions with public and nonprofit 
     organizations;
       ``(2) develop a national agenda and blueprint for creating 
     paid and unpaid positions for older individuals with public 
     and nonprofit organizations to increase the capacity of the 
     organizations to provide needed services to communities;
       ``(3) carry out demonstration and support projects to 
     provide older individuals with multigenerational activities, 
     and civic engagement activities, designed to meet critical 
     community needs; and
       ``(4) carry out demonstration projects to coordinate 
     multigenerational activities and civic engagement activities, 
     and facilitate development of and participation in 
     multigenerational activities.
       ``(b) Use of Funds.--An eligible organization shall use 
     funds made available under a grant awarded, or a contract 
     entered into, under subsection (a)--
       ``(1)(A) to conduct the research described in subsection 
     (a)(1);
       ``(B) to develop the national agenda and blueprint 
     described in subsection (a)(2); or
       ``(C) to carry out a demonstration or support project 
     described in subsection (a)(3);
       ``(D) to carry out a demonstration project described in 
     subsection (a)(4); and
       ``(2) to evaluate the project involved in accordance with 
     subsection (f).
       ``(c) Preference.--In awarding grants and entering into 
     contracts under subsection (a) to carry out a demonstration 
     or support project described in subsection (a)(3), the 
     Assistant Secretary shall give preference to--
       ``(1) eligible organizations with a demonstrated record of 
     carrying out multigenerational activities or civic engagement 
     activities;
       ``(2) eligible organizations proposing multigenerational 
     activity service projects that will serve older individuals 
     and communities with the greatest need (with particular 
     attention to low-income minority older individuals, older 
     individuals with limited English proficiency, older 
     individuals residing in rural areas, and low-income minority 
     communities);
       ``(3) eligible organizations proposing civic engagement 
     activity service projects that will serve communities with 
     the greatest need; and
       ``(4) eligible organizations with the capacity to develop 
     meaningful roles and assignments that use the time, skills, 
     and experience of older individuals to serve public and 
     nonprofit organizations.
       ``(d) Application.--To be eligible to receive a grant or a 
     contract under subsection (a), an organization shall submit 
     an application to the Assistant Secretary at such time, in 
     such manner, and accompanied by such information as the 
     Assistant Secretary may reasonably require.
       ``(e) Eligible Organizations.--Organizations eligible to 
     receive a grant or enter into a contract under subsection 
     (a)--
       ``(1) to carry out activities described in subsection 
     (a)(1) shall be research or academic organizations with the 
     capacity to conduct productivity and cost-benefit research 
     described in subsection (a)(1);
       ``(2) to carry out activities described in subsection 
     (a)(2) shall be organizations with the capacity to develop 
     the national agenda and blueprint described in subsection 
     (a)(2);
       ``(3) to carry out activities described in subsection 
     (a)(3) shall be organizations that provide paid or unpaid 
     positions for older individuals to serve in multigenerational 
     activities, or civic engagement activities, designed to meet 
     critical community needs and use the full range of time, 
     skills, and experience of older individuals; and
       ``(4) to carry out activities described in subsection 
     (a)(4) shall be organizations with the capacity to facilitate 
     and coordinate activities as described in subsection (a)(4), 
     through the use of multigenerational coordinators.
       ``(f) Local Evaluation and Report.--
       ``(1) Evaluation.--Each organization receiving a grant or a 
     contract under subsection (a) to carry out a demonstration or 
     support project under subsection (a)(3) shall evaluate the 
     multigenerational activities or civic engagement activities 
     assisted under the project to determine the effectiveness of 
     the activities involved, the impact of such activities on the 
     community being served and the organization providing the 
     activities, and the impact of such activities on older 
     individuals involved in such project.
       ``(2) Report.--The organization shall submit a report to 
     the Assistant Secretary containing the evaluation not later 
     than 6 months after the expiration of the period for which 
     the grant or contract is in effect.
       ``(g) Report to Congress.--Not later than 6 months after 
     the Assistant Secretary receives the reports described in 
     subsection (f)(2), the Assistant Secretary shall prepare and 
     submit to the Speaker of the House of Representatives and the 
     President pro tempore of the Senate a report that assesses 
     the evaluations and includes, at a minimum--
       ``(1) the names or descriptive titles of the demonstration, 
     support, and research projects funded under subsection (a);
       ``(2) a description of the nature and operation of the 
     projects;
       ``(3) the names and addresses of organizations that 
     conducted the projects;
       ``(4) in the case of demonstration and support projects 
     carried out under subsection

[[Page S6570]]

