[Congressional Record Volume 165, Number 170 (Monday, October 28, 2019)]
[House]
[Pages H8466-H8479]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DIGNITY IN AGING ACT OF 2019
Ms. BONAMICI. Mr. Speaker, I move to suspend the rules and pass the
bill (H.R. 4334) to amend the Older Americans Act of 1965 to authorize
appropriations for fiscal years 2020 through 2024, and for other
purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 4334
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Dignity in
Aging Act of 2019''.
(b) Table of Contents.--The table of contents of this Act
is the following:
Sec. 1. Short title; table of contents.
TITLE I--ENSURING COLLABORATION AND PROMOTING INDEPENDENCE FOR OLDER
INDIVIDUALS
Sec. 101. Person-centered, trauma-informed care.
Sec. 102. Vaccination.
Sec. 103. Functions of Assistant Secretary.
Sec. 104. Professional standards for nutrition official under Assistant
Secretary.
Sec. 105. Interagency Coordinating Committee on Age-Friendly
Communities.
Sec. 106. Technical assistance on age-friendly communities.
Sec. 107. Malnutrition.
Sec. 108. Coordination with resource centers.
Sec. 109. Arts education.
Sec. 110. Social determinants of health.
Sec. 111. Falls prevention and chronic disease self-management
education.
Sec. 112. Extension of RAISE Family Caregivers Act.
Sec. 113. Support for socially-isolated older Americans.
Sec. 114. Increased focus of Assistant Secretary on health effects
associated with social isolation.
Sec. 115. Advisory council on health effects associated with social
isolation.
Sec. 116. Supportive services and senior centers.
Sec. 117. Demonstration projects.
Sec. 118. Younger onset Alzheimer's Disease.
Sec. 119. Priority for the senior community service employment program.
Sec. 120. Direct care workforce.
Sec. 121. National resource center for older individuals experiencing
the long-term and adverse consequences of trauma.
Sec. 122. National Resource Center for Women and Retirement.
Sec. 123. Definition.
Sec. 124. Review of reports.
Sec. 125. Area plans.
Sec. 126. Addressing chronic pain management.
Sec. 127. Extension of the Supporting Grandparents Raising
Grandchildren Act.
Sec. 128. Screening for suicide risk.
Sec. 129. Traumatic brain injury.
Sec. 130. Addressing public health emergencies and emerging health
threats.
Sec. 131. Prevention of sexually transmitted diseases.
Sec. 132. Aging and Disability Resource Center.
TITLE II--EMPOWERING THE AGING NETWORK TO MEET THE NEEDS OF OLDER
INDIVIDUALS
Sec. 201. National family caregiver support program cap.
Sec. 202. Minimum funding level for State administrative expenses.
Sec. 203. Culturally-appropriate, medically-tailored meals.
Sec. 204. Business acumen provisions and clarification regarding
outside funding for area agencies on aging.
Sec. 205. Other practices.
Sec. 206. Caregiver assessments.
Sec. 207. Research and evaluation.
Sec. 208. Grant program for multigenerational collaboration.
TITLE III--STRENGTHENING PROTECTIONS FOR OLDER INDIVIDUALS
Sec. 301. State Long-Term Care Ombudsman Program minimum funding and
maintenance of effort.
Sec. 302. State long-term care volunteer ombudsman representatives.
Sec. 303. Clarification regarding board and care facilities.
Sec. 304. Report on legal hotlines.
Sec. 305. Community outreach.
Sec. 306. Principles for person-directed services and supports during
serious illness.
TITLE IV--MEETING THE NEEDS OF OLDER NATIVE AMERICANS
Sec. 401. Expanding supportive services for Native American aging
programs.
Sec. 402. Enhancing capacity to support Native American aging programs.
TITLE V--MISCELLANEOUS
Sec. 501. Technical corrections.
Sec. 502. Authorization of appropriations; uses of funds.
Sec. 503. Hold harmless formula.
TITLE I--ENSURING COLLABORATION AND PROMOTING INDEPENDENCE FOR OLDER
INDIVIDUALS
SEC. 101. PERSON-CENTERED, TRAUMA-INFORMED CARE.
Section 101(2) of the Older Americans Act of 1965 (42
U.S.C. 3001(2)) is amended by inserting ``(including access
to person-centered, trauma-informed care)'' after ``health''.
SEC. 102. VACCINATION.
Section 102(14) of the Older Americans Act of 1965 (42
U.S.C. 3002(14)) is amended--
(1) in subparagraph (B) by inserting ``immunization
status,'' after ``oral health,'', and
(2) in subparagraph (D) by inserting ``infectious disease,
and vaccine preventable disease,'' after ``disease),''.
SEC. 103. FUNCTIONS OF ASSISTANT SECRETARY.
(a) Review of Applications.-- Section 202 of the Older
Americans Act of 1965 (42 U.S.C. 3012) is amended--
(1) by amending subsection (a)(4) to read as follows:
``(4) administer the grants provided by this Act but not
approve an application submitted by an applicant for a grant
for a program for which such applicant previously received a
grant unless the Assistant Secretary determines--
``(A) the program for which such application was submitted
is operating effectively to achieve its stated purpose; and
``(B) such applicant complied with the assurances provided
to the Assistant Secretary with the application for such
previous grant; and'', and
(2) by adding at the end the following:
``(h) The Assistant Secretary shall publish, on an annual
basis, a list of centers and demonstration projects funded
under each title of the Act. The Assistant Secretary shall
ensure that this information is also directly provided to
States and area agencies on aging.''.
(b) Addressing the Needs of Older Individuals in
Disasters.--Section 202(a) of the Older Americans Act of 1965
(42 U.S.C. 3012(a)) is amended--
(1) in paragraph (30) by striking ``and'' at the end,
(2) in paragraph (31) by striking the period at the end and
inserting ``; and'', and
(3) by adding at the end the following:
``(32) provide technical assistance to and share best
practices with States and area agencies on aging on how to
collaborate and coordinate activities and develop long-range
emergency preparedness plans with local and State emergency
response agencies, relief organizations, local and State
governments, federal agencies as appropriate, and any other
institutions that have responsibility for disaster relief
service delivery.''.
SEC. 104. PROFESSIONAL STANDARDS FOR NUTRITION OFFICIAL UNDER
ASSISTANT SECRETARY.
Section 205(a)(2)(C)(ii) of the Older Americans Act of 1965
(42 U.S.C. 3016(a)(2)(C)(ii) is amended to read as follows:
``(ii) be a registered dietitian or registered dietitian
nutritionist.''.
SEC. 105. INTERAGENCY COORDINATING COMMITTEE ON AGE-FRIENDLY
COMMUNITIES.
Section 203 of the Older Americans Act of 1965 (42 U.S.C.
3013) is amended--
(1) in subsection (b)--
(A) in paragraph (18) by striking ``and'' at the end,
(B) in subparagraph (19) by striking the period at the end,
and inserting ``, and'', and
(C) by adding at the end the following:
``(20) section 393D of the Public Health Service Act (42
U.S.C. 280b-1f), relating to safety of seniors.'', and
(2) in subsection (c)--
(A) in paragraph (1)--
(i) by striking ``Aging'' and inserting ``Age-Friendly
Communities'', and
(ii) by inserting ``to support the ability of older
individuals to age in place, including through the provision
of homelessness prevention services, support the ability of
older
[[Page H8467]]
individuals to access preventive health care, promote age-
friendly communities, and address the ability of older
individuals to access long-term care supports, including
access to caregivers and home- and community-based services''
before the period at the end,
(B) in paragraph (4) by inserting ``, except that the 1st
term of a member appointed to the Interagency Coordinating
Committee on Age-Friendly Communities shall begin not later
than 1 year after the effective date of this exception''
before the period at the end,
(C) in paragraph (5) by striking ``once each year'' and
inserting ``semiannually'',
(D) in paragraph (6)--
(i) in subparagraph (A)--
(I) in clause (iii) by striking ``and'' at the end,
(II) in clause (iv) by adding ``and'' at the end, and
(III) by adding at the end the following:
``(v) identifying best practices for connecting older
individuals to services for which they may be eligible;'',
(ii) in subparagraph (B)--
(I) by inserting ``transportation,'' after ``housing,'' the
1st place it appears,
(II) in clause (i) by striking ``and'' at the end,
(III) by amending clause (ii) to read as follows:
``(ii) innovations in technology applications (including
assistive technology devices and assistive technology
services) that--
``(I) promote safe and accessible independent living
environments; and
``(II) give older individuals access to information on
available services or help in providing services to older
individuals, including information on transportation services
such as public transit, on-demand transportation services,
volunteer-based transportation services, and other private
transportation services; and'', and
(IV) by adding at the end the following:
``(iii) transportation models that reduce costs of
transportation for older individuals and provide the ability
to schedule trips in advance and on demand, as
appropriate;'',
(iii) in subparagraph (E)--
(I) by striking ``nongovernmental experts and
organizations, including public health interest and research
groups and foundations'' and inserting ``nongovernmental
organizations, academic or research institutions, community-
based organizations, and philanthropic organizations'', and
(II) by striking ``(F)'' and inserting ``(G)'',
(iv) by redesignating subparagraphs (E), (F), and (G) as
subparagraphs (F), (G), and (H), respectively,
(v) by inserting after subparagraph (D) the following:
``(E) work with the Centers for Disease Control and
Prevention, the National Institute on Aging, Centers for
Medicare and Medicaid Services, the Housing and Urban
Development Office of Lead Hazard Control and Healthy Homes,
and other Federal agencies as appropriate, to develop
recommendations, in accordance with paragraph (1), to reduce
falls among older individuals that incorporate evidence-based
falls prevention programs and home modifications to reduce
and prevent falls;'', and
(vi) by adding at the end the following:
``(9) In this subsection, the term `age-friendly community'
means a community that---
``(A) is taking steps--
``(i) to include accessible housing, accessible spaces and
buildings, safe and secure paths, variable route
transportation services, and programs and services designed
to maintain health and well-being;
``(ii) to respect and include older individuals in social
opportunities, civic participation, volunteerism, and
employment; and
``(iii) to facilitate access to supportive services for
older individuals; and
``(B) has a plan in place to meet local needs for housing,
transportation, civic participation, social connectedness,
and accessible spaces.'' and
(3) by adding at the end the following:
``(d) Not later than 2 years after the effective date of
this subsection, the Comptroller General of the United States
shall conduct a study and issue a report that includes--
``(1) an inventory of Federal programs, administered by the
Department of Health and Human Services, the Department of
Housing and Urban Development, or any other Federal agency
determined appropriate by the Comptroller General, that
support home assessments and home modifications for older
individuals and individuals with disabilities,
``(2) statistical data, for recent fiscal years, on the
number of older individuals and individuals with disabilities
served by each Federal program described in paragraph (1) and
the approximate amount of Federal funding invested in each
such program,
``(3) a demographic analysis of individuals served by each
such program for recent fiscal years;
``(4) an analysis of duplication and gaps in populations
supported by the Federal programs described in paragraph (1),
``(5) what is known about the impact of the Federal
programs described in paragraph (1) on health status and
health outcomes in populations supported by such programs,
``(6) a review of Federal efforts to coordinate Federal
programs existing prior to the effective date of this
subsection that support home assessments and home
modifications for older individuals and individuals with
disabilities and any considerations for improving
coordination, which may include an indication of the Federal
agency or department that is best suited to coordinate such
Federal efforts, and
``(7) information on the extent to which consumer-friendly
resources, such as a brochure, are available through the
National Eldercare Locator Service established under section
202(a)(21), are accessible to all area agencies on aging, and
contain information on home assessments and home
modifications for older individuals attempting to live
independently and safely in their homes and for the
caregivers of such individuals.''.
SEC. 106. TECHNICAL ASSISTANCE ON AGE-FRIENDLY COMMUNITIES.
Section 205(a)(2) of the Older Americans Act of 1965 (42
U.S.C. 3016(a)(2)) is amended--
(1) by redesignating subparagraph (C) as subparagraph (D),
and
(2) by inserting after subparagraph (B) the following:
``(C) The Assistant Secretary may provide technical
assistance, including through the regional offices of the
Administration, to State agencies, area agencies on aging,
local government agencies, or leaders in age-friendly
communities (as defined in section 203(c)(9)) regarding--
``(i) support for public and private entities in building
partnerships to promote such age-friendly communities;
``(ii) dissemination of, or consideration of ways to
implement, best practices and recommendations from the
Interagency Coordinating Committee on Age-Friendly
Communities established under section 203(c); and
``(iii) methods for managing and coordinating existing
programs to meet the needs of growing age-friendly
communities.''.
SEC. 107. MALNUTRITION.
The Older Americans Act of 1965 (42 U.S.C. 2011 et seq.) is
amended--
(1) in section 102(14)(B) by inserting ``(including
screening for malnutrition)'' before the semicolon at the
end, and
(2) in section 330(1) by striking ``and food insecurity''
and inserting ``, food insecurity, and malnutrition''.
SEC. 108. COORDINATION WITH RESOURCE CENTERS.
(a) Area Plans.--Section 306(a) of the Older Americans Act
of 1965 (42 U.S.C. 3026(a)) is amended--
(1) in paragraph (16) by striking ``and'' at the end,
(2) in paragraph (17) by striking the period at the end and
inserting ``; and'', and
(3) by adding at the end the following:
``(18) provide assurances that the area agency on aging
will collect data to determine--
``(A) the services that are needed by older individuals
whose needs were the focus of all centers funded under title
IV in fiscal year 2019; and
``(B) the effectiveness of the programs, policies, and
services provided by such area agency on aging in assisting
such individuals; and
``(19) provide assurances that the area agency on aging
will use outreach efforts that will identify older
individuals eligible for assistance under this Act, with
special emphasis on those older individuals whose needs were
the focus of all centers funded under title IV in fiscal year
2019.''.
