[House Report 116-258]
[From the U.S. Government Publishing Office]
116th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 116-258
======================================================================
DIGNITY IN AGING ACT OF 2019
_______
October 28, 2019.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Scott of Virginia, from the Committee on Education and Labor,
submitted the following
R E P O R T
[To accompany H.R. 4334]
[Including cost estimate of the Congressional Budget Office]
The Committee on Education and Labor, to whom was referred
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, having considered the same, report
favorably thereon with an amendment and recommend that the bill
as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 16
Committee Action................................................. 17
Committee Views.................................................. 20
Section-by-Section Analysis...................................... 29
Explanation of Amendments........................................ 34
Application of Law to the Legislative Branch..................... 34
Unfunded Mandate Statement....................................... 34
Earmark Statement................................................ 34
Roll Call Votes.................................................. 34
Statement of Performance Goals and Objectives.................... 34
Duplication of Federal Programs.................................. 35
Hearings......................................................... 35
Statement of Oversight Findings and Recommendations of the
Committee...................................................... 35
New Budget Authority and CBO Cost Estimate....................... 35
Committee Cost Estimate.......................................... 37
Changes in Existing Law Made by the Bill, as Reported............ 37
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
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 the
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. Federal coordination of supports and services for living
independently and safely at home.
Sec. 112. Falls prevention and chronic disease self-management
education.
Sec. 113. Extension of RAISE Family Caregivers Act.
Sec. 114. Support for socially-isolated older Americans.
Sec. 115. Increased focus of Assistant Secretary on social isolation.
Sec. 116. Advisory council on social isolation.
Sec. 117. Supportive services and senior centers.
Sec. 118. Demonstration projects.
Sec. 119. Younger onset Alzheimer's Disease.
Sec. 120. Priority for the senior community service employment program.
Sec. 121. Direct care workforce.
Sec. 122. National resource center for older individuals experiencing
the long-term and adverse consequences of trauma.
Sec. 123. National Resource Center for Women and Retirement.
Sec. 124. Definition.
Sec. 125. Review of reports.
Sec. 126. Area plans.
Sec. 127. Addressing chronic pain management.
Sec. 128. Extension of the Supporting Grandparents Raising
Grandchildren Act.
Sec. 129. Screening for suicide risk.
Sec. 130. Traumatic brain injury.
Sec. 131. Addressing public health emergencies and emerging health
threats.
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.
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. Effective date.
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--
``(i) complied with the assurances provided
to the Assistant Secretary with the application
for such previous grant; and
``(ii) will comply with the assurances
provided with the current submitted
application;'', 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 following 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 THE
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 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 date of the
enactment of 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) by amending subparagraph (B)(ii) to read
as follows:
``(ii) innovations in technology applications
(including assistance technology devices and assistance
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;'',
(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, and
(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.''.
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) 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
``(ii) 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 the services that are needed by older
individuals whose needs are the focus of all centers funded
under title IV and the effectiveness of the programs, policies,
and services provided by such area agency on aging in assisting
these individuals. Each agency plan shall provide assurances
that the area agency on aging will use outreach efforts that
will identify individuals eligible for assistance under this
Act, with special emphasis on those individuals whose needs are
the focus of all centers established under title IV. This
requirement applies to all centers funded on the day before the
effective date of this paragraph.''.
(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 State shall prepare and submit to the Assistant
Secretary annual reports on the data collected to determine the
services that are needed by older individuals whose needs are
the focus of all centers funded under title IV and the
effectiveness of the programs, policies, and services provided
by area agencies on aging in assisting these individuals. The
reports shall describe any outreach efforts and other
activities described in section 306(a)(18). This requirement
applies to all centers funded on the day before the date of the
enactment of the effective date of this paragraph.''.
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. FEDERAL COORDINATION OF SUPPORTS AND SERVICES FOR LIVING
INDEPENDENTLY AND SAFELY AT HOME.
Title II of the Older Americans Act of 1965 (42 U.S.C. 3011-3020) is
amended by inserting after section 203A the following:
``SEC. 203B. FEDERAL COORDINATION OF SUPPORTS AND SERVICES FOR LIVING
INDEPENDENTLY AND SAFELY AT HOME.
``(a) Initiative.--The Assistant Secretary shall carry out an
initiative under this section to identify and disseminate information
about Federal resources to promote falls prevention, home assessments,
and home modifications, which may include in-home assistive technology,
to enable older individuals to live independently and safely in a home
environment.
``(b) Coordination of Federal Efforts.--In carrying out the
initiative under this section, the Assistant Secretary shall
coordinate, through memoranda of understanding, agreements, or other
appropriate means of coordination, with all Federal efforts and Federal
programs in effect on the effective date of this section that support
evidence-based falls prevention, home assessments, and home
modifications, which may include in-home assistive technology, for
older individuals, including older individuals with disabilities.
``(c) Reports.--Not later than 1 year after the effective date of
this section, and triennially thereafter as needed, the Assistant
Secretary shall publish a report that includes--
``(1) an inventory of the then current Federal programs that
support evidence-based falls prevention, home assessments, and
home modifications, which may include in-home assistive
technology, for older individuals and older individuals with
disabilities;
``(2) for the fiscal year of the report, statistical data on
the number of older individuals and older individuals with
disabilities served by each Federal program described in
paragraph (1), including a demographic analysis and the
approximate amount of Federal funding invested in each such
program;
``(3) an evaluation of the impact of Federal programs that
support falls prevention and home modifications, which may
include in-home assistive technology, on health status and
health outcomes in populations supported by such efforts and
programs; and
``(4) information on the extent to which consumer-friendly
resources, such as a brochure--
``(A) are available through the National Eldercare
Locator Service established under section 202(a)(21);
``(B) are accessible to all area agencies on aging;
and
``(C) 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. 112. 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 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. 113. 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. 114. 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 social
isolation and coordination of supportive services and
health care to address social isolation and loneliness;
and''.
SEC. 115. INCREASED FOCUS OF ASSISTANT SECRETARY ON 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 social
isolation among older individuals.''.
SEC. 116. ADVISORY COUNCIL ON 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
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 social
isolation and loneliness 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. 117. 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 social isolation; and''.
SEC. 118. DEMONSTRATION PROJECTS.
(a) Demonstrations.--Section 411(a) of the Older Americans Act of
1965 (42 U.S.C. 3032(a)), as amended by section 112, 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 social isolation and loneliness
among older adults; and''.
(b) Repeal.--Section 416 of the Older Americans Act of 1965 (42
U.S.C. 3032e) is repealed.
SEC. 119. 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. 120. PRIORITY FOR THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM.
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 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 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.''.
SEC. 121. 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 112 and 118, 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 and 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, and 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. 122. 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 112, 118, and 121, is amended--
(1) by redesignating paragraphs (17) and (18) as paragraphs
(18) and (19), respectively, and
(2) by inserting after paragraph (16) the following:
``(17) the implementation 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. 123. 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 116, 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. 124. DEFINITION.
Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is
amended--
(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. 125. 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 in the report required by section
207(a), aggregated data, including the effectiveness and outreach
efforts included in 307(a)(31), on services that are needed by older
individuals whose needs are the focus of all centers funded under title
IV. This requirement applies to all centers funded on the day before
the date of the effective date of this paragraph.''.
SEC. 126. 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. 127. 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. 128. 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. 129. 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. 130. TRAUMATIC BRAIN INJURY.
(a) Definitions.--Section 102 of the Older Americans Act of 1965 (42
U.S.C. 3002), as amended by section 114, 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) Health Screening.--Section 321(a)(8) of the Older Americans Act
of 1965 (42 U.S.C.3030d(a)(8)) is amended to read as follows:
``(8) services designed to provide health screening
(including mental and behavioral health screening, screening
for social isolation and loneliness, falls prevention services
screening and traumatic brain injury screening) to detect or
prevent (or both) illnesses and injuries that occur most
frequently in older individuals;''.
(c) Activities for Health.--Section 411(a)(12) of the Older Americans
Act of 1965 (42 U.S.C. 3032(a)(12)) is amended to read as follows:
``(12) building public awareness of cognitive impairments
such as Alzheimer's disease and related disorders with
neurological and organic brain dysfunction, depression, mental
health disorders, and traumatic brain injury;''.
SEC. 131. 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 114 and 130, 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;''.
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 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 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 impacts that
programs and interventions under this Act have on the
health outcomes, social determinants of health, quality
of life, 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, 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 family 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
``(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) in section 306(a)(9)--
(A) by inserting ``together with any other funds''
after ``Act'', and
(B) by striking ``2000'' and inserting ``2019'', and
(2) in section 307(a)(9)--
(A) by striking ``an amount'' the 1st place it
appears and inserting ``the total amount'',
(B) by striking ``2000'' and inserting ``2019'' each
place it appears, and
(C) by inserting ``from all sources including'' after
``received'' each place it appears.
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,''.
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, 5
percent shall be made available to carry out part D for such fiscal
year.'',
(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
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 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.''.
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--
``(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 section 215, $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 2020.''.
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 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'',
(8) in section 339 by striking ``Institute of Medicine of the
National Academy of Sciences'' and inserting ``National
Academies of Sciences, Engineering, and Medicine'',
(9) in section 611 by striking ``(a)'', and
(10) 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 304(a)(3)(D) of the Older Americans Act of 1965 (42
U.S.C. 3024(a)(3)(D)) is amended--
(1) in clause (i) by striking ``2017 through 2019'' and
inserting ``2020 through 2024'', and
(2) in clause (ii) by striking ``2020'' and inserting
``2025''.
(c) 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.''.
(d) 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.''.
(e) 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.''.
(f) 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. EFFECTIVE DATE.
This Act shall take effect on October 1, 2019.
Purpose and Summary
The purpose of H.R. 4334, the Dignity in Aging Act of 2019
(Dignity in Aging Act), is to reauthorize and strengthen the
Older Americans Act (OAA) to better support the aging
population and help older individuals and individuals with
disabilities maintain their independence and live with dignity.
Between 2006 and 2016, the population of adults aged 60 and
above increased by 36 percent,\1\ and the population of adults
aged 65 and above is projected to nearly double between 2016
and 2060.\2\ With this dramatic demographic shift, Congress
must ensure that services are available to support this
population.
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\1\Administration for Community Living, 2017 Profile of Older
Americans 1 (2018), https://acl.gov/sites/default/files/
Aging%20and%20Disability%20in%20America/2017OlderAmericansProfile.pdf.
\2\Id.
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The Dignity in Aging Act updates OAA programs to reflect
the needs of this growing population and its caregivers by
ensuring that State Units on Aging (SUAs) and Area Agencies on
Aging (AAAs) have the tools and flexibility they need to
provide robust services.
The Dignity in Aging Act also includes key policies that
support the health and independence of older Americans. The
Dignity in Aging Act codifies existing chronic disease self-
management education and falls prevention programs; updates the
definition of disease prevention and health promotion services
within OAA; and includes person-centered, trauma-informed care
as part of the purpose of OAA. It also supports community-level
interventions that facilitate aging in place, including
increasing the interagency coordinating committee's focus on
encouraging age-friendly communities. The Dignity in Aging Act
strengthens nutrition services programs by clarifying the
ability of service providers to serve culturally-appropriate,
medically-tailored meals, and it includes the reduction of
malnutrition as one of the purposes of OAA's nutrition services
programs.
The bill further recognizes the key role family caregivers
play in maintaining the health and independence of older adults
and other family members. The Dignity in Aging Act provides
critical support for family caregivers by extending the
authorization of the RAISE Family Caregivers Act (P.L. 115-
119), eliminating the funding cap on support services for older
adult caregivers, and supporting the use of caregiver
assessments.
The Dignity in Aging Act strengthens protections for
vulnerable older adults by providing needed resources and
clarifications for the State Long-Term Care Ombudsman Program.
It also supports targeted improvements in OAA's Title VI
programs serving Native American older adults by funding
technical assistance for tribal organizations and creating a
demonstration program to fund the provision of supportive
services.
Finally, the Dignity in Aging Act increases funding
authorization levels for all OAA programs. Despite the dramatic
shift in age distribution within the U.S. population, funding
for OAA programs has actually decreased in inflation-adjusted
terms. Expressed in today's dollars, it has declined from
$42.95 per senior in Fiscal Year 2010 to approximately $27.25
in Fiscal Year 2019\3\--a reduction of 36.5 percent.\4\ H.R.
4334 increases funding for all OAA programs by 7 percent in
Fiscal Year 2020 and 6 percent every year thereafter.
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\3\Persons aged 60 and older are considered seniors for the purpose
of this calculation. Dollar values are values per senior, not values
per senior served by OAA programs.
\4\Analysis based on Kirsten J. Colello & Angela Napili, Cong.
Research Serv., R43414, Older Americans Act: Overview and Funding 11
(2018), https://fas.org/sgp/crs/misc/R43414.pdf; U.S. Bureau of the
Census, American Community Survey 1-Year Estimates Table S0102, https:/
/factfinder.census.gov/faces/nav/jsf/pages/index.xhtml (last visited
Sept. 27, 2019); Bureau of Labor Statistics, Consumer Price Index for
All Urban Consumers: All Items, Index 1982-1984=100, Annual, Seasonally
Adjusted, https://fred.stlouisfed.org (last visited Sept. 27, 2019);
and Congressional Budget Office, 10-Year Economic Projections, Jan
2019, https://www.cbo.gov/about/products/budget-economic-data (last
visited Sept. 27, 2019).
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Committee Action
115TH CONGRESS
Two related pieces of legislation were taken up in the
115th Congress.
On December 18, 2017, the House agreed by a voice vote to
suspend the rules and pass H.R. 3759, the RAISE Family
Caregivers Act, introduced by Rep. Gregg Harper (R-MS-3). The
bill directs the Department of Health and Human Services (HHS)
to create a council to develop and make publicly available a
National Family Caregiving Strategy that identifies recommended
actions recognizing and supporting family caregivers in a
manner that reflects their diverse needs. The strategy is
required to identify recommended actions that federal, state,
and local governments, communities, health care providers,
long-term services and supports providers, and others are
taking, or may take. The bill terminates the council after
three years.
On June 13, 2018, the House agreed by a voice vote to
suspend the rules and pass, as amended, S. 1091, the Supporting
Grandparents Raising Grandchildren Act, introduced by Sen.
Susan Collins (R-ME). The bill establishes an Advisory Council
to Support Grandparents Raising Children. The council must
identify, promote, coordinate, and publicly disseminate
information and resources to help older relatives meet the
needs of the children in their care and maintain their own
health and resources. The bill terminates the council after
three years.
116TH CONGRESS
On May 15, 2019, the Committee on Education and Labor's
(Committee) Subcommittee on Civil Rights and Human Services
held a legislative hearing entitled ``Examining the Older
Americans Act: Promoting Independence and Dignity for Older
Americans.'' The purpose of the hearing was to examine the
breadth of programs and supports authorized and funded through
the Older Americans Act that promote the independence and
dignity of older Americans. The Committee heard testimony from:
Ms. Lee Girard, MPA:HA, Director of Multnomah County Aging,
Disability, and Veterans Services; Ms. Stephanie Archer-Smith,
Executive Director of Meals on Wheels of Central Maryland,
Inc.; Ms. Grace Whiting, J.D., President and CEO of the
National Alliance for Caregiving; and Ms. Patricia Ducayet,
L.M.S.W., Texas State Long-Term Care Ombudsman for Texas Health
and Human Services.
On September 13, 2019, Rep. Suzanne Bonamici (D-OR-1)
introduced H.R. 4334, the Dignity in Aging Act of 2019, with
Representatives Elise Stefanik (R-NY-21), Susie Lee (D-NV-3),
James Comer (R-KY-1), Susan Wild (D-PA-7), and Dusty Johnson
(R-SD-At Large) as original cosponsors. On September 18, 2019,
the Committee marked up H.R. 4334 and ordered it to be reported
favorably, as amended, to the House of Representatives by a
voice vote. The Committee considered the following amendments
to H.R. 4334.
Rep. Bonamici offered an Amendment in the
Nature of a Substitute (ANS) that made several
improvements and clarifications to H.R. 4334. The ANS
includes a clarification to the provision creating an
inventory of federal programs that support evidence-
based falls prevention, home assessments, and home
modifications to include supports available to older
people with disabilities. It includes a new section
codifying a national technical assistance center to
expand the aging network's capacity to deliver person-
centered, trauma-informed services that meet the needs
of aging trauma survivors. It clarifies that cultural
considerations and preferences including religious,
cultural, or ethnic requirements should be accommodated
to the maximum extent practicable in OAA meal programs.
Finally, the ANS corrects an error in the newly created
OAA Title VI Part D funding set aside. The ANS, as
amended with further amendments described below, was
adopted by voice vote.
Rep. Bonamici offered an amendment making
several technical changes and strengthening the
language regarding resource center coordination to
require state and Administration for Community Living
(ACL) reporting on efforts to address and serve the
needs of all populations served by centers funded under
Title IV. The amendment also requires assurances from
AAAs that they will conduct outreach to older
individuals at risk for institutional placement,
including survivors of the Holocaust. Further, the
amendment codifies the existing National Resource
Center for Women and Retirement. Lastly, the amendment
includes a definition of person-centered, trauma-
informed services. The amendment was adopted by voice
vote.
Rep. Brett Guthrie (R-KY-2) offered, in
coordination with Rep. David Trone (D-MD-6), an
amendment adding chronic pain management to the
definition of disease prevention and health promotion
services. The amendment was adopted by voice vote.
Rep. Johnson offered, in coordination with
Rep. Donna Shalala (D-FL-27), an amendment directing
the Assistant Secretary for Aging (Assistant Secretary)
to provide technical assistance and share best
practices with states and AAAs on how to collaborate
and coordinate activities and develop long-range
emergency preparedness plans. The amendment was adopted
by voice vote.
Rep. Mark Takano (D-CA-41) offered an
amendment to include aging lesbian, bisexual, gay, and
transgender (LGBT) individuals to the list of
populations of greatest social need enumerated in the
statute. The amendment was withdrawn.
Rep. Joseph Morelle (D-NY-25) offered, in
coordination with Rep. Stefanik, an amendment to ensure
that information about supports and services is shared
with eligible individuals through consumer-friendly
resources. The amendment was adopted by voice vote.
Rep. Glenn Thompson (R-PA-15), offered, in
coordination with Rep. Joaquin Castro (D-TX-20), an
amendment extending the authorization period of the
Supporting Grandparents Raising Grandchildren Act by
one year. The amendment was adopted by voice vote.
Rep. Wild offered an amendment clarifying
that screening for suicide risk is included in the
definition of disease prevention and health promotion
services. The amendment was adopted by voice vote.
Rep. Fred Keller (R-PA-12) offered an
amendment to add screening for fall-related traumatic
brain injury, coordination of treatment, rehabilitation
and related services, and referral services to the
definition of disease prevention and health promotion
services; to include a definition of traumatic brain
injury in OAA; to add traumatic brain injury screening
to allowable supportive services that can be provided
by states; and to add public awareness building around
traumatic brain injury as an allowable use of grant
funds that may be awarded by the Assistant Secretary.
The amendment was adopted by voice vote.
Rep. Josh Harder (D-CA-10) offered an
amendment to include caregivers as members of the
advisory council on social isolation. The amendment was
adopted by voice vote.
Rep. Lauren Underwood (D-IL-14) offered, in
coordination with Rep. Phil Roe (R-TN-1), an amendment
adding addressing public health emergencies and
emerging health threats to the definition of disease
prevention and health promotion services. The amendment
was adopted by voice vote.
Rep. Pramila Jayapal (D-WA-7) offered, in
coordination with Rep. Lloyd Smucker (R-PA-11), an
amendment to add homelessness prevention services to
the focus of the Interagency Coordinating Committee on
Age-Friendly Communities. The amendment was adopted by
voice vote.
Committee Views
INTRODUCTION
The Older Americans Act--first signed into law in 1965--is
the primary federal statute authorizing the delivery of
community-based nutrition and supportive services to older
Americans and their caregivers. It allows older Americans to
delay or avoid costlier care by promoting healthy behaviors,
such as chronic disease management, and by providing the
supportive services that allow seniors to age in place, such as
support for falls prevention, home modifications, and services
provided through senior centers.
In addition to serving older adults broadly, OAA also
serves individuals with disabilities. Specific OAA services are
available to individuals with disabilities of any age,
including persons having physical, mental, or developmental
disabilities. Available services include access to the State
Long-Term Care Ombudsman Program (SLTCOP) and Aging and
Disability Resource Centers (ADRC). Both the SLTCOP and ADRCs
provide assistance related to planning, care, services, and
supports. Specifically, the SLTCOP provides advocates for
residents of long-term care facilities and their families to
help ensure quality care for individuals. Ombudsmen also work
to resolve problems related to patient care while preserving
the confidentiality of patients. ADRCs operate as a network of
information and access for those seeking long-term support and
services. Most importantly, ADRCs disseminate accurate
information for aging persons and persons with disabilities.
These entities serve communities throughout the country and are
a necessary part of efficiently serving older Americans as well
as Americans with disabilities.
The Older Americans Act includes language requiring states
and AAAs to prioritize services for certain populations,
including populations of greatest social need. In 2012, the
Administration on Aging (AoA) recognized that ``[w]hile the
definition of greatest social need' in the Older Americans Act
includes isolation caused by racial or ethnic status, the
definition is not intended to exclude the targeting of other
populations that experience cultural, social, or geographic
isolation due to other factors.''\5\ To the contrary, AoA
stated that pursuant to the statutory requirement ``each
planning and service area must assess their particular
environment to determine those populations best targeted based
on greatest social need.'''\6\ The Committee agrees with this
guidance and reiterates the requirement for states and AAAs to
assess the needs of their service area and conduct appropriate
outreach to ensure populations of greatest social need are
being reached.
---------------------------------------------------------------------------
\5\U.S. Department of Health and Human Services Administration for
Community Living, Older Americans Act (2017), https://acl.gov/about-
acl/authorizing-statutes/older-americans-act (see Targeting
subsection).
\6\Id.
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The services provided through OAA remain important given
the demographic shift in the United States. The population of
Americans aged 60 and over has grown more than 60 percent since
2001,\7\ and adults aged 65 and older are projected to make up
more than 20 percent of the total U.S. population by 2030.\8\
Older Americans also now have longer lifespans than previous
generations; in 2016, a 60-year-old could expect to live an
additional 23.3 years, which is nearly a full year longer
compared to someone that age a decade earlier.\9\
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\7\AARP Policy Institute, Older Americans Act 3 (2019), https://
www.aarp.org/content/dam/aarp/ppi/2019/02/older-americans-act.pdf.
\8\AARP, Baby Boomer Facts and Figures 1 (2019), https://
www.aarp.org/livable-communities/info-2014/livable-communities-facts-
and-figures.html.
\9\Supra at 4.
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Programs under OAA have helped increase the health and
independence of seniors, which also results in long-term
government savings. According to an AARP study, 90 percent of
people age 65 and over would prefer to stay in their own homes
as they get older.\10\ In an evaluation of the nutrition
services programs under OAA Title III, more than six in ten
congregate meal recipients and nine in ten home-delivered meal
recipients reported that the program enabled them to continue
living in their own home.\11\ In addition, studies show that
the Meals on Wheels program prevents falls, which cost the U.S.
$50 billion each year,\12\ and reduces hospitalizations by 33
percent.\13\ Moreover, the cost of serving one senior through
Meals on Wheels for an entire year is equivalent to the cost of
just one day in a hospital, and two weeks in an institutional
care setting.\14\
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\10\Supra at 7.
\11\U.S. Department of Health and Human Services Administration for
Community Living, FY 2015 Report to Congress: Older Americans Act,
https://ltcombudsman.org/uploads/files/support/FY15OAAReportCongress-
2017-1-24.pdf.
\12\Meals on Wheels America, Factsheet (2016), https://
www.mealsonwheelsamerica.org/docs/default-source/fact-sheets/2012/mow-
factsheet-national2016.pdf?sfvrsn=2; Examining the Older Americans Act:
Promoting Independence and Dignity for Older Americans Before the
Subcomm. on Civil Rights and Human Services of the H. Comm. on Educ.
And Labor, 116th Cong. (2019) (written testimony of Stephanie Archer-
Smith at 3).
\13\Examining the Older Americans Act: Promoting Independence and
Dignity for Older Americans Before the Subcomm. on Civil Rights and
Human Services of the H. Comm. on Educ. And Labor, 116th Cong. (2019)
(written testimony of Stephanie Archer-Smith at 4).
\14\Quentin Fottrell, This is how much it costs `Meals on Wheels'
to feed one elderly person for a year, MarketWatch (March 2017),
https://www.marketwatch.com/story/this-is-how-much-it-costs-meals-on-
wheels-to-feed-one-elderly-person-for-a-year-2017-03-16.
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In addition to making up a greater percentage of the
population and living longer, many older Americans are also
facing economic strain. According to the U.S. Census Bureau's
Supplemental Poverty Measure, more than 14 percent of adults
aged 65 and older live in poverty.\15\ Approximately 24 percent
of low-income older adults are food insecure, according to a
2015 report by the Government Accountability Office (GAO).\16\
Despite these troubling statistics, few are able to access
critical services available through the Older Americans Act.
The same GAO report found that 83 percent of low-income older
adults who are food insecure do not receive any meal services
through OAA, and two in three Americans aged 60 and over who
struggle with activities of daily living receive limited or no
home-based care.\17\
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\15\Kaiser Family Foundation, How Many Seniors Live in Poverty? 1
(2018), http://files.kff.org/attachment/Issue-Brief-How-Many-Seniors-
Live-in-Poverty.
\16\U.S. Government Accountability Office, Older Americans Act:
Updated Information on Unmet Need for Services 4 (2015), https://
www.gao.gov/assets/680/670738.pdf.
\17\Id.
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The Dignity in Aging Act seeks to reverse these trends and
ensure that older Americans and their families have access to
the supports they need. To achieve this goal, the bill builds
upon current OAA programs that promote the health and
independence of older adults, provides increased support for
family caregivers, strengthens protections against abuse and
neglect of older adults, and sets aside dedicated resources for
tribal organizations to provide supportive services.
Most importantly, the Dignity in Aging Act includes funding
authorization levels so that funding may keep pace with the
growing older adult population, even after adjusting for
inflation. By adjusting funding to account for the rising
number of older Americans and their needs, the Dignity in Aging
Act provides seniors the ability to live independently and
safely at home while increasing the effectiveness of taxpayer
funds.
SUPPORTING THE HEALTH AND INDEPENDENCE OF OLDER AMERICANS
H.R. 4334 includes several policies designed to improve the
health and preserve the independence of older adults and
individuals with disabilities. The Dignity in Aging Act
clarifies the definition of disease prevention and health
promotion services under OAA, incorporates reducing
malnutrition into the purpose of OAA Title III nutrition
services, clarifies the availability of certain services for
individuals with early-onset Alzheimer's disease, and codifies
evidence-based interventions for chronic disease self-
management education and falls prevention. Falls prevention and
chronic disease self-management education programs are
currently authorized through broad authority under OAA and
receive mandatory funding through the Prevention and Public
Health Fund, funded under the Patient Protection and Affordable
Care Act of 2010. It is the Committee's view that these
programs should continue to receive this funding.
Provisions of the Dignity in Aging Act incorporate a focus
on person-centered, trauma-informed care and serving survivors
of trauma into OAA. The Substance Abuse and Mental Health
Services Administration describes trauma as resulting from ``an
event, series of events, or set of circumstances that is
experienced by an individual as physically or emotionally
harmful or life threatening with lasting adverse effects on the
individual's functioning and mental, physical, social,
emotional, or spiritual well-being.''\18\ It is estimated that
up to 90 percent of older adults have experienced at least one
traumatic event during their lives.\19\ This includes refugees,
military veterans, and survivors of historical traumas such as
genocide, racial discrimination, and other forms of violence.
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\18\U.S. Department of Health and Human Services Substance Abuse
and Mental Health Services Administration, Trauma and Violence 1
(2019), https://www.samhsa.gov/trauma-violence.
\19\F. H. Norris, Epidemiology of Trauma: Frequency and Impact of
Different Potentially Traumatic Events on Different Demographic Groups,
60 Journal of Consulting and Clinical Psychology 409, 409-18 (1992).
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The term historical trauma refers to emotional and
psychological harm to entire communities and groups of people
due to historical violence and oppression, systemic abuse, and
injustice.\20\ It is critical for the aging services network to
be equipped to appropriately serve diverse populations impacted
by trauma.
---------------------------------------------------------------------------
\20\Supra at 14.
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To this end, H.R. 4334 authorizes the implementation of a
national technical assistance center devoted to expanding the
aging services network's capacity to deliver person-centered,
trauma-informed services that meet the needs of aging trauma
survivors, including Holocaust survivors.
The Dignity in Aging Act clarifies that the aging network
should provide appropriate resources and support to the
populations specifically served by resource centers funded
under Title IV of OAA. Many of the populations served by these
centers face unique challenges and barriers to services and it
is the Committee's belief that these provisions will help the
aging network to better identify and meet their needs. For
example, LGBT individuals face disproportionate rates of
physical and mental health conditions,\21\ social
isolation,\22\ and poverty.\23\ Yet they are only 20 percent as
likely to access government services, including meal programs
and senior centers.\24\As another example, the number of deaths
from Alzheimer's increased by 145 percent from 2000 to 2017,
while only 16 percent of seniors receive regular cognitive
assessments during routine health check-ups. These examples,
and many others, demonstrate the necessity of the resource
centers funded by ACL. The Dignity in Aging Act requires SUAs
and AAAs to collect data on the services needed by the
populations whose needs are the focus of the centers funded by
Title IV of OAA and to conduct outreach to identify individuals
eligible for assistance under OAA, with an emphasis on
populations served by the Title IV centers. Additionally, it
requires the Assistant Secretary to publish aggregated data and
information on the efforts of the aging network in serving
these populations.
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\21\Karen I. Fredriksen-Goldsen et al., Health Disparities Among
Lesbian, Gay, and Bisexual Older Adults: Results from a Population-
Based Survey, 103 American Journal of Public Health 1802, 1804-07
(2013). Karen I. Fredriksen-Goldsen et al., Physical and Mental Health
of Transgender Older Adults: An At-Risk and Underserved Population, 54
The Gerontologist 488, 493-96 (2014).
\22\Mark Brennan-Ing et al., Social Care Networks and Older LGBT
Adults: Challenges for the Future, 61 Journal of Homosexuality 21, 21-
52 (2013).
\23\Brad Sears, Beyond Stereotypes: Poverty in the LGBT Community,
(June 2012), https://williamsinstitute.law.ucla.edu/williams-in-the-
news/beyond-stereotypes-poverty-in-the-lgbt-community/.