     (a)(3), a description of the methods and success of the 
     projects in recruiting older individuals as employees and 
     volunteers to participate in the projects;
       ``(5) in the case of demonstration and support projects 
     carried out under subsection (a)(3), a description of the 
     success of the projects in retaining older individuals 
     involved in the projects as employees and as volunteers;
       ``(6) in the case of demonstration and support projects 
     carried out under subsection (a)(3), the rate of turnover of 
     older individual employees and volunteers in the projects;
       ``(7) a strategy for disseminating the findings resulting 
     from the projects described in paragraph (1); and
       ``(8) any policy change recommendations relating to the 
     projects.
       ``(h) Definitions.--As used in this section:
       ``(1) Civic engagement activity.--The term `civic 
     engagement activity' includes an opportunity that uses the 
     time, skills, and experience of older individuals, in paid or 
     unpaid positions with a public or nonprofit organization, to 
     help address the unmet human, educational, health care, 
     environmental, and public safety needs and nurture and 
     sustain active participation in community affairs.
       ``(2) Multigenerational activity.--The term 
     `multigenerational activity' includes an opportunity that 
     uses the time, skills, and experience of older individuals, 
     in paid or unpaid positions with a public or nonprofit 
     organization, to serve as a mentor or adviser in a child care 
     program, a youth day care program, an educational assistance 
     program, an at-risk youth intervention program, a juvenile 
     delinquency treatment program, a before- or after-school 
     program, or a family support program.
       ``(3) Multigenerational coordinator.--The term 
     `multigenerational coordinator' means a person who--
       ``(A) builds the capacity of public and nonprofit 
     organizations to develop meaningful roles and assignments, 
     that use the time, skill, and experience of older individuals 
     to serve those organizations; and
       ``(B) nurtures productive, sustainable working 
     relationships between--
       ``(i) individuals from the generations with older 
     individuals; and
       ``(ii) individuals in younger generations.''.

     SEC. 39. NATIVE AMERICAN PROGRAMS.

       Section 418(a)(2)(B)(i) of the Older Americans Act of 1965 
     (42 U.S.C. 3032g)(a)(2)(B)(i)) is amended by inserting 
     ``(including mental health)'' after ``health''.

     SEC. 40. MULTIDISCIPLINARY CENTERS AND MULTIDISCIPLINARY 
                   SYSTEMS.

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

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

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

     SEC. 41. COMMUNITY INNOVATIONS FOR AGING IN PLACE.

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

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

       ``(a) Definitions.--In this section:
       ``(1) Eligible entity.--The term `eligible entity'--
       ``(A) means a nonprofit health or social service 
     organization, a community-based nonprofit organization, an 
     area agency on aging or other local government agency, a 
     tribal organization, or another entity that--
       ``(i) the Assistant Secretary determines to be appropriate 
     to carry out a project under this part; and
       ``(ii) demonstrates a record of, and experience in, 
     providing or administering group and individual health and 
     social services for older individuals; and
       ``(B) does not include an entity providing housing under 
     the congregate housing services program carried out under 
     section 802 of the Cranston-Gonzalez National Affordable 
     Housing Act (42 U.S.C. 8011) or the multifamily service 
     coordinator program carried out under section 202(g) of the 
     Housing Act of 1959 (12 U.S.C. 1701q(g)).
       ``(2) Naturally occurring retirement community.--The term 
     `Naturally Occurring Retirement Community' means a 
     residential building, a housing complex, an area (including a 
     rural area) of single family residences, or a neighborhood 
     composed of age-integrated housing--
       ``(A) where--
       ``(i) 40 percent of the heads of households are older 
     individuals; or
       ``(ii) a critical mass of older individuals exists, based 
     on local factors which, taken in total, allow an organization 
     to achieve efficiencies in the provision of health and social 
     services to older individuals living in the community; and
       ``(B) that is not an institutional care or assisted living 
     setting.
       ``(b) Grants.--
       ``(1) In general.--The Assistant Secretary shall make 
     grants to eligible entities to enable the entities to pay for 
     developing or carrying out model aging in place projects. The 
     projects shall permit aging in place for older individuals, 
     including such individuals who reside in Naturally Occurring 
     Retirement Communities, which help to sustain the 
     independence of older individuals in communities where the 
     individuals have established personal, family, and 
     professional supportive networks. The entities shall provide 
     comprehensive and coordinated health and social services 
     through the projects.
       ``(2) Grant periods.--The Assistant Secretary shall make 
     the grants for periods of 3 years.
       ``(c) Applications.--
       ``(1) In general.--To be eligible to receive a grant under 
     subsection (b) for a project, an entity shall submit an 
     application to the Assistant Secretary at such time, in such 
     manner, and containing such information as the Assistant 
     Secretary may require.

[[Page S6571]]