(b) State Plans.--Section 307(a) of the Older Americans Act
of 1965 (42 U.S.C. 3027) is amended by adding at the end the
following:
``(31) The plan shall contain an assurance that the State
shall prepare and submit to the Assistant Secretary annual
reports that describe--
``(A) data collected to determine the services that are
needed by older individuals whose needs were the focus of all
centers funded under title IV in fiscal year 2019;
``(B) data collected to determine the effectiveness of the
programs, policies, and services provided by area agencies on
aging in assisting such individuals; and,
``(C) outreach efforts and other activities carried out to
satisfy the assurances described in paragraphs (18) and (19)
of section 306(a).''.
SEC. 109. ARTS EDUCATION.
(a) Program Design.--Section 202(a)(5) of the Older
Americans Act of 1965 (42 U.S.C. 3012(a)(5)) is amended by
inserting ``cultural experiences, activities and services,
including the arts,'' after ``education),''.
(b) Supportive Services.--Section 321(a)(7) of the Older
Americans Act of 1965 (42 U.S.C. 3030d(a)(7)) is amended by
inserting ``cultural experiences (including the arts),''
after ``art therapy,''.
SEC. 110. SOCIAL DETERMINANTS OF HEALTH.
Section 301(a)(1) of the Older Americans Act of 1965 (42
U.S.C. 3021(a)(1)) is amended--
(1) in subparagraph (C) by striking ``and'' at the end,
(2) in subparagraph (D) by striking the period at the end
and inserting ``; and'', and
(3) by adding at the end the following:
``(E) address the social determinants of health of older
individuals.''.
SEC. 111. FALLS PREVENTION AND CHRONIC DISEASE SELF-
MANAGEMENT EDUCATION.
Section 411(a) of the Older Americans Act of 1965 (42
U.S.C. 3032(a)) is amended--
(1) by redesignating paragraphs (13) and (14) as paragraphs
(15) and (16), respectively, and
(2) by inserting after paragraph (12) the following:
``(13) bringing to scale and sustaining evidence-based
falls prevention programs that
[[Page H8468]]
will reduce the number of falls, fear of falling, and fall-
related injuries in older individuals and older individuals
with disabilities;
``(14) bringing to scale and sustaining evidence-based
chronic disease self-management programs that empower older
individuals and older individuals with disabilities to better
manage their chronic conditions;''.
SEC. 112. EXTENSION OF RAISE FAMILY CAREGIVERS ACT.
Section 6 of the RAISE Family Caregivers Act (Public Law
115-119; 132 Stat. 27) is amended by striking ``3'' and
inserting ``4''.
SEC. 113. SUPPORT FOR SOCIALLY-ISOLATED OLDER AMERICANS.
Section 102(14) of the Older Americans Act of 1965 (42
U.S.C. 3002(14)) is amended--
(1) in subparagraph (K) by striking ``and'' at the end,
(2) in subparagraph (L) by striking ``(K)'' and inserting
``(L)'',
(3) by redesignating subparagraph (L) as subparagraph (M),
and
(4) by inserting after subparagraph (K) the following:
``(L) screening for the prevention of negative health
effects associated with social isolation and coordination of
supportive services and health care to address negative
health effects associated with social isolation; and''.
SEC. 114. INCREASED FOCUS OF ASSISTANT SECRETARY ON HEALTH
EFFECTS ASSOCIATED WITH SOCIAL ISOLATION.
Section 202(a) of the Older Americans Act of 1965 (42
U.S.C. 3012(a)), as amended by section 103, is amended--
(1) in paragraph (31) by striking ``; and'' and inserting a
semicolon,
(2) in paragraph (32) by striking the period at the end and
inserting ``; and'', and
(3) by adding at the end the following:
``(33) develop objectives, priorities, and a long-term plan
for supporting State and local efforts involving education
about, prevention of, detection of, and response to negative
health effects associated with social isolation among older
individuals.''.
SEC. 115. ADVISORY COUNCIL ON HEALTH EFFECTS ASSOCIATED WITH
SOCIAL ISOLATION.
Section 202 of the Older Americans Act of 1965 (42 U.S.C.
3012), as amended by section 103, is amended by adding at the
end the following:
``(i)(1) The Assistant Secretary shall convene an advisory
council on negative health effects associated with social
isolation with aging network stakeholders, including
caregivers, and select members in a manner that ensures
geographic diversity of the members--
``(A) to review and evaluate efforts to address negative
health effects associated with social isolation among older
individuals; and
``(B) to identify challenges, solutions, and best practices
related to such efforts.
``(2) The advisory council convened under paragraph (1)
shall--
``(A) ensure consideration of consumer-directed care
models; and
``(B) submit a report to Congress on its findings.
``(3) The Federal Advisory Committee Act (5 U.S.C. App.)
shall not apply with respect to the advisory council convened
under paragraph (1).''.
SEC. 116. 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 (24) by striking ``and'' at the end,
(2) by redesignating paragraph (25) as paragraph (26), and
(3) by inserting after paragraph (24) the following:
``(25) services that promote or support social
connectedness and reduce negative health effects associated
with social isolation; and''.
SEC. 117. DEMONSTRATION PROJECTS.
(a) Demonstrations.--Section 411(a) of the Older Americans
Act of 1965 (42 U.S.C. 3032(a)), as amended by section 111,
is amended--
(1) in paragraph (15) by striking ``and'' at the end,
(2) by redesignating paragraph (16) as paragraph (17), and
(3) by inserting after paragraph (15) the following:
``(16) projects that address negative health effects
associated with social isolation among older adults; and''.
(b) Repeal.--Section 416 of the Older Americans Act of 1965
(42 U.S.C. 3032e) is repealed.
SEC. 118. YOUNGER ONSET ALZHEIMER'S DISEASE.
(a) Definition of ``Family Caregiver''.--Section 302(3) of
the Older Americans Act of 1965 (42 U.S.C. 3022(3)) is
amended by inserting ``of any age'' after ``an individual''.
(b) Definition of ``Resident''.--Section 711(6) of the
Older Americans Act of 1965 (42 U.S.C. 3058(6)) is amended by
inserting ``of any age'' after ``individual''.
SEC. 119. PRIORITY FOR THE SENIOR COMMUNITY SERVICE
EMPLOYMENT PROGRAM.
(a) Priority.--The Older Americans Act of 1965 (42 U.S.C.
3001 et seq.) is amended--
(1) in section 503(a)(4)(C)--
(A) in clause (iii) by striking ``and'' at the end,
(B) in clause (iv) by adding ``and'' at the end, and
(C) by adding at the end the following:
``(v) eligible individuals who have been incarcerated
within the last 5 years or are under supervision following
the release from prison or jail within the last 5 years;'',
(2) in section 514(e)(1) by inserting ``older individuals
who have been incarcerated or are under supervision following
the release from prison or jail,'' after ``need,'', and
(3) in section 518--
(A) in subsection (a)(3)(B)(ii)--
(i) in clause (IV) by striking ``or'' at the end,
(ii) in clause (V) by striking the period at the end and
inserting ``; or'', and
(iii) by adding at the end the following:
``(VI) have been incarcerated within the last 5 years or
are under supervision following the release from prison or
jail within the last 5 years.'', and
(B) in subsection (b)(2)--
(i) in subparagraph (F) by striking ``or'' at the end,
(ii) in subparagraph (G) by striking the period at the end
and inserting ``; or'',
(iii) by adding at the end the following:
``(H) has been incarcerated or is under supervision
following the release from prison or jail within the last 5
years.''.
(b) Transition Period.--This section shall take effect 1
year after the date of the enactment of this Act.
SEC. 120. DIRECT CARE WORKFORCE.
(a) Demonstrations.--Section 411(a) of the Older Americans
Act of 1965 (42 U.S.C. 3032(a)), as amended by sections 111
and 117, is amended--
(1) by redesignating paragraphs (16) and (17) as paragraphs
(17) and (18), respectively, and
(2) by inserting after paragraph (15) the following:
``(16) in coordination with the Secretary of Labor, the
demonstration of new strategies for the recruitment,
retention, or advancement of direct care workers, and to
solicit, develop, and implement strategies--
``(A) to reduce barriers to entry for a diverse and high-
quality direct care workforce, including providing wages,
benefits, and advancement opportunities needed to attract or
retain direct care workers;
``(B) to provide supportive services and career planning
for direct care workers; and
``(C) to support the advancement of direct care workers
through education and workforce development programs that
include necessary credential or licensing preparation, paid
on-the-job training or work-based learning, and appropriate
safety training;''.
(b) Older American Community Service Employment Program.--
Section 502(e)(2)(B) of the Older Americans Act of 1965 (42
U.S.C. 3056(e)(2)(B)) is amended--
(1) in clause (iii) by striking ``and'' at the end,
(2) in clause (iv) by adding ``and'' at the end, and
(3) by adding at the end the following:
``(v) attract, retain, or advance the direct care
workforce, in consultation with the Assistant Secretary,
providing for wages and benefits needed to reduce barriers to
entry for a diverse and high-quality direct care workforce,
supportive services and career planning, and paid on-the-job
training or work-based learning, with appropriate safety
training;''.
SEC. 121. NATIONAL RESOURCE CENTER FOR OLDER INDIVIDUALS
EXPERIENCING THE LONG-TERM AND ADVERSE
CONSEQUENCES OF TRAUMA.
Section 411(a) of the Older Americans Act of 1965 (42
U.S.C. 3032(a), as amended by sections 111, 117, and 120, is
amended--
(1) in paragraph (17) by striking ``and'' at the end,
(2) in paragraph (18) by striking the period at the end,
and
(3) by adding at the end the following:
``(19) the establishment and operation of a national
resource center that shall--
``(A) provide training and technical assistance to agencies
in the aging network delivering services to older individuals
experiencing the long-term and adverse consequences of
trauma;
``(B) share best practices with the aging network; and
``(C) make subgrants to the agencies best positioned to
advance and improve the delivery of person-centered, trauma-
informed services for older individuals experiencing the
long-term and adverse consequences of trauma.''.
SEC. 122. NATIONAL RESOURCE CENTER FOR WOMEN AND RETIREMENT.
Section 202 of the Older Americans Act of 1965 (42 U.S.C.
3012), as amended by sections 103 and 115, is amended by
adding at the end the following:
``(j)(1) The Assistant Secretary shall, directly or by
grant or contract, operate the National Resource Center for
Women and Retirement (in this subsection referred to as the
`Center').
``(2) The Center shall--
``(A) provide basic financial management, retirement
planning, and other educational tools that promote financial
wellness and help to identify and prevent fraud and elder
exploitation, and integrate these with information on health
and long-term care;
``(B) annually disseminate a summary of outreach provided,
including work to provide user-friendly consumer information
and public education materials;
``(C) develop targeted outreach strategies;
``(D) provide technical assistance to State agencies and to
other public and nonprofit private agencies and
organizations; and
``(E) develop partnerships and collaborations to address
program objectives.''.
SEC. 123. DEFINITION .
Section 102 of the Older Americans Act of 1965 (42 U.S.C.
3002) is amended--
[[Page H8469]]
(1) by redesignating paragraphs (41) through (54) as
paragraphs (42) through (55), and
(2) by inserting after paragraph (40) the following:
``(41) The term `person-centered, trauma-informed' when
used with respect to services means services provided through
an aging program that--
``(A) use a holistic approach to providing services;
``(B) promote the dignity, strength and empowerment of
victims of trauma; and
``(C) incorporate research-based practices based on
knowledge about the role of trauma in trauma victims'
lives.''.
SEC. 124. REVIEW OF REPORTS.
Sec. 308(b) of the Older Americans Act of 1965 (42 U.S.C.
3028(b)) is amended by inserting at the end the following:
``(8) The Assistant Secretary shall review the reports
submitted under section 307(a)(31) and include aggregate data
in the report required by section 207(a), including data on--
``(A) the effectiveness of the programs, policies, and
services provided by area agencies on aging in assisting
individuals whose needs were the focus of all centers funded
under title IV in fiscal year 2019; and,
``(B) outreach efforts and other activities carried out to
satisfy the assurances described in paragraphs (18) and (19)
of section 306(a), to identify such older individuals and
their service needs.''.
SEC. 125. AREA PLANS.
Section 306(a)(4) of the Older Americans Act of 1965 (42
U.S.C. 3026(a)(4)) is amended in subparagraph (B)(i)(VII) by
inserting ``, specifically including survivors of the
Holocaust'' after ``placement''.
SEC. 126. ADDRESSING CHRONIC PAIN MANAGEMENT.
Section 102(14)(D) of the Older Americans Act of 1965 (42
U.S.C. 3002(14)) is amended by inserting ``chronic pain
management,'' after ``substance abuse reduction,''.
SEC. 127. EXTENSION OF THE SUPPORTING GRANDPARENTS RAISING
GRANDCHILDREN ACT.
Section 3(f) of the Supporting Grandparents Raising
Grandchildren Act (Public Law 115-196) is amended by striking
``3'' and inserting ``4''.
SEC. 128. SCREENING FOR SUICIDE RISK.
Section 102(14)(G) of the Older Americans Act of 1965 (42
U.S.C. 3002(14)(G)) is amended by inserting ``and screening
for suicide risk'' after ``depression''.
SEC. 129. TRAUMATIC BRAIN INJURY.
(a) Section 102 of the Older Americans Act of 1965 (42
U.S.C. 3002), as amended by section 113, is amended--
(1) in paragraph (14)--
(A) in paragraph (M) by striking ``(L)'' and inserting
``(M)'',
(B) by redesignating subparagraphs (H) through (M) as
subparagraphs (I) through (N), respectively,
(C) by inserting after subparagraph (G) the following:
``(H) screening for fall-related traumatic brain injury;
coordination of treatment, rehabilitation, and related
services; and referral services;'', and
(2) by adding at the end the following:
``(56) The term `traumatic brain injury' has the meaning
given to it in section 339B(d) of the Public Health Service
Act.''.
(b) Section 321(a)(8) of the Older Americans Act of 1965
(42 U.S.C.3030d(a)(8)) is amended--
(1) by striking ``screening and'' and inserting
``screening, screening for negative health effects associated
with social isolation,'', and
(2) by striking ``screening)'' and inserting ``screening,
and traumatic brain injury screening)''.