\24\LGBT Movement Advancement Project & Services and Advocacy for
Gay, Lesbian, Bisexual and Transgender Elders (MAP & SAGE), Improving
the Lives of LGBT Older Adults 5 (2010), www.lgbtmap.org/file/
improving-the-lives-of-lgbt-older-adults.pdf.
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Provisions of H.R. 4334 clarify that vaccination,
malnutrition screening, social isolation screening, chronic
pain management, screening for suicide risk, screening for
traumatic brain injury, and public health emergency response
are all included in the definition of disease prevention and
health promotion services under OAA. The Dignity in Aging Act
additionally adds reducing malnutrition to the purpose of OAA's
nutrition service programs, in recognition of the fact that
malnutrition is distinct from food insecurity and is a highly
prevalent and costly health concern among older adults that can
worsen quality of life and exacerbate other health conditions.
The Committee acknowledges the critical role and
effectiveness of OAA-funded nutrition services programs, which
include both congregate and home-delivered meals. The Dignity
in Aging Act continues support for these important programs,
and it clarifies that providers have the authority to serve
culturally-appropriate and medically-tailored meals.
Culturally-appropriate meals that meet religious and other
needs are important to preserving the dignity of older adults
and ensuring that investments in nutrition programs are meeting
the needs of the population. Medically-tailored meals are
particularly important for the older adult population, many of
whom are impacted by multiple chronic diseases with dietary
implications such as diabetes, HIV-AIDS, and cancer. Studies
have shown that the receipt of medically-tailored meals has
reduced hospital and skilled nursing facility admissions as
well as overall medical spending.\25\
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\25\Seth A. Berkowitz et al., Association Between Receipt of a
Medically Tailored Meal Program and Health Care Use, 179 JAMA Internal
Medicine 786, 788-92 (2019).
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The Dignity in Aging Act also creates a National Research,
Demonstration, and Evaluation Center for the Aging Network
under the Assistant Secretary. In creating this center, the
Committee recognizes the vital need to coordinate research,
demonstration, and evaluation activities authorized throughout
OAA, and ensure resources are dedicated to building the
evidence base of effective programs. Expanding the evidence
base is particularly important to ensure the needs of
underserved populations are being met. It is also the intention
of the Committee that the center will collaborate, as
appropriate, with community-based health organizations on
project planning and implementation. The director of the center
shall be an individual designated by the Assistant Secretary,
who may be either an existing employee of the administration or
a new hire.
The Dignity in Aging Act also requires the Assistant
Secretary to establish an initiative to coordinate federal
resources dedicated to helping older adults, including those
with disabilities, live safely and independently at home. This
includes the coordination of falls prevention, home assessment,
and home modification efforts. The Committee recognizes the
importance of falls prevention and home modification efforts
and acknowledges that the federal government is currently
dedicating resources to these efforts. The Committee's
intention is to assess the current federal efforts in this
area, promote coordination, and identify any potential gaps in
services.
Additionally, the Dignity in Aging Act provides support for
age-friendly communities, which are communities taking specific
steps to support their older adult residents in areas such as
transportation, housing, and accessible spaces. Community-level
supports and accommodations are a critical part of helping
older adults, including those with disabilities, remain in
their homes and communities as long as possible, and age-
friendly communities are intentionally focusing on ensuring
that these supports are available.
The Committee recognizes social isolation as a significant
health concern for older adults. Research has demonstrated
detrimental impacts of social isolation on health, including
increasing the risk of premature death (by between 60 and over
200 percent),\26\ stroke or coronary heart disease (by 30
percent),\27\ and dementia (by 40 percent).\28\ The Dignity in
Aging Act makes needed changes to the Older Americans Act to
address this problem. Specifically, the legislation allows for
demonstration projects to test local solutions, includes social
isolation screening in the definition of disease prevention and
health promotion and health screening for the purposes of
supportive services and senior centers, and requires the
Assistant Secretary to convene a working group and develop
objectives and plans to address social isolation. It is the
Committee's view that in addressing social isolation, the aging
network should engage with individuals in a manner consistent
with their needs and preferences, including such individuals'
choice to live in remote or rural areas.
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\26\Kassandra I. Alcaraz et al., Social Isolation and Mortality in
US Black and White Men and Women, 188 American Journal of
Epidemiology102, 104-07 (2019).
\27\Nicole K. Valtorta et al., Loneliness and Social Isolation as
Risk Factors for Coronary Heart Disease and Stroke: Systemic Review and
Meta-Analysis of Longitudinal Observational Studies, 102 Heart 1009,
1012-14 (2016).
\28\Angelina R. Sutin et al., Loneliness and Risk of Dementia, The
Journals of Gerontology Series b, 1, 4-7 (2018).
---------------------------------------------------------------------------
The Senior Community Service Employment Program (SCSEP)
also plays a key role in promoting the independence of older
adults through part-time community service employment
opportunities. In recognition of the increased barriers to
employment and community engagement faced by justice-involved
individuals, the Committee added this population as a priority
for SCSEP in the legislation. For the purposes of this
provision, ``individuals who have been incarcerated or are
under supervision following the release from prison or jail''
means any individual aged 55 years and over who is an ex-
offender as described in section 3(24)(F) of the Workforce
Innovation and Opportunity Act, who was previously incarcerated
and released from prison or jail or is currently under
supervision (which includes individuals confined in a
correctional facility with a release date within six months,
residing in a residential reentry center, on electronic
monitoring or home-based monitoring, on probation or parole, or
enrolled in a jail-based work release center).
The Committee recognizes the importance of the business
acumen work being conducted by the Administration on Community
Living and AAAs as an important piece of leveraging funding to
support the aging population. The Dignity in Aging Act
authorizes these activities and makes clarifications regarding
outside funding for AAAs.
According to a survey by T. Rowe Price, the median 401(k)
savings balance for women ages 54 or older is $59,000 compared
to $138,000 for men in the same age category.\29\ Since 1998,
the Administration on Aging has funded a National Resource
Center on Women and Retirement Planning in order to address
this gender gap in retirement savings and ensure women can
retain their independence as they age. The Dignity in Aging Act
codifies this existing center into law.
---------------------------------------------------------------------------
\29\T. Rowe Price, Focus on Gender: Retirement Savings and Spending
4: Financial Behavior & Attitudes 12 (2019), https://
www.troweprice.com/content/dam/trowecorp/
RSS4%20Gender%20Differences%20Deck_FINAL.pdf.
---------------------------------------------------------------------------
SUPPORTING FAMILY CAREGIVERS
Family caregivers provide critical long-term care and
support for aging adults and people with disabilities. Middle-
age family caregivers who may simultaneously be financially
supporting or responsible for an aging parent and a dependent
child or adult children face unique obstacles to caregiving,
and make up nearly half of all adults in their 40s and 50s.\30\
Another population of caregivers in need of particular
attention are older relative caregivers, often grandparents,
who are raising children as they age. Between 2006 and 2016,
the percentage of children in foster care raised in
grandfamilies or kinship care grew from approximately 24
percent to approximately 32 percent.\31\ Nationally, more than
2.5 million children are being raised by grandparents, aunts,
uncles, siblings and other extended family and close
relatives.\32\ This increase has been attributed to the
nation's opioid epidemic.\33\ The legislation eliminates the 10
percent funding cap that currently limits support under the
National Family Caregiver Support Program (NFCSP) for older
relative caregivers. This will allow for local flexibility in
meeting communities' needs. In recognition of the importance of
assessing the impact resulting from elimination of the cap, the
Committee also included a requirement for the Assistant
Secretary to report on the impact of the change and the
resulting share of federal funds directed to family caregivers
as compared to older relative caregivers.
---------------------------------------------------------------------------
\30\Pew Research Center, The Sandwich Generation: Rising Financial
Burdens for Middle-Aged Americans 1 (2013) https://www.pewresearch.org/
wp-content/uploads/sites/3/2013/01/Sandwich_Generation_Report_FINAL_1-
29.pdf.
\31\Generations United, Grandfamilies Statistics: Key Graphs and
Statistics for Grandfamilies, https://www.gu.org/grandfamilies-
statistics/ (last visited Sept. 27, 2019).
\32\U.S. Department of Health and Human Services Administration for
Children and Families, Working With Kinship Caregivers 2 (2018),
https://www.childwelfare.gov/pubPDFs/kinship.pdf.
\33\Generations United, Raising the Children of the Opioid
Epidemic: Solutions and Support for Caregivers 1 (2016), https://
www.gu.org/app/uploads/2018/05/Grandfamilies-Report-SOGF-2016.pdf.
---------------------------------------------------------------------------
Provisions of H.R. 4334 provide much-needed support to
family caregivers by supporting the appropriate use of
caregiver assessments. This provision responds to findings from
the 2018 evaluation of the National Family Caregiver Support
Program, which showed that ``there is room for improvement and
for standardization among NFCSP AAAs and providers in assessing
and reassessing the impact of caregiving on the caregiver's
health and well-being.''\34\ The Committee worked carefully
with stakeholders to ensure that the language is not overly
prescriptive and will not harm efforts currently underway to
support caregivers through assessments and reassessments.
Instead, the provisions support the appropriate and voluntary
use of assessments, provide technical assistance, and call for
a report to inform policymakers on the current use of
assessments and their impact.
---------------------------------------------------------------------------
\34\Cecilia Avison et al., Outcome Evaluation of the National
Family Caregiver Support Program 1-2 (2018), https://acl.gov/sites/
default/files/programs/2018-12/
Caregiver_Outcome_Evaluation_Final_Report.pdf.
---------------------------------------------------------------------------
SUPPORTING DIRECT CARE WORKERS
By 2024, 5.2 million direct care workers will be needed
across all care settings to fulfill the needs of the growing
population of older Americans and people with disabilities.\35\
The Dignity in Aging Act presents a unique opportunity to
recruit, retain, and advance older adult workers to help fill
crucial roles in direct care. The potential of this concept has
been illustrated by a 2007 Senior Community Service Education
Program (SCSEP) demonstration project administered by the
Department of Labor (DOL). DOL awarded funding for a Healthcare
Workforce Development Project to the National Council on Aging
to support both SCSEP-eligible and non-eligible mature workers
in finding employment as community health workers through
SCSEP. At its conclusion, the project had served 424
individuals and secured unsubsidized employment for 73 percent
of them, primarily as direct care workers in long-term care
settings.\36\ Given the success of this pilot project and the
urgent need for more direct care workers to meet the needs of
older adults, the Dignity in Aging Act adds projects that
expand and improve the direct care workforce as an allowable
use to the list of authorized grant programs and demonstration
projects under Title IV and Title V of OAA. By incorporating
direct care demonstration projects into Title IV of OAA, the
Dignity in Aging Act also provides the Assistant Secretary for
Aging with the authority to conduct demonstration projects
within ACL, in recognition of the critical need to increase the
direct care workforce to support the health of aging Americans.
It is the Committee's view that such projects should be
implemented to build off the success of the 2007 pilot program.
---------------------------------------------------------------------------
\35\PHI, Federal Policy Priorities: Strengthening the Direct Care
Workforce 1 (2017), https://phinational.org/resource/federal-policy-
priorities-strengthening-the-direct-care-workforce/.
\36\National Council on Aging, Securing Healthcare Jobs for Mature
Workers: The Public/Private Sector Approach 3 (2011), https://
www.ncoa.org/wp-content/uploads/Securing-Health-Care-Jobs-Issue-
Brief.pdf.
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PREVENTING ABUSE AND NEGLECT
It is estimated that 10 percent of older adults experience
elder abuse, including physical abuse, psychological or verbal
abuse, sexual abuse, financial exploitation, and neglect.\37\
The Older Americans Act combats elder abuse by funding the
National Center on Elder Abuse and providing states with grants
to conduct elder justice activities, including elder abuse
prevention. OAA also authorizes the State Long-Term Care
Ombudsman Program that investigates and resolves complaints by
residents of nursing facilities and other community residential
care facilities. The Dignity in Aging Act strengthens the State
Long-Term Care Ombudsman Program by updating minimum funding
and maintenance of effort provisions.
---------------------------------------------------------------------------
\37\Mark S. Lachs and Karl Pillemer, Elder Abuse, 373 New England
Journal of Medicine 1947, 1947-49 (2015).
---------------------------------------------------------------------------
It is the Committee's understanding that a State Long-Term
Care Ombudsman may report and also refer to the appropriate
federal, state, or local authorities violations of law that
negatively impact and diminish the care being provided, or may
pose a threat to the residents of a long-term care facility.
Therefore, the Committee recognizes that ombudsman may act to
protect workers who are victims of wage or hour violations in
instances where care for residents is implicated.
MEETING THE NEEDS OF OLDER NATIVE AMERICANS
Native American populations face disproportionate rates of
poor health conditions as well as lower income rates than non-
Native American populations. An analysis of data between 1990
and 2009 showed that American Indians and Alaska Natives
experienced an approximately 46 percent greater all-cause
mortality rate than white individuals over this time
period.\38\ As of 2017, median household income for Native
Americans was less than 70 percent that of households overall--
$41,882 per year compared to $60,336.\39\ Native Americans also
experienced poverty rates at more than twice the rate of the
overall population, with 25.4 percent of Native Americans
living in poverty in 2017.\40\ In addition, the Committee
recognizes the particular need to support Native American
caregivers caring for family members with Alzheimer's disease
due to the disproportionate impact of this disease on the
Native American population.\41\ The Dignity in Aging Act
supports Native American older adults by funding technical
assistance for tribal organizations and creating a
demonstration program to fund the provision of supportive
services. Specifically, a new Part D in Title VI of OAA
authorizes demonstration projects to fund the implementation of
supportive services by tribal and Native Hawaiian
organizations. Funds are provided for the new Part D through a
5 percent set aside of funds appropriated for Parts A and B of
Title VI of OAA.
---------------------------------------------------------------------------
\38\Feyaz Sancar et al., Mortality Among American Indians and
Alaska Natives, 319 Journal of the American Medical Association 112,
112 (2018).
\39\Valerie Wilson, Digging into the 2017 ACS: Improved Income
Growth for Native American, but Lots of Variation in the Pace of
Recovery for Different Asian Ethnic Groups, Working Economics Blog
(Sept. 14, 2018, 4:27 PM), https://www.epi.org/blog/digging-into-2017-
acs-income-native-americans-asians/.
\40\Talk Poverty, Basic Statistics, https://talkpoverty.org/basics/
(last visited Sept. 27, 2019).
\41\Elizabeth Rose Mayeda et al., Inequalities in Dementia
Incidence Between Six Racial and Ethnic Groups Over 14 Years, 12 The
Journal of the Alzheimer's Association 216, 218-24 (2016) https://
www.alzheimersanddementia.com/article/S1552-5260%2815%2903031-9/
abstract.
---------------------------------------------------------------------------
CONCLUSION
The Committee has a duty and obligation to protect and
support older Americans in maintaining their health and
independence as they age. As the aging population continues to
grow, it is crucial that Congress make available additional
resources to meet the needs of the population through updates
and changes that strengthen the key federal law supporting this
population. It is also important for Congress to respond to the
changing needs of the population in light of the opioid
epidemic and other factors that have added new challenges to
the lives of older Americans. The Dignity in Aging Act creates
a new, robust authority for innovation and evaluation under ACL
and provides critical federal funding for supportive services
and nutrition programs for older adults and their caregivers.
It increases supports for family and older relative caregivers
and addresses key public health issues such as social isolation
and its associated health impacts. The Dignity in Aging Act
provides key protections for vulnerable older adults and
provides new focused resources for supportive services for
aging Native Americans in recognition of the significant unmet
needs in this population. Finally, it makes critical funding
increases in OAA programs to address the needs of the growing
population of older adults.
Section-by-Section Analysis
Section 1. Short title
This section states that the title of the bill is the
Dignity in Aging Act of 2019.
Section 101. Person-centered, trauma-informed care
This section adds access to person-centered, trauma-
informed care to the objectives of OAA.
Section 102. Vaccination
This section adds immunization status screening to the list
of routine health screenings allowed under the definition of
disease prevention and health promotion.
Section 103. Functions of Assistant Secretary
This section clarifies that the Assistant Secretary for
Aging at the Department of Health and Human Services (Assistant
Secretary) shall not approve grant applications for programs
that have received previous grants unless programs meet certain
standards. The section further requires the Assistant Secretary
to publish a list of resource centers as well as demonstration
projects funded through OAA on an annual basis. Additionally,
this section directs the Assistant Secretary to provide
technical assistance and share best practices with states and
AAAs on how to collaborate and coordinate activities and
develop long-range emergency preparedness plans.
Section 104. Professional standards for nutrition official under the
Assistant Secretary
This section ensures that the nutrition official under the
Assistant Secretary is a Registered Dietitian/Registered
Dietitian Nutritionist.
Section 105. Interagency Coordinating Committee on Age-Friendly
Communities
This section re-names the Interagency Coordinating
Committee on Aging as the Interagency Coordinating Committee on
Age-Friendly Communities and tasks the Committee with
coordinating efforts to promote safe and accessible independent
living environments.
Section 106. Technical assistance on age-friendly communities
This section allows the Assistant Secretary to provide
technical assistance to state agencies, AAAs, local
governments, and leaders in age-friendly communities to
implement best practices and the recommendations of the
Interagency Coordinating Committee.
Section 107. Malnutrition
This section clarifies that screening for malnutrition is
included as part of nutrition screening within broader routine
health screening in the definition of disease prevention and
health promotion services. Additionally, this section adds
reducing malnutrition to the purpose of OAA's nutrition
services programs.
Section 108. Coordination with resource centers
This section requires states and AAAs to collect data on
the services needed by the populations whose needs are the
focus of the centers funded by Title IV of OAA; it also
requires states and AAAs to conduct outreach to identify
individuals eligible for assistance under OAA, with an emphasis
on these populations.
Section 109. Arts education
This section clarifies that arts education is an authorized
activity as part of the functions of the Assistant Secretary
and that cultural experiences--including the arts--are included
in the definition of supportive services.
Section 110. Social determinants of health
This section adds social determinants of health to the
purpose of Title III of OAA.
Section 111. Federal coordination of supports and services for living
independently and safely at home
This section creates an initiative under the Assistant
Secretary to coordinate federal resources to promote the
independence and safety of adults living at home as they age,
including falls prevention, home assessments, and home
modifications.
Section 112. Falls Prevention and Chronic Disease Self-Management
education
This section provides an authorization for the currently
funded Falls Prevention and Chronic Disease Self-Management
programs.
Section 113. Extension of RAISE Family Caregivers Act
This section extends by one year the authorization of the
RAISE Family Caregivers Act, which requires the Secretary of
Health and Human Services to develop a National Family
Caregiving Strategy and convene a Family Caregiving Advisory
Council.
Section 114. Support for socially-isolated older americans
This section adds social isolation screening to the
definition of disease prevention and health promotion services.
Section 115. Increased focus of Assistant Secretary on social isolation
This section adds a requirement for the Assistant Secretary
to develop objectives and a long-term plan to improve the
prevention of, detection of, and response to social isolation.
Section 116. Advisory council on social isolation
This section requires the Assistant Secretary to convene an
advisory council on social isolation and loneliness tasked with
identifying best practices to address these challenges.
Section 117. Supportive services and senior centers
This section adds social isolation to the definition of
health screening for the purposes of grant-making authority to
senior centers and supportive services in Title III of OAA.
Section 118. Demonstration projects
This section adds projects that address social isolation
and loneliness among older adults to the list of authorized
grant programs under Title IV of OAA. Additionally, this
section repeals section 416 of OAA, which is a technical
assistance program that has never received funding.
Section 119. Younger onset Alzheimer's disease
This section clarifies that family caregivers include adult
caregivers for individuals of any age with Alzheimer's disease
for the purposes of OAA. Additionally, this section clarifies
that individuals of any age with Alzheimer's disease can be
served by the State Long-Term Care Ombudsman Program.
Section 120. Priority for the Senior Community Service Employment
Program
This section adds individuals who are justice-involved as a
priority population for the Senior Community Service Employment
Program.
Section 121. Direct care workforce
This section adds projects that expand and improve the
direct care workforce to the list of authorized grant programs
and demonstration projects under Title IV and Title V of OAA.
Section 122. National resource center for older individuals
experiencing the long-term and adverse consequences of trauma
This section authorizes the implementation of a national
technical assistance center devoted to expanding the aging
services network's capacity to deliver person-centered, trauma-
informed services that meet the needs of older individuals
experiencing the long-term and adverse consequences of trauma.
Section 123. National Resource Center for Women and Retirement
This section codifies the existing National Resource Center
for Women and Retirement, which provides financial management,
retirement planning, and other educational tools to support
women and their families.
Section 124. Definition
This section defines the term ``person-centered, trauma-
informed.''
Section 125. Review of reports
This section requires the Assistant Secretary to review
reports submitted under section 307(a)(31) of OAA in relation
to data collection and outreach efforts to older individuals
whose needs are the focus of all centers funded under Title IV
of OAA.
Section 126. Area plans
This section adds Holocaust survivors to individuals to
whom AAAs must conduct outreach.
Section 127. Addressing chronic pain management
This section adds chronic pain management to the definition
of disease prevention and health promotion services.
Section 128. Extension of the Supporting Grandparents Raising
Grandchildren Act
This section extends the authorization period of the
Supporting Grandparents Raising Grandchildren Act by one year.
Section 129. Screening for suicide risk
This section clarifies that screening for suicide risk is
included in the definition of disease prevention and health
promotion services.
Section 130. Traumatic brain injury
This section adds a definition for traumatic brain injury
to OAA and adds brain injury screening to the list of allowable
services performed with state grants.
Section 131. Addressing public health emergencies and emerging health
threats
This section adds public health emergencies and emerging
health threats to the definition of disease prevention and
health promotion services.
Section 201. National Family Caregiver Support Program cap
This section eliminates the cap on Title III-E National
Family Caregiver Support Program resources that can be
allocated toward older relative caregivers, which is currently
set at 10 percent of total federal and non-federal funding.
This section further requires the Assistant Secretary to submit
a report to Congress on the impact of lifting this cap.
Section 202. Minimum funding level for state administrative expenses
This section increases the minimum funding level for state
administrative expenses from $500,000 to $750,000.
Section 203. Culturally-appropriate, medically-tailored meals
This section acknowledges flexibility for meal planning to
address cultural, religious, or ethnic considerations and
preferences and medically-tailored meals in Title III-C
nutrition programs.
Section 204. Business acumen provisions and clarification regarding
outside funding for Area Agencies on Aging
This section provides support for capacity building for
AAAs. It also clarifies that AAAs can engage in the provision
of privately paid services or services covered by other health
care and Long-Term Supports and Services payers outside of
their OAA funding.
Section 205. Other practices
This section requires state agencies to provide state
policies to AAAs upon request.
Section 206. Caregiver assessments
This section defines and allows for the use of caregiver
assessments in the provision of caregiver support services.
Additionally, this section requires the Assistant Secretary to
issue technical assistance and a report on the use of caregiver
assessments.
Section 207. Research and evaluation
This section establishes a National Research,
Demonstration, and Evaluation Center for the Aging Network in
the Office of the Assistant Secretary. The Center is tasked
with conducting, promoting, and coordinating research, research
dissemination, evaluation, demonstration projects, and related
technical assistance throughout OAA.
Section 208. Grant program for multigenerational collaboration
This section authorizes the Assistant Secretary to award
grants to provide opportunities for older individuals to
participate in multigeneration activities and civic engagement
activities.
Section 301. State Long-Term Care Ombudsman Program minimum funding and
maintenance of effort
This section updates minimum funding and maintenance of
effort provisions for the State Long-Term Care Ombudsman
Program.
Section 302. State long-term care volunteer ombudsman representatives
This section recognizes the use of volunteer
representatives in the ombudsman program by clarifying that OAA
funds can be used for volunteer transportation and other
volunteer expenses.
Section 303. Clarification regarding board and care facilities
This section clarifies that board and care facilities are
included within the definition of assisted living facility
under OAA.
Section 401. Expanding supportive services for Native American aging
programs
This section creates a demonstration program (new Part D)
to provide grants to tribal organizations to provide in-home
and supportive services. The new Part D receives a 5 percent
set-aside from funds provided for Parts A and B, which receive
additional funding to accommodate the set aside.
Section 402. Enhancing capacity to support Native American aging
programs
This section provides an additional $500,000 for Fiscal
Year 2020 for technical assistance for tribal organizations
implementing OAA programs.
Section 501. Assistive technology
The section updates OAA's reference to the Assistive
Technology Act of 2004.
Section 502. Technical corrections
This section makes technical and conforming amendments.
Section 503. Authorization of appropriations; Uses of funds
This section authorizes appropriations for programs under
OAA.
Section 504. Effective date
This section states that the Dignity in Aging Act of 2019
shall take effect on October 1, 2019.
Explanation of Amendments
The amendments, including the amendment in the nature of a
substitute, are explained in the descriptive portions of this
report.
Application of Law to the Legislative Branch
H.R. 4334 does not apply to terms and conditions of
employment or to access to public services or accommodations
within the legislative branch.
Unfunded Mandate Statement
Pursuant to Section 423 of the Congressional Budget and
Impoundment Control Act (as amended by Section 101(a)(2) of the
Unfunded Mandates Reform Act, Pub. L. 104-4) H.R. 4334, as
amended, contains no intergovernmental or private-sector
mandates as defined by the Unfunded Mandates Reform Act (UMRA).
Earmark Statement
In accordance with clause 9 of rule XXI of the Rules of the
House of Representatives, H.R. 4334 does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as described in clauses 9(e), 9(f), and 9(g) of rule
XXI.
Roll Call Votes
In compliance with clause 3(b) of rule XIII of the Rules of
House of the Representatives, the Committee advises that no
roll call votes occurred during the Committee's consideration
of H.R. 4334.
Statement of Performance Goals and Objectives
Pursuant to clause 3(c) of rule XIII of the Rules of the
House of Representatives, the goals of H.R. 4334 are to support
the aging population and help older individuals and individuals
with disabilities maintain their independence and live with
dignity.
Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII of the Rules of the
House of Representatives, the Committee states that no
provision of H.R. 4334 establishes or reauthorizes a program of
the Federal Government known to be duplicative of another
federal program, a program that was included in any report from
the Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
Hearings
Pursuant to section 103(i) of H. Res. 6 for the 116th
Congress, the Subcommittee on Civil Rights and Human Services
held a legislative hearing on May 15, 2019, entitled
``Examining the Older Americans Act: Promoting Independence and
Dignity for Older Americans,'' which was used to develop H.R.
4334. The hearing examined the breadth of programs and supports
authorized and funded through the Older Americans Act that
promote the independence and dignity of older Americans. The
Committee heard testimony from: Ms. Lee Girard, MPA:HA,
Director of Multnomah County Aging, Disability, and Veterans
Services; Ms. Stephanie Archer-Smith, Executive Director of
Meals on Wheels of Central Maryland, Inc.; Ms. Grace Whiting,
J.D., President and CEO of the National Alliance for
Caregiving; and Ms. Patricia Ducayet, L.M.S.W., Texas State
Long-Term Care Ombudsman for Texas Health and Human Services.
Statement of Oversight Findings and Recommendations of the Committee
In compliance with clause 3(c)(1) of rule XIII and clause
2(b)(1) of rule X of the House of Representatives, the
Committee's oversight findings and recommendations are
reflected in the descriptive portions of the report.
New Budget Authority and CBO Cost Estimate
Pursuant to clause 3(c)(2) of rule XIII of the Rules of the
House of Representatives and section 308(a) of the
Congressional Budget Act of 1974, and pursuant to clause
3(c)(3) of rule XIII of the Rules of the House of
Representatives and section 402 of the Congressional Budget Act
of 1974, the Committee has received the following estimate for
H.R. 4334 from the Director of the Congressional Budget Office:
U.S. Congress,
Congressional Budget Office,
Washington, DC, October 16, 2019.
Hon. Bobby Scott,
Chairman, Committee on Education and Labor,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 4334, the Dignity
in Aging Act of 2019.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Meredith
Decker.
Sincerely,
Phillip L. Swagel,
Director.
Enclosure.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
H.R. 4334 would amend the Older Americans Act (OAA) of
1965, which provides funding through the Department of Health
and Human Services (HHS) and the Department of Labor (DOL) for
services to the elderly. HHS administers most programs
authorized by the act, including congregate and home-delivered
meals, home and community-based supportive services (such as
assistance with transportation, in-home care, and adult day
care), and support for caregivers. DOL administers the Senior
Community Service Employment program, which provides low-income
senior citizens with work-based job training and community
service opportunities. The authorization for the OAA programs
expired at the end of fiscal year 2019; those programs received
discretionary appropriations totaling $2.1 billion that year.
H.R. 4334 also would extend the authority and obligations of
the Family Caregiving Advisory Council and the Advisory Council
to Support Grandparents Raising Grandchildren for an additional
year to 2022. Those extensions would cost less than $500,000 in
2022.
H.R. 4334 would authorize the appropriation of $12.5
billion over the 2020-2024 period for OAA programs. Assuming
appropriation of specified amounts, and based on historical
spending patterns, CBO estimates that implementing the bill
would cost $10.9 billion over the same period and $1.4 billion
after 2024. The bill would authorize the appropriation of
specific amounts for those programs, totaling $10.1 billion for
HHS, and $2.4 billion for DOL over the 2020-2024 period.
For this estimate, CBO assumes that H.R. 4334 will be
enacted near the beginning of 2020. The costs of the
legislation, detailed in Table 1, fall within budget function
500 (education, training, employment, and social services.)
TABLE 1.--ESTIMATED INCREASES IN SPENDING SUBJECT TO APPROPRIATION UNDER H.R. 4334
----------------------------------------------------------------------------------------------------------------
By fiscal year, millions of dollars--
--------------------------------------------------
2020 2021 2022 2023 2024 2020-2024
----------------------------------------------------------------------------------------------------------------
Health and Human Services:
Authorization............................................ 1,788 1,894 2,006 2,125 2,252 10,065
Estimated Outlays........................................ 1,112 1,761 1,919 2,043 2,167 9,002
Department of Labor:
Authorization............................................ 429 455 482 511 542 2,418
Estimated Outlays........................................ 75 421 454 483 513 1,946
Total Changes:
Authorization........................................ 2,217 2,348 2,488 2,636 2,793 12,483
Estimated Outlays.................................... 1,187 2,182 2,372 2,526 2,680 10,948
----------------------------------------------------------------------------------------------------------------
The CBO staff contact for this estimate is Meredith Decker.
The estimate was reviewed by H. Samuel Papenfuss, Deputy
Assistant Director for Budget Analysis.
Committee Cost Estimate
Clause 3(d)(1) of rule XIII of the Rules of the House of
Representatives requires an estimate and a comparison of the
costs that would be incurred in carrying out H.R. 4334.
However, clause 3(d)(2)(B) of that rule provides that this
requirement does not apply when the committee has included in
its report a timely submitted cost estimate of the bill
prepared by the Director of the Congressional Budget Office
under section 402 of the Congressional Budget Act of 1974.