       ``(2) Contents.--The application shall include--
       ``(A) a detailed description of the entity's experience in 
     providing services to older individuals in age-integrated 
     settings;
       ``(B) a definition of the contiguous service area and a 
     description of the project boundaries in which the older 
     individuals reside or carry out activities to sustain their 
     well-being;
       ``(C) a description of how the entity will cooperate and 
     coordinate planning and services, with agencies and 
     organizations that provide publicly supported services for 
     older individuals within the project boundaries, including 
     the State agency and area agencies on aging with planning and 
     service areas within the project boundaries;
       ``(D) an assurance that the entity will seek to establish 
     cooperative relationships with interested local entities, 
     including private agencies and businesses that provide health 
     and social services, housing entities, community development 
     organizations, philanthropic organizations, foundations, and 
     other non-Federal entities;
       ``(E) a description of the entity's protocol for referral 
     of residents who may require long-term care services, 
     including coordination with local information and referral 
     agencies and Aging and Disability Resource Centers who serve 
     as single points of entry to public services;
       ``(F) a description of how the entity will offer 
     opportunities for older individuals to be involved in the 
     governance, oversight, and operation of the project;
       ``(G) an assurance that the entity will submit to the 
     Assistant Secretary such evaluations and reports as the 
     Assistant Secretary may require; and
       ``(H) a plan for long-term sustainability of the project.
       ``(d) Use of Funds.--
       ``(1) In general.--An eligible entity that receives a grant 
     under subsection (b) shall use the funds made available 
     through the grant to provide and coordinate, through aging in 
     place projects described in subsection (b), services that 
     include a comprehensive and coordinated array of community-
     based health and social services, which may include mental 
     health services, for eligible older individuals.
       ``(2) Services.--The services described in paragraph (1) 
     shall include--
       ``(A) providing--
       ``(i) case management, case assistance, and social work 
     services;
       ``(ii) health care management and health care assistance, 
     including disease prevention and health promotion services;
       ``(iii) education, socialization, and recreational 
     activities; and
       ``(iv) volunteer opportunities for project participants; 
     and
       ``(B) coordinating the services provided under title III 
     for eligible older individuals served by the project.
       ``(3) Preference.--In carrying out an aging in place 
     project, an eligible entity shall, to the extent practicable, 
     serve communities of low-income individuals and operate or 
     locate projects and services in or in close proximity to 
     locations where large concentrations of older individuals 
     have aged in place and resided, such as Naturally Occurring 
     Retirement Communities.
       ``(4) Supplement not supplant.--Funds made available to an 
     eligible entity under this section shall be used to 
     supplement, not supplant, any Federal, State, or other funds 
     otherwise available to the entity to provide health and 
     social services to eligible older individuals.
       ``(e) Competitive Grants for Technical Assistance.--
       ``(1) Grants.--The Assistant Secretary shall (or shall make 
     a grant, on a competitive basis, to an eligible nonprofit 
     organization, to enable the organization to)--
       ``(A) provide technical assistance to recipients of grants 
     under subsection (b); and
       ``(B) carry out other duties, as determined by the 
     Assistant Secretary.
       ``(2) Eligible organization.--To be eligible to receive a 
     grant under this subsection, an organization shall be a 
     nonprofit organization (including a partnership of nonprofit 
     organizations), that--
       ``(A) has experience and expertise in providing technical 
     assistance to a range of entities serving older individuals 
     and experience evaluating and reporting on programs; and
       ``(B) has demonstrated knowledge of and expertise in 
     community-based health and social services.
       ``(3) Application.--To be eligible to receive a grant under 
     this subsection, an organization (including a partnership of 
     nonprofit organizations) shall submit an application to the 
     Assistant Secretary at such time, in such manner, and 
     containing such information as the Assistant Secretary may 
     require, including an assurance that the organization will 
     submit to the Assistant Secretary such evaluations and 
     reports as the Assistant Secretary may require.
       ``(f) Report.--The Assistant Secretary shall annually 
     prepare and submit a report to Congress that shall include--
       ``(1) the findings resulting from the evaluations of the 
     model projects conducted under this section;
       ``(2) a description of recommended best practices regarding 
     carrying out health and social service projects for older 
     individuals aging in place; and
       ``(3) recommendations for legislative or administrative 
     action, as the Assistant Secretary determines appropriate.''.

     SEC. 42. CHOICES FOR INDEPENDENCE DEMONSTRATION PROJECTS.