(c) Section 411(a)(12) of the Older Americans Act of 1965
(42 U.S.C. 3032(a)(12)) is amended--
(1) by inserting ``dementia,'' after ``dysfunction,'',
(2) by striking ``and'' the 2d place it appears, and
(3) by inserting ``and traumatic brain injury'' before the
semicolon at the end.
SEC. 130. ADDRESSING PUBLIC HEALTH EMERGENCIES AND EMERGING
HEALTH THREATS.
Section 102(14) of the Older Americans Act of 1965 (42
U.S.C. 3002(14)), as amended by sections 113 and 129, is
amended--
(1) in subparagraph (M) by striking ``and'' at the end,
(2) in subparagraph (N) by striking ``(M)'' and inserting
``(N)'',
(3) by redesignating subparagraphs (K), (L), (M), and (N)
as subparagraphs (L), (M), (N), and (O) respectively, and
(4) by inserting after subparagraph (J) the following:
``(K) responses to public health emergencies and emerging
health threats;''.
SEC. 131. PREVENTION OF SEXUALLY TRANSMITTED DISEASES.
Section 102(14)(D) of the Older Americans Act of 1965 (42
U.S.C. 3002(14)(D)), as amended by section 102, is amended by
inserting ``prevention of sexually transmitted disease,''
after ``disease)''.
SEC. 132. AGING AND DISABILITY RESOURCE CENTER.
Section 102(4) of the Older Americans Act of 1965 (42
U.S.C. 3002(4)) is amended--
(1) in the matter preceding subparagraph (A), by inserting
``, in collaboration with (as appropriate) area agencies on
aging, centers for independent living (as described in part C
of title VII of the Rehabilitation Act of 1973 (29 U.S.C.
796f et seq.)), and other aging or disability entities''
after ``provides'',
(2) in subparagraph (B)--
(A) by inserting ``services, supports, and'' after ``plan
for long-term'', and
(B) by inserting ``and choices'' after ``desires''; and
(3) in subparagraph (D) by striking ``(29 U.S.C. 796f et
seq.), and other community-based entities,'' and inserting
``, and other community-based entities, including other aging
or disability entities''.
TITLE II--EMPOWERING THE AGING NETWORK TO MEET THE NEEDS OF OLDER
INDIVIDUALS
SEC. 201. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM CAP.
(a) Federal Share.--Section 373(g)(2) of the Older
Americans Act of 1965 (42 U.S.C. 3030s-1(g)(2)) is amended by
striking subparagraph (C).
(b) Monitoring the Impact of the Elimination of the Cap on
Funds for Older Relative Caregivers.--
(1) Report.--Not later than 18 months after the date of the
enactment of this Act, and annually thereafter, the Assistant
Secretary shall submit to the Committee on Education and
Labor of the House of Representatives and the Committee on
Health, Education, Labor, and Pensions of the Senate a report
on the impact of the amendment made by subsection (a) to
eliminate the limitation on funds that States may allocate to
provide support services to older relative caregivers in the
National Family Caregiver Support Program established under
part E of title III of the Older Americans Act of 1965 (42
U.S.C. 3030s-3030s-2). Each such report shall also be made
available to the public.
(2) Contents.--For purposes of reports required by
paragraph (1), each State that receives an allotment under
such National Family Caregiver Support Program for fiscal
year 2020 or a subsequent fiscal year shall report to the
Assistant Secretary for the fiscal year involved the amount
of funds of the total Federal and non-Federal share allotment
used by the State to provide support services for caregiver
support for older relative caregivers and family caregivers.
SEC. 202. MINIMUM FUNDING LEVEL FOR STATE ADMINISTRATIVE
EXPENSES.
Section 308(b)(2)(A) of the Older Americans Act of 1965 (42
U.S.C. 3028(b)(2)(B)) is amended by striking ``$500,000'' and
inserting ``$750,000''.
SEC. 203. CULTURALLY-APPROPRIATE, MEDICALLY-TAILORED MEALS.
Section 339(2)(A) of the Older Americans Act of 1965 (42
U.S.C. 3939h(2)(A)) is amended by inserting ``, including
cultural considerations and preferences (including needs
based on religious, cultural, or ethnic requirements) and
medically tailored meals'' before the comma at the end.
SEC. 204. BUSINESS ACUMEN PROVISIONS AND CLARIFICATION
REGARDING OUTSIDE FUNDING FOR AREA AGENCIES ON
AGING.
(a) Assistance Relating to Growing and Sustaining
Capacity.--Section 202(b)(9) of the Older Americans Act of
1965 (42 U.S.C. 3012(b)(9)) is amended--
(1) in subparagraph (A) by striking ``and'' after the
semicolon at the end,
(2) in subparagraph (B) by inserting ``and'' after the
semicolon at the end, and
(3) by adding at the end the following:
``(C) business acumen, capacity building, organizational
development, innovation, and other methods of growing and
sustaining the capacity of the aging network to serve older
individuals and caregivers most effectively;''.
(b) Clarifying Partnerships for Area Agencies on Aging.--
Section 306 of the Older Americans Act of 1965 (42 U.S.C.
3026) is amended by adding at the end the following:
``(g) Nothing in this Act shall restrict an area agency on
aging from providing services not provided or authorized by
this Act, including through--
``(1) contracts with health care payers;
``(2) consumer private pay programs; or
``(3) other arrangements with entities or individuals that
increase the availability of home and community-based
services and supports in the planning and service area
supported by the area agency on aging.''.
SEC. 205. OTHER PRACTICES.
Section 315 of the Older Americans Act of 1965 (42 U.S.C.
3030c-2) is amended by adding at the end the following:
``(e) Response to Area Agencies on Aging.--Upon request
from an area agency on aging, the State shall make available
any policies or guidance pertaining to policies under this
section.''.
SEC. 206. CAREGIVER ASSESSMENTS.
(a) Definition of Caregiver Assessment.--Section 372(a) of
the Older Americans Act of 1965 (42 U.S.C. 3030s(a)) is
amended by adding at the end the following:
``(4) Caregiver assessment.--The term `caregiver
assessment' means a systematic process of gathering
information about the situation of a caregiver who
voluntarily participates in such process, which may include
contact through a home visit, the Internet, telephone or
teleconference, or in-person interaction, to identify the
caregiver's specific needs, barriers, and existing supports
as identified by the caregiver that--
``(A) provides the opportunity for the recognized caregiver
to participate in such process;
``(B) requires direct contact with the caregiver and is
used to appropriately target and tailor support services to
the caregiver's unique needs; and
``(C) includes reassessment of such specific needs,
barriers, and existing supports, including to accommodate a
significant change
[[Page H8470]]
in the caregiving situation, which shall occur on a voluntary
basis with the consent of the caregiver.''.
(b) Use of Caregiver Assessments.--Section 373(b) of the
Older Americans Act of 1965 (42 U.S.C. 3030s-1(b)) is amended
by inserting ``may be informed through the use of caregiver
assessments and'' after ``with,''.
(c) Technical Assistance for Caregiver Assessments.--
Section 373 of the Older Americans Act of 1965 (42 U.S.C.
3030s-1) is amended by adding at the end the following:
``(h) Technical Assistance for Caregiver Assessments.--Not
later than 1 year after the effective date of this
subsection, the Assistant Secretary, in consultation with
caregivers, older individuals, individuals with a disability
who receive care from an older relative caregiver, the aging
network, and other experts and stakeholders, shall provide
technical assistance to promote and implement the use of
caregiver assessments. Such technical assistance shall
include sharing available tools and templates, comprehensive
assessment protocols, and best practices concerning--
``(1) conducting caregiver assessments and reassessments;
``(2) implementing such assessments that are consistent
across a planning and service area; and
``(3) implementing caregiver support service plans,
including referrals to and coordination of activities with
relevant State and local services.''.
(d) Reporting on Caregiver Assessment.--Section 373(e) of
the Older Americans Act of 1965 (42 U.S.C. 3030s-1(e)) is
amended--
(1) in paragraph (3) by inserting ``, including caregiver
assessments used in the State,'' after ``mechanisms'' the 1st
place it appears, and
(2) by adding at the end the following:
``(4) Report on caregiver assessments.--
``(A) In general.--Not later than 3 years after the
effective date of this paragraph, the Assistant Secretary
shall issue a report on the use of caregiver assessments by
area agencies on aging, entities contracting with such
agencies, and organizations. Such report shall include--
``(i) an analysis of the current use of caregiver
assessments, including a repository of caregiver assessment
tools or templates and comprehensive assessment protocols;
``(ii) using objective data, an analysis of the impact of
caregiver assessments on--
``(I) family caregivers and older relative caregivers; and
``(II) the individuals to whom the caregivers described in
subclause (I) provide care;
``(iii) an analysis of the impact of using caregiver
assessments on the aging network;
``(iv) an analysis of how caregiver assessments are being
used to identify the specific needs, barriers, and existing
supports of family caregivers and older relative caregivers;
``(v) recommendations for using caregiver assessments,
including in rural or underserved areas; and
``(vi) feedback from State agencies and area agencies on
aging, particularly in rural or underserved areas, on the
implementation of caregiver assessments.
``(B) Submission.--Not later than 6 months after the
issuance of the report under subparagraph (A), the Assistant
Secretary shall submit the report to the Committee on
Education and Labor of the House of Representatives, the
Committee on Health, Education, Labor, and Pensions of the
Senate, and the Special Committee on Aging of the Senate.''.
SEC. 207. RESEARCH AND EVALUATION.
Section 201 of the Older Americans Act of 1965 (42 U.S.C.
3011) is amended by adding at the end the following:
``(g)(1) The Assistant Secretary shall coordinate the
research and evaluation functions of this Act under a
National Research, Demonstration, and Evaluation Center for
the Aging Network (in this subsection referred to as the
`Center'), which shall be headed by a director designated by
the Assistant Secretary from individuals described in
paragraph (4).
``(2) The purpose of the Center shall be--
``(A) to coordinate research, research dissemination,
evaluation, demonstration projects, and related activities
carried out under this Act;
``(B) to provide assessment of the programs authorized
under this Act; and
``(C) to increase the repository of information on
evidence-based programs and interventions available to the
aging network. Such information shall be applicable to
existing programs and help in the development of new
evidence-based programs and interventions.
``(3) Activities of the Center shall include conducting,
promoting, coordinating, and providing support for--
``(A) research and evaluation activities that support the
objectives of this Act, including--
``(i) evaluation of new and existing programs and
interventions authorized by this Act; and
``(ii) research on and assessment of the relationship
between programs and interventions under this Act and the
health outcomes, social determinants of health, quality of
life, health care savings (including to the Medicare program
under title XVIII of the Social Security Act and the Medicaid
program under title XIX of such Act as practicable), and
independence of individuals served under this Act;
``(B) demonstration projects that support the objectives of
the Act and activities to bring effective demonstration
projects to scale with a prioritization of projects that
address the needs of underserved populations;
``(C) outreach and dissemination of research findings; and
``(D) technical assistance related to the activities
described in this subparagraph.
``(4) The director shall be an individual with substantial
knowledge of and experience in aging and health policy, and
research administration.
``(5) Not later than October 1, 2020, and at 5-year
intervals thereafter, the director shall prepare and publish
in the Federal Register for public comment a draft of a 5-
year plan that--
``(A) outlines priorities for research, research
dissemination, evaluation, and related activities;
``(B) explains the basis for such priorities; and
``(C) describes how the plan will meet the needs of
underserved populations.
``(6) The director shall coordinate research, research
dissemination, evaluation, and demonstration projects, and
related activities with appropriate agency program staff,
and, as appropriate, coordinate with other Federal
departments and agencies involved in research in the field of
aging.
``(7) Not later than December 31, 2020, and annually
thereafter, the director shall prepare, and submit to the
Secretary, the Committee on Health, Education, Labor, and
Pensions of the Senate, the Special Committee on Aging of the
Senate, and the Committee on Education and Labor of the House
of Representatives, a report on the activities funded under
this section and title IV.
``(8) The director shall, as appropriate, consult with
experts on aging research and evaluation and aging network
stakeholders on the implementation of the activities
described under paragraph (3) of this subsection.
``(9) The director shall coordinate all research and
evaluation authorities under this Act.''.
SEC. 208. GRANT PROGRAM FOR MULTIGENERATIONAL COLLABORATION.
Section 417 of the Older Americans Act of 1965 (42 U.S.C.
3032f) is amended--
(1) by amending subsection (a) to read as follows:
``(a) Grants and Contracts.--The Assistant Secretary shall
award grants to, and enter into contracts with, eligible
organizations to carry out projects--
``(1) to provide opportunities for older individuals to
participate in multigenerational activities and civic
engagement activities that contribute to the health and
wellness of older individuals and individuals in younger
generations by developing--
``(A) meaningful roles for participants;
``(B) reciprocity in relationship building;
``(C) reduced social isolation and improved participant
social connectedness;
``(D) improved economic well-being for older individuals;
``(E) increased lifelong learning; or
``(F) support for older relative caregivers by--
``(i) providing support for older relative caregivers (as
defined in section 372) raising children (such as kinship
navigator programs); or
``(ii) involving volunteers who are older individuals who
provide support and information to families who have a child
with a disability or chronic illness, or other families in
need of such family support;
``(2) to coordinate multigenerational activities and civic
engagement activities, including multigenerational nutrition
and meal service programs;
``(3) to promote volunteerism, including becoming a mentor
to young people; and
``(4) to facilitate development of and participation in
multigenerational activities and civic engagement
activities.'',
(2) by amending subsection (b) to read as follows:
``(b) Use of Funds.--
``(1) In general.--An eligible organization shall use funds
made available under a grant awarded, or a contract entered
into, under this section to carry out a project described in
subsection (a).