Change in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, H.R. 4334, as reported, are shown as follows:
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
OLDER AMERICANS ACT OF 1965
* * * * * * *
TITLE I--DECLARATION OF OBJECTIVES; DEFINITIONS
declaration of objectives for older americans
Sec. 101. The Congress hereby finds and declares that, in
keeping with the traditional American concept of the inherent
dignity of the individual in our democratic society, the older
people of our Nation are entitled to, and it is the joint and
several duty and responsibility of the governments of the
United States, of the several States and their political
subdivisions, and of Indian tribes to assist our older people
to secure equal opportunity to the full and free enjoyment of
the following objectives:
(1) An adequate income in retirement in accordance
with the American standard of living.
(2) The best possible physical and mental health
(including access to person-centered, trauma-informed
care) which science can make available and without
regard to economic status.
(3) Obtaining and maintaining suitable housing,
independently selected, designed and located with
reference to special needs and available at costs which
older citizens can afford.
(4) Full restorative services for those who require
institutional care, and a comprehensive array of
community-based, long-term care services adequate to
appropriately sustain older people in their communities
and in their homes, including support to family members
and other persons providing voluntary care to older
individuals needing long-term care services.
(5) Opportunity for employment with no discriminatory
personnel practices because of age.
(6) Retirement in health, honor, dignity--after years
of contribution to the economy.
(7) Participating in and contributing to meaningful
activity within the widest range of civic, cultural,
educational and training and recreational
opportunities.
(8) Efficient community services, including access to
low-cost transportation, which provide a choice in
supported living arrangements and social assistance in
a coordinated manner and which are readily available
when needed, with emphasis on maintaining a continuum
of care for vulnerable older individuals.
(9) Immediate benefit from proven research knowledge
which can sustain and improve health and happiness.
(10) Freedom, independence, and the free exercise of
individual initiative in planning and managing their
own lives, full participation in the planning and
operation of community-based services and programs
provided for their benefit, and protection against
abuse, neglect, and exploitation.
definitions
Sec. 102. For the purposes of this Act--
(1) The term ``abuse'' means the knowing infliction
of physical or psychological harm or the knowing
deprivation of goods or services that are necessary to
meet essential needs or to avoid physical or
psychological harm.
(2) The term ``Administration'' means the
Administration on Aging.
(3) The term ``adult protective services'' means such
services provided to adults as the Secretary may
specify and includes services such as--
(A) receiving reports of adult abuse,
neglect, or exploitation;
(B) investigating the reports described in
subparagraph (A);
(C) case planning, monitoring, evaluation,
and other casework and services; and
(D) providing, arranging for, or facilitating
the provision of medical, social service,
economic, legal, housing, law enforcement, or
other protective, emergency, or support
services.
(4) The term ``Aging and Disability Resource Center''
means an entity, network, or consortium established by
a State as part of the State system of long-term care,
to provide a coordinated and integrated system for
older individuals and individuals with disabilities (as
defined in section 3 of the Americans with Disabilities
Act of 1990 (42 U.S.C. 12102)), and the caregivers of
older individuals and individuals with disabilities,
that provides--
(A) comprehensive information on the full
range of available public and private long-term
care programs, options, service providers, and
resources within a community, including
information on the availability of integrated
long-term care services, and Federal or State
programs that provide long-term care services
and supports through home and community-based
service programs;
(B) person-centered counseling to assist
individuals in assessing their existing or
anticipated long-term care needs and goals, and
developing and implementing a person-centered
plan for long-term care that is consistent with
the desires of such an individual and designed
to meet the individual's specific needs, goals,
and circumstances;
(C) access for individuals to the full range
of publicly-supported long-term care services
and supports for which the individuals may be
eligible, including home and community-based
service options, by serving as a convenient
point of entry for such programs and supports;
and
(D) in cooperation with area agencies on
aging, centers for independent living described
in part C of title VII of the Rehabilitation
Act of 1973 (29 U.S.C. 796f et seq.), and other
community-based entities, information and
referrals regarding available home and
community-based services for individuals who
are at risk for residing in, or who reside in,
institutional settings, so that the individuals
have the choice to remain in or to return to
the community.
(5) The term ``aging network'' means the network of--
(A) State agencies, area agencies on aging,
title VI grantees, and the Administration; and
(B) organizations that--
(i)(I) are providers of direct
services to older individuals; or
(II) are institutions of higher
education; and
(ii) receive funding under this Act.
(6) The term ``area agency on aging'' means an area
agency on aging designated under section 305(a)(2)(A)
or a State agency performing the functions of an area
agency on aging under section 305(b)(5).
(7) The term ``Assistant Secretary'' means the
Assistant Secretary for Aging.
(8)(A) The term ``assistive device'' includes an
assistive technology device.
(B) The terms ``assistive technology'', ``assistive
technology device'', and ``assistive technology
service'' have the meanings given such terms in section
3 of the Assistive Technology Act of 1998 (29 U.S.C.
3002).
(9) The term ``at risk for institutional placement''
means, with respect to an older individual, that such
individual is unable to perform at least 2 activities
of daily living without substantial assistance
(including verbal reminding, physical cuing, or
supervision) and is determined by the State involved to
be in need of placement in a long-term care facility.
(10) The term ``board and care facility'' means an
institution regulated by a State pursuant to section
1616(e) of the Social Security Act (42 U.S.C.
1382e(e)).
(11) The term ``case management service''--
(A) means a service provided to an older
individual, at the direction of the older
individual or a family member of the
individual--
(i) by an individual who is trained
or experienced in the case management
skills that are required to deliver the
services and coordination described in
subparagraph (B); and
(ii) to assess the needs, and to
arrange, coordinate, and monitor an
optimum package of services to meet the
needs, of the older individual; and
(B) includes services and coordination such
as--
(i) comprehensive assessment of the
older individual (including the
physical, psychological, and social
needs of the individual);
(ii) development and implementation
of a service plan with the older
individual to mobilize the formal and
informal resources and services
identified in the assessment to meet
the needs of the older individual,
including coordination of the resources
and services--
(I) with any other plans that
exist for various formal
services, such as hospital
discharge plans; and
(II) with the information and
assistance services provided
under this Act;
(iii) coordination and monitoring of
formal and informal service delivery,
including coordination and monitoring
to ensure that services specified in
the plan are being provided;
(iv) periodic reassessment and
revision of the status of the older
individual with--
(I) the older individual; or
(II) if necessary, a primary
caregiver or family member of
the older individual; and
(v) in accordance with the wishes of
the older individual, advocacy on
behalf of the older individual for
needed services or resources.
(12) The term ``civic engagement'' means an
individual or collective action designed to address a
public concern or an unmet human, educational, health
care, environmental, or public safety need.
(13) The term ``disability'' means (except when such
term is used in the phrase ``severe disability'',
``developmental disabilities'', ``physical or mental
disability'', ``physical and mental disabilities'', or
``physical disabilities'') a disability attributable to
mental or physical impairment, or a combination of
mental and physical impairments, that results in
substantial functional limitations in 1 or more of the
following areas of major life activity: (A) self-care,
(B) receptive and expressive language, (C) learning,
(D) mobility, (E) self-direction, (F) capacity for
independent living, (G) economic self-sufficiency, (H)
cognitive functioning, and (I) emotional adjustment.
(14) The term ``disease prevention and health
promotion services'' means--
(A) health risk assessments;
(B) routine health screening, which may
include hypertension, glaucoma, cholesterol,
cancer, vision, hearing, diabetes, bone
density, oral health, immunization status, and
nutrition screening (including screening for
malnutrition);
(C) nutritional counseling and educational
services for individuals and their primary
caregivers;
(D) evidence-based health promotion programs,
including programs related to the prevention
and mitigation of the effects of chronic
disease (including osteoporosis, hypertension,
obesity, diabetes, and cardiovascular disease),
infectious disease, and vaccine preventable
disease, alcohol and substance abuse reduction,
chronic pain management, smoking cessation,
weight loss and control, stress management,
falls prevention, physical activity, and
improved nutrition;
(E) programs regarding physical fitness,
group exercise, and music therapy, art therapy,
and dance-movement therapy, including programs
for multigenerational participation that are
provided by--
(i) an institution of higher
education;
(ii) a local educational agency, as
defined in section 14101 of the
Elementary and Secondary Education Act
of 1965 (20 U.S.C. 8801); or
(iii) a community-based organization;
(F) home injury control services, including
screening of high-risk home environments and
provision of educational programs on injury
prevention (including fall and fracture
prevention) in the home environment;
(G) screening for the prevention of
depression and screening for suicide risk,
coordination of community mental and behavioral
health services, provision of educational
activities, and referral to psychiatric and
psychological services;
(H) screening for fall-related traumatic
brain injury, coordination of treatment,
rehabilitation and related services, and
referral services;
[(H)] (I) educational programs on the
availability, benefits, and appropriate use of
preventive health services covered under title
XVIII of the Social Security Act (42 U.S.C.
1395 et seq.);
[(I)] (J) medication management screening and
education to prevent incorrect medication and
adverse drug reactions;
(K) responses to public health emergencies
and emerging health threats;
[(J)] (L) information concerning diagnosis,
prevention, treatment, and rehabilitation
concerning age-related diseases and chronic
disabling conditions, including osteoporosis,
cardiovascular diseases, diabetes, and
Alzheimer's disease and related disorders with
neurological and organic brain dysfunction;
[(K)] (M) gerontological counseling; [and]
(N) screening for the prevention of social
isolation and coordination of supportive
services and health care to address social
isolation and loneliness; and
[(L)] (O) counseling regarding social
services and followup health services based on
any of the services described in subparagraphs
(A) through [(K)] (N).
The term shall not include services for which payment
may be made under titles XVIII and XIX of the Social
Security Act (42 U.S.C. 1395 et seq., 1396 et seq.).
(15) The term ``elder abuse'' means abuse of an older
individual.
(16) The term ``elder abuse, neglect, and
exploitation'' means abuse, neglect, and exploitation,
of an older individual.
(17) The term ``elder justice'' means--
(A) from a societal perspective, efforts to--
(i) prevent, detect, treat, intervene
in, and prosecute elder abuse, neglect,
and exploitation; and
(ii) protect older individuals with
diminished capacity while maximizing
their autonomy; and
(B) from an individual perspective, the
recognition of an older individual's rights,
including the right to be free of abuse,
neglect, and exploitation.
(18)(A) The terms ``exploitation'' and ``financial
exploitation'' mean the fraudulent or otherwise
illegal, unauthorized, or improper act or process of an
individual, including a caregiver or fiduciary, that
uses the resources of an older individual for monetary
or personal benefit, profit, or gain, or that results
in depriving an older individual of rightful access to,
or use of, benefits, resources, belongings, or assets.
(B) In subparagraph (A), the term ``caregiver'' means
an individual who has the responsibility for the care
of an older individual, either voluntarily, by
contract, by receipt of payment for care, or as a
result of the operation of law and means a family
member or other individual who provides (on behalf of
such individual or of a public or private agency,
organization, or institution) compensated or
uncompensated care to an older individual.
(19) The term ``family violence'' has the same
meaning given the term in the Family Violence
Prevention and Services Act.
(20) The term ``fiduciary''--
(A) means a person or entity with the legal
responsibility--
(i) to make decisions on behalf of
and for the benefit of another person;
and
(ii) to act in good faith and with
fairness; and
(B) includes a trustee, a guardian, a
conservator, an executor, an agent under a
financial power of attorney or health care
power of attorney, or a representative payee.
(21) The term ``focal point'' means a facility
established to encourage the maximum collocation and
coordination of services for older individuals.
(22) The term ``frail'' means, with respect to an
older individual in a State, that the older individual
is determined to be functionally impaired because the
individual--
(A)(i) is unable to perform at least two
activities of daily living without substantial
human assistance, including verbal reminding,
physical cueing, or supervision; or
(ii) at the option of the State, is unable to
perform at least three such activities without
such assistance; or
(B) due to a cognitive or other mental
impairment, requires substantial supervision
because the individual behaves in a manner that
poses a serious health or safety hazard to the
individual or to another individual.
(23) The term ``greatest economic need'' means the
need resulting from an income level at or below the
poverty line.
(24) The term ``greatest social need'' means the need
caused by noneconomic factors, which include--
(A) physical and mental disabilities;
(B) language barriers; and
(C) cultural, social, or geographical
isolation, including isolation caused by racial
or ethnic status, that--
(i) restricts the ability of an
individual to perform normal daily
tasks; or
(ii) threatens the capacity of the
individual to live independently.
(25) The term ``Hispanic-serving institution'' has
the meaning given the term in section 502 of the Higher
Education Act of 1965 (20 U.S.C. 1101a).
(26) The term ``Indian'' means a person who is a
member of an Indian tribe.
(27) Except for the purposes of title VI of this Act,
the term ``Indian tribe'' means any tribe, band,
nation, or other organized group or community of
Indians (including any Alaska Native village or
regional or village corporation as defined in or
established pursuant to the Alaska Native Claims
Settlement Act (Public Law 92-203; 85 Stat. 688) which
(A) is recognized as eligible for the special programs
and services provided by the United States to Indians
because of their status as Indians; or (B) is located
on, or in proximity to, a Federal or State reservation
or rancheria.
(28) The term ``information and assistance service''
means a service for older individuals that--
(A) provides the individuals with current
information on opportunities and services
available to the individuals within their
communities, including information relating to
assistive technology;
(B) assesses the problems and capacities of
the individuals;
(C) links the individuals to the
opportunities and services that are available;
(D) to the maximum extent practicable,
ensures that the individuals receive the
services needed by the individuals, and are
aware of the opportunities available to the
individuals, by establishing adequate followup
procedures; and
(E) serves the entire community of older
individuals, particularly--
(i) older individuals with greatest
social need;
(ii) older individuals with greatest
economic need; and
(iii) older individuals at risk for
institutional placement.
(29) The term ``information and referral'' includes
information relating to assistive technology.
(30) The term ``in-home services'' includes--
(A) services of homemakers and home health
aides;
(B) visiting and telephone reassurance;
(C) chore maintenance;
(D) in-home respite care for families, and
adult day care as a respite service for
families;
(E) minor modification of homes that is
necessary to facilitate the ability of older
individuals to remain at home and that is not
available under another program (other than a
program carried out under this Act);
(F) personal care services; and
(G) other in-home services as defined--
(i) by the State agency in the State
plan submitted in accordance with
section 307; and
(ii) by the area agency on aging in
the area plan submitted in accordance
with section 306.
(31) The term ``institution of higher education'' has
the meaning given the term in section 101 of the Higher
Education Act of 1965.
(32) The term ``integrated long-term care''--
(A) means items and services that consist
of--
(i) with respect to long-term care--
(I) long-term care items or
services provided under a State
plan for medical assistance
under the Medicaid program
established under title XIX of
the Social Security Act (42
U.S.C. 1396 et seq.), including
nursing facility services, home
and community-based services,
personal care services, and
case management services
provided under the plan; and
(II) any other supports,
items, or services that are
available under any federally
funded long-term care program;
and
(ii) with respect to other health
care, items and services covered
under--
(I) the Medicare program
established under title XVIII
of the Social Security Act (42
U.S.C. 1395 et seq.);
(II) the State plan for
medical assistance under the
Medicaid program; or
(III) any other federally
funded health care program; and
(B) includes items or services described in
subparagraph (A) that are provided under a
public or private managed care plan or through
any other service provider.
(33) The term ``legal assistance''--
(A) means legal advice and representation
provided by an attorney to older individuals
with economic or social needs; and
(B) includes--
(i) to the extent feasible,
counseling or other appropriate
assistance by a paralegal or law
student under the direct supervision of
an attorney; and
(ii) counseling or representation by
a nonlawyer where permitted by law.
(34) The term ``long-term care'' means any service,
care, or item (including an assistive device),
including a disease prevention and health promotion
service, an in-home service, and a case management
service--
(A) intended to assist individuals in coping
with, and to the extent practicable compensate
for, a functional impairment in carrying out
activities of daily living;
(B) furnished at home, in a community care
setting (including a small community care
setting as defined in subsection (g)(1), and a
large community care setting as defined in
subsection (h)(1), of section 1929 of the
Social Security Act (42 U.S.C. 1396t)), or in a
long-term care facility; and
(C) not furnished to prevent, diagnose,
treat, or cure a medical disease or condition.
(35) The term ``long-term care facility'' means--
(A) any skilled nursing facility, as defined
in section 1819(a) of the Social Security Act
(42 U.S.C. 1395i-3(a));
(B) any nursing facility, as defined in
section 1919(a) of the Social Security Act (42
U.S.C. 1396r(a));
(C) [for purposes of sections 307(a)(12) and
712,] a board and care facility; and
(D) any other adult care home, including an
assisted living facility, similar to a facility
or institution described in subparagraphs (A)
through (C).
(36) The term ``multipurpose senior center'' means a
community facility for the organization and provision
of a broad spectrum of services, which shall include
provision of health (including mental and behavioral
health), social, nutritional, and educational services
and the provision of facilities for recreational
activities for older individuals.
(37) The term ``Native American'' means--
(A) an Indian as defined in [paragraph (5)]
paragraph (26); and
(B) a Native Hawaiian, as defined in section
625.
(38) The term ``neglect'' means--
(A) the failure of a caregiver (as defined in
paragraph (18)(B)) or fiduciary to provide the
goods or services that are necessary to
maintain the health or safety of an older
individual; or
(B) self-neglect.
(39) The term ``nonprofit'' as applied to any agency,
institution, or organization means an agency,
institution, or organization which is, or is owned and
operated by, one or more corporations or associations
no part of the net earnings of which inures, or may
lawfully inure, to the benefit of any private
shareholder or individual.
(40) The term ``older individual'' means an
individual who is 60 years of age or older.
(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.
[(41)] (42) The term ``physical harm'' means bodily
injury, impairment, or disease.
[(42)] (43) The term ``planning and service area''
means an area designated by a State agency under
section 305(a)(1)(E), including a single planning and
service area described in section 305(b)(5)(A).
[(43)] (44) The term ``poverty line'' means the
official poverty line (as defined by the Office of
Management and Budget, and adjusted by the Secretary in
accordance with section 673(2) of the Community
Services Block Grant Act (42 U.S.C. 9902(2)).
[(44)] (45) The term ``representative payee'' means a
person who is appointed by a governmental entity to
receive, on behalf of an older individual who is unable
to manage funds by reason of a physical or mental
incapacity, any funds owed to such individual by such
entity.
[(45)] (46) The term ``Secretary'' means the
Secretary of Health and Human Services, expect that for
purposes of title V such term means the Secretary of
Labor.
[(46)] (47) The term ``self-directed care'' means an
approach to providing services (including programs,
benefits, supports, and technology) under this Act
intended to assist an individual with activities of
daily living, in which--
(A) such services (including the amount,
duration, scope, provider, and location of such
services) are planned, budgeted, and purchased
under the direction and control of such
individual;
(B) such individual is provided with such
information and assistance as are necessary and
appropriate to enable such individual to make
informed decisions about the individual's care
options;
(C) the needs, capabilities, and preferences
of such individual with respect to such
services, and such individual's ability to
direct and control the individual's receipt of
such services, are assessed by the area agency
on aging (or other agency designated by the
area agency on aging) involved;
(D) based on the assessment made under
subparagraph (C), the area agency on aging (or
other agency designated by the area agency on
aging) develops together with such individual
and the individual's family, caregiver (as
defined in paragraph (18)(B)), or legal
representative--
(i) a plan of services for such
individual that specifies which
services such individual will be
responsible for directing;
(ii) a determination of the role of
family members (and others whose
participation is sought by such
individual) in providing services under
such plan; and
(iii) a budget for such services; and
(E) the area agency on aging or State agency
provides for oversight of such individual's
self-directed receipt of services, including
steps to ensure the quality of services
provided and the appropriate use of funds under
this Act.
[(47)] (48) The term ``self-neglect'' means an
adult's inability, due to physical or mental impairment
or diminished capacity, to perform essential self-care
tasks including--
(A) obtaining essential food, clothing,
shelter, and medical care;
(B) obtaining goods and services necessary to
maintain physical health, mental and behavioral
health, or general safety; or
(C) managing one's own financial affairs.
[(48)] (49) The term ``severe disability'' means a
severe, chronic disability attributable to mental or
physical impairment, or a combination of mental and
physical impairments, that--
(A) is likely to continue indefinitely; and
(B) results in substantial functional
limitation in 3 or more of the major life
activities specified in subparagraphs (A)
through (G) of paragraph (8).
[(49) ] (50) The term ``sexual assault'' has the
meaning given the term in section 2003 of the Omnibus
Crime Control and Safe Streets Act of 1968 (42 U.S.C.
3796gg-2).
[(50)] (51) The term ``State'' means any of the
several States, the District of Columbia, the Virgin
Islands of the United States, the Commonwealth of
Puerto Rico, Guam, American Samoa, and the Commonwealth
of the Northern Mariana Islands.
[(51)] (52) The term ``State agency'' means the
agency designated under section 305(a)(1).
[(52)] (53) The term ``State system of long-term
care'' means the Federal, State, and local programs and
activities administered by a State that provide,
support, or facilitate access to long-term care for
individuals in such State.
[(53)] (54) The term ``supportive service'' means a
service described in section 321(a).
[(54)] (55) Except for the purposes of title VI of
this Act, the term ``tribal organization'' means the
recognized governing body of any Indian tribe, or any
legally established organization of Indians which is
controlled, sanctioned, or chartered by such governing
body. In any case in which a contract is let or grant
made to an organization to perform services benefiting
more than one Indian tribe, the approval of each such
Indian tribe shall be a prerequisite to the letting or
making of such contract or grant.
(56) The term ``traumatic brain injury'' has the
meaning given to it in section 339B(d) of the Public
Health Service Act.
TITLE II--ADMINISTRATION ON AGING
establishment of administration on aging
Sec. 201. (a) There is established in the Office of the
Secretary an Administration on Aging which shall be headed by
an Assistant Secretary for Aging. Except for title V, the
Administration shall be the agency for carrying out this Act.
There shall be a direct reporting relationship between the
Assistant Secretary and the Secretary. In the performance of
the functions of the Assistant Secretary, the Assistant
Secretary shall be directly responsible to the Secretary. The
Secretary shall not approve or require any delegation of the
functions of the Assistant Secretary (including the functions
of the Assistant Secretary carried out through regional
offices) to any other officer not directly responsible to the
Assistant Secretary.
(b) The Assistant Secretary shall be appointed by the
President by and with the advice and consent of the Senate.
(c)(1) There is established in the Administration an Office
for American Indian, Alaskan Native, and Native Hawaiian
Programs.
(2) The Office shall be headed by a Director of the Office
for American Indian, Alaskan Native, and Native Hawaiian Aging
appointed by the Assistant Secretary.
(3) The Director of the Office for American Indian, Alaskan
Native, and Native Hawaiian Aging shall--
(A)(i) evaluate the adequacy of outreach under title
III and title VI for older individuals who are Native
Americans and recommend to the Assistant Secretary
necessary action to improve service delivery, outreach,
coordination between title III and title VI services,
and particular problems faced by older Indians and
Native Hawaiians; and
(ii) include a description of the results of such
evaluation and recommendations in the annual report
required by section 207(a) to be submitted by the
Assistant Secretary;
(B) serve as the effective and visible advocate in
behalf of older individuals who are Native Americans
within the Department of Health and Human Services and
with other departments and agencies of the Federal
Government regarding all Federal policies affecting
such individuals, with particular attention to services
provided to Native Americans by the Indian Health
Service;
(C) coordinate activities between other Federal
departments and agencies to assure a continuum of
improved services through memoranda of agreements or
through other appropriate means of coordination;
(D) administer and evaluate the grants provided under
this Act to Indian tribes, public agencies and
nonprofit private organziations serving Native
Hawaiians;
(E) recommend to the Assistant Secretary policies and
priorities with respect to the development and
operation of programs and activities conducted under
this Act relating to older individuals who are Native
Americans;
(F) collect and disseminate information related to
problems experienced by older Native Americans,
including information (compiled with assistance from
public or nonprofit private entities, including
institutions of higher education, with experience in
assessing the characteristics and health status of
older individuals who are Native Americans) on elder
abuse, in-home care, health problems, and other
problems unique to Native Americans;
(G) develop research plans, and conduct and arrange
for research, in the field of American Native aging
with a special emphasis on the gathering of statistics
on the status of older individuals who are Native
Americans;
(H) develop and provide technical assistance and
training programs to grantees under title VI 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;
(I) promote coordination--
(i) between the administration of title III
and the administration of title VI; and
(ii) between programs established under title
III by the Assistant Secretary and programs
established under title VI by the Assistant
Secretary;
including sharing among grantees information on
programs funded, and on training and technical
assistance provided, under such titles; and
(J) serve as the effective and visible advocate on
behalf of older individuals who are Indians, Alaskan
Natives, and Native Hawaiians, in the States to promote
the enhanced delivery of services and implementation of
programs, under this Act and other Federal Acts, for
the benefit of such individuals.
(d)(1) There is established in the Administration the Office
of Long-Term Care Ombudsman Programs (in this subsection
referred to as the ``Office'').
(2)(A) The Office shall be headed by a Director of the Office
of Long-Term Care Ombudsman Programs (in this subsection
referred to as the ``Director'') who shall be appointed by the
Assistant Secretary from among individuals who have expertise
and background in the fields of long-term care advocacy and
management. The Director shall report directly to the Assistant
Secretary.
(B) No individual shall be appointed Director if--
(i) the individual has been employed within the
previous 2 years by--
(I) a long-term care facility;
(II) a corporation that then owned or
operated a long-term care facility; or
(III) an association of long-term care
facilities;
(ii) the individual--
(I) has an ownership or investment interest
(represented by equity, debt, or other
financial relationship) in a long-term care
facility or long-term care service; or
(II) receives, or has the right to receive,
directly or indirectly remuneration (in cash or
in kind) under a compensation arrangement with
an owner or operator of a long-term care
facility; or
(iii) the individual, or any member of the immediate
family of the individual, is subject to a conflict of
interest.
(3) The Director shall--
(A) serve as an effective and visible advocate on
behalf of older individuals who reside in long-term
care facilities, within the Department of Health and
Human Services and with other departments, agencies,
and instrumentalities of the Federal Government
regarding all Federal policies affecting such
individuals;
(B) review and make recommendations to the Assistant
Secretary regarding--
(i) the approval of the provisions in State
plans submitted under section 307(a) that
relate to State Long-Term Care Ombudsman
programs; and
(ii) the adequacy of State budgets and
policies relating to the programs;
(C) after consultation with State Long-Term Care
Ombudsmen and the State agencies, make recommendations
to the Assistant Secretary regarding--
(i) policies designed to assist State Long-
Term Care Ombudsmen; and
(ii) methods to periodically monitor and
evaluate the operation of State Long-Term Care
Ombudsman programs, to ensure that the programs
satisfy the requirements of section 307(a)(9)
and section 712, including provision of service
to residents of board and care facilities and
of similar adult care facilities;
(D) keep the Assistant Secretary and the Secretary
fully and currently informed about--
(i) problems relating to State Long-Term Care
Ombudsman programs; and
(ii) the necessity for, and the progress
toward, solving the problems;
(E) review, and make recommendations to the Secretary
and the Assistant Secretary regarding, existing and
proposed Federal legislation, regulations, and policies
regarding the operation of State Long-Term Care
Ombudsman programs;
(F) make recommendations to the Assistant Secretary
and the Secretary regarding the policies of the
Administration, and coordinate the activities of the
Administration with the activities of other Federal
entities, State and local entities, and nongovernmental
entities, relating to State Long-Term Care Ombudsman
programs;
(G) supervise the activities carried out under the
authority of the Administration that relate to State
Long-Term Care Ombudsman programs;
(H) administer the National Ombudsman Resource Center
established under section 202(a)(18) and make
recommendations to the Assistant Secretary regarding
the operation of the National Ombudsman Resource
Center;
(I) advocate, monitor, and coordinate Federal and
State activities of Long-Term Care Ombudsmen under this
Act;
(J) submit to the Speaker of the House of
Representatives and the President pro tempore of the
Senate an annual report on the effectiveness of
services provided under section 307(a)(9) and section
712;
(K) have authority to investigate the operation or
violation of any Federal law administered by the
Department of Health and Human Services that may
adversely affect the health, safety, welfare, or rights
of older individuals;
(L) not later than 180 days after the date of the
enactment of the Older Americans Act Reauthorization
Act of 2016, establish standards applicable to the
training required by section 712(h)(5); and
(M) collect and analyze best practices related to
responding to elder abuse, neglect, and exploitation in
long-term care facilities, and publish a report of such
best practices.
(e)(1) The Assistant Secretary is authorized to designate
within the Administration a person to have responsibility for
elder abuse prevention and services.
(2) It shall be the duty of the Assistant Secretary, acting
through the person designated to have responsibility for elder
abuse prevention and services, and in coordination with the
heads of State adult protective services programs and the
Director of the Office of Long-Term Care Ombudsman Programs--
(A) to develop objectives, priorities, policy, and a
long-term plan for--
(i) facilitating the development,
implementation, and continuous improvement of a
coordinated, multidisciplinary elder justice
system in the United States;
(ii) providing Federal leadership to support
State efforts in carrying out elder justice
programs and activities relating to--
(I) elder abuse prevention,
detection, treatment, intervention, and
response;
(II) training of individuals
regarding the matters described in
subclause (I); and
(III) the development of a State
comprehensive elder justice system, as
defined in section 752(b);
(iii) establishing Federal guidelines and
disseminating best practices for uniform data
collection and reporting by States;
(iv) working with States, the Department of
Justice, and other Federal entities to annually
collect, maintain, and disseminate data
relating to elder abuse, neglect, and
exploitation, to the extent practicable;
(v) establishing an information clearinghouse
to collect, maintain, and disseminate
information concerning best practices and
resources for training, technical assistance,
and other activities to assist States and
communities to carry out evidence-based
programs to prevent and address elder abuse,
neglect, and exploitation;
(vi) conducting research related to elder
abuse, neglect, and exploitation;
(vii) providing technical assistance to
States and other eligible entities that provide
or fund the provision of the services described
in title VII;
(viii) carrying out a study to determine the
national incidence and prevalence of elder
abuse, neglect, and exploitation in all
settings; and
(ix) promoting collaborative efforts and
diminishing duplicative efforts in the
development and carrying out of elder justice
programs at the Federal, State and local
levels; and
(B) to assist States and other eligible entities
under title VII to develop strategic plans to better
coordinate elder justice activities, research, and
training.
(3) The Secretary, acting through the Assistant Secretary,
may issue such regulations as may be necessary to carry out
this subsection and section 752.
(f)(1) The Assistant Secretary may designate an officer or
employee who shall be responsible for the administration of
mental and behavioral health services authorized under this
Act.