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

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

       ``(a) Definitions.--In this section:
       ``(1) Consumer.--The term `consumer' means an older 
     individual, a family member of such individual, and any other 
     person seeking information or assistance with respect to 
     long-term care.
       ``(2) High-risk individual.--The term `high-risk 
     individual' means an older individual who--
       ``(A) has a functional impairment affecting the 
     individual's activities of daily living;
       ``(B) is ineligible for the Medicaid program under title 
     XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and
       ``(C) meets such income and functional status criteria as 
     are determined to be appropriate by the State involved and 
     approved by the Assistant Secretary.
       ``(3) Qualified expenditures.--The term `qualified 
     expenditures' means reported expenditures of a State under 
     this section that have been reviewed and approved by the 
     Assistant Secretary.
       ``(4) Service coordination.--The term `service 
     coordination' means a coordinated approach taken on behalf of 
     high-risk older individuals to facilitate the development and 
     implementation of a long-term care plan and the choice and 
     independence of the individuals in securing long-term care.
       ``(b) Authority.--The Assistant Secretary shall make grants 
     on a competitive basis, in accordance with this section, to 
     States to enable the States to pay for the Federal share of 
     the cost of modifying their systems of long-term care in 
     order to promote and facilitate--
       ``(1) the choice and control of older individuals and their 
     families in securing long-term care;
       ``(2) the coordination and cost-effectiveness of State 
     systems of long-term care;
       ``(3) the provision of long-term care in home and 
     community-based settings; and
       ``(4) the ability of individuals receiving long-term care 
     to remain as independent and self-sufficient as possible.
       ``(c) Applications by States.--For a State to be eligible 
     to receive a grant under this section, the Governor of such 
     State shall submit an application to the Assistant Secretary, 
     at such time, in such manner, and containing such information 
     as the Assistant Secretary may specify, containing a plan for 
     implementation of the component strategies described in 
     subsection (d) and such other information and assurances as 
     the Secretary determines to be appropriate.
       ``(d) Use of Funds by States.--
       ``(1) Component strategies.--A State that receives funds 
     through a grant made under subsection (b) shall use the funds 
     to carry out a demonstration project under this section 
     (directly or by grant or contract) by integrating into the 
     State's system of long-term care the component strategies 
     described in paragraphs (2) through (5).
       ``(2) Public education.--In carrying out the demonstration 
     project, the State shall conduct activities that shall 
     include media campaigns, targeted mailings, and related 
     activities, to help ensure that consumers are aware of--
       ``(A) the need to plan in advance for long-term care;
       ``(B) available public and private long-term care options, 
     including private long-term care insurance; and
       ``(C) sources of information and resources related to long-
     term care, including the resource centers described in 
     paragraph (3).
       ``(3) Aging and disability resource centers.--
       ``(A) In general.--The State shall provide for community-
     level Aging and Disability Resource Centers, which, 
     consistent with section 102(47) and subsection (f), shall 
     provide--
       ``(i) comprehensive information on available public and 
     private long-term care programs, options, and resources;
       ``(ii) personal counseling and service coordination to 
     assist consumers in assessing their existing or anticipated 
     long-term care needs and circumstances, and developing and 
     implementing a plan for long-term care designed to meet their 
     specific needs and circumstances;
       ``(iii) a convenient point of entry to the range of 
     publicly-supported long-term care programs for which an 
     individual may be eligible, including the Medicaid program 
     under title XIX of the Social Security Act (42 U.S.C. 1396 et 
     seq.), and to such other public benefit programs as the State 
     determines to be appropriate;
       ``(iv) a single process for consumer intake, assessment, 
     and application for benefits under the programs described in 
     subparagraph (C), including, where appropriate and feasible, 
     facilitating the determination of an individual's eligibility 
     (including facilitating that determination in compliance with 
     the requirements of title XIX of the Social Security Act) 
     under such programs by collaborating with the appropriate 
     programmatic office; and
       ``(v) the ability--

       ``(I) to respond immediately to a request for assistance 
     from an individual or a family member of the individual, in 
     the event of a

[[Page S6572]]

     crisis situation that could result in placement of such 
     individual in an institutional care setting; and
       ``(II) to provide (or coordinate the provision of), such 
     available short-term assistance as would be necessary and 
     appropriate to temporarily preclude the need for such 
     institutional placement, until a plan for home and community-
     based long-term care can be developed and implemented.

       ``(B) Training.--In providing for the Centers, the State 
     shall ensure that the staff of the Centers is appropriately 
     trained to understand the interactions between private long-
     term care insurance (especially insurance through long-term 
     care partnership policies) and eligibility for benefits under 
     the Medicaid program under title XIX of the Social Security 
     Act (42 U.S.C. 1396 et seq.).
       ``(4) Healthy lifestyle choices.--The State shall, in 
     accordance with standards established by the Assistant 
     Secretary, provide for low-cost, community-level, evidence-
     based prevention programs and related tools to assist older 
     individuals and their family caregivers in learning about and 
     making behavioral changes intended to reduce the risk of 
     injury, disease, and disability among older individuals.
       ``(5) Community living incentives.--
       ``(A) In general.--The State shall provide funding toward 
     and otherwise assist with the provision of home and 
     community-based long-term care to individuals at high risk 
     for placement in institutional care (referred to in this 
     paragraph as `high-risk individuals'). The State shall ensure 
     that individuals at greatest risk for becoming eligible for 
     benefits under the Medicaid program receive priority for the 
     home and community-based long-term care.
       ``(B) Long-term care plan.--The State shall provide for 
     assessments of the needs and preferences of high-risk 
     individuals with respect to long-term care, and based on such 
     assessments, shall develop with such individuals and their 
     family members, caregivers, or legal representatives a plan 
     for long-term care for such individuals, specifying the types 
     of support, providers, budget, and, if the State elects, 
     cost-sharing contributions involved.
       ``(C) Allocation of funds based on individual budgets.--The 
     State shall ensure that the funding described in subparagraph 
     (A) will be allocated among, and disbursed for, the budgets 
     of high-risk individuals under long-term care plans developed 
     for such individuals.
       ``(D) Option to provide consumer-directed care.--The State 
     shall provide high-risk individuals with the option to 
     receive home and community-based long-term care under this 
     paragraph in a manner that permits such individuals to direct 
     and control, in conjunction with a service coordinator, the 
     selection, planning, budgeting, and purchasing of such care 
     (including the amount, duration, scope, providers, and 
     location of such care), to the extent determined appropriate 
     and feasible under the long-term care plan developed under 
     subparagraph (B). The service coordinator shall assist the 
     high-risk individuals in purchasing a range of long-term care 
     services or supplies, not otherwise available or eligible for 
     payment through an entity carrying out a Federal or State 
     program or a similar third party, from a qualified provider 
     that are delivered in home and community-based settings and 
     in a manner that best meets the individuals' needs and 
     respects the individuals' preferences to remain in the least 
     restrictive setting possible.
       ``(e) Federal Share.--The Federal share of the cost of 
     modifying systems of long-term systems care as described in 
     subsection (b) shall be not more than 75 percent of such cost 
     (calculated on an annual basis as the State's qualified 
     expenditures for such modifications for such year).
       ``(f) Special Provisions Relating to Aging and Disability 
     Resource Centers.--A State shall ensure that any Aging and 
     Disability Resource Center shall--
       ``(1) fully coordinate its activities with any health 
     insurance information, counseling, and assistance (receiving 
     funding under section 4360 of the Omnibus Budget 
     Reconciliation Act of 1990 (42 U.S.C. 1395b-4)) in the State;
       ``(2) be subject to such controls as the Assistant 
     Secretary determines to be appropriate to ensure there is no 
     conflict of interest with respect to any referrals, for 
     information or otherwise, made by the Center for individuals 
     receiving services through the Center; and
       ``(3) provide no long-term care services or supplies, with 
     the exception of case management services provided through 
     area agencies on aging as described in section 306(a)(8).
       ``(g) Special Provisions Relating to Option to Provide 
     Consumer-Directed Care.--Payments made for a high-risk 
     individual under subsection (d)(5)(D) shall not be included 
     in the gross income of the high-risk individual for purposes 
     of the Internal Revenue Code of 1986 or be treated as income, 
     be treated as assets or benefits, or otherwise be taken into 
     account, for purposes of determining the individual's 
     eligibility for, the amount of benefits for the individual 
     under, or the amount of cost-sharing required of the 
     individual by, any other Federal or State program, other than 
     the program carried out under this section.
       ``(h) Technical Assistance to States.--The Assistant 
     Secretary, directly or by grant or contract, shall provide 
     for technical assistance to and oversight of States carrying 
     out demonstration projects under this section, for purposes 
     of administration, quality assurance, and quality 
     improvement.
       ``(i) Evaluation and Report.--The Assistant Secretary, 
     directly or by grant or contract, shall provide for an 
     evaluation of the demonstration projects carried out under 
     this section. The Assistant Secretary shall submit to the 
     President a report containing the findings resulting from 
     such evaluation not later than 6 months after the termination 
     of the demonstration projects.''.