``(2) Provision of projects through grantees.--In making
grants under this section, the Assistant Secretary shall
ensure that awards are made for the activities and projects
described in each of paragraphs (1) and (2) of subsection
(a).'';
(3) in subsection (c)--
(A) in the matter preceding paragraph (1), by inserting
``that serves individuals in younger generations and older
individuals'' after ``to carry out a project'';
(B) in paragraph (1) by inserting ``, intent to carry out,
or intent to partner with local organizations or multiservice
organizations to carry out,'' after ``record of carrying
out'',
(C) in paragraph (3) by striking ``; and'' and inserting a
semicolon,
(D) in paragraph (4) by striking the period at the end and
inserting ``; and'', and
(E) by adding at the end the following:
``(5) eligible organizations proposing multigenerational
activity projects that utilize shared site programs, such as
collocated child care and long-term care facilities.'',
(4) by amending subsection (e) to read as follows:
``(e) Eligible Organizations.--Organizations eligible to
receive a grant or enter into a contract under subsection (a)
shall--
``(1) be a State, an area agency on aging, or an
organization that provides opportunities for older
individuals to participate in activities described in such
subsection; and
[[Page H8471]]
``(2) have the capacity to conduct the coordination,
promotion, and facilitation described in such subsection
through the use of multigenerational coordinators.'',
(5) by striking subsection (g),
(6) in subsection (h)(2)(B)(i) by striking ``individuals
from the generations with older individuals'' and inserting
``older individuals'',
(7) by redesignating subsections (b) through (f) as
subsections (c) through (g), respectively, and
(8) by inserting after subsection (a) the following:
``(b) Grant Period.--Each grant awarded or contract made
under subsection (a) shall be to carry out projects for a
period of not less than 36 months.''.
TITLE III--STRENGTHENING PROTECTIONS FOR OLDER INDIVIDUALS
SEC. 301. STATE LONG-TERM CARE OMBUDSMAN PROGRAM MINIMUM
FUNDING AND MAINTENANCE OF EFFORT.
The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) by amending section 306(a)(9) to read as follows:
``(9) provide assurances that--
``(A) the area agency on aging, in carrying out the State
Long-Term Care Ombudsman program under section 307(a)(9),
will expend not less than the total amount of funds
appropriated under this Act and expended by the agency in
fiscal year 2019 in carrying out such a program under this
title; and
``(B) funds made available to area agencies on aging
pursuant to section 712 shall be used to supplement and not
supplant other Federal, State, and local funds expended to
support activities described in section 712.'', and
(2) by amending section 307(a)(9) to read as follows:
``(9) The plan shall provide assurances that--
``(A) the State agency will carry out, through the Office
of the State Long-Term Care Ombudsman, a State Long-Term Care
Ombudsman program in accordance with section 712 and this
title, and will expend for such purpose an amount that is not
less than an amount expended by the State agency with funds
received under this title for fiscal year 2019, and an amount
that is not less than the amount expended by the State agency
with funds received under title VII for fiscal year 2019; and
``(B) funds made available to state agencies pursuant to
section 712 shall be used to supplement and not supplant
other Federal, State, and local funds expended to support
activities described in section 712.''.
SEC. 302. STATE LONG-TERM CARE VOLUNTEER OMBUDSMAN
REPRESENTATIVES.
Section 712(a)(5) of the Older Americans Act of 1965 (42
U.S.C. 3058g(a)(5)) is amended--
(1) by redesignating subparagraph (D) as subparagraph (E),
and
(2) by inserting after subparagraph (C) the following:
``(D) Volunteer ombudsman representatives.--An individual
designated as a volunteer ombudsman representative may
receive financial support and recognition from the Office of
the State Long-Term Care Ombudsman Program for expenses
incurred during service.''.
SEC. 303. CLARIFICATION REGARDING BOARD AND CARE FACILITIES.
Section 102(35)(C) of the Older Americans Act of 1965 (42
U.S.C. 3002(35)(C)) is amended by striking ``for purposes of
sections 307(a)(12) and 712,''.
SEC. 304. REPORT ON LEGAL HOTLINES.
Not later than 3 years after the date of the enactment of
this Act, the Assistant Secretary on Aging shall prepare and
submit to the Congress a report containing--
(1) information on which States or localities operate
senior legal hotlines,
(2) information on how such hotlines operated by States or
localities are funded,
(3) information on the usefulness of senior legal hotlines
in the coordination and provision of legal assistance, and
(4) recommendations on additional actions that should be
taken related to senior legal hotlines.
SEC. 305. COMMUNITY OUTREACH.
Section 721(b)(12) of the Older Americans Act of 1965 (42
U.S.C. 3058i(b)(12)) is amended--
(1) in subparagraph (C) by inserting ``community outreach
and education,'' after ``technical assistance'', and
(2) in subparagraph (F)--
(A) by striking ``studying'' and inserting
``implementing'', and
(B) by inserting ``, programs, and materials'' after
``practices''.
SEC. 306. PRINCIPLES FOR PERSON-DIRECTED SERVICES AND
SUPPORTS DURING SERIOUS ILLNESS.
(a) Definitions.--
(1) Administrator.--The term ``Administrator'' means the
Administrator of the Administration for Community Living.
(2) Area agency on aging; assistant secretary; state
agency.--The terms ``area agency on aging'', ``Assistant
Secretary'', and ``State agency'' have the meanings given the
terms in section 102 of the Older Americans Act of 1965 (42
U.S.C. 3002).
(3) Covered agency.--The term ``covered agency'' means--
(A) a State agency or area agency on aging; and
(B) a Federal agency other than the Department of Health
and Human Services, and a unit of that Department other than
the Administration on Aging, that the Assistant Secretary
determines performs functions for which the principles are
relevant, and the Centers for Medicare & Medicaid Services.
(4) Principles.--The term ``principles'' means the
Principles for Person-directed Services and Supports during
Serious Illness, issued by the Administration on September 1,
2017, or an updated set of such Principles.
(b) Dissemination.--The Administrator shall disseminate the
principles to appropriate stakeholders within the aging
network, as determined by the Assistant Secretary, and to
covered agencies. The covered agencies may use the principles
in setting priorities for service delivery and care plans in
programs carried out by the agencies.
(c) Feedback.--The Administrator shall solicit, on an
ongoing basis, feedback on the principles from covered
agencies, experts in the fields of aging and dementia, and
stakeholders who provide or receive disability services.
(d) Report.--Not less often than once, but not more often
than annually, during the 3 years after the date of the
enactment of this Act, the Administrator shall prepare and
submit to Congress a report describing the feedback received
under subsection (c) and indicating if any changes or updates
are needed to the principles.
TITLE IV--MEETING THE NEEDS OF OLDER NATIVE AMERICANS
SEC. 401. EXPANDING SUPPORTIVE SERVICES FOR NATIVE AMERICAN
AGING PROGRAMS.
Title VI of the Older Americans Act of 1965 (42 U.S.C. 3057
et seq.) is amended--
(1) in part D--
(A) by amending section 643 to read as follows:
``SEC. 643. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out this
title--
``(1) for parts A and B, $38,524,324 for fiscal year 2020,
$40,835,783 for fiscal year 2021, $43,285,930 for fiscal year
2022, $45,883,086 for fiscal year 2023, and $48,636,071 for
fiscal year 2024; and
``(2) for part C subject to section 644, $10,785,575 for
fiscal year 2020, $11,432,710 for fiscal year 2021,
$12,118,672 for fiscal year 2022, $12,845,792 for fiscal year
2023, and $13,616,540 for fiscal year 2024.'', and
(B) by adding at the end the following:
``SEC. 644. FUNDING SET ASIDE.
``Of the funds appropriated under section 643(1) for a
fiscal year, not more than 5 percent shall be made available
to carry out part D for such fiscal year if for such fiscal
year--
``(1) the funds appropriated for parts A and B are greater
than the funds appropriated for such parts for fiscal year
2019; and
``(2) the Assistant Secretary makes available for parts A
and B not less than the amount of resources made available
for fiscal year 2019.'',
(2) by redesignating part D as part E, and
(3) by inserting after part C the following:
``PART D--SUPPORTIVE SERVICES FOR HEALTHY AGING AND INDEPENDENCE
``SEC. 636. PROGRAM.
``(a) In General.--The Assistant Secretary shall carry out
a competitive demonstration program for making grants to
tribal or Native Hawaiian organizations with applications
approved under parts A and B, to pay for the Federal share of
carrying out programs, to enable the organizations to build
their capacity to provide a wider range of in-home and
community supportive services to enable older individuals to
maintain their health and independence and to avoid long-term
care facility placement.
``(b) Supportive Services.--
``(1) In general.--Subject to paragraph (2), supportive
services described in subsection (a) may include any of the
activities described in section 321(a).
``(2) Priority.--The Assistant Secretary, in making grants
under this section, shall give priority to organizations that
will use the grant funds for supportive services described in
subsection (a) that are for in-home assistance,
transportation, information and referral, case management,
health and wellness programs, legal services, family
caregiver support services, and other services that directly
support the independence of the older individuals served.
``(c) Rule of Construction.--Nothing in this section shall
be construed or interpreted to prohibit the provision of
supportive services under part A or B.''.
SEC. 402. ENHANCING CAPACITY TO SUPPORT NATIVE AMERICAN AGING
PROGRAMS.
Title II of the Older Americans Act of 1965 (42 U.S.C. 3011
et seq.) is amended--
(1) in section 201(c)(3)(H) by inserting ``to ensure
adequate capacity to deliver the services under such title,
which technical assistance programs may include program
management, data development and use, basic business skills,
grant development, program and service innovations, and staff
professional development and certification'' before the
semicolon at the end, and
(2) section 216 is amended to read as follows:
``SEC. 216. AUTHORIZATION OF APPROPRIATIONS.
``(a) In General.--For purposes of carrying out this Act,
there are authorized to be appropriated for administration,
salaries, and expenses of the Administration $44,042,171 for
fiscal year 2020, $46,684,701 for fiscal year 2021,
$49,485,783 for fiscal year 2022, $52,454,930 for fiscal year
2023, and $55,602,226 for fiscal year 2024.
``(b) Authorization of Appropriations for Programs.--There
are authorized to be appropriated--
[[Page H8472]]
``(1) to carry out section 201(g), $20,000,000 for each of
the fiscal years 2020 through 2024;
``(2) to carry out section 202(a)(21) (relating to the
National Eldercare Locator Service), $2,186,227 for fiscal
year 2020, $2,317,401 for fiscal year 2021, $2,456,445 for
fiscal year 2022, $2,603,832 for fiscal year 2023, and
$2,760,062 for fiscal year 2024;
``(3) to carry out sections 215 and 202(j), $1,992,460 for
fiscal year 2020, $2,112,008 for fiscal year 2021, $2,238,728
for fiscal year 2022, $2,373,052 for fiscal year 2023, and
$2,515,435 for fiscal year 2024;
``(4) to carry out section 202 (relating to Elder Rights
Support Activities under this title), $1,375,011 for fiscal
year 2020, $1,457,511 for fiscal year 2021, $1,544,962 for
fiscal year 2022, $1,637,660 for fiscal year 2023, and
$1,735,919 for fiscal year 2024;
``(5) to carry out section 202(b) (relating to the Aging
and Disability Resource Centers), $8,708,043 for fiscal year
2020, $9,230,526 for fiscal year 2021, $9,784,357 for fiscal
year 2022, $10,371,419 for fiscal year 2023, and $10,993,704
for fiscal year 2024; and
``(6) to carry out section 201(c)(3)(H) (relating to
professional development and technical assistance for
programs under title VI), $500,000 for fiscal year 2021.''.
TITLE V--MISCELLANEOUS
SEC. 501. TECHNICAL CORRECTIONS.
The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is
amended--
(1) in section 102(37)(A) by striking ``paragraph (5)'' and
inserting ``paragraph (26)'',
(2) in section 202(a)(23) by striking ``sections 307(a)(18)
and 731(b)(2)'' and inserting ``sections 307(a)(13) and
731'',
(3) in section 202(e)(1)(A) by moving the left margin of
clause (i) 2 ems to the left,
(4) in sections 203(c)(7), 207(b)(2)(B), and 215(i) by
striking ``Committee on Education and the Workforce'' and
inserting ``Committee on Education and Labor'',
(5) in section 207(b)(3)(A) by striking ``Administrator of
the Health Care Finance Administration'' and inserting
``Administrator of the Centers for Medicare and Medicaid
Services'',
(6) in section 304(a)(3)(C) by striking ``term'' and all
that follows through ``does'', and inserting ``term `State'
does'',
(7) in section 304(d)(1)(B) by striking ``(excluding'' and
all that follows through ``303(a)(3))'',
(8) in section 306(a)--
(A) by inserting ``the number of older individuals at risk
for institutional placement residing in such area,'' after
``areas) residing in such area,'' the last place it appears,
and
(B) in paragraph (2) by striking ``who are victims of'' and
inserting ``with'',
(9) in section 339 by striking ``Institute of Medicine of
the National Academy of Sciences'' and inserting ``National
Academies of Sciences, Engineering, and Medicine'',
(10) in section 611 by striking ``(a)'', and
(11) in section 614(c)(4) by striking ``(a)(12)'' and
inserting ``(a)(11)''.
SEC. 502. AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS.
(a) Authorization of Appropriations; Uses of Funds.--
Section 303 of the Older Americans Act of 1965 (42 U.S.C.
3023) is amended to read as follows:
``SEC. 303. AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS.
``(a)(1) There are authorized to be appropriated to carry
out part B (relating to supportive services) $413,011,586 for
fiscal year 2020, $437,792,281 for fiscal year 2021,
$464,059,818 for fiscal year 2022, $491,903,407 for fiscal
year 2023, and $521,417,612 for fiscal year 2024.
``(2) Funds appropriated under paragraph (1) shall be
available to carry out section 712.
``(b)(1) There are authorized to be appropriated to carry
out subpart 1 of part C (relating to congregate nutrition
services) $531,279,663 for fiscal year 2020, $563,156,443 for
fiscal year 2021, $596,945,830 for fiscal year 2022,
$632,762,580 for fiscal year 2023, and $670,728,334 for
fiscal year 2024.
``(2) There are authorized to be appropriated to carry out
subpart 2 of part C (relating to home delivered nutrition
services) $269,577,167 for fiscal year 2020, $285,751,797 for
fiscal year 2021, $302,896,905 for fiscal year 2022,
$321,070,719 for fiscal year 2023, and $340,334,963 for
fiscal year 2024.