(2) It shall be the duty of the Assistant Secretary, acting
through the individual designated under paragraph (1), to
develop objectives, priorities, and a long-term plan for
supporting State and local efforts involving education about
and prevention, detection, and treatment of mental disorders,
including age-related dementia, depression, and Alzheimer's
disease and related neurological disorders with neurological
and organic brain dysfunction.
(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
impacts that programs and interventions under
this Act have on the health outcomes, social
determinants of health, quality of life, 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, 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.
Functions of Assistant Secretary
Sec. 202. (a) It shall be the duty and function of the
Administration to--
(1) serve as the effective and visible advocate for
older individuals within the Department of Health and
Human Services and with other departments, agencies,
and instrumentalities of the Federal Government by
maintaining active review and commenting
responsibilities over all Federal policies affecting
older individuals;
(2) collect and disseminate information related to
problems of the aged and aging;
(3) directly assist the Secretary in all matters
pertaining to problems of the aged and aging;
[(4) administer the grants provided by this Act;]
(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--
(i) complied with the assurances
provided to the Assistant Secretary
with the application for such previous
grant; and
(ii) will comply with the assurances
provided with the current submitted
application;
(5) develop plans, conduct and arrange for research
in the field of aging, and assist in the establishment
and implementation of programs designed to meet the
health and economic needs of older individuals for
supportive services, including nutrition,
hospitalization, education and training services
(including preretirement training, and continuing
education), cultural experiences, activities and
services, including the arts, low-cost transportation
and housing, assistive technology, and health
(including mental and behavioral health) services;
(6) provide technical assistance and consultation to
States and political subdivisions thereof with respect
to programs for the aged and aging;
(7) prepare, publish, and disseminate educational
materials dealing with the health and economic welfare
of older individuals;
(8) gather statistics in the field of aging which
other Federal agencies are not collecting, and take
whatever action is necessary to achieve coordination of
activities carried out or assisted by all departments,
agencies, and instrumentalities of the Federal
Government with respect to the collection, preparation,
and dissemination of information relevant to older
individuals;
(9) develop basic policies and set priorities with
respect to the development and operation of programs
and activities conducted under authority of this Act;
(10) coordinate Federal programs and activities
related to such purposes;
(11) coordinate, and assist in, the planning and
development by public (including Federal, State, and
local agencies) and private organizations or programs
for older individuals with a view to the establishment
of a nationwide network of comprehensive, coordinated
services and opportunities for such individuals;
(12)(A) consult and coordinate activities with the
Administrator of the Centers for Medicare & Medicaid
Services and the heads of other Federal entities to
implement and build awareness of programs providing
benefits affecting older individuals; and
(B) carry on a continuing evaluation of the programs
and activities related to the objectives of this Act,
with particular attention to the impact of the programs
and activities carried out under--
(i) titles XVIII and XIX of the Social
Security Act (42 U.S.C. 1395 et seq., 1396 et
seq.);
(ii) the Age Discrimination in Employment Act
of 1967 (29 U.S.C. 621 et seq.); and
(iii) the National Housing Act (12 U.S.C.
1701 et seq.) relating to housing for older
individuals and the setting of standards for
the licensing of nursing homes, intermediate
care homes, and other facilities providing care
for such individuals;
(13) provide information and assistance to private
organizations for the establishment and operation by
them of programs and activities related to the
objectives of this Act;
(14) develop, in coordination with other agencies
(including the Health Resources and Services
Administration), a national plan for meeting the needs
for trained personnel in the field of aging, and for
training persons for carrying out programs related to
the objectives of this Act, and conduct and provide for
the conducting of such training;
(15) consult with national organizations representing
minority individuals to develop and disseminate
training packages and to provide technical assistance
efforts designed to assist State and area agencies on
aging, and service providers, in providing services to
older individuals with greatest economic need or
individuals with greatest social need, with particular
attention to and specific objectives for providing
services to low-income minority individuals and older
individuals residing in rural areas;
(16) collect for each fiscal year, for fiscal years
beginning after September 30, 1988, directly or by
contract, statistical data regarding programs and
activities carried out with funds provided under this
Act, including--
(A) with respect to each type of service or
activity provided with such funds--
(i) the aggregate amount of such
funds expended to provide such service
or activity;
(ii) the number of individuals who
received such service or activity; and
(iii) the number of units of such
service or activity provided;
(B) the number of senior centers which
received such funds; and
(C) the extent to which each area agency on
aging designated under section 305(a) satisfied
the requirements of paragraphs (2) and (5)(A)
of section 306(a);
(17) obtain from--
(A) the Department of Agriculture information
explaining the requirements for eligibility to
receive benefits under the Food and Nutrition
Act of 2008; and
(B) the Social Security Administration
information explaining the requirements for
eligibility to receive supplemental security
income benefits under title XVI of the Social
Security Act (or assistance under a State plan
program under title XVI of that Act);
and distribute such information, in written form, to
State agencies, for redistribution to area agencies on
aging, to carry out outreach activities and application
assistance;
(18)(A) establish and operate the National Ombudsman
Resource Center (in this paragraph referred to as the
``Center''), under the administration of the Director
of the Office of Long-Term Care Ombudsman Programs,
that will--
(i) by grant or contract--
(I) conduct research;
(II) provide training, technical
assistance, and information to State
Long-Term Care Ombudsmen;
(III) analyze laws, regulations,
programs, and practices; and
(IV) provide assistance in recruiting
and retaining volunteers for State
Long-Term Care Ombudsman programs by
establishing a national program for
recruitment efforts that utilizes the
organizations that have established a
successful record in recruiting and
retaining volunteers for ombudsman or
other programs;
relating to Federal, State, and local long-term
care ombudsman policies; and
(ii) assist State Long-Term Care Ombudsmen in
the implementation of State Long-Term Care
Ombudsman programs; and
(B) make available to the Center not less than the
amount of resources made available to the Long-Term
Care Ombudsman National Resource Center for fiscal year
2000;
(19) conduct strict monitoring of State compliance
with the requirements in effect, under this Act to
prohibit conflicts of interest and to maintain the
integrity and public purpose of services provided and
service providers, under this Act in all contractual
and commercial relationships;
(20)(A) encourage, and provide technical assistance
to, States, area agencies on aging, and service
providers to carry out outreach and benefits enrollment
assistance to inform and enroll older individuals with
greatest economic need, who may be eligible to
participate, but who are not participating, in Federal
and State programs providing benefits for which the
individuals are eligible, including--
(i) supplemental security income benefits
under title XVI of the Social Security Act (42
U.S.C. 1381 et seq.), or assistance under a
State plan program under such title;
(ii) medical assistance under title XIX of
such Act (42 U.S.C. 1396 et seq.);
(iii) benefits under the Food and Nutrition
Act of 2008 (7 U.S.C. 2011 et seq.); or
(iv) benefits under any other applicable
program; and
(B) at the election of the Assistant Secretary and in
cooperation with related Federal agency partners
administering the Federal programs, make a grant to or
enter into a contract with a qualified, experienced
entity to establish a National Center on Senior
Benefits Outreach and Enrollment, which shall--
(i) maintain and update web-based decision
support and enrollment tools, and integrated,
person-centered systems, designed to inform
older individuals about the full range of
benefits for which the individuals may be
eligible under Federal and State programs;
(ii) utilize cost-effective strategies to
find older individuals with greatest economic
need and enroll the individuals in the
programs;
(iii) create and support efforts for Aging
and Disability Resource Centers, and other
public and private State and community-based
organizations, including faith-based
organizations and coalitions, to serve as
benefits enrollment centers for the programs;
(iv) develop and maintain an information
clearinghouse on best practices and cost-
effective methods for finding and enrolling
older individuals with greatest economic need
in the programs for which the individuals are
eligible; and
(v) provide, in collaboration with related
Federal agency partners administering the
Federal programs, training and technical
assistance on effective outreach, screening,
enrollment, and follow-up strategies;
(21) establish information and assistance services as
priority services for older individuals, and develop
and operate, either directly or through contracts,
grants, or cooperative agreements, a National Eldercare
Locator Service, providing information and assistance
services through a nationwide toll-free number to
identify community resources for older individuals;
(22) develop guidelines for area agencies on aging to
follow in choosing and evaluating providers of legal
assistance;
(23) develop guidelines and a model job description
for choosing and evaluating legal assistance developers
referred to in [sections 307(a)(18) and 731(b)(2)]
sections 307(a)(13) and 731;
(24) establish and carry out pension counseling and
information programs described in section 215;
(25) provide technical assistance, training, and
other means of assistance to State agencies, area
agencies on aging, and service providers regarding
State and local data collection and analysis;
(26) design and implement, for purposes of compliance
with paragraph (19), uniform data collection procedures
for use by State agencies, including--
(A) uniform definitions and nomenclature;
(B) standardized data collection procedures;
(C) a participant identification and
description system;
(D) procedures for collecting information on
services needed by older individuals (including
services that would permit such individuals to
receive long-term care in home and community-
based settings), as identified by service
providers in assisting clients through the
provision of the supportive services; and
(E) procedures for the assessment of unmet
needs for services under this Act;
(27) improve the delivery of services to older
individuals living in rural areas through--
(A) synthesizing results of research on how
best to meet the service needs of older
individuals in rural areas;
(B) developing a resource guide on best
practices for States, area agencies on aging,
and service providers; and
(C) providing training and technical
assistance to States to implement these best
practices of service delivery;
(28) make available to States, area agencies on
aging, and service providers information and technical
assistance to support the provision of evidence-based
disease prevention and health promotion services;
(29) provide information and technical assistance to
States, area agencies on aging, and service providers,
in collaboration with relevant Federal agencies, on
providing efficient, person-centered transportation
services, including across geographic boundaries;
(30) identify model programs and provide information
and technical assistance to States, area agencies on
aging, and service providers (including providers
operating multipurpose senior centers), to support the
modernization of multipurpose senior centers[; and];
(31) provide technical assistance to and share best
practices with States, area agencies on aging, and
Aging and Disability Resource Centers, on how to
collaborate and coordinate services with health care
entities, such as Federally-qualified health centers,
as defined in section 1905(l)(2)(B) of the Social
Security Act (42 U.S.C. 1396d(l)(2)(B)), in order to
improve care coordination for individuals with multiple
chronic illnesses[.];
(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; and
(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 social isolation among older individuals.
(b) To promote the development and implementation of
comprehensive, coordinated systems at Federal, State, and local
levels that enable older individuals to receive long-term care
in home and community-based settings, in a manner responsive to
the needs and preferences of older individuals and their family
caregivers, the Assistant Secretary shall, consistent with the
applicable provisions of this title--
(1) collaborate, coordinate, and consult with other
Federal entities responsible for formulating and
implementing programs, benefits, and services related
to providing long-term care, and may make grants,
contracts, and cooperative agreements with funds
received from other Federal entities;
(2) conduct research and demonstration projects to
identify innovative, cost-effective strategies for
modifying State systems of long-term care to--
(A) respond to the needs and preferences of
older individuals and family caregivers; and
(B) target services to individuals at risk
for institutional placement, to permit such
individuals to remain in home and community-
based settings;
(3) establish criteria for and promote the
implementation (through area agencies on aging, service
providers, and such other entities as the Assistant
Secretary determines to be appropriate) of evidence-
based programs to assist older individuals and their
family caregivers in learning about and making
behavioral changes intended to reduce the risk of
injury, disease, and disability among older
individuals;
(4) facilitate, in coordination with the
Administrator of the Centers for Medicare & Medicaid
Services, and other heads of Federal entities as
appropriate, the provision of long-term care in home
and community-based settings, including the provision
of such care through self-directed care models that--
(A) provide for the assessment of the needs
and preferences of an individual at risk for
institutional placement to help such individual
avoid unnecessary institutional placement and
depletion of income and assets to qualify for
benefits under the Medicaid program under title
XIX of the Social Security Act (42 U.S.C. 1396
et seq.);
(B) respond to the needs and preferences of
such individual and provide the option--
(i) for the individual to direct and
control the receipt of supportive
services provided; or
(ii) as appropriate, for a person who
was appointed by the individual, or is
legally acting on the individual's
behalf, in order to represent or advise
the individual in financial or service
coordination matters (referred to in
this paragraph as a ``representative''
of the individual), to direct and
control the receipt of those services;
and
(C) assist an older individual (or, as
appropriate, a representative of the
individual) to develop a plan for long-term
support, including selecting, budgeting for,
and purchasing home and community-based long-
term care and supportive services;
(5) provide for the Administration to play a lead
role with respect to issues concerning home and
community-based long-term care, including--
(A) directing (as the Secretary or the
President determines to be appropriate) or
otherwise participating in departmental and
interdepartmental activities concerning long-
term care;
(B) reviewing and commenting on departmental
rules, regulations, and policies related to
providing long-term care;
(C) making recommendations to the Secretary
with respect to home and community-based long-
term care, including recommendations based on
findings made through projects conducted under
paragraph (2); and
(D) when feasible, developing, in
consultation with States and national
organizations, a consumer-friendly tool to
assist older individuals and their families in
choosing home and community-based services,
with a particular focus on ways for consumers
to assess how providers protect the health,
safety, welfare, and rights, including the
rights provided under section 314, of older
individuals;
(6) promote, in coordination with other appropriate
Federal agencies--
(A) enhanced awareness by the public of the
importance of planning in advance for long-term
care; and
(B) the availability of information and
resources to assist in such planning;
(7) ensure access to, and the dissemination of,
information about all long-term care options and
service providers, including the availability of
integrated long-term care;
(8) implement in all States Aging and Disability
Resource Centers--
(A) to serve as visible and trusted sources
of information on the full range of long-term
care options, including both institutional and
home and community-based care, which are
available in the community;
(B) to provide personalized and consumer-
friendly assistance to empower individuals to
identify and articulate goals of care and to
make informed decisions about their care
options;
(C) to provide coordinated and streamlined
access to all publicly supported long-term care
options so that consumers can obtain the care
they need through a single intake, assessment,
and eligibility determination process;
(D) to help individuals to respond to or plan
ahead for their long-term care needs;
(E) to assist (in coordination with the
entities carrying out the health insurance
information, counseling, and assistance program
(receiving funding under section 4360 of the
Omnibus Budget Reconciliation Act of 1990 (42
U.S.C. 1395b-4)) in the States) beneficiaries,
and prospective beneficiaries, under the
Medicare program established under title XVIII
of the Social Security Act (42 U.S.C. 1395 et
seq.) in understanding and accessing
prescription drug and preventative health
benefits under the provisions of, and
amendments made by, the Medicare Prescription
Drug, Improvement, and Modernization Act of
2003; and
(F) to provide information and referrals
regarding available home and community-based
services for individuals who are at risk for
residing in, or who reside in, institutional
settings, so that the individuals have the
choice to remain in or to return to the
community;
(9) establish, either directly or through grants or
contracts, national technical assistance programs to
assist State agencies, area agencies on aging, and
community-based service providers funded under this Act
in implementing--
(A) home and community-based long-term care
systems, including evidence-based programs;
[and]
(B) evidence-based disease prevention and
health promotion services programs; and
(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;
(10) develop, in collaboration with the Administrator
of the Centers for Medicare & Medicaid Services,
performance standards and measures for use by States to
determine the extent to which their State systems of
long-term care fulfill the objectives described in this
subsection; and
(11) conduct such other activities as the Assistant
Secretary determines to be appropriate.
(c) The Assistant Secretary, in consultation with the Chief
Executive Officer of the Corporation for National and Community
Service, shall--
(1) encourage and permit volunteer groups (including
organizations carrying out national service programs
and including organizations of youth in secondary or
postsecondary school) that are active in supportive
services and civic engagement to participate and be
involved individually or through representative groups
in supportive service and civic engagement programs or
activities to the maximum extent feasible;
(2) develop a comprehensive strategy for utilizing
older individuals to address critical local needs of
national concern, including the engagement of older
individuals in the activities of public and nonprofit
organizations such as community-based organizations,
including faith-based organizations; and
(3) encourage other community capacity-building
initiatives involving older individuals, with
particular attention to initiatives that demonstrate
effectiveness and cost savings in meeting critical
needs.
(d)(1) The Assistant Secretary shall establish and operate
the National Center on Elder Abuse (in this subsection referred
to as the ``Center'').
(2) In operating the Center, the Assistant Secretary shall--
(A) annually compile, publish, and disseminate a
summary of recently conducted research on elder abuse,
neglect, and exploitation;
(B) develop and maintain an information clearinghouse
on all programs (including private programs) showing
promise of success, for the prevention, identification,
and treatment of elder abuse, neglect, and
exploitation;
(C) compile, publish, and disseminate training
materials for personnel who are engaged or intend to
engage in the prevention, identification, and treatment
of elder abuse, neglect, and exploitation;
(D) provide technical assistance to State agencies
and to other public and nonprofit private agencies and
organizations to assist the agencies and organizations
in planning, improving, developing, and carrying out
programs and activities relating to the special
problems of elder abuse, neglect, and exploitation; and
(E) conduct research and demonstration projects
regarding the causes, prevention, identification, and
treatment of elder abuse, neglect, and exploitation.
(3)(A) The Assistant Secretary shall carry out paragraph (2)
through grants or contracts.
(B) The Assistant Secretary shall issue criteria applicable
to the recipients of funds under this subsection. To be
eligible to receive a grant or enter into a contract under
subparagraph (A), an entity shall submit an application to the
Assistant Secretary at such time, in such manner, and
containing such information as the Assistant Secretary may
require.
(C) The Assistant Secretary shall--
(i) establish research priorities for making grants
or contracts to carry out paragraph (2)(E); and
(ii) not later than 60 days before the date on which
the Assistant Secretary establishes such priorities,
publish in the Federal Register for public comment a
statement of such proposed priorities.
(4) The Assistant Secretary shall make available to the
Center such resources as are necessary for the Center to carry
out effectively the functions of the Center under this Act and
not less than the amount of resources made available to the
Resource Center on Elder Abuse for fiscal year 2000.
(e)(1)(A) The Assistant Secretary shall make grants or enter
into contracts with eligible entities to establish the National
Aging Information Center (in this subsection referred to as the
``Center'') to--
(i) provide information about grants and projects
under title IV;
(ii) annually compile, analyze, publish, and
disseminate--
(I) statistical data collected under
subsection (a)(19);
(II) census data on aging demographics; and
(III) data from other Federal agencies on the
health, social, and economic status of older
individuals and on the services provided to
older individuals;
(iii) biennially compile, analyze, publish, and
disseminate statistical data collected on the
functions, staffing patterns, and funding sources of
State agencies and area agencies on aging;
(iv) analyze the information collected under section
201(c)(3)(F) by the Director of the Office for American
Indian, Alaskan Native, and Native Hawaiian Aging;
(v) provide technical assistance, training, and other
means of assistance to State agencies, area agencies on
aging, and service providers, regarding State and local
data collection and analysis; and
(vi) be a national resource on statistical data
regarding aging.
(B) To be eligible to receive a grant or enter into a
contract under subparagraph (A), an entity shall submit an
application to the Assistant Secretary at such time, in such
manner, and containing such information as the Assistant
Secretary may require.
(C) Entities eligible to receive a grant or enter into a
contract under subparagraph (A) shall be organizations with a
demonstrated record of experience in education and information
dissemination.
(2)(A) The Assistant Secretary shall establish procedures
specifying the length of time that the Center shall provide the
information described in paragraph (1) with respect to a
particular project or activity. The procedures shall require
the Center to maintain the information beyond the term of the
grant awarded, or contract entered into, to carry out the
project or activity.
(B) The Assistant Secretary shall establish the procedures
described in subparagraph (A) after consultation with--
(i) practitioners in the field of aging;
(ii) older individuals;
(iii) representatives of institutions of higher
education;
(iv) national aging organizations;
(v) State agencies;
(vi) area agencies on aging;
(vii) legal assistance providers;
(viii) service providers; and
(ix) other persons with an interest in the field of
aging.
(f)(1) The Assistant Secretary, in accordance with the
process described in paragraph (2), and in collaboration with a
representative group of State agencies, tribal organizations,
area agencies on aging, and providers of services involved in
the performance outcome measures shall develop and publish by
December 31, 2001, a set of performance outcome measures for
planning, managing, and evaluating activities performed and
services provided under this Act. To the maximum extent
possible, the Assistant Secretary shall use data currently
collected (as of the date of development of the measures) by
State agencies, area agencies on aging, and service providers
through the National Aging Program Information System and other
applicable sources of information in developing such measures.
(2) The process for developing the performance outcome
measures described in paragraph (1) shall include--
(A) a review of such measures currently in use by
State agencies and area agencies on aging (as of the
date of the review);
(B) development of a proposed set of such measures
that provides information about the major activities
performed and services provided under this Act;
(C) pilot testing of the proposed set of such
measures, including an identification of resource,
infrastructure, and data collection issues at the State
and local levels; and
(D) evaluation of the pilot test and recommendations
for modification of the proposed set of such measures.
(g) The Assistant Secretary shall, as appropriate, ensure
that programs authorized under this Act include appropriate
training in the prevention of abuse, neglect, and exploitation
and provision of services that address elder justice and the
exploitation of older individuals.
(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.
(i)(1) The Assistant Secretary shall convene an advisory
council on 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 social
isolation and loneliness 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).
(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.
federal agency consultation
Sec. 203. (a)(1) The Assistant Secretary, in carrying out the
objectives and provisions of this Act, shall coordinate,
advise, consult with, and cooperate with the head of each
department, agency, or instrumentality of the Federal
Government proposing or administering programs or services
substantially related to the objectives of this Act, with
respect to such programs or services. In particular, the
Assistant Secretary shall coordinate, advise, consult, and
cooperate with the Secretary of Labor in carrying out title V
and with the Corporation for National and Community Service in
carrying out this Act.
(2) The head of each department, agency, or instrumentality
of the Federal Government proposing to establish programs and
services substantially related to the objectives of this Act
shall consult with the Assistant Secretary prior to the
establishment of such programs and services. To achieve
appropriate coordination, the head of each department, agency,
or instrumentality of the Federal Government administering any
program substantially related to the objectives of this Act,
particularly administering any program referred to in
subsection (b), shall consult and cooperate with the Assistant
Secretary in carrying out such program. In particular, the
Secretary of Labor shall consult and cooperate with the
Assistant Secretary in carrying out title I of the Workforce
Innovation and Opportunity Act.
(3) The head of each department, agency, or instrumentality
of the Federal Government administering programs and services
substantially related to the objectives of this Act shall
collaborate with the Assistant Secretary in carrying out this
Act, and shall develop a written analysis, for review and
comment by the Assistant Secretary, of the impact of such
programs and services on--
(A) older individuals (with particular attention to
low-income older individuals, including low-income
minority older individuals, older individuals with
limited English proficiency, and older individuals
residing in rural areas) and eligible individuals (as
defined in section 518); and
(B) the functions and responsibilities of State
agencies and area agencies on aging.
(b) For the purposes of subsection (a), programs related to
the objectives of this Act shall include--
(1) title I of the Workforce Innovation and
Opportunity Act,
(2) title II of the Domestic Volunteer Service Act of
1973,
(3) titles XVI, XVIII, XIX, and XX of the Social
Security Act,
(4) sections 231 and 232 of the National Housing Act,
(5) the United States Housing Act of 1937,
(6) section 202 of the Housing Act of 1959,
(7) title I of the Housing and Community Development
Act of 1974,
(8) title I of the Higher Education Act of 1965 and
the Adult Education and Family Literacy Act,
(9) sections 3, 9, and 16 of the Urban Mass
Transportation Act of 1964,
(10) the Public Health Service Act, including block
grants under title XIX of such Act,
(11) the Low-Income Home Energy Assistance Act of
1981,
(12) part A of the Energy Conservation in Existing
Buildings Act of 1976, relating to weatherization
assistance for low income persons,
(13) the Community Services Block Grant Act,
(14) demographic statistics and analysis programs
conducted by the Bureau of the Census under title 13,
United States Code,
(15) parts II and III of title 38, United States
Code,
(16) the Rehabilitation Act of 1973,
(17) the Developmental Disabilities Assistance and
Bill of Rights Act of 2000,
(18) the Edward Byrne Memorial State and Local Law
Enforcement Assistance Programs, established under part
E of title I of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3750-3766b)), [and]
(19) sections 4 and 5 of the Assistive Technology Act
of 1998 (29 U.S.C. 3003, 3004)[.], and
(20) section 393D of the Public Health Service Act
(42 U.S.C. 280b-1f), relating to safety of seniors.
(c)(1) The Secretary, in collaboration with the Federal
officials specified in paragraph (2), shall establish an
Interagency Coordinating Committee on [Aging] Age-Friendly
Communities (referred to in this subsection as the
``Committee'') focusing on the coordination of agencies with
respect to aging issues to support the ability of older
individuals to age in place, including through the provision of
homelessness prevention services, support the ability of older
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.
(2) The officials referred to in paragraph (1) shall include
the Secretary of Labor and the Secretary of Housing and Urban
Development, and may include, at the direction of the
President, the Attorney General, the Secretary of
Transportation, the Secretary of the Treasury, the Secretary of
Agriculture, the Secretary of Homeland Security, the
Commissioner of Social Security, and such other Federal
officials as the President may direct. An official described in
this paragraph may appoint a designee to carry out the
official's duties under paragraph (1).
(3) The Secretary of Health and Human Services shall serve as
the first chairperson of the Committee, for 1 term, and the
Secretary of Housing and Urban Development shall serve as the
chairperson for the following term. After that following term,
the Committee shall select a chairperson from among the members
of the Committee, and any member may serve as the chairperson.
No member may serve as the chairperson for more than 1
consecutive term.
(4) For purposes of this subsection, a term shall be a period
of 2 calendar years, 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 date of the enactment of the effective date of this
exception.
(5) The Committee shall meet not less often than [once each
year] semiannually.
(6) The Committee shall--
(A) share information with and establish an ongoing
system to improve coordination among Federal agencies
with responsibility for programs and services for older
individuals and recommend improvements to such system
with an emphasis on--
(i) improving access to programs and services
for older individuals;
(ii) maximizing the impact of federally
funded programs and services for older
individuals by increasing the efficiency,
effectiveness, and delivery of such programs
and services;
(iii) planning and preparing for the impact
of demographic changes on programs and services
for older individuals; [and]
(iv) reducing or eliminating areas of overlap
and duplication by Federal agencies in the
provision and accessibility of such programs
and services; and
(v) identifying best practices for connecting
older individuals to services for which they
may be eligible;
(B) identify, promote, and implement (as
appropriate), best practices and evidence-based program
and service models to assist older individuals in
meeting their housing, health care, and other
supportive service needs, including--
(i) consumer-directed care models for home
and community-based care and supportive
services that link housing, health care, and
other supportive services and that facilitate
aging in place, enabling older individuals to
remain in their homes and communities as the
individuals age; and
[(ii) innovations in technology applications
(including assistive technology devices and
assistive technology services) that give older
individuals access to information on available
services or that help in providing services to
older individuals;]
(ii) innovations in technology applications
(including assistance technology devices and
assistance 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;
(C) collect and disseminate information about older
individuals and the programs and services available to
the individuals to ensure that the individuals can
access comprehensive information;
(D) work with the Federal Interagency Forum on Aging-
Related Statistics, the Bureau of the Census, and
member agencies to ensure the continued collection of
data relating to the housing, health care, and other
supportive service needs of older individuals and to
support efforts to identify and address unmet data
needs;
(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;
[(E)] (F) actively seek input from and consult with
[nongovernmental experts and organizations, including
public health interest and research groups and
foundations] nongovernmental organizations, academic or
research institutions, community-based organizations,
and philanthropic organizations about the activities
described in subparagraphs (A) through [(F)] (G);
[(F)] (G) identify any barriers and impediments,
including barriers and impediments in statutory and
regulatory law, to the access and use by older
individuals of federally funded programs and services;
and
[(G)] (H) work with States to better provide housing,
health care, and other supportive services to older
individuals by--
(i) holding meetings with State agencies;
(ii) providing ongoing technical assistance
to States about better meeting the needs of
older individuals; and
(iii) working with States to designate
liaisons, from the State agencies, to the
Committee.
(7) Not later than 90 days following the end of each term,
the Committee shall prepare and submit to the Committee on
Financial Services of the House of Representatives, the
[Committee on Education and the Workforce] Committee on
Education and Labor of the House of Representatives, the
Committee on Energy and Commerce of the House of
Representatives, the Committee on Ways and Means of the House
of Representatives, the Committee on Banking, Housing, and
Urban Affairs of the Senate, the Committee on Health,
Education, Labor, and Pensions of the Senate, and the Special
Committee on Aging of the Senate, a report that--
(A) describes the activities and accomplishments of
the Committee in--
(i) enhancing the overall coordination of
federally funded programs and services for
older individuals; and
(ii) meeting the requirements of paragraph
(6);
(B) incorporates an analysis from the head of each
agency that is a member of the interagency coordinating
committee established under paragraph (1) that
describes the barriers and impediments, including
barriers and impediments in statutory and regulatory
law (as the chairperson of the Committee determines to
be appropriate), to the access and use by older
individuals of programs and services administered by
such agency; and
(C) makes such recommendations as the chairman
determines to be appropriate for actions to meet the
needs described in paragraph (6) and for coordinating
programs and services designed to meet those needs.
(8) On the request of the Committee, any Federal Government
employee may be detailed to the Committee without
reimbursement, and such detail shall be without interruption or
loss of civil service status or privilege.
(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.
* * * * * * *
SEC. 203B. FEDERAL COORDINATION OF SUPPORTS AND SERVICES FOR LIVING
INDEPENDENTLY AND SAFELY AT HOME.
(a) Initiative.--The Assistant Secretary shall carry out an
initiative under this section to identify and disseminate
information about Federal resources to promote falls
prevention, home assessments, and home modifications, which may
include in-home assistive technology, to enable older
individuals to live independently and safely in a home
environment.
(b) Coordination of Federal Efforts.--In carrying out the
initiative under this section, the Assistant Secretary shall
coordinate, through memoranda of understanding, agreements, or
other appropriate means of coordination, with all Federal
efforts and Federal programs in effect on the effective date of
this section that support evidence-based falls prevention, home
assessments, and home modifications, which may include in-home
assistive technology, for older individuals, including older
individuals with disabilities.
(c) Reports.--Not later than 1 year after the effective date
of this section, and triennially thereafter as needed, the
Assistant Secretary shall publish a report that includes--
(1) an inventory of the then current Federal programs
that support evidence-based falls prevention, home
assessments, and home modifications, which may include
in-home assistive technology, for older individuals and
older individuals with disabilities;
(2) for the fiscal year of the report, statistical
data on the number of older individuals and older
individuals with disabilities served by each Federal
program described in paragraph (1), including a
demographic analysis and the approximate amount of
Federal funding invested in each such program;
(3) an evaluation of the impact of Federal programs
that support falls prevention and home modifications,
which may include in-home assistive technology, on
health status and health outcomes in populations
supported by such efforts and programs; and
(4) information on the extent to which consumer-
friendly resources, such as a brochure--
(A) are available through the National
Eldercare Locator Service established under
section 202(a)(21);
(B) are accessible to all area agencies on
aging; and
(C) 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.