     SEC. 43. RESPONSIBILITIES OF ASSISTANT SECRETARY.

       Section 432(c)(2)(B) of the Older Americans Act of 1965 (42 
     U.S.C. 3033a(c)(2)(B)) is amended by inserting before the 
     period the following: ``, including preparing an analysis of 
     such services, projects, and programs, and of how the 
     evaluation relates to improvements in such services, 
     projects, and programs and in the strategic plan of the 
     Administration''.

     SEC. 44. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT PROGRAM.

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

     SEC. 45. PERFORMANCE.

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

[[Page S6573]]

     soliciting proposals for grants, until the day that is the 
     later of--
       ``(i) the date on which the Secretary implements all 
     required indicators described in subsection (b); and
       ``(ii) January 1, 2010.''; and
       (2) by adding at the end the following:
       ``(e) Effect of Exemption.--In implementing a performance 
     measure under this section, the Secretary shall not reduce a 
     score on the performance measure of--
       ``(1) a grantee that receives a waiver under section 
     502(g)(3) on the basis that the grantee is extending the 
     period of participation for project participants under that 
     section; and
       ``(2) a grantee on the basis that the grantee is extending 
     the period of participation for project participants under 
     section 502(g)(2).''.

     SEC. 46. COMPETITIVE REQUIREMENTS.

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

     SEC. 47. DEFINITIONS.

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

     SEC. 48. CLARIFICATION OF MAINTENANCE REQUIREMENT.

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

     SEC. 49. NATIVE AMERICANS CAREGIVER SUPPORT PROGRAM.

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

     SEC. 50. VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES.

       Section 702 of the Older Americans Act of 1965 (42 U.S.C. 
     3058a) is amended by striking ``2001'' each place it appears 
     and inserting ``2007''.

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

       Section 721 of the Older Americans Act of 1965 (42 U.S.C. 
     3058i) is amended--
       (1) in subsection (b)--
       (A) by redesignating paragraphs (2) through (8) as 
     paragraphs (3) through (9), respectively; and
       (B) by inserting after paragraph (1) the following new 
     paragraph:
       ``(2) providing for public education and outreach to 
     promote financial literacy and prevent identity theft and 
     financial exploitation of older individuals;''; and
       (2) in subsection (e)(2)--
       (A) by striking ``subsection (b)(8)(B)(i)'' and inserting 
     ``subsection (b)(9)(B)(i)''; and
       (B) by striking ``subsection (b)(8)(B)(ii)'' and inserting 
     ``subsection (b)(9)(B)(ii)''.

     SEC. 52. NATIVE AMERICAN ORGANIZATION PROVISIONS.

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

     SEC. 53. ELDER JUSTICE PROGRAMS.

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

                  ``Subtitle B--Elder Justice Programs

     ``SEC. 751. DEFINITIONS.