``(c) Grants made under part B, and subparts 1 and 2 of
part C, of this title may be used for paying part of the cost
of--
``(1) the administration of area plans by area agencies on
aging designated under section 305(a)(2)(A), including the
preparation of area plans on aging consistent with section
306 and the evaluation of activities carried out under such
plans; and
``(2) the development of comprehensive and coordinated
systems for supportive services, congregate and home
delivered nutrition services under subparts 1 and 2 of part
C, the development and operation of multipurpose senior
centers, and the delivery of legal assistance.
``(d) There are authorized to be appropriated to carry out
part D (relating to disease prevention and health promotion
services) $26,650,753 for fiscal year 2020, $28,249,798 for
fiscal year 2021, $29,944,786 for fiscal year 2022,
$31,741,473 for fiscal year 2023, and $33,645,961 for fiscal
year 2024.
``(e) There are authorized to be appropriated to carry out
part E (relating to family caregiver support) $194,331,264
for fiscal year 2020, $205,991,140 for fiscal year 2021,
$218,350,609 for fiscal year 2022, $231,451,645 for fiscal
year 2023, and $245,338,744 for fiscal year 2024.''.
(b) Section 311(e) of the Older Americans Act of 1965 (42
U.S.C. 3030a(e)) is amended to read as follows:
``(e) There are authorized to be appropriated to carry out
this section (other than subsection (c)(1)) $171,682,200 for
fiscal year 2020, $181,983,132 for fiscal year 2021,
$192,902,120 for fiscal year 2022, $204,476,247 for fiscal
year 2023, and $216,744,822 for fiscal year 2024.''.
(c) Section 411(b) of the Older Americans Act of 1965 (42
U.S.C. 3032(b)) is amended to read as follows:
``(b) Authorization of Appropriations.--There are
authorized to be appropriated to carry out--
``(1) aging network support activities under this section,
$14,549,157 for fiscal year 2020, $15,422,107 for fiscal year
2021, $16,347,433 for fiscal year 2022, $17,328,279 for
fiscal year 2023, and $18,367,976 for fiscal year 2024; and
``(2) elder rights support activities under this section,
$15,650,667 for fiscal year 2020, $16,589,707 for fiscal year
2021, $17,585,090 for fiscal year 2022, $18,640,195 for
fiscal year 2023, and $19,758,607 for fiscal year 2024.''.
(d) Section 517(a) of the Older Americans Act of 1965 (42
U.S.C. 3056o(a)) is amended to read as follows:
``(a) In General.--There are authorized to be appropriated
to carry out this title $429,020,486 for fiscal year 2020,
$454,761,715 for fiscal year 2021, $482,047,418 for fiscal
year 2022, $510,970,263 for fiscal year 2023, and
$541,628,478 for fiscal year 2024.''.
(e) Section 702 of the Older Americans Act of 1965 (42
U.S.C.3058a) is amended to read as follows:
``SEC. 702. AUTHORIZATION OF APPROPRIATIONS.
``(a) Ombudsman Program.--There are authorized to be
appropriated to carry out chapter 2, $18,110,027 for fiscal
year 2020, $19,196,629 for fiscal year 2021, $20,348,427 for
fiscal year 2022, $21,569,332 for fiscal year 2023, and
$22,863,492 for fiscal year 2024.
``(b) Other Programs.--There are authorized to be
appropriated to carry out chapters 3 and 4, $5,119,287 for
fiscal year 2020, $5,426,444 for fiscal year 2021, $5,752,031
for fiscal year 2022, $6,097,153 for fiscal year 2023, and
$6,462,982 for fiscal year 2024.''.
SEC. 503. HOLD HARMLESS FORMULA.
(a) In General.--Section 304(a)(3)(D) of the Older
Americans Act of 1965 (42 U.S.C. 3024(a)(3)(D)) is amended to
read as follows:
``(D)(i) In this subparagraph and paragraph (5):
``(I) The term `allot' means allot under this subsection
from a sum appropriated under section 303(a) or 303(b)(1), as
the case may be.
``(II) The term `covered fiscal year' means any of fiscal
years 2020 through 2029.
``(ii) If the sum appropriated under section 303(a) or
303(b)(1) for a particular fiscal year is less than or equal
to the sum appropriated under section 303(a) or 303(b)(1),
respectively, for fiscal year 2019, amounts shall be allotted
to States from the sum appropriated for the particular year
in accordance with paragraphs (1) and (2), and subparagraphs
(A) through (C) as applicable, but no State shall be allotted
an amount that is less than--
``(I) for fiscal year 2020, 99.75 percent of the
corresponding sum appropriated for fiscal year 2019;
``(II) for fiscal year 2021, 99.50 percent of that sum;
``(III) for fiscal year 2022, 99.25 percent of that sum;
``(IV) for fiscal year 2023, 99.00 percent of that sum;
``(V) for fiscal year 2024, 98.75 percent of that sum;
``(VI) for fiscal year 2025, 98.50 percent of that sum;
``(VII) for fiscal year 2026, 98.25 percent of that sum;
``(VIII) for fiscal year 2027, 98.00 percent of that sum;
``(IX) for fiscal year 2028, 97.75 percent of that sum;
``(X) for fiscal year 2029, 97.50 percent of that sum.
``(iii) If the sum appropriated under section 303(a) or
303(b)(1) for a particular covered fiscal year is greater
than the sum appropriated under section 303(a) or 303(b)(1),
respectively, for fiscal year 2019, the allotments to States
from the sum appropriated for the particular year shall be
calculated as follows:
``(I) From the portion equal to the corresponding sum
appropriated for fiscal year 2019, amounts shall be allotted
in accordance with paragraphs (1) and (2), and subparagraphs
(A) through (C) as applicable, but no State shall be allotted
an amount that is less than the percentage specified in
clause (ii), for that particular year, of the corresponding
sum appropriated for fiscal year 2019.
``(II) From the remainder, amounts shall be allotted in
accordance with paragraph (1), subparagraphs (A) through (C)
as applicable, and paragraph (2) to the extent needed to meet
the requirements of those subparagraphs.''.
(b) Repeal.--Section 304(a)(3)(D) of the Older Americans
Act of 1965 (42 U.S.C. 3024(a)(3)(D)) is repealed effective
October 1, 2029.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
Oregon (Ms. Bonamici) and the gentlewoman from New York (Ms. Stefanik)
each will control 20 minutes.
The Chair recognizes the gentlewoman from Oregon.
General Leave
Ms. BONAMICI. Mr. Speaker, I ask unanimous consent that all Members
[[Page H8473]]
may have 5 legislative days in which to revise and extend their remarks
and insert extraneous material on H.R. 4334, the Dignity in Aging Act.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from Oregon?
There was no objection.
Ms. BONAMICI. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise in strong support of H.R. 4334, the Dignity in
Aging Act of 2019. I introduced this bipartisan bill to reauthorize and
update the Older Americans Act, or OAA, which was first passed in 1965
as part of President Lyndon Johnson's Great Society initiative.
For more than 50 years, OAA programs have helped older Americans
maintain their independence and their dignity.
Today, the Older Americans Act serves about 11 million individuals
each year, with 3 million of those Americans relying regularly on OAA
programs to meet their basic needs. Unfortunately, funding for the
Older Americans Act lags far behind the increasing demand for its
services.
Although the population of Americans over age 60 has grown more than
60 percent since 2001, OAA funding has only grown by about 20 percent.
Adjusting for inflation, this means that OAA funding has declined by
about 16 percent.
That erosion of funding exacerbates the vast unmet need in my home
State of Oregon and across the country. It means that every day in our
communities there are seniors who do not have the care they need and
deserve.
I have heard and read too many stories about seniors rationing
medication or saving portions of their meal so they can stretch their
resources just a bit further into the week. I will never forget the
story I heard of an 80-year-old woman in Oregon who was living in her
car. She did not know where to turn for help.
Far too many Americans continue to face poverty, discrimination, and
barriers to basic necessities. This is, in part, because OAA programs
are underfunded and not fully supported.
According a 2015 GAO report, OAA services do not reach 83 percent of
the low-income, older Americans who experience food insecurity. That is
more than four out of every five seniors in need.
Today, we recommit to investing in OAA programs because we have an
obligation, a moral obligation, to take care of those who cared for us.
The Dignity in Aging Act authorizes record levels of funding for OAA
programs, which will help expand access to food assistance,
transportation, and other basic services that the growing population of
seniors needs to live independently.
Under this bill, all OAA programs are eligible to receive an
immediate 7 percent increase in funding and a 6 percent increase each
year thereafter. This will result in a more than 35 percent total
increase in program funding over the 5-year reauthorization program,
restoring OAA funding to prerecession baseline.
This is a good investment because OAA programs help seniors stay in
their homes and out of costly facilities.
The bill also recognizes the need to support family caregivers and
direct-care workers. It extends the RAISE Family Caregivers Act, which
helps develop a national strategy to recognize and support those caring
for their loved ones. My 91-year-old mother has Alzheimer's, so I know
how important caregivers are.
H.R. 4334 strengthens our focus on combating social isolation, which
greatly increases the risk of stroke, heart disease, dementia, and
premature death. It does so by incorporating social isolation screening
into the health and supportive services that seniors receive and by
empowering local organizations to evaluate solutions for social
isolation.
The Dignity in Aging Act also establishes a National Research,
Demonstration, and Evaluation Center for the Aging Network. This center
will be responsible for conducting, promoting, and coordinating
research, including evaluation and demonstration projects and related
technical assistance through the act. The center will increase the
repository of information on evidence-based programs and interventions
available to the Aging Network.
The bill improves economic opportunity and engagement for older
Americans. It includes individuals who are justice-involved as a
priority population for the Senior Community Service Employment
Program.
The bill also encourages the inclusion of arts education and cultural
experiences, among other supportive services, and further allows for
demonstration funds to be used for multigenerational collaboration
projects that provide opportunities for older individuals to
participate in multigenerational activities and civic engagement
activities.
Finally, this bipartisan legislation seeks to improve services for
historically underserved and marginalized individuals, including Native
Americans, Holocaust survivors, and LGBT seniors. For example, it will
create a National Technical Assistance Center dedicated to expanding
the Aging Network's capacity to deliver person-centered, trauma-
informed services that meet the needs of aging trauma survivors.
The bill codifies the National Resource Center on Women and
Retirement to recognize the ongoing importance of their work, and it
improves data collection and outreach for all resource centers that
focus on populations needing additional or unique services.
This bill provides a rare bipartisan opportunity to help millions of
older Americans across the country spend less of their limited income
on costly care and, just as importantly, empowers every individual to
age with dignity.
I would like to thank Education and Labor Committee Chairman Bobby
Scott and Ranking Member Virginia Foxx, as well as my coleads on the
bill--Representative Elise Stefanik; Subcommittee Ranking Member
Representative James Comer; and Representatives Susie Lee, Susan
Wild, and Dusty Johnson--for working together to bring this bipartisan
bill to the floor.
I also want to thank the hardworking staff, especially Carrie Hughes
and Ali Hard from the committee; my personal office staff: Jack
Arriaga, Allison Smith, and Rachael Bornstein; and the staff on both
sides of the aisle.
Mr. Speaker, I encourage my colleagues to join me in supporting this
legislation so we can better care for those who have cared for us, and
I reserve the balance of my time.
Ms. STEFANIK. Mr. Speaker, I yield myself such time as I may consume.
As the Representative of a district that has one of the largest
constituencies of older Americans, I am proud to rise as a coauthor of
H.R. 4334, the Dignity in Aging Act, bipartisan legislation that
reauthorizes the Older Americans Act, which will directly benefit the
seniors in my district and the seniors across the country.
Since 1965, this statute has provided a wide range of social and
nutrition services for Americans aged 60 years or older. In addition to
well-known programs like Meals on Wheels, the Older Americans Act
supports services that include nutrition programs providing meals at
senior centers, schools, and churches; care to prevent abuse, neglect,
and exploitation of seniors; family caregiver support systems; and
community service employment opportunities for older Americans.
This legislation is full of bipartisan agreements and priorities, and
during times of stark political divide, it is encouraging to be here
today with my colleagues on both sides of the aisle to speak in support
of the Dignity in Aging Act, which is the product of a diligent,
congenial effort that embodies the good that can come from working
across the aisle.
The bill before us today provides States the flexibility to spend
funds on the issues impacting their senior communities, which include
support for older Americans who have become caregivers of younger
relatives due to the devastating toll of the opioid epidemic on our
communities.
It enhances the cost effectiveness of critical programs and ensures
program accountability and integrity by prohibiting the renewal of
grants that do not demonstrate effectiveness.
It assists formerly incarcerated, older individuals in reentering the
workforce rather than re-offend and ensures that funded programs are
evidence based and effectively serving seniors.
[[Page H8474]]
Additionally, this bill includes long-overdue updates from the
Younger Onset Alzheimer's Act that I co-led with my friend and
colleague from New York, Congresswoman Kathleen Rice.
Those under 60 with this heartbreaking disease face unique hardships,
for themselves and for their families. The current support structures
for individuals with Alzheimer's are focused almost exclusively on
seniors, leaving the 200,000 Americans living with younger onset
Alzheimer's without access to these critical services.
This bill ensures individuals of any age living with Alzheimer's
receive full access to the services and support provided by the Older
Americans Act.
I am also very proud to say that included in this bill is language
from another bipartisan legislative proposal that I coauthored
encouraging the use of caregiver assessments to identify the needs of
family caregivers.
This individualized approach to care will ensure that both caregivers
and those who require assistance are provided tailored support to
achieve the best possible health outcomes.
There is another group of older Americans in this country we must not
forget: the nearly 80,000 Holocaust survivors who live among us. As
victims of the very worst of humanity, Holocaust survivors deserve
devoted care and support to address the unimaginable, horrific trauma
they experienced. Sadly, one-third of our country's Holocaust survivors
live in poverty.
During the markup process in the House Committee on Education and
Labor, I was honored to work with my friend and colleague,
Representative Bonamici, on a provision that works to address the needs
of aging Holocaust survivors.
Institutional placement can present a unique challenge to those who
have suffered the trauma of the Holocaust, so it is critical that these
individuals are identified for the services necessary to support
independent living. Our provision will ensure local outreach efforts
place a special emphasis on Holocaust survivors and others at risk for
institutional placement.