* * * * * * *
administration of the act
Sec. 205. (a)(1) In carrying out the objectives of this Act,
the Assistant Secretary is authorized to--
(A) provide consultative services and technical
assistance to public or nonprofit private agencies and
organizations;
(B) provide short-term training and technical
instruction;
(C) conduct research and demonstrations; and
(D) collect, prepare, publish, and disseminate
special educational or informational materials,
including reports of the projects for which funds are
provided under this Act.
(2)(A) The Assistant Secretary shall designate an officer or
employee who shall serve on a full-time basis and who shall be
responsible for the administration of the nutrition services
described in subparts 1 and 2 of part C of title III and shall
have duties that include--
(i) designing, implementing, and evaluating evidence-
based programs to support improved nutrition and
regular physical activity for older individuals;
(ii) developing guidelines for nutrition providers
concerning safety, sanitary handling of food,
equipment, preparation, and food storage;
(iii) conducting outreach and disseminating evidence-
based information to nutrition service providers about
the benefits of healthful diets and regular physical
activity, including information about the most current
Dietary Guidelines for Americans published under
section 301 of the National Nutrition Monitoring and
Related Research Act of 1990 (7 U.S.C. 5341), the Food
Guidance System of the Department of Agriculture, and
advances in nutrition science;
(iv) promoting coordination between nutrition service
providers and community-based organizations serving
older individuals;
(v) developing guidelines on cost containment;
(vi) defining a long range role for the nutrition
services in community-based care systems;
(vii) developing model menus and other appropriate
materials for serving special needs populations and
meeting cultural meal preferences;
(viii) disseminating guidance that describes
strategies for improving the nutritional quality of
meals provided under title III, including strategies
for increasing the consumption of whole grains, lowfat
dairy products, fruits, and vegetables;
(ix) developing and disseminating guidelines for
conducting nutrient analyses of meals provided under
subparts 1 and 2 of part C of title III, including
guidelines for averaging key nutrients over an
appropriate period of time; and
(x) providing technical assistance to the regional
offices of the Administration with respect to each duty
described in clauses (i) through (ix).
(B) The regional offices of the Administration shall be
responsible for disseminating, and providing technical
assistance regarding, the guidelines and information described
in clauses (ii), (iii), and (v) of subparagraph (A) to State
agencies, area agencies on aging, and persons that provide
nutrition services under part C of title III.
(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) 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
(ii) methods for managing and coordinating existing
programs to meet the needs of growing age-friendly
communities.
[(C)] (D) The officer or employee designated under
subparagraph (A) shall--
(i) have expertise in nutrition, energy balance, and
meal planning; and
[(ii)(I) be a registered dietitian;
[(II) be a credentialed nutrition professional; or
[(III) have education and training that is
substantially equivalent to the education and training
for a registered dietitian or a credentialed nutrition
professional.]
(ii) be a registered dietitian or registered
dietitian nutritionist.
(b) In administering the functions of the Administration
under this Act, the Assistant Secretary may utilize the
services and facilities of any agency of the Federal Government
and of any other public or nonprofit agency or organization, in
accordance with agreements between the Assistant Secretary and
the head thereof, and is authorized to pay therefor, in advance
or by way of reimbursement, as may be provided in the
agreement.
* * * * * * *
reports
Sec. 207. (a) Not later than one hundred and twenty days
after the close of each fiscal year, the Assistant Secretary
shall prepare and submit to the President and to the Congress a
full and complete report on the activities carried out under
this Act. Such annual reports shall include--
(1) statistical data reflecting services and
activities provided to individuals during the preceding
fiscal year;
(2) statistical data collected under section
202(a)(16);
(3) statistical data and an analysis of information
regarding the effectiveness of the State agency and
area agencies on aging in targeting services to older
individuals with greatest economic need and older
individuals with greatest social need, with particular
attention to low-income minority individuals, older
individuals residing in rural areas, low-income
individuals, and frail individuals (including
individuals with any physical or mental functional
impairment); and
(4) a description of the implementation of the plan
required by section 202(a)(14).
(b)(1) Not later than March 1 of each year, the Assistant
Secretary shall compile a report--
(A) summarizing and analyzing the data collected
under titles III and VII in accordance with section
712(c) for the then most recently concluded fiscal
year;
(B) identifying significant problems and issues
revealed by such data (with special emphasis on
problems relating to quality of care and residents'
rights);
(C) discussing current issues concerning the long-
term care ombudsman programs of the States; and
(D) making recommendations regarding legislation and
administrative actions to resolve such problems.
(2) The Assistant Secretary shall submit the report required
by paragraph (1) to--
(A) the Special Committee on Aging of the Senate;
(B) the Committee on [Education and the Workforce]
Education and Labor of the House of Representatives;
and
(C) the Committee on Health, Education, Labor, and
Pensions of the Senate.
(3) The Assistant Secretary shall provide the report required
by paragraph (1), and make the State reports required under
titles III and VII in accordance with section 712(h)(1)
available, to--
(A) the [Administrator of the Health Care Finance
Administration] Administrator of the Centers for
Medicare and Medicaid Services;
(B) the Office of the Inspector General of the
Department of Health and Human Services;
(C) the Office of Civil Rights of the Department of
Health and Human Services;
(D) the Secretary of Veterans Affairs; and
(E) each public agency or private organization
designated as an Office of the State Long-Term Care
Ombudsman under title III or VII in accordance with
section 712(a)(4)(A).
(c) The Assistant Secretary shall, as part of the annual
report submitted under subsection (a), prepare and submit a
report on the outreach activities supported under this Act,
together with such recommendations as the Assistant Secretary
deems appropriate. In carrying out this subsection, the
Assistant Secretary shall consider--
(1) the number of older individuals reached through
the activities;
(2) the dollar amount of the assistance and benefits
received by older individuals as a result of such
activities;
(3) the cost of such activities in terms of the
number of individuals reached and the dollar amount
described in paragraph (2);
(4) the effect of such activities on supportive
services and nutrition services furnished under title
III of this Act; and
(5) the effectiveness of State and local efforts to
target older individuals with greatest economic need
(including low-income minority individuals and older
individuals residing in rural areas) and older
individuals with greatest social need (including low-
income minority individuals and older individuals
residing in rural areas) to receive services under this
Act.
* * * * * * *
SEC. 215. PENSION COUNSELING AND INFORMATION PROGRAMS.
(a) Definitions.--In this section:
(1) Pension and other retirement benefits.--The term
``pension and other retirement benefits'' means
private, civil service, and other public pensions and
retirement benefits, including benefits provided
under--
(A) the Social Security program under title
II of the Social Security Act (42 U.S.C. 401 et
seq.);
(B) the railroad retirement program under the
Railroad Retirement Act of 1974 (45 U.S.C. 231
et seq.);
(C) the government retirement benefits
programs under the Civil Service Retirement
System set forth in chapter 83 of title 5,
United States Code, the Federal Employees
Retirement System set forth in chapter 84 of
title 5, United States Code, or other Federal
retirement systems; or
(D) employee pension benefit plans as defined
in section 3(2) of the Employee Retirement
Income Security Act of 1974 (29 U.S.C.
1002(2)).
(2) Pension counseling and information program.--The
term ``pension counseling and information program''
means a program described in subsection (b).
(b) Program Authorized.--The Assistant Secretary shall award
grants to eligible entities to establish and carry out pension
counseling and information programs that create or continue a
sufficient number of pension assistance and counseling programs
to provide outreach, information, counseling, referral, and
other assistance regarding pension and other retirement
benefits, and rights related to such benefits, to individuals
in the United States.
(c) Eligible Entities.--The Assistant Secretary shall award
grants under this section to--
(1) State agencies or area agencies on aging; and
(2) nonprofit organizations with a proven record of
providing--
(A) services related to retirement of older
individuals;
(B) services to Native Americans; or
(C) specific pension counseling.
(d) Citizen Advisory Panel.--The Assistant Secretary shall
establish a citizen advisory panel to advise the Assistant
Secretary regarding which entities should receive grant awards
under this section. Such panel shall include representatives of
business, labor, national senior advocates, and national
pension rights advocates. The Assistant Secretary shall consult
such panel prior to awarding grants under this section.
(e) Application.--To be eligible to receive a grant under
this section, an entity shall submit an application to the
Assistant Secretary at such time, in such manner, and
containing such information as the Assistant Secretary may
require, including--
(1) a plan to establish a pension counseling and
information program that--
(A) establishes or continues a State or area
pension counseling and information program;
(B) serves a specific geographic area;
(C) provides counseling (including direct
counseling and assistance to individuals who
need information regarding pension and other
retirement benefits) and information that may
assist individuals in obtaining, or
establishing rights to, and filing claims or
complaints regarding, pension and other
retirement benefits;
(D) provides information on sources of
pension and other retirement benefits;
(E) establishes a system to make referrals
for legal services and other advocacy programs;
(F) establishes a system of referral to
Federal, State, and local departments or
agencies related to pension and other
retirement benefits;
(G) provides a sufficient number of staff
positions (including volunteer positions) to
ensure information, counseling, referral, and
assistance regarding pension and other
retirement benefits;
(H) provides training programs for staff
members, including volunteer staff members, of
pension and other retirement benefits programs;
(I) makes recommendations to the
Administration, the Department of Labor and
other Federal, State, and local agencies
concerning issues for older individuals related
to pension and other retirement benefits; and
(J) establishes or continues an outreach
program to provide information, counseling,
referral and assistance regarding pension and
other retirement benefits, with particular
emphasis on outreach to women, minorities,
older individuals residing in rural areas, low-
income retirees, and older individuals with
limited English proficiency; and
(2) an assurance that staff members (including
volunteer staff members) have no conflict of interest
in providing the services described in the plan
described in paragraph (1).
(f) Criteria.--The Assistant Secretary shall consider the
following criteria in awarding grants under this section:
(1) Evidence of a commitment by the entity to carry
out a proposed pension counseling and information
program.
(2) The ability of the entity to perform effective
outreach to affected populations, particularly
populations with limited English proficiency and other
populations that are identified as in need of special
outreach.
(3) Reliable information that the population to be
served by the entity has a demonstrable need for the
services proposed to be provided under the program.
(4) The ability of the entity to provide services
under the program on a statewide or regional basis.
(g) Training and Technical Assistance Program.--
(1) In general.--The Assistant Secretary
shall award grants to eligible entities to
establish training and technical assistance
programs that shall provide information and
technical assistance to the staffs of entities
operating pension counseling and information
programs described in subsection (b), and
general assistance to such entities, including
assistance in the design of program evaluation
tools.
(2) Eligible entities.--Entities that are
eligible to receive a grant under this
subsection include nonprofit private
organizations with a record of providing
national information, referral, and advocacy in
matters related to pension and other retirement
benefits.
(3) Application.--To be eligible to receive a
grant under this subsection, an entity shall
submit an application to the Assistant
Secretary at such time, in such manner, and
containing such information as the Assistant
Secretary may require.
(h) Pension Assistance Hotline and Intragency Coordination.--
(1) Hotline.--The Assistant Secretary shall enter
into agreements with other Federal agencies to
establish and administer a national telephone hotline
that shall provide information regarding pension and
other retirement benefits, and rights related to such
benefits.
(2) Content.--Such hotline described in paragraph (1)
shall provide information for individuals (including
individuals with limited English proficiency) seeking
outreach, information, counseling, referral, and
assistance regarding pension and other retirement
benefits, and rights related to such benefits.
(3) Agreements.--The Assistant Secretary may enter
into agreements with the Secretary of Labor and the
heads of other Federal agencies that regulate the
provision of pension and other retirement benefits in
order to carry out this subsection.
(i) Report to Congress.--Not later than 30 months after the
date of the enactment of this section, the Assistant Secretary
shall submit to the [Committee on Education and the Workforce]
Committee on Education and Labor of the House of
Representatives and the Committee on Health, Education, Labor
and Pensions of the Senate a report that--
(1) summarizes the distribution of funds authorized
for grants under this section and the expenditure of
such funds;
(2) summarizes the scope and content of training and
assistance provided under a program carried out under
this section and the degree to which the training and
assistance can be replicated;
(3) outlines the problems that individuals
participating in programs funded under this section
encountered concerning rights related to pension and
other retirement benefits; and
(4) makes recommendations regarding the manner in
which services provided in programs funded under this
section can be incorporated into the ongoing programs
of State agencies, area agencies on aging, multipurpose
senior centers and other similar entities.
(j) Administrative Expenses.--Of the funds appropriated under
section 216 to carry out this section for a fiscal year, not
more than $100,000 may be used by the Administration for
administrative expenses.
[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 $40,063,000 for
each of the fiscal years 2017, 2018, and 2019.
[(b) There are authorized to be appropriated--
[(1) to carry out section 202(a)(21) (relating to the
National Eldercare Locator Service), $2,088,758 for
fiscal year 2017, $2,132,440 for fiscal year 2018, and
$2,176,121 for fiscal year 2019;
[(2) to carry out section 215, $1,904,275 for fiscal
year 2017, $1,944,099 for fiscal year 2018, and
$1,983,922 for fiscal year 2019;
[(3) to carry out section 202 (relating to Elder
Rights Support Activities under this title), $1,312,904
for fiscal year 2017, $1,340,361 for fiscal year 2018,
and $1,367,817 for fiscal year 2019; and
[(4) to carry out section 202(b) (relating to the
Aging and Disability Resource Centers), $6,271,399 for
fiscal year 2017, $6,402,551 for fiscal year 2018, and
$6,533,703 for fiscal year 2019.]
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--
(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 section 215, $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
2020.
* * * * * * *
TITLE III--GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
Part A--General Provisions
purpose; administration
Sec. 301. (a)(1) It is the purpose of this title to encourage
and assist State agencies and area agencies on aging to
concentrate resources in order to develop greater capacity and
foster the development and implementation of comprehensive and
coordinated systems to serve older individuals by entering into
new cooperative arrangements in each State with the persons
described in paragraph (2), for the planning, and for the
provision of, supportive services, and multipurpose senior
centers, in order to--
(A) secure and maintain maximum independence and
dignity in a home environment for older individuals
capable of self care with appropriate supportive
services;
(B) remove individual and social barriers to economic
and personal independence for older individuals;
(C) provide a continuum of care for vulnerable older
individuals; [and]
(D) secure the opportunity for older individuals to
receive managed in-home and community-based long-term
care services[.]; and
(E) address the social determinants of health of
older individuals.
(2) The persons referred to in paragraph (1) include--
(A) State agencies and area agencies on aging;
(B) other State agencies, including agencies that
administer home and community care programs;
(C) Indian tribes, tribal organizations, and Native
Hawaiian organizations;
(D) the providers, including voluntary organizations
or other private sector organizations, of supportive
services, nutrition services, and multipurpose senior
centers;
(E) organizations representing or employing older
individuals or their families; and
(F) organizations that have experience in providing
training, placement, and stipends for volunteers or
participants who are older individuals (such as
organizations carrying out Federal service programs
administered by the Corporation for National and
Community Service), in community service settings.
(b)(1) In order to effectively carry out the purpose of this
title, the Assistant Secretary shall administer programs under
this title through the Administration.
(2) In carrying out the provisions of this title, the
Assistant Secretary may request the technical assistance and
cooperation of the Department of Education, the Department of
Labor, the Department of Housing and Urban Development, the
Department of Transportation, the Office of Community Services,
the Department of Veterans Affairs, the Substance Abuse and
Mental Health Services Administration, and such other agencies
and departments of the Federal Government as may be
appropriate.
(c) The Assistant Secretary shall provide technical
assistance and training (by contract, grant, or otherwise) to
State long-term care ombudsman programs established under
section 307(a)(9) in accordance with section 712, and to
individuals within such programs designated under section 712
to be representatives of a long-term care ombudsman, in order
to enable such ombudsmen and such representatives to carry out
the ombudsman program effectively.
(d)(1) Any funds received under an allotment as described in
section 304(a), or funds contributed toward the non-Federal
share under section 304(d), shall be used only for activities
and services to benefit older individuals and other individuals
as specifically provided for in this title.
(2) No provision of this title shall be construed as
prohibiting a State agency or area agency on aging from
providing services by using funds from sources not described in
paragraph (1).
definitions
Sec. 302. For the purpose of this title--
(1) The term ``comprehensive and coordinated system''
means a system for providing all necessary supportive
services, including nutrition services, in a manner
designed to--
(A) facilitate accessibility to, and
utilization of, all supportive services and
nutrition services provided within the
geographic area served by such system by any
public or private agency or organization;
(B) develop and make the most efficient use
of supportive services and nutrition services
in meeting the needs of older individuals;
(C) use available resources efficiently and
with a minimum of duplication; and
(D) encourage and assist public and private
entities that have unrealized potential for
meeting the service needs of older individuals
to assist the older individuals on a voluntary
basis.
(2) The term ``education and training service'' means
a supportive service designed to assist older
individuals to better cope with their economic, health,
and personal needs through services such as consumer
education, continuing education, health education,
preretirement education, financial planning, and other
education and training services which will advance the
objectives of this Act.
(3) The term ``family caregiver'' means an adult
family member, or another individual, who is an
informal provider of in-home and community care to an
older individual or to an individual of any age with
Alzheimer's disease or a related disorder with
neurological and organic brain dysfunction.
(4) The term ``unit of general purpose local
government'' means--
(A) a political subdivision of the State
whose authority is general and not limited to
only one function or combination of related
functions; or
(B) an Indian tribal organization.
[authorization of appropriations; uses of funds
[Sec. 303. (a)(1) There are authorized to be appropriated to
carry out part B (relating to supportive services) $356,717,276
for fiscal year 2017, $364,456,847 for fiscal year 2018, and
$372,196,069 for fiscal year 2019.ff
[(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)
$459,937,586 for fiscal year 2017, $469,916,692 for fiscal year
2018, and $479,895,348 for fiscal year 2019.
[(2) There are authorized to be appropriated to carry out
subpart 2 of part C (relating to home delivered nutrition
services) $232,195,942 for fiscal year 2017, $237,233,817 for
fiscal year 2018, and $242,271,465 for fiscal year 2019.
[(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) $20,361,334 for fiscal year 2017, $20,803,107 for
fiscal year 2018, and $21,244,860 for fiscal year 2019.
[(e) There are authorized to be appropriated to carry out
part E (relating to family caregiver support) $154,336,482 for
fiscal year 2017, $157,564,066 for fiscal year 2018, and
$160,791,658 for fiscal year 2019.]
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.
allotment; federal share
Sec. 304. (a)(1) From the sums appropriated under subsections
(a) through (d) of section 303 for each fiscal year, each State
shall be allotted an amount which bears the same ratio to such
sums as the population of older individuals in such State bears
to the population of older individuals in all States.
(2) In determining the amounts allotted to States from the
sums appropriated under section 303 for a fiscal year, the
Assistant Secretary shall first determine the amount allotted
to each State under paragraph (1) and then proportionately
adjust such amounts, if necessary, to meet the requirements of
paragraph (3).
(3)(A) No State shall be allotted less than \1/2\ of 1
percent of the sum appropriated for the fiscal year for which
the determination is made.
(B) Guam and the United States Virgin Islands shall each be
allotted not less than \1/4\ of 1 percent of the sum
appropriated for the fiscal year for which the determination is
made.
(C) American Samoa and the Commonwealth of the Northern
Mariana Islands shall each be allotted not less than \1/16\ of
1 percent of the sum appropriated for the fiscal year for which
the determination is made. For the purposes of the exception
contained in subparagraph (A) only, the [term ```State''' does]
term ``State'' does not include Guam, American Samoa, the
United States Virgin Islands, and the Commonwealth of the
Northern Mariana Islands.
(D)(i) For each of fiscal years [2017 through 2019] 2020
through 2024, no State shall be allotted an amount that is less
than 99 percent of the amount allotted to such State for the
previous fiscal year.
(ii) For fiscal year [2020] 2025 and each subsequent fiscal
year, no State shall be allotted an amount that is less than
100 percent of the amount allotted to such State for fiscal
year 2019.
(4) The number of individuals aged 60 or older in any State
and in all States shall be determined by the Assistant
Secretary on the basis of the most recent data available from
the Bureau of the Census, and other reliable demographic data
satisfactory to the Assistant Secretary.
(5) State allotments for a fiscal year under this section
shall be proportionally reduced to the extent that
appropriations may be insufficient to provide the full
allotments of the prior year.
(b) Whenever the Assistant Secretary determines that any
amount allotted to a State under part B or C, or part E, for a
fiscal year under this section will not be used by such State
for carrying out the purpose for which the allotment was made,
the Assistant Secretary shall make such allotment available for
carrying out such purpose to one or more other States to the
extent the Assistant Secretary determines that such other State
will be able to use such additional amount for carrying out
such purpose. Any amount made available to a State from an
appropriation for a fiscal year in accordance with the
preceding sentence shall, for purposes of this title, be
regarded as part of such State's allotment (as determined under
subsection (a)) for such year, but shall remain available until
the end of the succeeding fiscal year.
(c) If the Assistant Secretary finds that any State has
failed to qualify under the State plan requirements of section
307 or the Assistant Secretary does not approve the funding
formula required under section 305(a)(2)(C), the Assistant
Secretary shall withhold the allotment of funds to such State
referred to in subsection (a). The Assistant Secretary shall
disburse the funds so withheld directly to any public or
private nonprofit institution or organization, agency, or
political subdivision of such State submitting an approved plan
under section 307, which includes an agreement that any such
payment shall be matched in the proportion determined under
subsection (d)(1)(D) for such State, by funds or in-kind
resources from non-Federal sources.
(d)(1) From any State's allotment, after the application of
section 308(b), under this section for any fiscal year--
(A) such amount as the State agency determines, but
not more than 10 percent thereof, shall be available
for paying such percentage as the agency determines,
but not more than 75 percent, of the cost of
administration of area plans;
(B) such amount (excluding any amount attributable to
funds appropriated under section 303(a)(3)) as the
State agency determines to be adequate for conducting
an effective ombudsman program under section 307(a)(9)
shall be available for conducting such program;
(C) not less than $150,000 and not more than 4
percent of the amount allotted to the State for
carrying out part B, shall be available for conducting
outreach demonstration projects under section 706; and
(D) the remainder of such allotment shall be
available to such State only for paying such percentage
as the State agency determines, but not more than 85
percent of the cost of supportive services, senior
centers, and nutrition services under this title
provided in the State as part of a comprehensive and
coordinated system in planning and service areas for
which there is an area plan approved by the State
agency.
(2) The non-Federal share shall be in cash or in kind. In
determining the amount of the non-Federal share, the Assistant
Secretary may attribute fair market value to services and
facilities contributed from non-Federal sources.
* * * * * * *
area plans
Sec. 306. (a) Each area agency on aging designated under
section 305(a)(2)(A) shall, in order to be approved by the
State agency, prepare and develop an area plan for a planning
and service area for a two-, three-, or four-year period
determined by the State agency, with such annual adjustments as
may be necessary. Each such plan shall be based upon a uniform
format for area plans within the State prepared in accordance
with section 307(a)(1). Each such plan shall--
(1) provide, through a comprehensive and coordinated
system, for supportive services, nutrition services,
and, where appropriate, for the establishment,
maintenance, modernization, or construction of
multipurpose senior centers (including a plan to use
the skills and services of older individuals in paid
and unpaid work, including multigenerational and older
individual to older individual work), within the
planning and service area covered by the plan,
including determining the extent of need for supportive
services, nutrition services, and multipurpose senior
centers in such area (taking into consideration, among
other things, the number of older individuals with low
incomes residing in such area, the number of older
individuals who have greatest economic need (with
particular attention to low-income older individuals,
including low-income minority older individuals, older
individuals with limited English proficiency, and older
individuals residing in rural areas) residing in such
area, the number of older individuals who have greatest
social need (with particular attention to low-income
older individuals, including low-income minority older
individuals, older individuals with limited English
proficiency, and older individuals residing in rural
areas) residing in such area, the number of older
individuals at risk for institutional placement
residing in such area, and the number of older
individuals who are Indians residing in such area, and
the efforts of voluntary organizations in the
community), evaluating the effectiveness of the use of
resources in meeting such need, and entering into
agreements with providers of supportive services,
nutrition services, or multipurpose senior centers in
such area, for the provision of such services or
centers to meet such need;
(2) provide assurances that an adequate proportion,
as required under section 307(a)(2), of the amount
allotted for part B to the planning and service area
will be expended for the delivery of each of the
following categories of services--
(A) services associated with access to
services (transportation, health services
(including mental and behavioral health
services), outreach, information and assistance
(which may include information and assistance
to consumers on availability of services under
part B and how to receive benefits under and
participate in publicly supported programs for
which the consumer may be eligible), and case
management services);
(B) in-home services, including supportive
services for families of older individuals [who
are victims of] with Alzheimer's disease and
related disorders with neurological and organic
brain dysfunction; and
(C) legal assistance;
and assurances that the area agency on aging will
report annually to the State agency in detail the
amount of funds expended for each such category during
the fiscal year most recently concluded;
(3)(A) designate, where feasible, a focal point for
comprehensive service delivery in each community,
giving special consideration to designating
multipurpose senior centers (including multipurpose
senior centers operated by organizations referred to in
paragraph (6)(C)) as such focal point; and
(B) specify, in grants, contracts, and agreements
implementing the plan, the identity of each focal point
so designated;
(4)(A)(i)(I) provide assurances that the area agency
on aging will--
(aa) set specific objectives, consistent with
State policy, for providing services to older
individuals with greatest economic need, older
individuals with greatest social need, and
older individuals at risk for institutional
placement;
(bb) include specific objectives for
providing services to low-income minority older
individuals, older individuals with limited
English proficiency, and older individuals
residing in rural areas; and
(II) include proposed methods to achieve the
objectives described in items (aa) and (bb) of
subclause (I);
(ii) provide assurances that the area agency on aging
will include in each agreement made with a provider of
any service under this title, a requirement that such
provider will--
(I) specify how the provider intends to
satisfy the service needs of low-income
minority individuals, older individuals with
limited English proficiency, and older
individuals residing in rural areas in the area
served by the provider;
(II) to the maximum extent feasible, provide
services to low-income minority individuals,
older individuals with limited English
proficiency, and older individuals residing in
rural areas in accordance with their need for
such services; and
(III) meet specific objectives established by
the area agency on aging, for providing
services to low-income minority individuals,
older individuals with limited English
proficiency, and older individuals residing in
rural areas within the planning and service
area; and
(iii) with respect to the fiscal year preceding the
fiscal year for which such plan is prepared--
(I) identify the number of low-income
minority older individuals in the planning and
service area;
(II) describe the methods used to satisfy the
service needs of such minority older
individuals; and
(III) provide information on the extent to
which the area agency on aging met the
objectives described in clause (i);
(B) provide assurances that the area agency on aging
will use outreach efforts that will--
(i) identify individuals eligible for
assistance under this Act, with special
emphasis on--
(I) older individuals residing in
rural areas;
(II) older individuals with greatest
economic need (with particular
attention to low-income minority
individuals and older individuals
residing in rural areas);
(III) older individuals with greatest
social need (with particular attention
to low-income minority individuals and
older individuals residing in rural
areas);
(IV) older individuals with severe
disabilities;
(V) older individuals with limited
English proficiency;
(VI) older individuals with
Alzheimer's disease and related
disorders with neurological and organic
brain dysfunction (and the caretakers
of such individuals); and
(VII) older individuals at risk for
institutional placement, specifically
including survivors of the Holocaust;
and
(ii) inform the older individuals referred to
in subclauses (I) through (VI) of clause (i),
and the caretakers of such individuals, of the
availability of such assistance; and
(C) contain an assurance that the area agency on
aging will ensure that each activity undertaken by the
agency, including planning, advocacy, and systems
development, will include a focus on the needs of low-
income minority older individuals and older individuals
residing in rural areas;
(5) provide assurances that the area agency on aging
will coordinate planning, identification, assessment of
needs, and provision of services for older individuals
with disabilities, with particular attention to
individuals with severe disabilities and individuals at
risk for institutional placement, with agencies that
develop or provide services for individuals with
disabilities;
(6) provide that the area agency on aging will--
(A) take into account in connection with
matters of general policy arising in the
development and administration of the area
plan, the views of recipients of services under
such plan;
(B) serve as the advocate and focal point for
older individuals within the community by (in
cooperation with agencies, organizations, and
individuals participating in activities under
the plan) monitoring, evaluating, and
commenting upon all policies, programs,
hearings, levies, and community actions which
will affect older individuals;
(C)(i) where possible, enter into
arrangements with organizations providing day
care services for children, assistance to older
individuals caring for relatives who are
children, and respite for families, so as to
provide opportunities for older individuals to
aid or assist on a voluntary basis in the
delivery of such services to children, adults,
and families;
(ii) if possible regarding the provision of
services under this title, enter into
arrangements and coordinate with organizations
that have a proven record of providing services
to older individuals, that--
(I) were officially designated as
community action agencies or community
action programs under section 210 of
the Economic Opportunity Act of 1964
(42 U.S.C. 2790) for fiscal year 1981,
and did not lose the designation as a
result of failure to comply with such
Act; or
(II) came into existence during
fiscal year 1982 as direct successors
in interest to such community action
agencies or community action programs;
and that meet the requirements under section
676B of the Community Services Block Grant Act;
and
(iii) make use of trained volunteers in
providing direct services delivered to older
individuals and individuals with disabilities
needing such services and, if possible, work in
coordination with organizations that have
experience in providing training, placement,
and stipends for volunteers or participants
(such as organizations carrying out Federal
service programs administered by the
Corporation for National and Community
Service), in community service settings;
(D) establish an advisory council consisting
of older individuals (including minority
individuals and older individuals residing in
rural areas) who are participants or who are
eligible to participate in programs assisted
under this Act, family caregivers of such
individuals, representatives of older
individuals, service providers, representatives
of the business community, local elected
officials, providers of veterans' health care
(if appropriate), and the general public, to
advise continuously the area agency on aging on
all matters relating to the development of the
area plan, the administration of the plan and
operations conducted under the plan;
(E) establish effective and efficient
procedures for coordination of--
(i) entities conducting programs that
receive assistance under this Act
within the planning and service area
served by the agency; and
(ii) entities conducting other
Federal programs for older individuals
at the local level, with particular
emphasis on entities conducting
programs described in section 203(b),
within the area;
(F) in coordination with the State agency and
with the State agency responsible for mental
and behavioral health services, increase public
awareness of mental health disorders, remove
barriers to diagnosis and treatment, and
coordinate mental and behavioral health
services (including mental health screenings)
provided with funds expended by the area agency
on aging with mental and behavioral health
services provided by community health centers
and by other public agencies and nonprofit
private organizations;
(G) if there is a significant population of
older individuals who are Indians in the
planning and service area of the area agency on
aging, the area agency on aging shall conduct
outreach activities to identify such
individuals in such area and shall inform such
individuals of the availability of assistance
under this Act; and
(H) in coordination with the State agency and
with the State agency responsible for elder
abuse prevention services, increase public
awareness of elder abuse, neglect, and
exploitation, and remove barriers to education,
prevention, investigation, and treatment of
elder abuse, neglect, and exploitation, as
appropriate;
(7) provide that the area agency on aging shall,
consistent with this section, facilitate the area-wide
development and implementation of a comprehensive,
coordinated system for providing long-term care in home
and community-based settings, in a manner responsive to
the needs and preferences of older individuals and
their family caregivers, by--
(A) collaborating, coordinating activities,
and consulting with other local public and
private agencies and organizations responsible
for administering programs, benefits, and
services related to providing long-term care;
(B) conducting analyses and making
recommendations with respect to strategies for
modifying the local system of long-term care to
better--
(i) respond to the needs and
preferences of older individuals and
family caregivers;
(ii) facilitate the provision, by
service providers, of long-term care in
home and community-based settings; and
(iii) target services to older
individuals at risk for institutional
placement, to permit such individuals
to remain in home and community-based
settings;
(C) implementing, through the agency or
service providers, evidence-based programs to
assist older individuals and their family
caregivers in learning about and making
behavioral changes intended to reduce the risk
of injury, disease, and disability among older
individuals; and
(D) providing for the availability and
distribution (through public education
campaigns, Aging and Disability Resource
Centers, the area agency on aging itself, and
other appropriate means) of information
relating to--
(i) the need to plan in advance for
long-term care; and
(ii) the full range of available
public and private long-term care
(including integrated long-term care)
programs, options, service providers,
and resources;
(8) provide that case management services provided
under this title through the area agency on aging
will--
(A) not duplicate case management services
provided through other Federal and State
programs;
(B) be coordinated with services described in
subparagraph (A); and
(C) be provided by a public agency or a
nonprofit private agency that--
(i) gives each older individual
seeking services under this title a
list of agencies that provide similar
services within the jurisdiction of the
area agency on aging;
(ii) gives each individual described
in clause (i) a statement specifying
that the individual has a right to make
an independent choice of service
providers and documents receipt by such
individual of such statement;
(iii) has case managers acting as
agents for the individuals receiving
the services and not as promoters for
the agency providing such services; or
(iv) is located in a rural area and
obtains a waiver of the requirements
described in clauses (i) through (iii);
(9) provide assurances that 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 together with any other funds and expended by the
agency in fiscal year [2000] 2019 in carrying out such
a program under this title;
(10) provide a grievance procedure for older
individuals who are dissatisfied with or denied
services under this title;
(11) provide information and assurances concerning
services to older individuals who are Native Americans
(referred to in this paragraph as ``older Native
Americans''), including--
(A) information concerning whether there is a
significant population of older Native
Americans in the planning and service area and
if so, an assurance that the area agency on
aging will pursue activities, including
outreach, to increase access of those older
Native Americans to programs and benefits
provided under this title;
(B) an assurance that the area agency on
aging will, to the maximum extent practicable,
coordinate the services the agency provides
under this title with services provided under
title VI; and
(C) an assurance that the area agency on
aging will make services under the area plan
available, to the same extent as such services
are available to older individuals within the
planning and service area, to older Native
Americans; and
(12) provide that the area agency on aging will
establish procedures for coordination of services with
entities conducting other Federal or federally assisted
programs for older individuals at the local level, with
particular emphasis on entities conducting programs
described in section 203(b) within the planning and
service area.