       ``In this subtitle:
       ``(1) Caregiver.--The term `caregiver' means an individual 
     who has the responsibility for the care of an elder, either 
     voluntarily, by contract, by receipt of payment for care, or 
     as a result of the operation of law and means a family member 
     or other individual who provides (on behalf of such 
     individual or of a public or private agency, organization, or 
     institution) compensated or uncompensated care to an elder.
       ``(2) Direct care.--The term `direct care' means care by an 
     employee or contractor who provides assistance or long-term 
     care services to a recipient.
       ``(3) Elder.--The term `elder' means an older individual, 
     as defined in section 102.
       ``(4) Elder justice.--The term `elder justice' means--
       ``(A) efforts to prevent, detect, treat, intervene in, and 
     respond to elder abuse, neglect,

[[Page S6574]]

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

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

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

[[Page S6575]]

       ``(j) Eligible Partnerships.--In subsection (c)(8), the 
     term `eligible partnership' means a multidisciplinary 
     community partnership consisting of eligible entities or 
     appropriate individuals, such as a partnership consisting of 
     representatives in a community of nursing facility providers, 
     State legal assistance developers, advocates for residents of 
     long-term care facilities, State Long-Term Care Ombudsmen, 
     surveyors, the State agency with responsibility for adult 
     protective services, the State agency with responsibility for 
     licensing long-term care facilities, law enforcement 
     agencies, courts, family councils, residents, certified nurse 
     aides, registered nurses, physicians, and other eligible 
     entities and appropriate individuals.
       ``(k) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section such 
     sums as may be necessary for each of fiscal years 2005 
     through 2008.

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

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

     SEC. 54. RULE OF CONSTRUCTION.

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

     ``SEC. 765. RULE OF CONSTRUCTION.

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

  Mr. KENNEDY. Mr. President, the Older Americans Act has been a 
lifeline for senior citizens across the country for 40 years, and all 
of us want it to continue to fulfill its important role in the years 
ahead.
  Like Social Security, Medicare and Medicaid, the Older Americans Act 
is part of our commitment to care for the nation's seniors in their 
golden years.
  This year, the first of the members of the baby boom generation will 
be eligible for the act's services. One in nine Americans are over age 
65 today. By the year 2030, the number will be one in five.
  It is clear we need to get our priorities right in this 
reauthorization. That means starting now to put the infrastructure in 
place to provide services to baby boomers who retire. This bill takes 
some of the necessary steps. It requires State and local agencies to 
acknowledge the changing demographics and to plan ahead. I hope 
Congress will continue to build on these efforts in the coming years 
and provide increased funds for the important programs in this act.
  Our bill also encourages civic activities by seniors. Numerous 
examples exist of successful volunteer programs involving seniors, such 
as Senior Corps, Experience Corps, and Family Friends, and we need to 
build on these successes.
  The members of the new generation of older Americans obviously want 
to be engaged in their communities after they retire, and it is 
essential to draw on their experience and knowledge in constructive 
ways.
  The bill is also intended to encourage good nutrition, healthy living 
and disease prevention among seniors. The Meals on Wheels program, 
enacted in the 1970s, is one of its greatest successes, and 
Massachusetts has been in the forefront of the effort to provide 
community-based nutrition services to the elderly. Our State program 
coordinates 28 nutrition projects throughout the State to deal with 
poor nutrition and social isolation of seniors. Our bill will expand 
the ability of programs such as Meals on Wheels to reach all older 
individuals who need better nutrition.
  According to the Census Bureau, 6.7 million persons aged 55 or older 
will be living in poverty by 2008, a 22 percent increase since 2000. By 
2015, the number will increase to 9 million if the current trend 
continues.

[[Page S6576]]