Additionally, the bill recognizes the specific needs of this
community by ensuring that nutrition programs should meet the
religious, cultural, or ethnic dietary requirements of all older
Americans.
These men and women have survived unconscionable suffering, yet many
continue to live with physical and emotional scars from the horror they
faced. Together, we acknowledge their resilience and seek to offer
opportunities that allow them to live healthy, dignified, and
independent lives through their elder years.
Mr. Speaker, I am encouraged by the bipartisan effort from the
Education and Labor Committee that has resulted in the meaningful
legislation before us today. I strongly encourage all of my colleagues
to vote ``yes'' on H.R. 4334, the Dignity in Aging Act. In doing so, we
reaffirm our commitment to our Nation's older generation.
Mr. Speaker, I reserve the balance of my time.
Ms. BONAMICI. Mr. Speaker, I yield 3 minutes to the gentleman from
Virginia (Mr. Scott), chairman of the Education and Labor Committee.
Mr. SCOTT of Virginia. Mr. Speaker, I thank Representatives Bonamici,
Stefanik, Lee of Nevada, Comer, Wild, and Johnson of South Dakota for
their work on this bipartisan bill.
I want to specifically recognize Ms. Bonamici, who serves as the
chair of the Subcommittee on Civil Rights and Human Services for the
Committee on Education and Labor. Because of her leadership, we are
here today to consider the Dignity in Aging Act and to reauthorize the
Older Americans Act and, thereby, support and invest in our Nation's
seniors.
{time} 1445
Congress first passed the Older Americans Act in 1965, along with
Medicare, Medicaid, and other civil rights legislation as part of
President Johnson's great society.
Fifty-four years later, this act continues to support a range of
programs that now help 11 million aging Americans retain their
independence and avoid costly institutional care. This includes 3
million Americans who regularly use OAA services to address their basic
needs, especially food, transportation, and social interaction.
Unfortunately, the OAA funding has not kept pace with inflation and
the growing population of aging Americans. In 2010, the annual funding
was $42.95 per senior in today's dollars. Today, it is not $42.95, it
is only $27.25.
This disinvestment has weakened the OAA programs at a time when
services are in high demand. According to a 2015 GAO report, OAA
services fail to reach a vast majority of low-income Americans who
experience food insecurity.
The investments we make through this legislation will not only allow
us to help seniors, but also help us save money. OAA services allow
older Americans to delay or altogether avoid costlier care by promoting
healthier behaviors and promoting critical supportive services.
The bill funds OAA services at record levels. It focuses on the vital
role of family caregivers, as well as direct care workers, and allows
those with early onset Alzheimer's to benefit from the act.
As the number of older Americans continues to increase, the Dignity
in Aging Act is an opportunity for us to strengthen essential services
that allow millions of Americans across the country to age
independently and with dignity. I urge my colleagues to support the
Dignity in Aging Act of 2019.
Ms. STEFANIK. Mr. Speaker, I yield 2 minutes to the gentleman from
Kentucky (Mr. Comer), the ranking member of the Subcommittee on Civil
Rights and Human Services.
Mr. COMER. Mr. Speaker, today's life expectancy rate in our Nation is
at a historic high, and that is great news. It also means we need to be
doing all we can to ensure that Americans have access to quality,
timely services which allow them to live independently in their homes
as long as possible.
Since 1965, the Older Americans Act, or OAA, has governed the
organization and delivery of services for senior citizens throughout
the country. With more than 41 million Americans aged 65 and older, the
social and nutritional programs offered by OAA are critical to helping
them maintain independence.
The reach of this law is substantial and covers many aspects of elder
care. In addition to well-known programs like Meals on Wheels, OAA
supports services provided by more than 300 State organizations and
approximately 20,000 local providers. Some of these services include:
Nutrition programs providing meals at senior centers, schools and
churches; care to prevent the abuse, neglect, and exploitation of
seniors; family caregiver support systems; and community service
employment opportunities for older Americans. These types of programs
offer valuable assistance for America's seniors, and we must ensure the
law is aging as well as the people it serves.
I am proud that our committee has worked together to produce
bipartisan, effective legislation to support our Nation's seniors.
Specifically, the Dignity in Aging Act we are considering today
eliminates the arbitrary cap on the percentage of funding Area Agencies
on Aging can use to provide services to older caregivers raising
younger relatives. These provisions will be especially beneficial for
my constituents in Kentucky where, in the midst of the opioid crisis,
many older relatives have taken on the responsibilities of raising
children whose parents are not present or unable to take care of them.
As an original cosponsor of this legislation, and the ranking member
of the subcommittee of jurisdiction, I appreciate the work of
Chairwoman Bonamici, and my colleagues on the Committee on Education
and Labor to advance the Dignity in Aging Act of 2019.
I urge all my colleagues to support this legislation to build upon
the flexible policies found in the Older Americans Act to promote
consumer-driven, independent living for our Nation's elderly
population.
Ms. BONAMICI. Mr. Speaker, I yield 1 minute to the gentlewoman from
Illinois (Ms. Underwood), a member of the Education and Labor
Committee.
Ms. UNDERWOOD. Mr. Speaker, I rise today in strong support of H.R.
4334, the Dignity in Aging Act of 2019. This is a strong bipartisan
bill to reauthorize the Older Americans Act, which provides vital
services and support to seniors and their families in our community.
[[Page H8475]]
Reauthorization has been an important local priority in my community
in northern Illinois.
During the August work period, I held a roundtable on the issue at
the Fox Valley Older Adult Services with local stakeholders. Their
priorities for reauthorization included increased funding,
transportation, legal services, and support for seniors who age in
place, and their caregivers.
That is why I am so proud that the bill that we are discussing today,
among other improvements: Increases overall transportation program
funding by 35 percent; improves access to that funding; increases
availability and accessibility of meals for seniors; and strengthens
support for family caregivers, including those caring for individuals
with younger-onset Alzheimer's disease.
I am so proud that this bill includes my bipartisan amendment to
ensure that programs that serve seniors are ready to respond to
outbreaks or other public health emergencies.
I urge my colleagues on both sides of the aisle to support the
Dignity in Aging Act so that our seniors have the services and support
they need.
Ms. STEFANIK. Mr. Speaker, I yield 2 minutes to the gentleman from
Georgia (Mr. Allen), the ranking member on the Subcommittee on Early
Childhood, Elementary, and Secondary Education.
Mr. ALLEN. Mr. Speaker, 54 years ago, our country made a commitment
to older Americans and their families. In 1965, the Older Americans Act
was enacted to support a wide range of services and programs for
individuals over the age of 60. By passing this legislation, Congress
made a promise to help provide compassionate care to our Nation's most
vulnerable adults who are sometimes exploited, abused, or neglected.
This legislation is vital to Georgia's seniors, and it supports many
important community-based services like nutrition programs at churches
and family caregiver support.
I have seen the benefits of these programs firsthand, as I have had
several opportunities to deliver Meals on Wheels to those who are
unable to grocery shop or prepare a warm meal for themselves. What a
privilege, as a Member of Congress, to visit with these older adults
and talk to them about their contribution to this great country as we
delivered these meals.
This legislation upholds the dignity of those who are aging, and it
has received bipartisan support for more than 50 years. Today should be
no different, as we have a responsibility to uphold the promise that
was made to support our Nation's seniors.
I urge my colleagues to, once again, reauthorize the Older Americans
Act.
Ms. BONAMICI. Mr. Speaker, I yield 3 minutes to the gentlewoman from
New York (Miss Rice) who, along with Representative Stefanik, were lead
sponsors of the Younger Onset Alzheimer's Act, which was included in
this legislation.
Miss RICE of New York. Mr. Speaker, I rise today in support of H.R.
4334, the Dignity in Aging Act of 2019, which includes key provisions
from our bill, the Younger Onset Alzheimer's Act.
This critical legislation will amend the Older Americans Act to
ensure that the hundreds of thousands of Americans living with younger-
onset Alzheimer's disease receive the care and support that they
desperately need and deserve.
The Older Americans Act was originally enacted in 1965 and supports a
range of home and community-based programs for Americans age 60 and
older. These programs include nutritional services like Meals on
Wheels, in-home and adult daycare, transportation services, legal aid,
elder abuse prevention, and vital assistance and support for family
caregivers. These programs have become absolutely essential to people
living with Alzheimer's disease and their families.
However, today 5 percent of Americans living with Alzheimer's
disease, approximately 250,000 people, are living with younger-onset
Alzheimer's, a disease that has a particularly devastating effect on
families, with diagnoses coming in individual's thirties, forties, or
fifties, when they still have young children, new homes and growing
careers. They are in the prime of their lives, and they don't always
have the financial stability to leave the workforce, which is usually
inevitable.
And because of their young age, they are currently ineligible for all
OAA-funded programs. Virtually overnight, these families face
unimaginable and unforeseen financial and emotional strain; and yet
they are denied access to critical OAA programs, programs that we know
work, and that so many people with Alzheimer's rely on every day.
By including major provisions from our bill, the Dignity in Aging Act
will ensure that younger Alzheimer's patients and their families have
access to critical programs and support.
Before I conclude, Mr. Speaker, I want to take a moment to
acknowledge two of my constituents who helped bring this issue to my
attention, Karen Henley and Connie Wasserman.
Karen lost her husband, Mike, to younger-onset Alzheimer's in 2012.
He was diagnosed at the age of 36 and passed away at 47.
Karen, Mike, and their two children, Brandon and Courtney,
experienced firsthand how challenging it is for people with this
disease to find affordable and quality care.
Connie Wasserman is the Associate Executive Director of Social
Services of the Sid Jacobson JCC in East Hills, New York. For years,
she has played a crucial role in supporting people and families living
with younger-onset Alzheimer's right on Long Island, families like the
Henleys, who had nowhere to go.
But because the government does not fund Alzheimer's programs for
people under the age of 60, Connie has had to start her own. And right
now, she relies almost entirely on private funding.
Connie and Karen have become tireless advocates for those living with
younger-onset Alzheimer's, and they worked closely with my office on
this bill.
As fate should have it, today is Karen and Mike Henley's wedding
anniversary and, in honor of them, I ask all of my colleagues to
support the Dignity in Aging Act of 2019.
Ms. STEFANIK. Mr. Speaker, I yield 4 minutes to the gentlewoman from
North Carolina (Ms. Foxx), the Republican leader of the Committee on
Education and Labor.
Ms. FOXX of North Carolina. Mr. Speaker, I would like to begin by
thanking Representative Stefanik for her leadership on this legislation
before us today.
I rise today to speak in support of H.R. 4334, the Dignity in Aging
Act, which will reauthorize the Older Americans Act through 2024.
For over 50 years, the Older Americans Act, or OAA, has helped
provide social and nutrition services to older Americans. With more
than 40 million Americans aged 65 and older, the programs and services
offered by OAA are helping them maintain independence, and the data
shows overwhelmingly that these programs help older Americans live
higher-quality lives.
The reach of this law is substantial and covers many aspects of elder
care beyond just well-known programs like Meals on Wheels. OAA supports
services that include: Nutrition programs providing meals at senior
centers, schools, and churches; care to prevent the abuse, neglect, and
exploitation of seniors; family caregiver support systems; and services
to help older Americans move into employment.
This reauthorization is the product of bipartisan hard work with
Members of the Education and Labor Committee and shows the good that
can come from working together. Through productive conversation and
compromise, we have successfully authorized grants for States and Area
Agencies on Aging, AAAs, responsible for coordinating local services
for older individuals.
Specifically, the supportive services program funds a wide range of
social services aimed at helping our older population remain
independent in their own homes and communities. These services include,
case management, adult daycare, and other numerous activities of senior
centers. Additionally, States are required to devote a certain portion
of funding to access services, home care, and legal assistance.
Furthermore, local agencies that implement the law on the ground will
receive additional clarity about cost-sharing policies designed to
increase the cost-effectiveness of OAA programs.
[[Page H8476]]
The bill also infuses additional accountability over hardworking
taxpayer funds into these programs by requiring programs to demonstrate
they met their stated goals prior to receiving a renewal of their
grant.
In addition to funding for supportive services and nutrition
services, H.R. 4334 also provides for caregiver support. The bill
continues support for the National Family Caregiver Support Program,
which provides funds to States to support Americans caring for aging
family members.
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The program provides a range of services, including information and
assistance to caregivers about available services, counseling,
organization of support groups and caregiver education, respite
services to provide families temporary relief from care-giving
responsibilities, and supplemental services to complement care provided
by other caregivers.
The bill also provides increased flexibility to states by lifting a
cap on the percentage of funds that can go to older relative
caregivers, which will allow for additional support for those seniors
who have taken responsibility for caring for family members due to the
growing problem of opioids in our Nation.
Mr. Speaker, I am very encouraged by the teamwork and bipartisanship
that went into this bill. H.R. 4334, the Dignity in Aging Act, reflects
Congress' commitment to our Nation's seniors and builds upon the law's
flexible policies, allowing older Americans to age with health,
dignity, and independence in the communities of their choosing.
I would like, again, to thank Representative Stefanik for her
diligent work on this legislation and Chairman Scott for his commitment
to bipartisanship. I strongly urge all of my colleagues to support this
reauthorization that will benefit an entire generation of older
Americans.
Ms. BONAMICI. Mr. Speaker, I yield 3 minutes to the gentlewoman from
Pennsylvania (Ms. Wild), a member of the Education and Labor Committee
and a passionate advocate for suicide prevention.
Ms. WILD. Mr. Speaker, back in 1965, when President Lyndon Johnson
signed the Older Americans Act, Congress codified into law an essential
and universal truth, that each generation has a responsibility to
protect and support those who raised and have cared for us.
These bonds of solidarity tie our society together. We are stronger
both as individuals and as a Nation when we hold each other up.
The objectives of the Older Americans Act were to secure adequate
income in retirement, the best possible physical and mental health
services without regard to economic status, suitable housing and
transportation, restorative services, and employment opportunities free
of discrimination.