(13) provide assurances that the area agency on aging
will--
(A) maintain the integrity and public purpose
of services provided, and service providers,
under this title in all contractual and
commercial relationships;
(B) disclose to the Assistant Secretary and
the State agency--
(i) the identity of each
nongovernmental entity with which such
agency has a contract or commercial
relationship relating to providing any
service to older individuals; and
(ii) the nature of such contract or
such relationship;
(C) demonstrate that a loss or diminution in
the quantity or quality of the services
provided, or to be provided, under this title
by such agency has not resulted and will not
result from such contract or such relationship;
(D) demonstrate that the quantity or quality
of the services to be provided under this title
by such agency will be enhanced as a result of
such contract or such relationship; and
(E) on the request of the Assistant Secretary
or the State, for the purpose of monitoring
compliance with this Act (including conducting
an audit), disclose all sources and
expenditures of funds such agency receives or
expends to provide services to older
individuals;
(14) provide assurances that preference in receiving
services under this title will not be given by the area
agency on aging to particular older individuals as a
result of a contract or commercial relationship that is
not carried out to implement this title;
(15) provide assurances that funds received under
this title will be used--
(A) to provide benefits and services to older
individuals, giving priority to older
individuals identified in paragraph (4)(A)(i);
and
(B) in compliance with the assurances
specified in paragraph (13) and the limitations
specified in section 212;
(16) provide, to the extent feasible, for the
furnishing of services under this Act, consistent with
self-directed care; [and]
(17) include information detailing how the area
agency on aging will coordinate activities, and develop
long-range emergency preparedness plans, with local and
State emergency response agencies, relief
organizations, local and State governments, and any
other institutions that have responsibility for
disaster relief service delivery[.]; and
(18) provide assurances that the area agency on aging
will collect data to determine the services that are
needed by older individuals whose needs are the focus
of all centers funded under title IV and the
effectiveness of the programs, policies, and services
provided by such area agency on aging in assisting
these individuals. Each agency plan shall provide
assurances that the area agency on aging will use
outreach efforts that will identify individuals
eligible for assistance under this Act, with special
emphasis on those individuals whose needs are the focus
of all centers established under title IV. This
requirement applies to all centers funded on the day
before the effective date of this paragraph.
(b)(1) An area agency on aging may include in the area plan
an assessment of how prepared the area agency on aging and
service providers in the planning and service area are for any
anticipated change in the number of older individuals during
the 10-year period following the fiscal year for which the plan
is submitted.
(2) Such assessment may include--
(A) the projected change in the number of older
individuals in the planning and service area;
(B) an analysis of how such change may affect such
individuals, including individuals with low incomes,
individuals with greatest economic need, minority older
individuals, older individuals residing in rural areas,
and older individuals with limited English proficiency;
(C) an analysis of how the programs, policies, and
services provided by such area agency can be improved,
and how resource levels can be adjusted to meet the
needs of the changing population of older individuals
in the planning and service area; and
(D) an analysis of how the change in the number of
individuals age 85 and older in the planning and
service area is expected to affect the need for
supportive services.
(3) An area agency on aging, in cooperation with government
officials, State agencies, tribal organizations, or local
entities, may make recommendations to government officials in
the planning and service area and the State, on actions
determined by the area agency to build the capacity in the
planning and service area to meet the needs of older
individuals for--
(A) health and human services;
(B) land use;
(C) housing;
(D) transportation;
(E) public safety;
(F) workforce and economic development;
(G) recreation;
(H) education;
(I) civic engagement;
(J) emergency preparedness;
(K) protection from elder abuse, neglect, and
exploitation; and
(L) any other service as determined by such agency.
(c) Each State, in approving area agency on aging plans under
this section, shall waive the requirement described in
paragraph (2) of subsection (a) for any category of services
described in such paragraph if the area agency on aging
demonstrates to the State agency that services being furnished
for such category in the area are sufficient to meet the need
for such services in such area and had conducted a timely
public hearing upon request.
(d)(1) Subject to regulations prescribed by the Assistant
Secretary, an area agency on aging designated under section
305(a)(2)(A) or, in areas of a State where no such agency has
been designated, the State agency, may enter into agreement
with agencies administering programs under the Rehabilitation
Act of 1973, and titles XIX and XX of the Social Security Act
for the purpose of developing and implementing plans for
meeting the common need for transportation services of
individuals receiving benefits under such Acts and older
individuals participating in programs authorized by this title.
(2) In accordance with an agreement entered into under
paragraph (1), funds appropriated under this title may be used
to purchase transportation services for older individuals and
may be pooled with funds made available for the provision of
transportation services under the Rehabilitation Act of 1973,
and titles XIX and XX of the Social Security Act.
(e) An area agency on aging may not require any provider of
legal assistance under this title to reveal any information
that is protected by the attorney-client privilege.
(f)(1) If the head of a State agency finds that an area
agency on aging has failed to comply with Federal or State
laws, including the area plan requirements of this section,
regulations, or policies, the State may withhold a portion of
the funds to the area agency on aging available under this
title.
(2)(A) The head of a State agency shall not make a final
determination withholding funds under paragraph (1) without
first affording the area agency on aging due process in
accordance with procedures established by the State agency.
(B) At a minimum, such procedures shall include procedures
for--
(i) providing notice of an action to withhold funds;
(ii) providing documentation of the need for such
action; and
(iii) at the request of the area agency on aging,
conducting a public hearing concerning the action.
(3)(A) If a State agency withholds the funds, the State
agency may use the funds withheld to directly administer
programs under this title in the planning and service area
served by the area agency on aging for a period not to exceed
180 days, except as provided in subparagraph (B).
(B) If the State agency determines that the area agency on
aging has not taken corrective action, or if the State agency
does not approve the corrective action, during the 180-day
period described in subparagraph (A), the State agency may
extend the period for not more than 90 days.
(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.
state plans
Sec. 307. (a) Except as provided in the succeeding sentence
and section 309(a), each State, in order to be eligible for
grants from its allotment under this title for any fiscal year,
shall submit to the Assistant Secretary a State plan for a two-
, three-, or four-year period determined by the State agency,
with such annual revisions as are necessary, which meets such
criteria as the Assistant Secretary may by regulation
prescribe. If the Assistant Secretary determines, in the
discretion of the Assistant Secretary, that a State failed in 2
successive years to comply with the requirements under this
title, then the State shall submit to the Assistant Secretary a
State plan for a 1-year period that meets such criteria, for
subsequent years until the Assistant Secretary determines that
the State is in compliance with such requirements. Each such
plan shall comply with all of the following requirements:
(1) The plan shall--
(A) require each area agency on aging
designated under section 305(a)(2)(A) to
develop and submit to the State agency for
approval, in accordance with a uniform format
developed by the State agency, an area plan
meeting the requirements of section 306; and
(B) be based on such area plans.
(2) The plan shall provide that the State agency
will--
(A) evaluate, using uniform procedures
described in section 202(a)(26), the need for
supportive services (including legal assistance
pursuant to 307(a)(11), information and
assistance, and transportation services),
nutrition services, and multipurpose senior
centers within the State;
(B) develop a standardized process to
determine the extent to which public or private
programs and resources (including volunteers
and programs and services of voluntary
organizations) that have the capacity and
actually meet such need; and
(C) specify a minimum proportion of the funds
received by each area agency on aging in the
State to carry out part B that will be expended
(in the absence of a waiver under section
306(c) or 316) by such area agency on aging to
provide each of the categories of services
specified in section 306(a)(2).
(3) The plan shall--
(A) include (and may not be approved unless
the Assistant Secretary approves) the statement
and demonstration required by paragraphs (2)
and (4) of section 305(d) (concerning
intrastate distribution of funds); and
(B) with respect to services for older
individuals residing in rural areas--
(i) provide assurances that the State
agency will spend for each fiscal year,
not less than the amount expended for
such services for fiscal year 2000;
(ii) identify, for each fiscal year
to which the plan applies, the
projected costs of providing such
services (including the cost of
providing access to such services); and
(iii) describe the methods used to
meet the needs for such services in the
fiscal year preceding the first year to
which such plan applies.
(4) The plan shall provide that the State agency will
conduct periodic evaluations of, and public hearings
on, activities and projects carried out in the State
under this title and title VII, including evaluations
of the effectiveness of services provided to
individuals with greatest economic need, greatest
social need, or disabilities (with particular attention
to low-income minority older individuals, older
individuals with limited English proficiency, and older
individuals residing in rural areas).
(5) The plan shall provide that the State agency
will--
(A) afford an opportunity for a hearing upon
request, in accordance with published
procedures, to any area agency on aging
submitting a plan under this title, to any
provider of (or applicant to provide) services;
(B) issue guidelines applicable to grievance
procedures required by section 306(a)(10); and
(C) afford an opportunity for a public
hearing, upon request, by any area agency on
aging, by any provider of (or applicant to
provide) services, or by any recipient of
services under this title regarding any waiver
request, including those under section 316.
(6) The plan shall provide that the State agency will
make such reports, in such form, and containing such
information, as the Assistant Secretary may require,
and comply with such requirements as the Assistant
Secretary may impose to insure the correctness of such
reports.
(7)(A) The plan shall provide satisfactory assurance
that such fiscal control and fund accounting procedures
will be adopted as may be necessary to assure proper
disbursement of, and accounting for, Federal funds paid
under this title to the State, including any such funds
paid to the recipients of a grant or contract.
(B) The plan shall provide assurances that--
(i) no individual (appointed or otherwise)
involved in the designation of the State agency
or an area agency on aging, or in the
designation of the head of any subdivision of
the State agency or of an area agency on aging,
is subject to a conflict of interest prohibited
under this Act;
(ii) no officer, employee, or other
representative of the State agency or an area
agency on aging is subject to a conflict of
interest prohibited under this Act; and
(iii) mechanisms are in place to identify and
remove conflicts of interest prohibited under
this Act.
(8)(A) The plan shall provide that no supportive
services, nutrition services, or in-home services will
be directly provided by the State agency or an area
agency on aging in the State, unless, in the judgment
of the State agency--
(i) provision of such services by the State
agency or the area agency on aging is necessary
to assure an adequate supply of such services;
(ii) such services are directly related to
such State agency's or area agency on aging's
administrative functions; or
(iii) such services can be provided more
economically, and with comparable quality, by
such State agency or area agency on aging.
(B) Regarding case management services, if the State
agency or area agency on aging is already providing
case management services (as of the date of submission
of the plan) under a State program, the plan may
specify that such agency is allowed to continue to
provide case management services.
(C) The plan may specify that an area agency on aging
is allowed to directly provide information and
assistance services and outreach.
(9) The plan shall provide assurances that 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] the total amount that is not less than an
amount expended by the State agency with funds received
from all sources including under this title for fiscal
year [2000] 2019, and an amount that is not less than
the amount expended by the State agency with funds
received from all sources including under title VII for
fiscal year [2000] 2019.
(10) The plan shall provide assurances that the
special needs of older individuals residing in rural
areas will be taken into consideration and shall
describe how those needs have been met and describe how
funds have been allocated to meet those needs.
(11) The plan shall provide that with respect to
legal assistance--
(A) the plan contains assurances that area
agencies on aging will (i) enter into contracts
with providers of legal assistance which can
demonstrate the experience or capacity to
deliver legal assistance; (ii) include in any
such contract provisions to assure that any
recipient of funds under division (i) will be
subject to specific restrictions and
regulations promulgated under the Legal
Services Corporation Act (other than
restrictions and regulations governing
eligibility for legal assistance under such Act
and governing membership of local governing
boards) as determined appropriate by the
Assistant Secretary; and (iii) attempt to
involve the private bar in legal assistance
activities authorized under this title,
including groups within the private bar
furnishing services to older individuals on a
pro bono and reduced fee basis;
(B) the plan contains assurances that no
legal assistance will be furnished unless the
grantee administers a program designed to
provide legal assistance to older individuals
with social or economic need and has agreed, if
the grantee is not a Legal Services Corporation
project grantee, to coordinate its services
with existing Legal Services Corporation
projects in the planning and service area in
order to concentrate the use of funds provided
under this title on individuals with the
greatest such need; and the area agency on
aging makes a finding, after assessment,
pursuant to standards for service promulgated
by the Assistant Secretary, that any grantee
selected is the entity best able to provide the
particular services;
(C) the State agency will provide for the
coordination of the furnishing of legal
assistance to older individuals within the
State, and provide advice and technical
assistance in the provision of legal assistance
to older individuals within the State and
support the furnishing of training and
technical assistance for legal assistance for
older individuals;
(D) the plan contains assurances, to the
extent practicable, that legal assistance
furnished under the plan will be in addition to
any legal assistance for older individuals
being furnished with funds from sources other
than this Act and that reasonable efforts will
be made to maintain existing levels of legal
assistance for older individuals; and
(E) the plan contains assurances that area
agencies on aging will give priority to legal
assistance related to income, health care,
long-term care, nutrition, housing, utilities,
protective services, defense of guardianship,
abuse, neglect, and age discrimination.
(12) The plan shall provide, whenever the State
desires to provide for a fiscal year for services for
the prevention of abuse of older individuals--
(A) the plan contains assurances that any
area agency on aging carrying out such services
will conduct a program consistent with relevant
State law and coordinated with existing State
adult protective service activities for--
(i) public education to identify and
prevent abuse of older individuals;
(ii) receipt of reports of abuse of
older individuals;
(iii) active participation of older
individuals participating in programs
under this Act through outreach,
conferences, and referral of such
individuals to other social service
agencies or sources of assistance where
appropriate and consented to by the
parties to be referred; and
(iv) referral of complaints to law
enforcement or public protective
service agencies where appropriate;
(B) the State will not permit involuntary or
coerced participation in the program of
services described in this paragraph by alleged
victims, abusers, or their households; and
(C) all information gathered in the course of
receiving reports and making referrals shall
remain confidential unless all parties to the
complaint consent in writing to the release of
such information, except that such information
may be released to a law enforcement or public
protective service agency.
(13) The plan shall provide assurances that each
State will assign personnel (one of whom shall be known
as a legal assistance developer) to provide State
leadership in developing legal assistance programs for
older individuals throughout the State.
(14) The plan shall, with respect to the fiscal year
preceding the fiscal year for which such plan is
prepared--
(A) identify the number of low-income
minority older individuals in the State,
including the number of low-income minority
older individuals with limited English
proficiency; and
(B) describe the methods used to satisfy the
service needs of the low-income minority older
individuals described in subparagraph (A),
including the plan to meet the needs of low-
income minority older individuals with limited
English proficiency.
(15) The plan shall provide assurances that, if a
substantial number of the older individuals residing in
any planning and service area in the State are of
limited English-speaking ability, then the State will
require the area agency on aging for each such planning
and service area--
(A) to utilize in the delivery of outreach
services under section 306(a)(2)(A), the
services of workers who are fluent in the
language spoken by a predominant number of such
older individuals who are of limited English-
speaking ability; and
(B) to designate an individual employed by
the area agency on aging, or available to such
area agency on aging on a full-time basis,
whose responsibilities will include--
(i) taking such action as may be
appropriate to assure that counseling
assistance is made available to such
older individuals who are of limited
English-speaking ability in order to
assist such older individuals in
participating in programs and receiving
assistance under this Act; and
(ii) providing guidance to
individuals engaged in the delivery of
supportive services under the area plan
involved to enable such individuals to
be aware of cultural sensitivities and
to take into account effectively
linguistic and cultural differences.
(16) The plan shall provide assurances that the State
agency will require outreach efforts that will--
(A) identify individuals eligible for
assistance under this Act, with special
emphasis on--
(i) older individuals residing in
rural areas;
(ii) older individuals with greatest
economic need (with particular
attention to low-income older
individuals, including low-income
minority older individuals, older
individuals with limited English
proficiency, and older individuals
residing in rural areas);
(iii) older individuals with greatest
social need (with particular attention
to low-income older individuals,
including low-income minority older
individuals, older individuals with
limited English proficiency, and older
individuals residing in rural areas);
(iv) older individuals with severe
disabilities;
(v) older individuals with limited
English-speaking ability; and
(vi) older individuals with
Alzheimer's disease and related
disorders with neurological and organic
brain dysfunction (and the caretakers
of such individuals); and
(B) inform the older individuals referred to
in clauses (i) through (vi) of subparagraph
(A), and the caretakers of such individuals, of
the availability of such assistance.
(17) The plan shall provide, with respect to the
needs of older individuals with severe disabilities,
assurances that the State will coordinate planning,
identification, assessment of needs, and service for
older individuals with disabilities with particular
attention to individuals with severe disabilities with
the State agencies with primary responsibility for
individuals with disabilities, including severe
disabilities, to enhance services and develop
collaborative programs, where appropriate, to meet the
needs of older individuals with disabilities.
(18) The plan shall provide assurances that area
agencies on aging will conduct efforts to facilitate
the coordination of community-based, long-term care
services, pursuant to section 306(a)(7), for older
individuals who--
(A) reside at home and are at risk of
institutionalization because of limitations on
their ability to function independently;
(B) are patients in hospitals and are at risk
of prolonged institutionalization; or
(C) are patients in long-term care
facilities, but who can return to their homes
if community-based services are provided to
them.
(19) The plan shall include the assurances and
description required by section 705(a).
(20) The plan shall provide assurances that special
efforts will be made to provide technical assistance to
minority providers of services.
(21) The plan shall--
(A) provide an assurance that the State
agency will coordinate programs under this
title and programs under title VI, if
applicable; and
(B) provide an assurance that the State
agency will pursue activities to increase
access by older individuals who are Native
Americans to all aging programs and benefits
provided by the agency, including programs and
benefits provided under this title, if
applicable, and specify the ways in which the
State agency intends to implement the
activities.
(22) If case management services are offered to
provide access to supportive services, the plan shall
provide that the State agency shall ensure compliance
with the requirements specified in section 306(a)(8).
(23) The plan shall provide assurances that
demonstrable efforts will be made--
(A) to coordinate services provided under
this Act with other State services that benefit
older individuals; and
(B) to provide multigenerational activities,
such as opportunities for older individuals to
serve as mentors or advisers in child care,
youth day care, educational assistance, at-risk
youth intervention, juvenile delinquency
treatment, and family support programs.
(24) The plan shall provide assurances that the State
will coordinate public services within the State to
assist older individuals to obtain transportation
services associated with access to services provided
under this title, to services under title VI, to
comprehensive counseling services, and to legal
assistance.
(25) The plan shall include assurances that the State
has in effect a mechanism to provide for quality in the
provision of in-home services under this title.
(26) The plan shall provide assurances that funds
received under this title will not be used to pay any
part of a cost (including an administrative cost)
incurred by the State agency or an area agency on aging
to carry out a contract or commercial relationship that
is not carried out to implement this title.
(27) The plan shall provide assurances that area
agencies on aging will provide, to the extent feasible,
for the furnishing of services under this Act,
consistent with self-directed care.
(28)(A) The plan shall include, at the election of
the State, an assessment of how prepared the State is,
under the State's statewide service delivery model, for
any anticipated change in the number of older
individuals during the 10-year period following the
fiscal year for which the plan is submitted.
(B) Such assessment may include--
(i) the projected change in the number of
older individuals in the State;
(ii) an analysis of how such change may
affect such individuals, including individuals
with low incomes, individuals with greatest
economic need, minority older individuals,
older individuals residing in rural areas, and
older individuals with limited English
proficiency;
(iii) an analysis of how the programs,
policies, and services provided by the State
can be improved, including coordinating with
area agencies on aging, and how resource levels
can be adjusted to meet the needs of the
changing population of older individuals in the
State; and
(iv) an analysis of how the change in the
number of individuals age 85 and older in the
State is expected to affect the need for
supportive services.
(29) The plan shall include information detailing how
the State will coordinate activities, and develop long-
range emergency preparedness plans, with area agencies
on aging, local emergency response agencies, relief
organizations, local governments, State agencies
responsible for emergency preparedness, and any other
institutions that have responsibility for disaster
relief service delivery.
(30) The plan shall include information describing
the involvement of the head of the State agency in the
development, revision, and implementation of emergency
preparedness plans, including the State Public Health
Emergency Preparedness and Response Plan.
(31) The State shall prepare and submit to the
Assistant Secretary annual reports on the data
collected to determine the services that are needed by
older individuals whose needs are the focus of all
centers funded under title IV and the effectiveness of
the programs, policies, and services provided by area
agencies on aging in assisting these individuals. The
reports shall describe any outreach efforts and other
activities described in section 306(a)(18). This
requirement applies to all centers funded on the day
before the date of the enactment of the effective date
of this paragraph.
(b)(1) The Assistant Secretary shall approve any State plan
which the Assistant Secretary finds fulfills the requirements
of subsection (a), except the Assistant Secretary may not
approve such plan unless the Assistant Secretary determines
that the formula submitted under section 305(a)(2)(D) complies
with the guidelines in effect under section 305(a)(2)(C).
(2) The Assistant Secretary, in approving any State plan
under this section, may waive the requirement described in
paragraph (3)(B) of subsection (a) if the State agency
demonstrates to the Assistant Secretary that the service needs
of older individuals residing in rural areas in the State are
being met, or that the number of older individuals residing in
such rural areas is not sufficient to require the State agency
to comply with such requirement.
(c)(1) The Assistant Secretary shall not make a final
determination disapproving any State plan, or any modification
thereof, or make a final determination that a State is
ineligible under section 305, without first affording the State
reasonable notice and opportunity for a hearing.
(2) Not later than 30 days after such final determination, a
State dissatisfied with such final determination may appeal
such final determination to the Secretary for review. If the
State timely appeals such final determination in accordance
with subsection (e)(1), the Secretary shall dismiss the appeal
filed under this paragraph.
(3) If the State is dissatisfied with the decision of the
Secretary after review under paragraph (2), the State may
appeal such decision not later than 30 days after such decision
and in the manner described in subsection (e). For purposes of
appellate review under the preceding sentence, a reference in
subsection (e) to the Assistant Secretary shall be deemed to be
a reference to the Secretary.
(d) Whenever the Assistant Secretary, after reasonable notice
and opportunity for a hearing to the State agency, finds that--
(1) the State is not eligible under section 305,
(2) the State plan has been so changed that it no
longer complies substantially with the provisions of
subsection (a), or
(3) in the administration of the plan there is a
failure to comply substantially with any such provision
of subsection (a),
the Assistant Secretary shall notify such State agency that no
further payments from its allotments under section 304 and
section 308 will be made to the State (or, in the Assistant
Secretary's discretion, that further payments to the State will
be limited to projects under or portions of the State plan not
affected by such failure), until the Assistant Secretary is
satisfied that there will no longer be any failure to comply.
Until the Assistant Secretary is so satisfied, no further
payments shall be made to such State from its allotments under
section 304 and section 308 (or payments shall be limited to
projects under or portions of the State plan not affected by
such failure). The Assistant Secretary shall, in accordance
with regulations the Assistant Secretary shall prescribe,
disburse the funds so withheld directly to any public or
nonprofit private organization or agency or political
subdivision of such State submitting an approved plan in
accordance with the provisions of this section. Any such
payment shall be matched in the proportions specified in
section 304.
(e)(1) A State which is dissatisfied with a final action of
the Assistant Secretary under subsection (b), (c), or (d) may
appeal to the United States court of appeals for the circuit in
which the State is located, by filing a petition with such
court within 30 days after such final action. A copy of the
petition shall be forthwith transmitted by the clerk of the
court to the Assistant Secretary, or any officer designated by
the Assistant Secretary for such purpose. The Assistant
Secretary thereupon shall file in the court the record of the
proceedings on which the Assistant Secretary's action is based,
as provided in section 2112 of title 28, United States Code.
(2) Upon the filing of such petition, the court shall have
jurisdiction to affirm the action of the Assistant Secretary or
to set it aside, in whole or in part, temporarily or
permanently, but until the filing of the record, the Assistant
Secretary may modify or set aside the Assistant Secretary's
order. The findings of the Assistant Secretary as to the facts,
if supported by substantial evidence, shall be conclusive, but
the court, for good cause shown may remand the case to the
Assistant Secretary to take further evidence, and the Assistant
Secretary shall, within 30 days, file in the court the record
of those further proceedings. Such new or modified findings of
fact shall likewise be conclusive if supported by substantial
evidence. The judgment of the court affirming or setting aside,
in whole or in part, any action of the Assistant Secretary
shall be final, subject to review by the Supreme Court of the
United States upon certiorari or certification as provided in
section 1254 of title 28, United States Code.
(3) The commencement of proceedings under this subsection
shall not, unless so specifically ordered by the court, operate
as a stay of the Assistant Secretary's action.
(f) Neither a State, nor a State agency, may require any
provider of legal assistance under this title to reveal any
information that is protected by the attorney-client privilege.
planning, coordination, evaluation, and administration of state plans
Sec. 308. (a)(1) Amounts available to States under subsection
(b)(1) may be used to make grants to States for paying such
percentages as each State agency determines, but not more than
75 percent, of the cost of the administration of its State
plan, including the preparation of the State plan, the
evaluation of activities carried out under such plan, the
collection of data and the carrying out of analyses related to
the need for supportive services, nutrition services, and
multipurpose senior centers within the State, and dissemination
of information so obtained, the provision of short-term
training to personnel of public or nonprofit private agencies
and organizations engaged in the operation of programs
authorized by this Act, and the carrying out of demonstration
projects of statewide significance relating to the initiation,
expansion, or improvement of services assisted under this
title.
(2) Any sums available to a State under subsection (b)(1) for
part of the cost of the administration of its State plan which
the State determines is not needed for such purposes may be
used by the State to supplement the amount available under
section 304(d)(1)(A) to cover part of the cost of the
administration of area plans.
(3) Any State which has been designated a single planning and
service area under section 305(a)(1)(E) covering all, or
substantially all, of the older individuals in such State, as
determined by the Assistant Secretary, may elect to pay part of
the costs of the administration of State and area plans either
out of sums received under this section or out of sums made
available for the administration of area plans under section
304(d)(1)(A), but shall not pay such costs out of sums received
or allotted under both such sections.
(b)(1) If for any fiscal year the aggregate amount
appropriated under section 303 does not exceed $800,000,000,
then--
(A) except as provided in clause (ii), the greater of
5 percent of the allotment to a State under section
304(a)(1) or $300,000; and
(B) in the case of Guam, American Samoa, the United
States Virgin Islands, the Trust Territory of the
Pacific Islands, and the Commonwealth of the Northern
Mariana Islands, the greater of 5 percent of such
allotment or $75,000;
shall be available to such State to carry out the purposes of
this section.
(2) If for any fiscal year the aggregate amount appropriated
under section 303 exceeds $800,000,000, then--
(A) except as provided in clause (ii), the greater of
5 percent of the allotment to a State under section
304(a)(1) or [$500,000] $750,000; and
(B) in the case of Guam, American Samoa, the United
States Virgin Islands, the Trust Territory of the
Pacific Islands, and the Commonwealth of the Northern
Mariana Islands, the greater of 5 percent of such
allotment or $100,000;
shall be available to such State to carry out the purposes of
this section.