  The Older Americans Act also provides essential opportunities for 
employment of older Americans through the Senior Community Service 
Employment Program, which offers job training for seniors and involves 
them in the communities which they love, and which also love them. Last 
year, the program supported 61,000 jobs and served 92,000 people.
  Congress created this program to provide older adults with community 
service opportunities. We recognized that senior citizens are 
especially valuable assets to the communities in which they live. 
Through community service, older adults are also provided with the job 
training they need to become self-sufficient in the workforce.
  Unfortunately, in recent years the focus on community service has 
blurred, and many of us are concerned about the administration's lack 
of interest in maintaining this important aspect of the program.
  Older Americans today provide 45 million hours of valuable service to 
their communities, particularly in senior centers, public libraries, 
and nutrition programs.
  Overall, our bill maintains the emphasis on community service and 
enables the program to continue to serve older Americans efficiently 
and well. As this bill moves forward, it is essential that community 
service remain paramount and that any attempts to weaken this program 
be defeated.
  This is a good bipartisan bill and I support its passage.
  Mr. DeWINE. Mr. President, I rise today with my colleagues on the 
Health, Education, Labor, and Pensions Committee--Chairman Enzi, 
Ranking Member Kennedy, and Senator Mikulski--as we join in the 
introduction of the Older Americans Act Amendments of 2006. Senator 
Mikulski and I worked to draft and pass the Older Americans Act 
Amendments of 2000, and I am proud to have worked with her again to 
improve and update these important programs.
  I also thank Senators Enzi and Kennedy for making this 
reauthorization a priority for the HELP Committee. Over the months we 
have negotiated this bipartisan bill, I have greatly appreciated their 
thoughtful and steady work to get the Older Americans Act to this 
point. They understand well, as I do, that the quick passage of this 
reauthorization is the No. 1 recommendation that came out of the White 
House Conference on Aging. As I have mentioned in the hearings I have 
chaired of the Subcommittee on Retirement Security and Aging, the 
passage of the Older Americans Act reauthorization is the top priority 
for the subcommittee. Today's bill introduction is an important step 
forward in that process.
  As you know, older Americans are a vital and rapidly growing segment 
of our population. Over 36 million people living in the United States 
are over the age of 65, accounting for about 12 percent of the 
population. The Census Bureau projects that 45 years from now, people 
65 and older will number nearly 90 million in the United States and 
comprise 21 percent of the population.
  The Older Americans Act is an important service provider for these 
Americans. I strongly believe this reauthorization updates and 
strengthens the act in many ways. Changes to this bill include plans 
and means to prepare for changes to the aging demographics. This bill 
creates a Federal interagency council responsible for ensuring 
appropriate planning for baby boomer-related needs and population 
shifts across agencies. Additionally, it will provide for grants and 
technical assistance for local aging service providers to plan for the 
baby boomer population.
  Our bill will also increase the authorization levels of the National 
Family Caregiver Support Program by 25 percent over current 
appropriated levels over the next 5 years. This program is also 
expanded to allow for those caring for loved ones with Alzheimer's--
between the ages of 50 and 60--to become eligible for support services. 
Furthermore, it will clarify that this program will serve elderly 
caregivers who are caring for their adult children with developmental 
disabilities. Lastly, it clarifies that grandparents caring for adopted 
grandchildren are covered under this program, and it lowers the age 
threshold for grandparents to 55 years old. These are important changes 
to this program and will affect the quality of life for so many 
individuals who are struggling with the pressures of caring for loved 
ones.
  This bill also encourages the voluntary contributions related to 
title III services from those individuals with a self-declared income 
at or above 200 percent of the poverty level and based on actual cost 
of service. This will help programs such as Meals-on-Wheels to expand 
their services and enable them to more effectively take contributions 
from those older Americans willing to pay for services. As the number 
of seniors increases, we need to modify our programs to ensure their 
economic sustainability.
  Our amendments will also allow the Department of Health and Human 
Services to award grants related to the improvement of assistive 
technology for older Americans. The goal of this provision is to enable 
older Americans to have the necessary technology to monitor their 
health and help them remain in their homes as they age. We know most 
Americans want to remain independent and in their homes as they age, 
and these grants will help them do just that.
  This bill also creates a new grant program which provides grants to 
create innovative models that allow individuals to remain in community-
based settings. The need for this grant program was discussed at length 
in a hearing I held on models for aging in place--specifically 
naturally occurring retirement communities. As I stated before, 
Americans want to stay in their communities as they age, and this bill 
will help them do just that.
  Further, this bill creates a new grant program, based on 
recommendations in the President's fiscal year '07 budget, to provide 
grants to States to enable consumer-driven choices with respect to 
long-term care. Grants can be used to encourage the planning for long-
term care for older Americans. It will also facilitate access to long-
term care choices and opportunities and advice on choices for care.
  Our bill also updates the title V Senior Community Service Employment 
Program, SCSEP, to allow for a mandatory 4-year competitive grant 
cycle. It provides a sense of the Senate supporting the community 
service aspect of the program. Additionally, it limits the time on the 
program for participants to 3 years, with a 20-percent exemption for 
certain hard-to-serve populations.
  This provision balances the need for limiting the time a person 
spends in this employment program with the recognition that certain 
populations have special needs.
  Of great importance to me, this bill also amends the act to focus 
attention on the mental health needs of older Americans. These changes 
will establish grants for mental health screening of older Americans 
and increased awareness of its effects on the elderly population. Too 
often the mental health needs of older Americans are overlooked; 
however, they can be as serious and life-threatening as any other 
illness. The mental health needs of our seniors must be taken more 
seriously and dealt with more aggressively. I believe this provision 
significantly moves us forward in this struggle.
  Finally, this bill includes the language of the Elder Justice bill 
reported unanimously from the HELP Committee in the 108th Congress to 
create an office of elder abuse prevention in the administration on 
Aging; create grants to the States and tribes to prevent elder abuse, 
neglect, and exploitation; and collect data from States and other 
entities on elder abuse. These are important provisions to improve the 
safety and protect the well-being of our parents, grandparents, and 
other elderly loved ones.
  Again, I thank Senator Enzi, Senator Kennedy, and Senator Mikulski 
for their dedication to the needs of older Americans. I look forward to 
our continuing work together on this bill as we work to bring it to the 
Senate floor and the President's desk.
  Ms. MIKULSKI. Mr. President, I rise today to support older Americans. 
Seniors today are living longer, healthier lives. We must do what we 
can to help them be as independent and active as possible.
  We have worked together on both sides of the aisle and with aging 
organizations, including the organizations that make up the Leadership 
Council on Aging, to introduce S.3570, the Older