The programs funded through the OAA remain immensely popular, but
funding has not kept pace. In 2010, OAA funding was approximately
$42.95 per senior in today's dollars. Today, it is just $27.25 per
senior.
Every time funding fails to meet demand, the foundation of our Great
Society is chipped away. Every time funding fails to meet demand, we
run the risk of malnutrition, unsafe living conditions, and social
isolation for our seniors.
Fortunately, there is a solution, and that solution is the
legislation we are voting on today. The Dignity in Aging Act of 2019 is
a bipartisan reauthorization of the OAA, which gives all OAA programs
an immediate 7 percent increase in fiscal year 2020 and a 6 percent
increase every year thereafter.
Reflecting the fact that this is a national priority, transcending
differences of party and politics, three of my Republican colleagues--
Representative Dusty Johnson, Representative Stefanik, and
Representative Comer--worked alongside me as original cosponsors of
this legislation, which was introduced by my colleague Representative
Bonamici.
Critically, this legislation includes provisions that will guide
OAA's nutrition programs, like Meals on Wheels, programs that meet an
urgent need across our country, and it includes language that will
benefit our seniors by ensuring access to nutritional services that are
culturally sensitive and reflect the diverse needs of our communities.
I am particularly proud that this bill updates the OAA by putting a
greater focus on countering social isolation, empowering local
organizations to develop solutions that incorporate social isolation
screening into mental health and supportive services that seniors
receive.
That is why I proposed an amendment unanimously adopted by the
Education and Labor Committee as part of the underlying legislation to
add screening for suicide risk to the disease prevention and health
promotion services offered under the OAA.
Older Americans are among the most at-risk members of our population
when it comes to the suicide epidemic across our Nation. We must stand
with these fellow Americans and offer them our support as we all work
to break the stigma around suicide and mental health, and as we all
work to build a society in which we prioritize mental health just as
much as physical health.
Ms. STEFANIK. Mr. Speaker, I reserve the balance of my time.
Ms. BONAMICI. Mr. Speaker, I yield myself such time as I may consume.
I include in the Record letters of support from AARP supporting H.R.
4334, a letter from the Jewish Federation of North America supporting
H.R. 4334, a letter from the Alzheimer's Association and the
Alzheimer's Impact Movement supporting the legislation, a letter from
72 national organizations representing older adults and caregivers
across the country, and a letter from Meals on Wheels supporting H.R.
4334 and its attention to the impacts of social isolation.
AARP,
October 25, 2019.
Dear Representative: On behalf of our nearly 38 million
members and all older Americans nationwide, AARP is pleased
to support H.R. 4334, the bipartisan Dignity in Aging Act of
2019, legislation to reauthorize the Older Americans Act
(OAA). We urge you to pass this legislation that will
maintain the critical service and information roles of OAA
programs and promote greater responsiveness to the needs of
older Americans.
Too often, advancing age and increasing frailty threaten
the ability of older Americans to live independently in their
own homes and communities. The fear of having to leave family
behind and enter a nursing home weighs heavily on the minds
of many. According to AARP's Home and Community Preferences
Survey, the vast majority of adults age 50-plus--more than
three out of four people--want to remain in their community
as long as possible. Giving Americans the support they need
to live at home with independence and dignity has always been
a bedrock goal of OAA, and it has been remarkably successful.
For many older Americans, the key to being able to stay in
their own homes is the dedication and commitment of family
caregivers. An estimated 40 million family caregivers provide
a staggering $470 billion annually in unpaid care to their
loved ones--ranging from bathing and dressing to paying bills
and transportation and assisting with medical/nursing tasks.
By supporting family caregivers, we can help people stay at
home, helping to delay or prevent more costly nursing home
care and unnecessary hospitalizations. Therefore, we are
pleased the Dignity in Aging Act addresses AARP's family
caregiving priorities, including further strengthening the
National Family Caregiver Support Program (NFCSP) and
extending the bipartisan Recognize, Assist, Include, Support,
and Engage (RAISE) Family Caregivers Act (P.L. 115-119).
Specifically, the legislation includes H.R. 3782, the
bipartisan Supporting Family Caregivers Act sponsored by
Representatives Andy Levin and Elise Stefanik. This provision
will help make sure that more caregivers can get their needs
assessed when they turn to NFCSP for support. Understanding
the family caregiving situation is a critical step in the
process for linking the family caregiver to the most
appropriate support services, as every family's needs are
unique. Assessments of the caregiving situation provide
information to help target services more effectively. Better
targeting of support services can also help maintain the
health and well-being of the caregiver, sustain their ability
to provide care, produce better outcomes for their loved
ones, and prevent or delay nursing home placement. H.R. 4334
also provides more time for implementation of the RAISE
Family Caregivers Act. This will allow the Advisory Council
to do its work and find additional meaningful solutions to
better support the 40 million family caregivers nationwide.
Importantly, H.R. 4334 also provides increased funding
levels for OAA programs. People age 80 and older are among
the most likely to need assistance to live independently in
their homes and communities. The population of Americans in
this age group is projected to increase by 54 percent from
2019 to 2030. Additionally, over the next decade, the number
of family caregivers is not expected to keep up with the
large number of
[[Page H8477]]
older adults needing care, underscoring the need for greater
investments in OAA programs. Increased funding levels will
assist more older Americans and caregivers, thus helping more
older adults remain at home and in better health, avoiding
costlier services.
We urge you to vote for the Dignity in Aging Act. Prompt
reauthorization of this law will help ensure the
sustainability of OAA programs, and as a result, our loved
ones can continue to turn to these vital services for their
health and economic security as they age. If you have any
questions, feel free to contact me.
Sincerely,
Bill Sweeney,
Senior Vice President,
Government Affairs.
____
The Jewish Federations of
North America,
Washington, DC, October 25, 2019.
Chairman Robert C. Scott,
House Education and Labor Committee,
Washington, DC.
Ranking Member Virginia Foxx,
House Education and Labor Committee,
Washington, DC.
Chairwoman Suzanne Bonamici,
House Education and Labor Committee, Subcommittee on Civil
Rights and Human Services,
Washington, DC.
Ranking Member James R. Comer,
House Education and Labor Committee, Subcommittee on Civil
Rights and Human Services,
Washington, DC.
Dear Chairman Scott, Ranking Member Foxx, Chairwoman
Bonamici and Ranking Member Comer: The Jewish Federations of
North America (JFNA) is proud to endorse H.R. 4334, the
Dignity in Aging Act of 2019. JFNA represents 146 local
Jewish Federations, 300 Network communities, and thousands of
affiliated social service agencies across the continent. Our
movement protects and enhances the well-being of Jews
worldwide through the values of tikkun olam (repairing the
world), tzedakah (charity and social justice) and torah
(Jewish learning). Jewish social services provide support for
more than one million vulnerable individuals each year,
Jewish and non-Jewish alike, with our clients spanning the
age range and including approximately 100,000 older adults.
For more than 50 years, the Older Americans Act (OAA) has
been essential in developing, coordinating, and delivering
home and community-based services that help older adults age
with independence and dignity in their homes and communities.
Without these crucial services, many individuals served by
OAA-funded programs in our network are at significant risk of
hunger, isolation, and losing their ability to live with
health and independence.
The Jewish community is disproportionately older than the
general population in this country with more than 25% of
American Jews already over the age of 65, and the fastest
growing demographic in the Jewish community is those over the
age of 85. Jewish family service agencies, Jewish vocational
service agencies and Jewish community centers are a key
component of the country's Aging Services Network and, in a
classic public-private partnership, provide many services
funded through the OAA, including case management,
transportation, congregate and home-delivered meals, adult
day care, elder abuse prevention and intervention, family
caregiver support, home care, legal conservatorship, and
support groups.
This year's reauthorization process produced a bill that,
if passed by the full House of Representatives on Monday,
will significantly move the ball forward in how our country
and its Aging Services Network treat and care for seniors.
The very first provision of the Dignity in Aging Act
incorporates ``person-centered, trauma-informed care'' as a
new objective of the Older Americans Act. This principle,
which is subsequently defined in the bill, represents a new
trend in service delivery that will positively impact both
clients and agencies. It incorporates a holistic approach to
service provision that promotes the dignity, strength, and
empowerment of trauma victims by referencing knowledge about
the role of trauma in trauma victims' lives. The inclusion of
the PCTI approach in this bill is indicative of the forward
and necessary progress embedded in the Dignity in Aging Act.
The Dignity in Aging Act authorizes a technical assistance
center to serve older adults experiencing the long-term and
adverse consequences of trauma, including but not-limited to
Holocaust survivors. Holocaust survivors are also
specifically mentioned for the first time within the Older
Americans Act in the context of providing additional outreach
to older individuals ``including Holocaust survivors'' who
are at risk of institutional placement. The bill also
emphasizes cultural considerations (including religious and
ethnic requirements) in the provision of congregate and home-
delivered meals.
This Older American Act reauthorization incorporates new
support for age-friendly communities, a major new focus on
social isolation in older adults, recognition of the
emergency confronting our direct care workforce, an updating
of, recognition and support for multigenerational families,
and assistance to family caregivers with an extension of the
RAISE Family Caregivers Act. Each of these provisions and
many others contained in the bill will serve our nation well.
JFNA also commends the Education and Labor Committee for
supporting a five year reauthorization period for the Older
Americans Act, which helps safeguard support and removes
uncertainty for the growing aging population.
Finally, and very importantly, this bill provides
relatively robust funding increases of 7% for FY 2020 and 6%
for each of the next four years.
While the Older American Act formally expired on September
30, 2019, this year's process to reauthorize it was the most
efficient, transparent, bipartisan and productive of the five
similar reauthorizations that I have worked on going back to
1999. The result is a reauthorization vehicle that is very
worthy of support, and JFNA looks forward to the House of
Representatives passage of the Dignity in Aging Act and the
enactment of the reauthorization.
Sincerely,
Stephan O. Kline,
Associate Vice President, Public Policy, The Jewish
Federations of North America.
____
Alzheimer's Impact Movement,
October 25, 2019.
Hon. Bobby Scott,
Chairman, House Education and Labor Committee, Washington DC.
Hon. Virginia Foxx,
Ranking Member, House Education and Labor Committee,
Washington, DC.
Dear Chairman Scott and Ranking Member Foxx: On behalf of
the Alzheimer's Association and the Alzheimer's Impact
Movement (AIM), including our nationwide network of
advocates, thank you for your continued leadership on issues
and legislation important to Americans living with
Alzheimer's and other dementias and to their caregivers. In
addition, thank you for working together in a bipartisan
manner to reauthorize the Older Americans Act (OAA). We are
proud to support the Dignity in Aging Act of 2019 (H.R. 4334)
and are pleased to highlight several provisions that are
critical to persons living with dementia, their families and
their caregivers.
We strongly support the inclusion of language codifying
existing authority to provide services to individuals living
with younger-onset Alzheimer's disease under the National
Family Caregiver Support Program and the Long-Term Care
Ombudsman Program. We are very appreciative for the
Committee's inclusion of parts of the Younger-Onset
Alzheimer's Disease Act (S. 901/H.R. 1903).
There are approximately 5.8 million Americans living with
Alzheimer's disease. The vast majority of those individuals
are over the age of 65; however, approximately 200,000
Americans are under the age of 65 living with younger-onset
Alzheimer's disease. Individuals living with younger-onset
face unique challenges when it comes to family, work, and
finances. They may be parenting young children at home, or
may still be working as the primary income provider for their
families. Due to their young age, they may have more trouble
receiving an accurate diagnosis, and even family and friends
might question their diagnosis. The stigma associated with
younger-onset Alzheimer's can have a significant impact on
their well-being and quality of life.
Since 97 percent of all people living with Alzheimer's are
age 65 or older, current Alzheimer's support infrastructure
focuses exclusively on seniors. As a result, few supportive
services are available to those with younger-onset. With
other diseases--like heart disease, diabetes, and even
cancer--many people living with them are middle-aged and
there is a large support structure available to them. Those
same support structures are not available for the individuals
living with younger-onset Alzheimer's disease. The services
provided under the OAA are particularly helpful for
individuals with younger-onset Alzheimer's disease and
related dementias who need assistance with activities of
daily living.
The Younger-Onset Alzheimer's Disease Act is consistent
with the National Plan to Address Alzheimer's Disease. The
Advisory Council on Alzheimer's Research, Care, and Services,
which is responsible for updating and implementing the Plan,
has noted that persons living with younger-onset Alzheimer's
face unique challenges in accessing care. In the 2017
National Plan, the Advisory Council recommended that Congress
amend the OAA to allow additional services to be provided to
younger adults living with dementia.
The Alzheimer's Association and AIM also deeply appreciate
the Committee's extension of the RAISE Family Caregivers Act
from 3 to 4 years. We have been strong advocates for the
RAISE Family Caregivers Act since it was introduced in
Congress. There has been a delay in the implementation of the
Act and the decision to extend the authorization allows the
Department of Health and Human Services to better develop a
national strategy for education and training, longterm
services and supports, and financial stability and security
for caregivers.
For millions of Americans caring for individuals with
Alzheimer's and other dementias the emotional, physical, and
financial costs can be overwhelming. Caregivers of people
with dementia report higher levels of stress, depression, and
worse health outcomes than those providing care to
individuals without dementia. As a result, Alzheimer's
caregivers incurred $11.8 billion in
[[Page H8478]]
additional health costs last year. We appreciate the
Committee prioritizing this important program.
We also applaud the Committee's strengthening of Caregiver
Assessments. In 2018, more than 16 million unpaid caregivers
provided 18.5 billion hours of care valued at nearly $234
billion and face the challenges noted above. Eighty-three
percent of the help provided to older adults in the United
States comes from family members, friends, or other unpaid
caregivers. Nearly half of all caregivers who provide help to
older adults do so for someone living with Alzheimer's or
another dementia. Alzheimer's takes a devastating toll on
caregivers. Compared with caregivers of people without
dementia, twice as many caregivers of those with dementia
indicate substantial emotional, financial, and physical
difficulties. Of the total lifetime cost of caring for
someone with dementia, 70 percent is borne by families--
either through out-of-pocket health and longterm care
expenses or from the value of unpaid care.