(3)(A) If the aggregate amount appropriated under section 303
for a fiscal year does not exceed $800,000,000, then any State
which desires to receive amounts, in addition to amounts
allotted to such State under paragraph (1), to be used in the
administration of its State plan in accordance with subsection
(a) may transmit an application to the Assistant Secretary in
accordance with this paragraph. Any such application shall be
transmitted in such form, and according to such procedures, as
the Assistant Secretary may require, except that such
application may not be made as part of, or as an amendment to,
the State plan.
(B) The Assistant Secretary may approve any application
transmitted by a State under subparagraph (A) if the Assistant
Secretary determines, based upon a particularized showing of
need that--
(i) the State will be unable to fully and effectively
administer its State plan and to carry out programs and
projects authorized by this title unless such
additional amounts are made available by the Assistant
Secretary;
(ii) the State is making full and effective use of
its allotment under paragraph (1) and of the personnel
of the State agency and area agencies designated under
section 305(a)(2)(A) in the administration of its State
plan in accordance with subsection (a); and
(iii) the State agency and area agencies on aging of
such State are carrying out, on a full-time basis,
programs and activities which are in furtherance of the
objectives of this Act.
(C) The Assistant Secretary may approve that portion of the
amount requested by a State in its application under
subparagraph (A) which the Assistant Secretary determines has
been justified in such application.
(D) Amounts which any State may receive in any fiscal year
under this paragraph may not exceed three-fourths of 1 percent
of the sum of the amounts allotted under section 304(a) to such
State to carry out the State plan for such fiscal year.
(E) No application by a State under subparagraph (A) shall be
approved unless it contains assurances that no amounts received
by the State under this paragraph will be used to hire any
individual to fill a job opening created by the action of the
State in laying off or terminating the employment of any
regular employee not supported under this Act in anticipation
of filling the vacancy so created by hiring an employee to be
supported through use of amounts received under this paragraph.
(4)(A) Notwithstanding any other provision of this title and
except as provided in subparagraph (B), with respect to funds
received by a State and attributable to funds appropriated
under paragraph (1) or (2) of section 303(b), the State may
elect in its plan under section 307(a)(13) regarding part C of
this title, to transfer not more than 40 percent of the funds
so received between subpart 1 and subpart 2 of part C, for use
as the State considers appropriate to meet the needs of the
area served. The Assistant Secretary shall approve any such
transfer unless the Assistant Secretary determines that such
transfer is not consistent with the objectives of this Act.
(B) If a State demonstrates, to the satisfaction of the
Assistant Secretary, that funds received by the State and
attributable to funds appropriated under paragraph (1) or (2)
of section 303(b), including funds transferred under
subparagraph (A) without regard to this subparagraph, for any
fiscal year are insufficient to satisfy the need for services
under subpart 1 or subpart 2 of part C, then the Assistant
Secretary may grant a waiver that permits the State to transfer
under subparagraph (A) to satisfy such need an additional 10
percent of the funds so received by a State and attributable to
funds appropriated under paragraph (1) or (2) of section
303(b).
(C) A State's request for a waiver under subparagraph (B)
shall--
(i) be not more than one page in length;
(ii) include a request that the waiver be granted;
(iii) specify the amount of the funds received by a
State and attributable to funds appropriated under
paragraph (1) or (2) of section 303(b), over the
permissible 40 percent referred to in subparagraph (A),
that the State requires to satisfy the need for
services under subpart 1 or 2 of part C; and
(iv) not include a request for a waiver with respect
to an amount if the transfer of the amount would
jeopardize the appropriate provision of services under
subpart 1 or 2 of part C.
(5)(A) Notwithstanding any other provision of this title, of
the funds received by a State attributable to funds
appropriated under subsection (a)(1), and paragraphs (1) and
(2) of subsection (b), of section 303, the State may elect to
transfer not more than 30 percent for any fiscal year between
programs under part B and part C, for use as the State
considers appropriate. The State shall notify the Assistant
Secretary of any such election.
(B) At a minimum, the notification described in subparagraph
(A) shall include a description of the amount to be
transferred, the purposes of the transfer, the need for the
transfer, and the impact of the transfer on the provision of
services from which the funding will be transferred.
(6) A State agency may not delegate to an area agency on
aging or any other entity the authority to make a transfer
under paragraph (4)(A) or (5)(A).
(7) The Assistant Secretary shall annually collect, and
include in the report required by section 207(a), data
regarding the transfers described in paragraphs (4)(A) and
(5)(A), including--
(A) the amount of funds involved in the transfers,
analyzed by State;
(B) the rationales for the transfers;
(C) in the case of transfers described in paragraphs
(4)(A) and (5)(A), the effect of the transfers of the
provision of services, including the effect on the
number of meals served, under--
(i) subpart 1 of part C; and
(ii) subpart 2 of part C; and
(D) in the case of transfers described in paragraph
(5)(A)--
(i) in the case of transfers to part B,
information on the supportive services, or
services provided through senior centers, for
which the transfers were used; and
(ii) the effect of the transfers on the
provision of services provided under--
(I) part B; and
(II) part C, including the effect on
the number of meals served.
(8) The Assistant Secretary shall review the reports
submitted under section 307(a)(31), and include in the report
required by section 207(a), aggregated data, including the
effectiveness and outreach efforts included in 307(a)(31), on
services that are needed by older individuals whose needs are
the focus of all centers funded under title IV. This
requirement applies to all centers funded on the day before the
date of the effective date of this paragraph.
(c) The amounts of any State's allotment under subsection (b)
for any fiscal year which the Assistant Secretary determines
will not be required for that year for the purposes described
in subsection (a)(1) shall be available to provide services
under part B or part C, or both, in the State.
* * * * * * *
nutrition services incentive program
Sec. 311. (a) The purpose of this section is to provide
incentives to encourage and reward effective performance by
States and tribal organizations in the efficient delivery of
nutritious meals to older individuals.
(b)(1) The Secretary shall allot and provide, in accordance
with this section, to or on behalf of each State agency with a
plan approved under this title for a fiscal year, and to or on
behalf of each grantee with an application approved under title
VI for such fiscal year, an amount bearing the same ratio to
the total amount appropriated for such fiscal year under
subsection (e) as the number of meals served in the State under
such plan approved for the preceding fiscal year (or the number
of meals served by the title VI grantee, under such application
approved for such preceding fiscal year), bears to the total
number of such meals served in all States and by all title VI
grantees under all such plans and applications approved for
such preceding fiscal year.
(2) For purposes of paragraph (1), in the case of a grantee
that has an application approved under title VI for a fiscal
year but that did not receive assistance under this section for
the preceding fiscal year, the number of meals served by the
title VI grantee for the preceding fiscal year shall be deemed
to equal the number of meals that the Assistant Secretary
estimates will be served by the title VI grantee in the fiscal
year for which the application was approved.
(c)(1) Agricultural commodities (including bonus commodities)
and products purchased by the Secretary of Agriculture under
section 32 of the Act of August 24, 1935 (7 U.S.C. 612c), shall
be donated to a recipient of a grant or contract to be used for
providing nutrition services in accordance with the provisions
of this title.
(2) The Commodities Credit Corporation shall dispose of food
commodities (including bonus commodities) under section 416 of
the Agricultural Act of 1949 (7 U.S.C. 1431) by donating them
to a recipient of a grant or contract to be used for providing
nutrition services in accordance with the provisions of this
title.
(3) Dairy products (including bonus commodities) purchased by
the Secretary of Agriculture under section 709 of the Food and
Agriculture Act of 1965 (7 U.S.C. 1446a-1) shall be used to
meet the requirements of programs providing nutrition services
in accordance with the provisions of this title.
(4) Among the commodities provided under this subsection, the
Secretary of Agriculture shall give special emphasis to foods
of high nutritional value to support the health of older
individuals. The Secretary of Agriculture, in consultation with
the Assistant Secretary, is authorized to prescribe the terms
and conditions respecting the provision of commodities under
this subsection.
(d)(1) Each State agency and each title VI grantee shall be
entitled to use all or any part of amounts allotted under
subsection (b) to obtain, subject to paragraphs (2) and (3),
from the Secretary of Agriculture commodities available through
any food program of the Department of Agriculture at the rates
at which such commodities are valued for purposes of such
program.
(2) The Secretary of Agriculture shall determine and report
to the Secretary, by such date as the Secretary may require,
the amount (if any) of its allotment under subsection (b) which
each State agency and title VI grantee has elected to receive
in the form of commodities. Such amount shall include an amount
bearing the same ratio to the costs to the Secretary of
Agriculture of providing such commodities under this subsection
as the value of commodities received by such State agency or
title VI grantee under this subsection bears to the total value
of commodities so received.
(3) From the allotment under subsection (b) for each State
agency and title VI grantee, the Secretary shall transfer funds
to the Secretary of Agriculture for the costs of commodities
received by such State agency or grantee, and expenses related
to the procurement of the commodities on behalf of such State
agency or grantee, under this subsection, and shall then pay
the balance (if any) to such State agency or grantee. The
amount of funds transferred for the expenses related to the
procurement of the commodities shall be mutually agreed on by
the Secretary and the Secretary of Agriculture. The transfer of
funds for the costs of the commodities and the related expenses
shall occur in a timely manner after the Secretary of
Agriculture submits the corresponding report described in
paragraph (2), and shall be subject to the availability of
appropriations. Amounts received by the Secretary of
Agriculture pursuant to this section to make commodity
purchases for a fiscal year for a State agency or title VI
grantee shall remain available, only for the next fiscal year,
to make commodity purchases for that State agency or grantee
pursuant to this section.
(4) Each State agency and title VI grantee shall promptly and
equitably disburse amounts received under this subsection to
recipients of grants and contracts. Such disbursements shall
only be used by such recipients of grants or contracts to
purchase domestically produced foods for their nutrition
projects.
(5) Nothing in this subsection shall be construed to require
any State agency or title VI grantee to elect to receive cash
payments under this subsection.
[(e) There are authorized to be appropriated to carry out
this section (other than subsection (c)(1)) $164,055,664 for
fiscal year 2017, $167,486,502 for fiscal year 2018, and
$170,917,349 for fiscal year 2019.]
(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.
(f) In each fiscal year, the Secretary and the Secretary of
Agriculture shall jointly disseminate to State agencies, title
VI grantees, area agencies on aging, and providers of nutrition
services assisted under this title, information concerning the
foods available to such State agencies, title VI grantees, area
agencies on aging, and providers under subsection (c).
* * * * * * *
SEC. 315. CONSUMER CONTRIBUTIONS.
(a) Cost Sharing.--
(1) In general.--Except as provided in paragraphs (2)
and (3), a State is permitted to implement cost sharing
for all services funded by this Act by recipients of
the services.
(2) Exception.--The State is not permitted to
implement the cost sharing described in paragraph (1)
for the following services:
(A) Information and assistance, outreach,
benefits counseling, or case management
services.
(B) Ombudsman, elder abuse prevention, legal
assistance, or other consumer protection
services.
(C) Congregate and home delivered meals.
(D) Any services delivered through tribal
organizations.
(3) Prohibitions.--A State or tribal organization
shall not permit the cost sharing described in
paragraph (1) for any services delivered through tribal
organizations. A State shall not permit cost sharing by
a low-income older individual if the income of such
individual is at or below the Federal poverty line. A
State may exclude from cost sharing low-income
individuals whose incomes are above the Federal poverty
line. A State shall not consider any assets, savings,
or other property owned by older individuals when
defining low-income individuals who are exempt from
cost sharing, when creating a sliding scale for the
cost sharing, or when seeking contributions from any
older individual.
(4) Payment rates.--If a State permits the cost
sharing described in paragraph (1), such State shall
establish a sliding scale, based solely on individual
income and the cost of delivering services.
(5) Requirements.--If a State permits the cost
sharing described in paragraph (1), such State shall
require each area agency on aging in the State to
ensure that each service provider involved, and the
area agency on aging, will--
(A) protect the privacy and confidentiality
of each older individual with respect to the
declaration or nondeclaration of individual
income and to any share of costs paid or unpaid
by an individual;
(B) establish appropriate procedures to
safeguard and account for cost share payments;
(C) use each collected cost share payment to
expand the service for which such payment was
given;
(D) not consider assets, savings, or other
property owned by an older individual in
determining whether cost sharing is permitted;
(E) not deny any service for which funds are
received under this Act for an older individual
due to the income of such individual or such
individual's failure to make a cost sharing
payment;
(F) determine the eligibility of older
individuals to cost share solely by a
confidential declaration of income and with no
requirement for verification; and
(G) widely distribute State created written
materials in languages reflecting the reading
abilities of older individuals that describe
the criteria for cost sharing, the State's
sliding scale, and the mandate described under
subparagraph (E).
(6) Waiver.--An area agency on aging may request a
waiver to the State's cost sharing policies, and the
State shall approve such a waiver if the area agency on
aging can adequately demonstrate that--
(A) a significant proportion of persons
receiving services under this Act subject to
cost sharing in the planning and service area
have incomes below the threshold established in
State policy; or
(B) cost sharing would be an unreasonable
administrative or financial burden upon the
area agency on aging.
(b) Voluntary Contributions.--
(1) In general.--Voluntary contributions shall be
allowed and may be solicited for all services for which
funds are received under this Act if the method of
solicitation is noncoercive. Such contributions shall
be encouraged for individuals whose self-declared
income is at or above 185 percent of the poverty line,
at contribution levels based on the actual cost of
services.
(2) Local decision.--The area agency on aging shall
consult with the relevant service providers and older
individuals in agency's planning and service area in a
State to determine the best method for accepting
voluntary contributions under this subsection.
(3) Prohibited acts.--The area agency on aging and
service providers shall not means test for any service
for which contributions are accepted or deny services
to any individual who does not contribute to the cost
of the service.
(4) Required acts.--The area agency on aging shall
ensure that each service provider will--
(A) provide each recipient with an
opportunity to voluntarily contribute to the
cost of the service;
(B) clearly inform each recipient that there
is no obligation to contribute and that the
contribution is purely voluntary;
(C) protect the privacy and confidentiality
of each recipient with respect to the
recipient's contribution or lack of
contribution;
(D) establish appropriate procedures to
safeguard and account for all contributions;
and
(E) use all collected contributions to expand
the service for which the contributions were
given and to supplement (not supplant) funds
received under this Act.
(c) Participation.--
(1) In general.--The State and area agencies on
aging, in conducting public hearings on State and area
plans, shall solicit the views of older individuals,
providers, and other stakeholders on implementation of
cost-sharing in the service area or the State.
(2) Plans.--Prior to the implementation of cost
sharing under subsection (a), each State and area
agency on aging shall develop plans that are designed
to ensure that the participation of low-income older
individuals (with particular attention to low-income
older individuals, including low-income minority older
individuals, older individuals with limited English
proficiency, and older individuals residing in rural
areas) receiving services will not decrease with the
implementation of the cost sharing under such
subsection.
(d) Evaluation.--Not later than 1 year after the date of the
enactment of the Older Americans Act Amendments of 2000, and
annually thereafter, the Assistant Secretary shall conduct a
comprehensive evaluation of practices for cost sharing to
determine its impact on participation rates (with particular
attention to low-income older individuals, including low-income
minority older individuals, older individuals with limited
English proficiency, and older individuals residing in rural
areas). If the Assistant Secretary finds that there is a
disparate impact upon low-income or minority older individuals
or older individuals residing in rural areas in any State or
region within the State regarding the provision of services,
the Assistant Secretary shall take corrective action to assure
that such services are provided to all older individuals
without regard to the cost sharing criteria.
(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.
* * * * * * *
Part B--Supportive Services and Senior Centers
program authorized
Sec. 321. (a) The Assistant Secretary shall carry out a
program for making grants to States under State plans approved
under section 307 for any of the following supportive services:
(1) health (including mental and behavioral health),
education and training, welfare, informational,
recreational, homemaker, counseling, referral, chronic
condition self-care management, or falls prevention
services;
(2) transportation services to facilitate access to
supportive services or nutrition services, and services
provided by an area agency on aging, in conjunction
with local transportation service providers, public
transportation agencies, and other local government
agencies, that result in increased provision of such
transportation services for older individuals;
(3) services designed to encourage and assist older
individuals to use the facilities and services
(including information and assistance services)
available to them, including language translation
services to assist older individuals with limited-
English speaking ability to obtain services under this
title;
(4) services designed (A) to assist older individuals
to obtain adequate housing, including residential
repair and renovation projects designed to enable older
individuals to maintain their homes in conformity with
minimum housing standards; (B) to adapt homes to meet
the needs of older individuals who have physical
disabilities; (C) to prevent unlawful entry into
residences of older individuals, through the
installation of security devices and through structural
modifications or alterations of such residences; or (D)
to assist older individuals in obtaining housing for
which assistance is provided under programs of the
Department of Housing and Urban Development;
(5) services designed to assist older individuals in
avoiding institutionalization and to assist individuals
in long-term care institutions who are able to return
to their communities, including--
(A) client assessment, case management
services, and development and coordination of
community services;
(B) supportive activities to meet the special
needs of caregivers, including caretakers who
provide in-home services to frail older
individuals; and
(C) in-home services and other community
services, including home health, homemaker,
shopping, escort, reader, and letter writing
services, to assist older individuals to live
independently in a home environment;
(6) services designed to provide to older individuals
legal assistance and other counseling services and
assistance, including--
(A) tax counseling and assistance, financial
counseling, and counseling regarding
appropriate health and life insurance coverage;
(B) representation--
(i) of individuals who are wards (or
are allegedly incapacitated); and
(ii) in guardianship proceedings of
older individuals who seek to become
guardians, if other adequate
representation is unavailable in the
proceedings; and
(C) provision, to older individuals who
provide uncompensated care to their adult
children with disabilities, of counseling to
assist such older individuals with permanency
planning for such children;
(7) services designed to enable older individuals to
attain and maintain physical and mental well-being
through programs of regular physical activity,
exercise, music therapy, art therapy, cultural
experiences (including the arts), and dance-movement
therapy;
[(8) services designed to provide health screening
(including mental and behavioral health screening and
falls prevention services screening) to detect or
prevent (or both) illnesses and injuries that occur
most frequently in older individuals;]
(8) services designed to provide health screening
(including mental and behavioral health screening,
screening for social isolation and loneliness, falls
prevention services screening and traumatic brain
injury screening) to detect or prevent (or both)
illnesses and injuries that occur most frequently in
older individuals;
(9) services designed to provide, for older
individuals, preretirement counseling and assistance in
planning for and assessing future post-retirement needs
with regard to public and private insurance, public
benefits, lifestyle changes, relocation, legal matters,
leisure time, and other appropriate matters;
(10) services of an ombudsman at the State level to
receive, investigate, and act on complaints by older
individuals who are residents of long-term care
facilities and to advocate for the well-being of such
individuals;
(11) provision of services and assistive devices
(including provision of assistive technology services
and assistive technology devices) which are designed to
meet the unique needs of older individuals who are
disabled, and of older individuals who provide
uncompensated care to their adult children with
disabilities;
(12) services to encourage the employment of older
workers, including job and second career counseling
and, where appropriate, job development, referral, and
placement, and including the coordination of the
services with programs administered by or receiving
assistance from the Department of Labor, including
programs carried out under the Workforce Innovation and
Opportunity Act;
(13) crime prevention services and victim assistance
programs for older individuals;
(14) a program, to be known as ``Senior Opportunities
and Services'', designed to identify and meet the needs
of low-income older individuals in one or more of the
following areas: (A) development and provision of new
volunteer services; (B) effective referral to existing
health (including mental and behavioralhealth),
employment, housing, legal, consumer, transportation,
and other services; (C) stimulation and creation of
additional services and programs to remedy gaps and
deficiencies in presently existing services and
programs; and (D) such other services as the Assistant
Secretary may determine are necessary or especially
appropriate to meet the needs of low-income older
individuals and to assure them greater self-
sufficiency;
(15) services for the prevention of abuse of older
individuals in accordance with chapter 3 of subtitle A
of title VII and section 307(a)(12), and screening for
elder abuse, neglect, and exploitation;
(16) in service training and State leadership for
legal assistance activities;
(17) health and nutrition education services,
including information concerning prevention, diagnosis,
treatment, and rehabilitation of age-related diseases
and chronic disabling conditions;
(18) services designed to enable mentally impaired
older individuals to attain and maintain emotional
well-being and independent living through a coordinated
system of support services;
(19) services designed to support family members and
other persons providing voluntary care to older
individuals that need long-term care services;
(20) services designed to provide information and
training for individuals who are or may become
guardians or representative payees of older
individuals, including information on the powers and
duties of guardians and representative payees and on
alternatives to guardianships;
(21) services to encourage and facilitate regular
interaction between students and older individuals,
including services for older individuals with limited
English proficiency and visits in long-term care
facilities, multipurpose senior centers, and other
settings;
(22) in-home services for frail older individuals,
including individuals with Alzheimer's disease and
related disorders with neurological and organic brain
dysfunction, and their families, including in-home
services defined by a State agency in the State plan
submitted under section 307, taking into consideration
the age, economic need, and noneconomic and nonhealth
factors contributing to the frail condition and need
for services of the individuals described in this
paragraph, and in-home services defined by an area
agency on aging in the area plan submitted under
section 306;
(23) services designed to support States, area
agencies on aging, and local service providers in
carrying out and coordinating activities for older
individuals with respect to mental and behavioral
health services, including outreach for, education
concerning, and screening for such services, and
referral to such services for treatment;
(24) activities to promote and disseminate
information about life-long learning programs,
including opportunities for distance learning; [and]
(25) services that promote or support social
connectedness and reduce social isolation; and
[(25)] (26) any other services necessary for the
general welfare of older individuals;
if such services meet standards prescribed by the Assistant
Secretary and are necessary for the general welfare of older
individuals. For purposes of paragraph (5), the term ``client
assessment through case management'' includes providing
information relating to assistive technology.
(b)(1) The Assistant Secretary shall carry out a program for
making grants to States under State plans approved under
section 307 for the acquisition, alteration, or renovation of
existing facilities, including mobile units, and, where
appropriate, construction or modernization of facilities to
serve as multipurpose senior centers.
(2) Funds made available to a State under this part may be
used for the purpose of assisting in the operation of
multipurpose senior centers and meeting all or part of the
costs of compensating professional and technical personnel
required for the operation of multipurpose senior centers.
(c) In carrying out the provisions of this part, to more
efficiently and effectively deliver services to older
individuals, each area agency on aging shall coordinate
services described in subsection (a) with other community
agencies and voluntary organizations providing the same
services, and pursue opportunities for the development of
intergenerational shared site models for programs or projects,
consistent with the purposes of this Act. In coordinating the
services, the area agency on aging shall make efforts to
coordinate the services with agencies and organizations
carrying out intergenerational programs or projects.
(d) Funds made available under this part shall supplement,
and not supplant, any Federal, State, or local funds expended
by a State or unit of general purpose local government
(including an area agency on aging) to provide services
described in subsection (a).
(e) In this section, the term ``adult child with a
disability'' means a child who--
(1) is age 18 or older;
(2) is financially dependent on an older individual
who is a parent of the child; and
(3) has a disability.
Part C--Nutrition Service
SEC. 330. PURPOSES.
The purposes of this part are--
(1) to reduce hunger [and food insecurity], food
insecurity, and malnutrition;
(2) to promote socialization of older individuals;
and
(3) to promote the health and well-being of older
individuals by assisting such individuals to gain
access to nutrition and other disease prevention and
health promotion services to delay the onset of adverse
health conditions resulting from poor nutritional
health or sedentary behavior.
* * * * * * *
Subpart 3--General Provisions
SEC. 339. NUTRITION.
A State that establishes and operates a nutrition project
under this chapter shall--
(1) utilize the expertise of a dietitian or other
individual with equivalent education and training in
nutrition science, or if such an individual is not
available, an individual with comparable expertise in
the planning of nutritional services, and
(2) ensure that the project--
(A) provides meals that--
(i) comply with the most recent
Dietary Guidelines for Americans,
published by the Secretary and the
Secretary of Agriculture, and
(ii) provide to each participating
older individual--
(I) a minimum of 33\1/3\
percent of the dietary
reference intakes established
by the Food and Nutrition Board
of the [Institute of Medicine
of the National Academy of
Sciences] National Academies of
Sciences, Engineering, and
Medicine, if the project
provides one meal per day,
(II) a minimum of 66\2/3\
percent of the allowances if
the project provides two meals
per day, and
(III) 100 percent of the
allowances if the project
provides three meals per day,
and
(iii) to the maximum extent
practicable, are adjusted to meet any
special dietary needs of program
participants, including cultural
considerations and preferences
(including needs based on religious,
cultural, or ethnic requirements) and
medically tailored meals,
(B) provides flexibility to local nutrition
providers in designing meals that are appealing
to program participants,
(C) encourages providers to enter into
contracts that limit the amount of time meals
must spend in transit before they are consumed,
(D) where feasible, encourages joint
arrangements with schools and other facilities
serving meals to children in order to promote
intergenerational meal programs,
(E) provides that meals, other than in-home
meals, are provided in settings in as close
proximity to the majority of eligible older
individuals' residences as feasible,
(F) comply with applicable provisions of
State or local laws regarding the safe and
sanitary handling of food, equipment, and
supplies used in the storage, preparation,
service, and delivery of meals to an older
individual,
(G) ensures that meal providers solicit the
advice and expertise of--
(i) a dietitian or other individual
described in paragraph (1),
(ii) meal participants, and
(iii) other individuals knowledgeable
with regard to the needs of older
individuals,
(H) ensures that each participating area
agency on aging establishes procedures that
allow nutrition project administrators the
option to offer a meal, on the same basis as
meals provided to participating older
individuals, to individuals providing volunteer
services during the meal hours, and to
individuals with disabilities who reside at
home with older individuals eligible under this
chapter,
(I) ensures that nutrition services will be
available to older individuals and to their
spouses, and may be made available to
individuals with disabilities who are not older
individuals but who reside in housing
facilities occupied primarily by older
individuals at which congregate nutrition
services are provided,
(J) provides for nutrition screening and
nutrition education, and nutrition assessment
and counseling if appropriate,
(K) encourages individuals who distribute
nutrition services under subpart 2 to provide,
to homebound older individuals, available
medical information approved by health care
professionals, such as informational brochures
and information on how to get vaccines,
including vaccines for influenza, pneumonia,
and shingles, in the individuals' communities,
and
(L) where feasible, encourages the use of
locally grown foods in meal programs and
identifies potential partnerships and contracts
with local producers and providers of locally
grown foods.
* * * * * * *
PART E--NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM
* * * * * * *
SEC. 372. DEFINITIONS.
(a) In General.--In this part:
(1) Child.--The term ``child'' means an individual
who is not more than 18 years of age.
(2) Individual with a disability.--The term
``individual with a disability'' means an individual
with a disability, as defined in section 3 of the
Americans with Disabilities Act of 1990 (42 U.S.C.
12102), who is not less than age 18 and not more than
age 59.
(3) Older relative caregiver.--The term ``older
relative caregiver'' means a caregiver who--
(A)(i) is age 55 or older; and
(ii) lives with, is the informal provider of
in-home and community care to, and is the
primary caregiver for, a child or an individual
with a disability;
(B) in the case of a caregiver for a child--
(i) is the grandparent,
stepgrandparent, or other relative
(other than the parent) by blood,
marriage, or adoption, of the child;
(ii) is the primary caregiver of the
child because the biological or
adoptive parents are unable or
unwilling to serve as the primary
caregivers of the child; and
(iii) has a legal relationship to the
child, such as legal custody, adoption,
or guardianship, or is raising the
child informally; and
(C) in the case of a caregiver for an
individual with a disability, is the parent,
grandparent, or other relative by blood,
marriage, or adoption, of the individual with a
disability.
(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 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
in the caregiving situation, which shall occur
on a voluntary basis with the consent of the
caregiver.
(b) Rule.--In providing services under this part, for family
caregivers who provide care for individuals with Alzheimer's
disease and related disorders with neurological and organic
brain dysfunction, the State involved shall give priority to
caregivers who provide care for older individuals with such
disease or disorder.
SEC. 373. PROGRAM AUTHORIZED.
(a) In General.--The Assistant Secretary shall carry out a
program for making grants to States with State plans approved
under section 307, to pay for the Federal share of the cost of
carrying out State programs, to enable area agencies on aging,
or entities that such area agencies on aging contract with, to
provide multifaceted systems of support services--
(1) for family caregivers; and
(2) for older relative caregivers.
(b) Support Services.--The services provided, in a State
program under subsection (a), by an area agency on aging, or
entity that such agency has contracted with, may be informed
through the use of caregiver assessments and shall include--
(1) information to caregivers about available
services;
(2) assistance to caregivers in gaining access to the
services;
(3) individual counseling, organization of support
groups, and caregiver training to assist the caregivers
in the areas of health, nutrition, and financial
literacy, and in making decisions and solving problems
relating to their caregiving roles;
(4) respite care to enable caregivers to be
temporarily relieved from their caregiving
responsibilities; and
(5) supplemental services, on a limited basis, to
complement the care provided by caregivers.
(c) Population Served; Priority.--
(1) Population served.--Services under a State
program under this part shall be provided to family
caregivers, and older relative caregivers, who--
(A) are described in paragraph (1) or (2) of
subsection (a); and
(B) with regard to the services specified in
paragraphs (4) and (5) of subsection (b), in
the case of a caregiver described in paragraph
(1), is providing care to an older individual
who meets the condition specified in
subparagraph (A)(i) or (B) of section 102(22).
(2) Priority.--In providing services under this part,
the State, in addition to giving the priority described
in section 372(b), shall give priority--
(A) to caregivers who are older individuals
with greatest social need, and older
individuals with greatest economic need (with
particular attention to low-income older
individuals); and
(B) to older relative caregivers of children
with severe disabilities, or individuals with
disabilities who have severe disabilities.
(d) Use of Volunteers.--In carrying out this part, each area
agency on aging shall make use of trained volunteers to expand
the provision of the available services described in subsection
(b) and, if possible, work in coordination with organizations
that have experience in providing training, placement, and
stipends for volunteers or participants (such as organizations
carrying out Federal service programs administered by the
Corporation for National and Community Service), in community
service settings.
(e) Quality Standards and Mechanisms and Accountability.--
(1) Quality standards and mechanisms.--The State
shall establish standards and mechanisms designed to
assure the quality of services provided with assistance
made available under this part.
(2) Data and records.--The State shall collect data
and maintain records relating to the State program in a
standardized format specified by the Assistant
Secretary. The State shall furnish the records to the
Assistant Secretary, at such time as the Assistant
Secretary may require, in order to enable the Assistant
Secretary to monitor State program administration and
compliance, and to evaluate and compare the
effectiveness of the State programs.
(3) Reports.--The State shall prepare and submit to
the Assistant Secretary reports on the data and records
required under paragraph (2), including information on
the services funded under this part, and standards and
mechanisms, including caregiver assessments used in the
State, by which the quality of the services shall be
assured. The reports shall describe any mechanisms used
in the State to provide to persons who are family
caregivers, or older relative caregivers, information
about and access to various services so that the
persons can better carry out their care
responsibilities.