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Americans Act Amendments of 2006, which I believe is a strong 
bipartisan bill. I would like to thank Chairman Enzi, Ranking Member 
Kennedy, and Senator DeWine for their work. I have worked closely with 
Senator DeWine in the past, and this is the second Older Americans Act 
that we have reauthorized together. This bill honors and maintains the 
commitment we made to the nation's seniors through the Older Americans 
Act.
  The Older Americans Act is one of our most important 
responsibilities. The 1,200 delegates to the December 2005 White House 
Conference on Aging voted reauthorization of the act this year as their 
top priority. I am pleased that we were able to produce this bipartisan 
bill, but we still have work to do before the Older Americans Act is 
reauthorized.
  We need to continue to work on the Community Service Employment 
Program for Older Americans, in title V. Much of our bill is quite 
similar to what the House passed last week, but title V is not. Our 
bill has maintained the strong community service employment aspect of 
the program, which has been an integral component since the beginning. 
The House bill has elements that will minimize and chip away at this 
community service employment element. The Community Service Employment 
Program for Older Americans helps seniors obtain employment at Meals on 
Wheels programs, senior centers, local area agencies on aging, public 
libraries, and many other public organizations that rely heavily on 
these seniors. Through community service employment, community 
organizations receive valuable support while participants receive 
valuable skill training. I am strongly opposed to losing the community 
service aspect of this program, and I am pleased our bill strengthens 
it. I expect that we will continue to protect this as we move to work 
with the House.
  There are several principles that I believe must guide 
reauthorization. First, we must continue and improve the core services 
of this act to meet the vital needs of America's seniors. Secondly, we 
must modernize the act to meet the changing needs of America's senior 
population, including the growing number of seniors over 85, the 
impending senior boom, and the growing number of seniors in minority 
groups. Next, we must look for ways to help seniors live more 
independent and active lives. Finally, we must give national, State, 
and local programs the resources they need to carry out these vital 
responsibilities.
  I believe the 2006 reauthorization bill strengthens current Older 
Americans Act programs and offers innovative ideas that will address 
the needs of our country's aging population. The reauthorization bill 
strengthens information and referral services that are the backbone of 
OAA programs, providing seniors and their family members information 
about supportive services and information needed to prepare for long-
term care. Our bill also strengthens elder abuse programs.
  The reauthorization bill also improves the core services of the Older 
Americans Act. Seniors have come to depend on the information and 
referral services, congregate and home-delivered meals, transportation, 
home care, and other OAA programs to meet their daily needs. Whether it 
is pension counseling or the long-term care ombudsman program--these 
are vital to helping seniors navigate the complex financial and health 
care systems. Not all seniors have family and friends that can assist 
them with complicated decisions, like choosing a long-term care 
insurance plan or a nursing home. These programs put information in 
terms seniors can understand. These programs are a safety net for many.
  I am especially pleased that this bill authorizes programs to 
encourage community innovation to support and enhance the ability of 
seniors to age in place. Seniors will be able to remain in their homes 
and communities, close to family and friends by providing them 
necessary supporting services such as transportation, social work 
services, and health programs to help seniors remain independent and in 
their communities. Grant program will encourage innovation and build on 
the success of naturally occurring retirement communities, NORC, 
programs. NORC programs have been developed at the local level and have 
a proven record of success. We heard from successful programs in 
Maryland, Ohio, and New York at the Subcommittee on Aging hearing on 
NORCs last month. I thank them again for their work and leadership. I 
always say that the best ideas come from the people, and this is one of 
the best I have seen in a long time.
  This bill also improves the National Family Caregiver Support 
Program. With the reauthorization of OAA in 2000, we worked hard to 
create the National Family Caregiver Support Program. In 2003, this 
program provided assistance to nearly 600,000 caregivers. Services 
include respite care, caregiver counseling and training, information 
about available resources, and assistance in locating services. These 
services are invaluable to seniors and their families. We have worked 
with the aging community to expand these services. Upon the advice of 
the Alzheimer's Association our bill lowers the age eligibility for the 
program for individuals with Alzheimer's from 60 to 50, allowing more 
individuals with Alzheimer's to qualify for services. Our bill also 
lowers the age of eligible grandparents to 55. This allows the program 
to target services to those who need it most.
  Our bill also seeks to improve emergency preparedness for seniors. 
During Hurricanes Katrina and Rita, who was left behind? The elderly, 
the sick, the disabled. We must plan for their needs and use the senior 
network that exists in our country to make sure that they are not 
forgotten. Our bill requires States and Area Agencies on Aging to 
coordinate to develop plans and establish guidelines for addressing the 
senior population during a disaster/emergency.
  I believe that this bipartisan reauthorization bill honors and 
maintains the commitment Congress made to our Nation's seniors through 
the Older Americans Act when it was first created in 1965. 
Reauthorization of this program for America's seniors and their 
families is one of our most important responsibilities. I look forward 
to continuing to work to get a bill passed this year. It is an 
important responsibility that we have to our Nation's seniors.
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