These dedicated caregivers would greatly benefit from
increased resources, training and support to help them
navigate the strain of caregiving and improve their health
and quality of life. The proposed changes would provide these
caregivers much-needed resources, increase the use of
caregiver assessments, and identify best practices relating
to the programs. These important actions will enhance support
for caregivers through skills building, increased resources
and information, respite care, counseling, and other helpful
benefits.
Finally, the Alzheimer's Association and AIM appreciate
your commitment to supporting individuals facing social
isolation. Social isolation is an issue within the aging
community as a whole, and particularly in the Alzheimer's and
related dementias community. Studies have found that support
groups can decrease social isolation and increase social
support, the ability to accept the diagnosis, cope with
symptoms, improve quality of life, and enhance family
communication. (Alzheimer's Association Dementia Care
Practice Recommendations, 2018). Support programs offered
through the National Family Caregiver Support Program can
work to decrease social isolation. We appreciate the bill's
inclusion of an advisory council dedicated to identifying the
challenges, solutions, and best practices to address social
isolation.
Again, thank you for your leadership in ensuring OAA's
reauthorization, which will improve the quality of care for
people living with Alzheimer's.
Sincerely,
Robert Egge,
Chief Public Policy Officer, Executive Vice President,
Government Affairs, Alzheimer's Association.
____
October 28, 2019.
Hon. Nancy Pelosi, Speaker,
Hon. Kevin McCarthy, Minority Leader,
House of Representatives,
Washington, DC.
Hon. Bobby Scott, Chairman,
Hon. Virginia Foxx, Ranking Member,
Committee on Education and Labor, House of Representatives,
Washington, DC.
Dear Speaker Pelosi, Leader McCarthy, Chairman Scott and
Ranking Member Foxx: On behalf of the undersigned 72 national
organizations with a vested interest in the well-being of
America's older adults and caregivers, we write to you today
in support of the House-proposed Dignity in Aging Act (H.R.
4334) to reauthorize the Older Americans Act (OAA). We urge
Members of the House to support this important five-year OAA
reauthorization. Reauthorization of this critical Act, which
expired on September 30, will ensure the sustainability of
vital OAA programs, as well as the health, dignity, and
independence of older Americans and their caregivers.
The OAA is essential to developing, coordinating, and
delivering home and community-based services that help older
adults age with independence and dignity. Many individuals
served by OAA-funded programs are at significant risk of
hunger, isolation, abuse, and losing their ability to live
with health and independence. OAA-supported programs are
provided to more than 11 million seniors and their caregivers
annually. These vital supports include, but are not limited
to, home-delivered and congregate nutrition services, in-home
supportive services, multipurpose senior centers,
transportation, caregiver support, disease prevention and
health promotion, community service employment, the long-term
care ombudsman program, and services to prevent the abuse,
neglect, and exploitation of older adults.
By keeping seniors healthy and in their communities for
more than 50 years, OAA programs have delayed or prevented
the need for more expensive institutional care for many older
adults, which is often paid for through Medicare or Medicaid.
OAA services can effectively save taxpayer, state, and
federal dollars. In addition to helping older adults age in
place where they most often want to be, OAA programs have
improved our country's fiscal future and promoted
efficiencies within the health care system by preventing
unnecessary hospital stays, reducing readmission rates,
coordinating care, and managing care transitions.
We appreciate that the Dignity in Aging Act, H.R. 4334
builds upon the early bipartisan Senate draft bill and
incorporates a number of important priorities articulated by
stakeholder organizations. Most importantly, the Dignity in
Aging Act calls for much-needed and necessary investments in
the OAA by increasing funding authorizations over the next
five years--a top priority of the undersigned organizations
and the most critical need of the Aging Services Network
authorized by the OAA.
Other priority areas include research innovation and
demonstrations, Native American services, local planning and
development, supports for those suffering from dementias and
social isolation, legal services, nutrition, in-home
supportive services, disease prevention and health promotion,
multigenerational collaboration, and family caregiver
supports. We appreciate that the House proposal to
reauthorize the OAA has preserved the numerous ways in which
this Act works so well at the federal, state, and local
levels, on behalf of the older adults and caregivers for whom
it is a lifeline to dignity, independence, health, safety,
and economic security.
Thank you for your commitment to this important issue. The
undersigned organizations represent a diverse set of
stakeholders, and we urge Members of the House to swiftly
advance this bill to reauthorize the Older Americans Act.
Sincerely,
AARP, Academy of Geriatric Physical Therapy, Advancing
States, Aging and Vision Loss National Coalition, AHEPA
Management Company (AMC), Alliance for Aging Research,
Alliance for Retired Americans, Alliance to End Hunger,
Allies for Independence, Alzheimer's Association and the
Alzheimer's Impact Movement, American Association of Service
Coordinators, American Association on Health and Disability,
American Geriatrics Society, American Hellenic Educational
Progressive Association (Order of AHEPA), American Music
Therapy Association.
American Physical Therapy Association, American Public
Health Association, American Society of Consultant
Pharmacists (ASCP), American Society on Aging, Blinded
Veterans Association, Bread for the World, Caregiver Action
Network, Caregiver Voices United, Caring with Grace, LLC,
CaringKind, the Heart of Alzheimer's Caregiving, Center for
Medicare Advocacy, Center to Advance Palliative Care,
Collective Action Lab, Congregation of Our Lady of Charity of
the Good Shepherd, U.S. Provinces, Corporation for Supportive
Housing (CSH).
Daughters of Penelope, Dementia Alliance International,
Easterseals, Evangelical Lutheran Church in America, Feeding
America, Home Instead Senior Care, International Association
for Indigenous Aging, Jewish Council for Public Affairs,
Justice in Aging, Lakeshore Foundation, LeadingAge, Lutheran
Services in America, MAZON: A Jewish Response to Hunger,
Meals on Wheels America, Medicare Rights Center.
Mercy Housing, Inc., Michigan State College of Human
Medicine Alzheimer's Alliance, National Adult Protective
Services Association, National Alliance for Caregiving,
National Asian Pacific Center on Aging (NAPCA), National
Association of Activity Professionals, National Association
of Area Agencies on Aging (n4a), National Association of
Development Organizations (NADO), National Association of
Long-Term Care Ombudsman Programs (NASOP), National
Association of Nutrition and Aging Services Programs
(NANASP), National Certification Council for Activity
Professionals, National Council on Aging, National Health
Council, National Recreation and Park Association, National
Respite Coalition.
NETWORK Lobby, Network of Jewish Human Service Agencies,
Inc., PHI, RESULTS, Society for the Blind, The Gerontological
Society of America, The Jewish Federations of North America,
United Church of Christ Justice and Witness Ministries,
United Spinal Association, USF Health Byrd Alzheimer's
Institute, Village to Village Network, VisionServe Alliance,
Volunteers of America.
____
Meals on Wheels America,
Arlington, VA, October 28, 2019.
Hon. Nancy Pelosi,
Speaker, House of Representatives,
Washington, DC.
Hon. Kevin McCarthy,
Minority Leader, House of Representatives,
Washington, DC.
Hon. Bobby Scott,
Chairman, Committee on Education & Labor, House of
Representatives, Washington, DC.
Hon. Virginia Foxx,
Ranking Member, Committee on Education & Labor, House of
Representatives,
Washington, DC.
Dear Speaker Pelosi, Leader McCarthy, Chairman Scott and
Ranking Member Foxx: On behalf of Meals on Wheels America,
the nationwide network of community-based senior nutrition
programs and the individuals they serve, we write to express
our support for H.R. 4334, the Dignity in Aging Act of 2019
and urge swift and bipartisan passage in the House of
Representatives. We commend the efforts of the Education and
Labor Committee for receiving unanimous approval following
the September markup, as well as the leadership of
Subcommittee Chairwoman Bonamici (D-OR) and Ranking Member
Comer (R-KY), and Representatives Stefanik (R-NY), Lee (D-
NV), Wild (D-PA) and Johnson (R-SD) in the introduction of
this legislation.
For over five decades, the OAA has been the primary piece
of federal legislation focused on establishing, coordinating
and
[[Page H8479]]
strengthening community and home-based social and nutrition
services for adults age 60 and older, their families and
their caregivers. OAA services like Meals on Wheels,
transportation, caregiver assistance, senior employment and
training and elder rights protection are just some of the
vital functions the OAA delivers to more than 11 million
seniors annually.
As you and many of your colleagues know firsthand, OAA
services and supports, including the three nutrition programs
authorized under Title III of the Act, help keep our nation's
most vulnerable, isolated and food insecure seniors healthier
and in their own homes and communities longer. This in turn
delays and/or prevents altogether the need for more expensive
institutional care often paid for through Medicare or
Medicaid. OAA programs are not only extremely cost-effective,
but they are longstanding examples of public-private
partnerships that help save taxpayers at the local, state and
federal levels in reduced healthcare expenditures.
We specifically want to recognize the effort undertaken to
increase authorization of appropriations in this legislation.
With nearly half of our membership having a documented
waiting list for nutrition services, the 7% increase in
authorization of funding levels in Fiscal Year 2020--and 6%
in subsequent years for all OAA programs over the five-year
reauthorization period--will significantly improve the senior
nutrition network's ability to address these gaps.
We also applaud the attention to and inclusion of
additional research and innovation established through a new
National Research, Demonstration, and Evaluation Center for
aging services research and development. We already know the
difference that OAA services and supports are making in the
lives of those served each day, and this additional support
will help identify where the greatest needs and opportunities
are to produce substantial savings to Medicare and Medicaid
and support our nation's most at-risk seniors.
Furthermore, we are grateful for the Dignity in Aging Act's
acknowledgement of the components of our network's
comprehensive service model, particularly around the areas of
social isolation and loneliness; in-home safety; screenings
and prevention; and community connections and support. This
network has been addressing the social determinants of health
(SDOH) for seniors long before it was a common definition
used among policymakers, advocates and healthcare entities.
Thanks to the foresight of this body in establishing the OAA
Nutrition Program and its goals and purposes decades ago, the
focus has transcended beyond just the meal to include an
emphasis on socialization, overall health, well-being and
safety.
As with each reauthorization, we have a new opportunity to
evolve the OAA in ways that will help it better meet the
inherent changes in our country's aging population and serve
more of those in need. We are pleased that H.R. 4334, the
Dignity in Aging Act of 2019, helps to address these shifts,
and as such, we urge your support and swift passage in the
House of Representatives. Meals on Wheels America and the
network of senior nutrition programs across the county have
appreciated contributing feedback and policy recommendations
throughout this reauthorization process and look forward to
continuing to work with you to build upon the ongoing
successes of the OAA.
Thank you again for your leadership, public service and
support for our nation's older adults.
Sincerely,
Ellie Hollander,
President and CEO.
Ms. BONAMICI. Mr. Speaker, I reserve the balance of my time.
Ms. STEFANIK. Mr. Speaker, I yield myself the balance of my time.
In closing, I would like to again thank my good friend, the
gentlewoman from Oregon (Ms. Bonamici), and our colleagues and our
staff on the Education and Labor Committee for all of their work on
this bipartisan bill that will help improve the lives of millions of
seniors across the country.
As I said at the beginning of this debate, my district is home to one
of the largest constituencies of older Americans, so I could not be
prouder to have led the reauthorization of the Older Americans Act,
which will directly and tangibly benefit the seniors in New York's 21st
District and seniors across the country.
Our Nation's seniors deserve to age with health, dignity, and
independence in the communities of their choosing. Again, I urge a
``yes'' vote. Mr. Speaker, I yield back the balance of my time.
Ms. BONAMICI. Mr. Speaker, I yield myself the balance of my time. I
urge all of my colleagues to support the bipartisan Dignity in Aging
Act of 2019. We know that the OAA programs--Meals on Wheels, community
meal programs, caregiver support, protection against elder abuse--help
older Americans live their lives with dignity.
Once again, I thank Representatives Stefanik, Lee, Comer, Wild, and
Johnson for joining me in leading this effort. Again, I thank Chairman
Scott and Ranking Member Foxx for supporting this legislation as it
moved through the committee process. The bipartisan engagement and the
involvement of many committee members was crucial to achieving this
legislation to successfully address many priorities and incorporate the
input of numerous stakeholders.
I am sincerely grateful for the contributions of all involved, and I
am eager to support the passage of this bill today so we can better
empower every older American to age with dignity.
I urge my colleagues to support this legislation, and I yield back
the balance of my time.
Mr. LEVIN of Michigan. Mr. Speaker, I urge my colleagues to support
the Dignity in Aging Act. As vice chair of the House Education and
Labor Committee, I am honored to be a part of this bipartisan effort to
respond to the challenges facing a generation of aging Americans.
I'm also proud that this package includes my bill, the Supporting
Family Caregivers Act, which will facilitate the assessment of in-home
caregivers' needs to determine what resources would help them provide
care. I want to thank Congresswoman Elise Stefanik for partnering on
this bipartisan legislation to support in-home caregivers.
Americans across the country rely on family caregivers, whose
contributions range from bathing and dressing their loved ones, to
coordinating care across multiple health care providers, to managing
the payment of household and medical bills, and more. Each year, this
adds up to roughly $470 billion in unpaid care provided by 40 million
family caregivers.
I believe one of the best ways to improve home health care is to
protect the health and wellbeing of the caregivers who provide it. The
Supporting Family Caregivers Act encourages the use of assessments to
identify caregivers' individual needs and challenges, thereby allowing
services to be targeted to each person more effectively and
efficiently. Although resources are currently available to family
caregivers, direct feedback through assessments would improve the
quality of the support they receive.
I am so pleased to see this body take a needed step towards more
person- and family-centered care. Again, I am grateful to my partner on
this bill, Congresswoman Stefanik, as well as Chairman Scott, Ranking
Member Foxx and Dignity in Aging Act sponsor Bonamici for their
support.
I urge my colleagues to join me in supporting America's seniors, and
to vote for the Dignity in Aging Act.
The SPEAKER pro tempore. The question is on the motion offered by the
gentlewoman from Oregon (Ms. Bonamici) that the House suspend the rules
and pass the bill, H.R. 4334, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
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