(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.
(f) Caregiver Allotment.--
(1) In general.--
(A) From sums appropriated under section
303(e) for a fiscal year, the Assistant
Secretary shall allot amounts among the States
proportionately based on the population of
individuals 70 years of age or older in the
States.
(B) In determining the amounts allotted to
States from the sums appropriated under section
303 for a fiscal year, the Assistant Secretary
shall first determine the amount allotted to
each State under subparagraph (A) and then
proportionately adjust such amounts, if
necessary, to meet the requirements of
paragraph (2).
(C) The number of individuals 70 years of age
or older in any State and in all States shall
be determined by the Assistant Secretary on the
basis of the most recent data available from
the Bureau of the Census and other reliable
demographic data satisfactory to the Assistant
Secretary.
(2) Minimum allotment.--
(A) The amounts allotted under paragraph (1)
shall be reduced proportionately to the extent
necessary to increase other allotments under
such paragraph to achieve the amounts described
in subparagraph (B).
(B)(i) Each State shall be allotted \1/2\ of
1 percent of the amount appropriated for the
fiscal year for which the determination is
made.
(ii) Guam and the Virgin Islands of the
United States shall each be allotted \1/4\ of 1
percent of the amount appropriated for the
fiscal year for which the determination is
made.
(iii) American Samoa and the Commonwealth of
the Northern Mariana Islands shall each be
allotted \1/16\ of 1 percent of the amount
appropriated for the fiscal year for which the
determination is made.
(C) For the purposes of subparagraph (B)(i),
the term ``State'' does not include Guam,
American Samoa, the Virgin Islands of the
United States, and the Commonwealth of the
Northern Mariana Islands.
(g) Availability of Funds.--
(1) Use of funds for administration of area plans.--
Amounts made available to a State to carry out the
State program under this part may be used, in addition
to amounts available in accordance with section
303(c)(1), for costs of administration of area plans.
(2) Federal share.--
(A) In general.--Notwithstanding section
304(d)(1)(D), the Federal share of the cost of
carrying out a State program under this part
shall be 75 percent.
(B) Non-federal share.--The non-Federal share
of the cost shall be provided from State and
local sources.
(C) Limitation.--A State may use not more
than 10 percent of the total Federal and non-
Federal share available to the State to provide
support services to older relative caregivers.
(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.
* * * * * * *
TITLE IV--ACTIVITIES FOR HEALTH, INDEPENDENCE, AND LONGEVITY
* * * * * * *
PART A--GRANT PROGRAMS
SEC. 411. PROGRAM AUTHORIZED.
(a) In General.--For the purpose of carrying out this
section, the Assistant Secretary may make grants to and enter
into contracts with States, public agencies, private nonprofit
agencies, institutions of higher education, and organizations,
including tribal organizations, for--
(1) education and training to develop an adequately
trained workforce to work with and on behalf of older
individuals;
(2) applied social research and analysis to improve
access to and delivery of services for older
individuals;
(3) evaluation of the performance of the programs,
activities, and services provided under this section;
(4) the development of methods and practices to
improve the quality and effectiveness of the programs,
services, and activities provided under this section;
(5) the demonstration of new approaches to design,
deliver, and coordinate programs and services for older
individuals;
(6) technical assistance in planning, developing,
implementing, and improving the programs, services, and
activities provided under this section;
(7) coordination with the designated State agency
described in section 101(a)(2)(A)(i) of the
Rehabilitation Act of 1973 (29 U.S.C. 721(a)(2)(A)(i))
to provide services to older individuals who are blind
as described in such Act;
(8) the training of graduate level professionals
specializing in the mental health needs of older
individuals;
(9) planning activities to prepare communities for
the aging of the population, which activities may
include--
(A) efforts to assess the aging population;
(B) activities to coordinate the activities
of State and local agencies in order to meet
the needs of older individuals; and
(C) training and technical assistance to
support States, area agencies on aging, and
organizations receiving grants under title VI,
in engaging in community planning activities;
(10) the development, implementation, and assessment
of technology-based service models and best practices,
to support the use of health monitoring and assessment
technologies, communication devices, assistive
technologies, and other technologies that may remotely
connect family and professional caregivers to frail
older individuals residing in home and community-based
settings or rural areas;
(11) conducting activities of national significance
to promote quality and continuous improvement in the
support provided to family and other informal
caregivers of older individuals through activities that
include program evaluation, training, technical
assistance, and research, including--
(A) programs addressing unique issues faced
by rural caregivers;
(B) programs focusing on the needs of older
individuals with cognitive impairment such as
Alzheimer's disease and related disorders with
neurological and organic brain dysfunction, and
their caregivers; and
(C) programs supporting caregivers in the
role they play in providing disease prevention
and health promotion services;
[(12) building public awareness of cognitive
impairments such as Alzheimer's disease and related
disorders with neurological and organic brain
dysfunction, depression, and mental disorders;]
(12) building public awareness of cognitive
impairments such as Alzheimer's disease and related
disorders with neurological and organic brain
dysfunction, depression, mental health disorders, and
traumatic brain injury;
(13) bringing to scale and sustaining evidence-based
falls prevention programs that 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;
[(13)] (15) continuing support for program integrity
initiatives concerning the Medicare program under title
XVIII of the Social Security Act (42 U.S.C. 1395 et
seq.) that train senior volunteers to prevent and
identify health care fraud and abuse; [and]
(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 and
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;
(17) the implementation 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;
(18) projects that address social isolation and
loneliness among older adults; and
[(14)] (19) any other activities that the Assistant
Secretary determines will achieve the objectives of
this section.
[(b) Authorization of Appropriations.--There are authorized
to be appropriated to carry out--
[(1) aging network support activities under this
section, $6,216,054 for fiscal year 2017, $6,346,048
for fiscal year 2018, and $6,476,043 for fiscal year
2019; and
[(2) elder rights support activities under this
section, $10,856,828 for fiscal year 2017, $11,083,873
for fiscal year 2018, and $11,310,919 for fiscal year
2019.]
(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.
* * * * * * *
[SEC. 416. TECHNICAL ASSISTANCE AND INNOVATION TO IMPROVE
TRANSPORTATION FOR OLDER INDIVIDUALS.
[(a) In General.--The Secretary may award grants or contracts
to nonprofit organizations to improve transportation services
for older individuals.
[(b) Use of Funds.--
[(1) In general.--A nonprofit organization receiving
a grant or contract under subsection (a) shall use the
funds received through such grant or contract to carry
out a demonstration project, or to provide technical
assistance to assist local transit providers, area
agencies on aging, senior centers, and local senior
support groups, to encourage and facilitate
coordination of Federal, State, and local
transportation services and resources for older
individuals. The organization may use the funds to
develop and carry out an innovative transportation
demonstration project to create transportation services
for older individuals.
[(2) Specific activities.--In carrying out a
demonstration project or providing technical assistance
under paragraph (1) the organization may carry out
activities that include--
[(A) developing innovative approaches for
improving access by older individuals to
transportation services, including volunteer
driver programs, economically sustainable
transportation programs, and programs that
allow older individuals to transfer their
automobiles to a provider of transportation
services in exchange for the services;
[(B) preparing information on transportation
options and resources for older individuals and
organizations serving such individuals, and
disseminating the information by establishing
and operating a toll-free telephone number;
[(C) developing models and best practices for
providing comprehensive integrated
transportation services for older individuals,
including services administered by the
Secretary of Transportation, by providing
ongoing technical assistance to agencies
providing services under title III and by
assisting in coordination of public and
community transportation services; and
[(D) providing special services to link older
individuals to transportation services not
provided under title III.
[(c) Economically Sustainable Transportation.--In this
section, the term ``economically sustainable transportation''
means demand responsive transportation for older individuals--
[(1) that may be provided through volunteers; and
[(2) that the provider will provide without receiving
Federal or other public financial assistance, after a
period of not more than 5 years of providing the
services under this section.]
SEC. 417. DEMONSTRATION, SUPPORT, AND RESEARCH PROJECTS FOR
MULTIGENERATIONAL AND CIVIC ENGAGEMENT ACTIVITIES.
[(a) Grants and Contracts.--The Assistant Secretary shall
award grants and enter into contracts with eligible
organizations to carry out projects to--
[(1) provide opportunities for older individuals to
participate in multigenerational activities and civic
engagement activities designed to meet critical
community needs, and use the full range of time,
skills, and experience of older individuals, including
demonstration and support projects that--
[(A) provide support for older relative
caregivers (as defined in section 372) raising
children (such as kinship navigator programs);
or
[(B) involve 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; and
[(2) coordinate multigenerational activities and
civic engagement activities, promote volunteerism, and
facilitate development of and participation in
multigenerational activities and civic engagement
activities.
[(b) Use of Funds.--An eligible organization shall use funds
made available under a grant awarded, or a contract entered
into, under this section to--
[(1) carry out a project described in subsection (a);
and
[(2) evaluate the project in accordance with
subsection (f).]
(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 family 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.
(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.
(c) 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).
[(c)] (d) Preference.--In awarding grants and entering into
contracts to carry out a project that serves individuals in
younger generations and older individuals described in
subsection (a), the Assistant Secretary shall give preference
to--
(1) eligible organizations with a demonstrated record
of carrying out, intent to carry out, or intent to
partner with local organizations or multiservice
organizations to carry out, multigenerational
activities or civic engagement activities;
(2) eligible organizations proposing
multigenerational activity projects that will serve
older individuals and communities with the greatest
need (with particular attention to low-income minority
individuals, older individuals with limited English
proficiency, older individuals residing in rural areas,
and low-income minority communities);
(3) eligible organizations proposing civic engagement
projects that will serve communities with the greatest
need[; and];
(4) eligible organizations with the capacity to
develop meaningful roles and assignments that use the
time, skills, and experience of older individuals to
serve public and nonprofit organizations[.]; and
(5) eligible organizations proposing
multigenerational activity projects that utilize shared
site programs, such as collocated child care and long-
term care facilities.
[(d)] (e) Application.--To be eligible to receive a grant or
enter into a contract under subsection (a), an organization
shall submit an application to the Assistant Secretary at such
time, in such manner, and accompanied by such information as
the Assistant Secretary may reasonably require.
[(e) Eligible Organizations.--Organizations eligible to
receive a grant or enter into a contract under subsection (a)--
[(1) to carry out activities described in subsection
(a)(1), shall be organizations that provide
opportunities for older individuals to participate in
activities described in subsection (a)(1); and
[(2) to carry out activities described in subsection
(a)(2), shall be organizations with the capacity to
conduct the coordination, promotion, and facilitation
described in subsection (a)(2), through the use of
multigenerational coordinators.]
(f) 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
(2) have the capacity to conduct the coordination,
promotion, and facilitation described in such
subsection through the use of multigenerational
coordinators.
[(g) Report to Congress.--Not later than 6 months after the
Assistant Secretary receives the reports described in
subsection (f)(2), the Assistant Secretary shall prepare and
submit to the Speaker of the House of Representatives and the
President pro tempore of the Senate a report that assesses the
evaluations and includes, at a minimum--
[(1) the names or descriptive titles of the projects
funded under subsection (a);
[(2) a description of the nature and operation of the
projects;
[(3) the names and addresses of organizations that
conducted the projects;
[(4) in the case of projects carried out under
subsection (a)(1), a description of the methods and
success of the projects in recruiting older individuals
as employees and as volunteers to participate in the
projects;
[(5) in the case of projects carried out under
subsection (a)(1), a description of the success of the
projects in retaining older individuals participating
in the projects as employees and as volunteers;
[(6) in the case of projects carried out under
subsection (a)(1), the rate of turnover of older
individual employees and volunteers in the projects;
[(7) a strategy for disseminating the findings
resulting from the projects described in paragraph (1);
and
[(8) any policy change recommendations relating to
the projects.]
[(f)] (g) Local Evaluation and Report.--
(1) Evaluation.--Each organization receiving a grant
or a contract under subsection (a) to carry out a
project described in subsection (a) shall evaluate the
multigenerational activities or civic engagement
activities carried out under the project to determine--
(A) the effectiveness of the activities
involved;
(B) the impact of such activities on the
community being served and the organization
providing the activities; and
(C) the impact of such activities on older
individuals involved in such project.
(2) Report.--The organization shall submit a report
to the Assistant Secretary containing the evaluation
not later than 6 months after the expiration of the
period for which the grant or contract is in effect.
(h) Definitions.--As used in this section:
(1) Multigenerational activity.--The term
``multigenerational activity'' means an activity that
provides an opportunity for interaction between 2 or
more individuals of different generations, including
activities connecting older individuals and youth in a
child care program, a youth day care program, an
educational assistance program, an at-risk youth
intervention program, a juvenile delinquency treatment
program, a before- or after-school program, a library
program, or a family support program.
(2) Multigenerational coordinator.--The term
``multigenerational coordinator'' means a person who--
(A) builds the capacity of public and
nonprofit organizations to develop meaningful
roles and assignments, that use the time,
skill, and experience of older individuals to
serve those organizations; and
(B) nurtures productive, sustainable working
relationships between--
(i) [individuals from the generations
with older individuals] older
individuals; and
(ii) individuals in younger
generations.
* * * * * * *
TITLE V--COMMUNITY SERVICE SENIOR OPPORTUNITIES ACT
* * * * * * *
SEC. 502. OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT PROGRAM.
(a) In General.--
(1) Establishment of program.--To foster individual
economic self-sufficiency and promote useful
opportunities in community service activities (which
shall include community service employment) for
unemployed low-income persons who are age 55 or older,
particularly persons who have poor employment
prospects, and to increase the number of persons who
may enjoy the benefits of unsubsidized employment in
both the public and private sectors, the Secretary of
Labor (referred to in this title as the ``Secretary'')
may establish an older American community service
employment program.
(2) Use of appropriated amounts.--Amounts
appropriated to carry out this title shall be used only
to carry out the provisions contained in this title.
(b) Grant Authority.--
(1) Projects.--To carry out this title, the Secretary
may make grants to public and nonprofit private
agencies and organizations, agencies of a State, and
tribal organizations to carry out the program
established under subsection (a). Such grants may
provide for the payment of costs, as provided in
subsection (c), of projects developed by such
organizations and agencies in cooperation with the
Secretary in order to make such program effective or to
supplement such program. The Secretary shall make the
grants from allotments made under section 506, and in
accordance with section 514. No payment shall be made
by the Secretary toward the cost of any project
established or administered by such an organization or
agency unless the Secretary determines that such
project--
(A) will provide community service employment
only for eligible individuals except for
necessary technical, administrative, and
supervisory personnel, and such personnel will,
to the fullest extent possible, be recruited
from among eligible individuals;
(B)(i) will provide community service
employment and other authorized activities for
eligible individuals in the community in which
such individuals reside, or in nearby
communities; or
(ii) if such project is carried out by a
tribal organization that receives a grant under
this subsection or receives assistance from a
State that receives a grant under this
subsection, will provide community service
employment and other authorized activities for
such individuals, including those who are
Indians residing on an Indian reservation, as
defined in section 2601 of the Energy Policy
Act of 1992 (25 U.S.C. 3501);
(C) will comply with an average participation
cap for eligible individuals (in the aggregate)
of--
(i) 27 months; or
(ii) pursuant to the request of a
grantee, an extended period of
participation established by the
Secretary for a specific project area
for such grantee, up to a period of not
more than 36 months, if the Secretary
determines that extenuating
circumstances exist relating to the
factors identified in section
513(a)(2)(E) that justify such an
extended period for the program year
involved;
(D) will employ eligible individuals in
service related to publicly owned and operated
facilities and projects, or projects sponsored
by nonprofit organizations (excluding political
parties exempt from taxation under section
501(c)(3) of the Internal Revenue Code of
1986), but excluding projects involving the
construction, operation, or maintenance of any
facility used or to be used as a place for
sectarian religious instruction or worship;
(E) will contribute to the general welfare of
the community, which may include support for
children, youth, and families;
(F) will provide community service employment
and other authorized activities for eligible
individuals;
(G)(i) will not reduce the number of
employment opportunities or vacancies that
would otherwise be available to individuals not
participating in the program;
(ii) will not displace currently employed
workers (including partial displacement, such
as a reduction in the hours of nonovertime
work, wages, or employment benefits);
(iii) will not impair existing contracts or
result in the substitution of Federal funds for
other funds in connection with work that would
otherwise be performed; and
(iv) will not employ or continue to employ
any eligible individual to perform the same
work or substantially the same work as that
performed by any other individual who is on
layoff;
(H) will coordinate activities with training
and other services provided under title I of
the Workforce Innovation and Opportunity Act,
including utilizing the one-stop delivery
system of the local workforce development areas
involved to recruit eligible individuals to
ensure that the maximum number of eligible
individuals will have an opportunity to
participate in the project;
(I) will include such training (such as work
experience, on-the-job training, and classroom
training) as may be necessary to make the most
effective use of the skills and talents of
those individuals who are participating, and
will provide for the payment of the reasonable
expenses of individuals being trained,
including a reasonable subsistence allowance
equivalent to the wage described in
subparagraph (J);
(J) will ensure that safe and healthy
employment conditions will be provided, and
will ensure that participants employed in
community service and other jobs assisted under
this title will be paid wages that shall not be
lower than whichever is the highest of--
(i) the minimum wage that would be
applicable to such a participant under
the Fair Labor Standards Act of 1938
(29 U.S.C. 201 et seq.), if section
6(a)(1) of such Act (29 U.S.C.
206(a)(1)) applied to the participant
and if the participant were not exempt
under section 13 of such Act (29 U.S.C.
213);
(ii) the State or local minimum wage
for the most nearly comparable covered
employment; or
(iii) the prevailing rates of pay for
individuals employed in similar public
occupations by the same employer;
(K) will be established or administered with
the advice of persons competent in the field of
service in which community service employment
or other authorized activities are being
provided, and of persons who are knowledgeable
about the needs of older individuals;
(L) will authorize payment for necessary
supportive services costs (including
transportation costs) of eligible individuals
that may be incurred in training in any project
funded under this title, in accordance with
rules issued by the Secretary;
(M) will ensure that, to the extent feasible,
such project will serve the needs of minority
and Indian eligible individuals, eligible
individuals with limited English proficiency,
and eligible individuals with greatest economic
need, at least in proportion to their numbers
in the area served and take into consideration
their rates of poverty and unemployment;
(N)(i) will prepare an assessment of the
participants' skills and talents and their
needs for services, except to the extent such
project has, for the participant involved,
recently prepared an assessment of such skills
and talents, and such needs, pursuant to
another employment or training program (such as
a program under the Workforce Innovation and
Opportunity Act (29 U.S.C. 3101 et seq.), the
Carl D. Perkins Career and Technical Education
Act of 2006 (20 U.S.C. 2301 et seq.), or part A
of title IV of the Social Security Act (42
U.S.C. 601 et seq.)) and will prepare a related
service strategy;
(ii) will provide training and employment
counseling to eligible individuals based on
strategies that identify appropriate employment
objectives and the need for supportive
services, developed as a result of the
assessment and service strategy provided for in
clause (i), and provide other appropriate
information regarding such project; and
(iii) will provide counseling to participants
on their progress in meeting such objectives
and satisfying their need for supportive
services;
(O) will provide appropriate services for
participants, or refer the participants to
appropriate services, through the one-stop
delivery system of the local workforce
development areas involved as established under
section 121(e) of the Workforce Innovation and
Opportunity Act, and will be involved in the
planning and operations of such system pursuant
to a memorandum of understanding with the local
workforce development board in accordance with
section 121(c) of such Act;
(P) will post in such project workplace a
notice, and will make available to each person
associated with such project a written
explanation--
(i) clarifying the law with respect
to political activities allowable and
unallowable under chapter 15 of title
5, United States Code, applicable to
the project and to each category of
individuals associated with such
project; and
(ii) containing the address and
telephone number of the Inspector
General of the Department of Labor, to
whom questions regarding the
application of such chapter may be
addressed;
(Q) will provide to the Secretary the
description and information described in--
(i) clauses (ii) and (viii) of
paragraph (2)(B), relating to
coordination with other Federal
programs, of section 102(b) of the
Workforce Innovation and Opportunity
Act; and
(ii) paragraph (2)(C)(i), relating to
implementation of one-stop delivery
systems, of section 102(b) of the
Workforce Innovation and Opportunity
Act; and
(R) will ensure that entities that carry out
activities under the project (including State
agencies, local entities, subgrantees, and
subcontractors) and affiliates of such entities
receive an amount of the administrative cost
allocation determined by the Secretary, in
consultation with grantees, to be sufficient.
(2) Regulations.--The Secretary may establish, issue,
and amend such regulations as may be necessary to
effectively carry out this title.
(3) Assessment and service strategies.--
(A) Prepared under this act.--An assessment
and service strategy required by paragraph
(1)(N) to be prepared for an eligible
individual shall satisfy any condition for an
assessment and service strategy or individual
employment plan for an adult participant under
subtitle B of title I of the Workforce
Innovation and Opportunity Act, in order to
determine whether such eligible individual also
qualifies for career or training services
described in section 134(c) of such Act.
(B) Prepared under workforce innovation and
opportunity Act.--An assessment and service
strategy or individual employment plan prepared
under subtitle B of title I of the Workforce
Innovation and Opportunity Act for an eligible
individual may be used to comply with the
requirement specified in subparagraph (A).
(c) Federal Share and Use of Funds.--
(1) Federal share.--The Secretary may pay a Federal
share not to exceed 90 percent of the cost of any
project for which a grant is made under subsection (b),
except that the Secretary may pay all of such cost if
such project is--
(A) an emergency or disaster project; or
(B) a project located in an economically
depressed area, as determined by the Secretary
in consultation with the Secretary of Commerce
and the Secretary of Health and Human Services.
(2) Non-federal share.--The non-Federal share shall
be in cash or in kind. In determining the amount of the
non-Federal share, the Secretary may attribute fair
market value to services and facilities contributed
from non-Federal sources.
(3) Use of funds for administrative costs.--Of the
grant amount to be paid under this subsection by the
Secretary for a project, not to exceed 13.5 percent
shall be available for any fiscal year to pay the
administrative costs of such project, except that--
(A) the Secretary may increase the amount
available to pay the administrative costs to an
amount not to exceed 15 percent of the grant
amount if the Secretary determines, based on
information submitted by the grantee under
subsection (b), that such increase is necessary
to carry out such project; and
(B) if the grantee under subsection (b)
demonstrates to the Secretary that--
(i) major administrative cost
increases are being incurred in
necessary program components, including
liability insurance, payments for
workers' compensation, costs associated
with achieving unsubsidized placement
goals, and costs associated with other
operation requirements imposed by the
Secretary;
(ii) the number of community service
employment positions in the project or
the number of minority eligible
individuals participating in the
project will decline if the amount
available to pay the administrative
costs is not increased; or
(iii) the size of the project is so
small that the amount of administrative
costs incurred to carry out the project
necessarily exceeds 13.5 percent of the
grant amount;
the Secretary shall increase the amount
available for such fiscal year to pay the
administrative costs to an amount not to exceed
15 percent of the grant amount.
(4) Administrative costs.--For purposes of this
title, administrative costs are the costs, both
personnel-related and nonpersonnel-related and both
direct and indirect, associated with the following:
(A) The costs of performing general
administrative functions and of providing for
the coordination of functions, such as the
costs of--
(i) accounting, budgeting, and
financial and cash management;
(ii) procurement and purchasing;
(iii) property management;
(iv) personnel management;
(v) payroll functions;
(vi) coordinating the resolution of
findings arising from audits, reviews,
investigations, and incident reports;
(vii) audits;
(viii) general legal services;
(ix) developing systems and
procedures, including information
systems, required for administrative
functions;
(x) preparing administrative reports;
and
(xi) other activities necessary for
the general administration of
government funds and associated
programs.
(B) The costs of performing oversight and
monitoring responsibilities related to
administrative functions.
(C) The costs of goods and services required
for administrative functions of the project
involved, including goods and services such as
rental or purchase of equipment, utilities,
office supplies, postage, and rental and
maintenance of office space.
(D) The travel costs incurred for official
business in carrying out administrative
activities or overall management.
(E) The costs of information systems related
to administrative functions (such as personnel,
procurement, purchasing, property management,
accounting, and payroll systems), including the
purchase, systems development, and operating
costs of such systems.
(F) The costs of technical assistance,
professional organization membership dues, and
evaluating results obtained by the project
involved against stated objectives.
(5) Non-federal share of administrative costs.--To
the extent practicable, an entity that carries out a
project under this title shall provide for the payment
of the expenses described in paragraph (4) from non-
Federal sources.
(6) Use of funds for wages and benefits and
programmatic activity costs.--
(A) In general.--Amounts made available for a
project under this title that are not used to
pay for the administrative costs shall be used
to pay for the costs of programmatic
activities, including the costs of--
(i) participant wages, such benefits
as are required by law (such as
workers' compensation or unemployment
compensation), the costs of physical
examinations, compensation for
scheduled work hours during which an
employer's business is closed for a
Federal holiday, and necessary sick
leave that is not part of an
accumulated sick leave program, except
that no amounts provided under this
title may be used to pay the cost of
pension benefits, annual leave,
accumulated sick leave, or bonuses;
(ii) participant training (including
the payment of reasonable costs of
instructors, classroom rental, training
supplies, materials, equipment, and
tuition), which may be provided prior
to or subsequent to placement and which
may be provided on the job, in a
classroom setting, or pursuant to other
appropriate arrangements;
(iii) job placement assistance,
including job development and job
search assistance;
(iv) participant supportive services
to enable a participant to successfully
participate in a project under this
title, which may include the payment of
reasonable costs of transportation,
health and medical services, special
job-related or personal counseling,
incidentals (such as work shoes,
badges, uniforms, eyeglasses, and
tools), child and adult care, temporary
shelter, and follow-up services; and
(v) outreach, recruitment and
selection, intake, orientation, and
assessments.
(B) Use of funds for wages and benefits.--
From the funds made available through a grant
made under subsection (b), a grantee under this
title--
(i) except as provided in clause
(ii), shall use not less than 75
percent of the grant funds to pay the
wages, benefits, and other costs
described in subparagraph (A)(i) for
eligible individuals who are employed
under projects carried out under this
title; or
(ii) that obtains approval for a
request described in subparagraph (C)
may use not less than 65 percent of the
grant funds to pay the wages, benefits,
and other costs described in
subparagraph (A)(i).
(C) Request to use additional funds for
programmatic activity costs.--
(i) In general.--A grantee may submit
to the Secretary a request for
approval--
(I) to use not less than 65
percent of the grant funds to
pay the wages, benefits, and
other costs described in
subparagraph (A)(i);
(II) to use the percentage of
grant funds described in
paragraph (3) to pay for
administrative costs, as
specified in that paragraph;
(III) to use not more than 10
percent of the grant funds for
individual participants to
provide activities described in
clauses (ii) and (iv) of
subparagraph (A), in which case
the grantee shall provide (from
the funds described in this
subclause) the subsistence
allowance described in
subsection (b)(1)(I) for those
individual participants who are
receiving training described in
that subsection from the funds
described in this subclause,
but may not use the funds
described in this subclause to
pay for any administrative
costs; and
(IV) to use the remaining
grant funds to provide
activities described in clauses
(ii) through (v) of
subparagraph (A).
(ii) Contents.--In submitting the
request the grantee shall include in
the request--
(I) a description of the
activities for which the
grantee will spend the grant
funds described in subclauses
(III) and (IV) of clause (i),
consistent with those
subclauses;
(II) an explanation
documenting how the provision
of such activities will improve
the effectiveness of the
project, including an
explanation concerning whether
any displacement of eligible
individuals or elimination of
positions for such individuals
will occur, information on the
number of such individuals to
be displaced and of such
positions to be eliminated, and
an explanation concerning how
the activities will improve
employment outcomes for
individuals served, based on
the assessment conducted under
subsection (b)(1)(N); and
(III) a proposed budget and
work plan for the activities,
including a detailed
description of the funds to be
spent on the activities
described in subclauses (III)
and (IV) of clause (i).
(iii) Submission.--The grantee shall
submit a request described in clause
(i) not later than 90 days before the
proposed date of implementation
contained in the request. Not later
than 30 days before the proposed date
of implementation, the Secretary shall
approve, approve as modified, or reject
the request, on the basis of the
information included in the request as
described in clause (ii).
(D) Report.--Each grantee under subsection
(b) shall annually prepare and submit to the
Secretary a report documenting the grantee's
use of funds for activities described in
clauses (i) through (v) of subparagraph (A).
(d) Project Description.--Whenever a grantee conducts a
project within a planning and service area and the local
workforce development board in a State, such grantee shall
conduct such project in consultation with the area agency on
aging of the planning and service area and shall submit to the
State agency, the local workforce development board, and the
area agency on aging a description of such project to be
conducted in the State, including the location of the project,
90 days prior to undertaking the project, for review and public
comment according to guidelines the Secretary shall issue to
assure efficient and effective coordination of projects under
this title.
(e) Pilot, Demonstration, and Evaluation Projects.--
(1) In general.--The Secretary, in addition to
exercising any other authority contained in this title,
shall use funds reserved under section 506(a)(1) to
carry out demonstration projects, pilot projects, and
evaluation projects, for the purpose of developing and
implementing techniques and approaches, and
demonstrating the effectiveness of the techniques and
approaches, in addressing the employment and training
needs of eligible individuals. The Secretary shall
enter into such agreements with States, public
agencies, nonprofit private organizations, or private
business concerns, as may be necessary, to conduct the
projects authorized by this subsection. To the extent
practicable, the Secretary shall provide an
opportunity, prior to the development of a
demonstration or pilot project, for the appropriate
area agency on aging to submit comments on such a
project in order to ensure coordination of activities
under this title.
(2) Projects.--Such projects may include--
(A) activities linking businesses and
eligible individuals, including activities
providing assistance to participants
transitioning from subsidized activities to
private sector employment;
(B) demonstration projects and pilot projects
designed to--
(i) attract more eligible individuals
into the labor force;
(ii) improve the provision of
services to eligible individuals under
one-stop delivery systems established
under section 121(e) of the Workforce
Innovation and Opportunity Act;
(iii) enhance the technological
skills of eligible individuals; [and]
(iv) provide incentives to grantees
under this title for exemplary
performance and incentives to
businesses to promote their
participation in the program under this
title; and
(v) attract, retain, and 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;
(C) demonstration projects and pilot
projects, as described in subparagraph (B), for
workers who are older individuals (but targeted
to eligible individuals) only if such
demonstration projects and pilot projects are
designed to assist in developing and
implementing techniques and approaches in
addressing the employment and training needs of
eligible individuals;
(D) provision of training and technical
assistance to support any project funded under
this title;
(E) dissemination of best practices relating
to employment of eligible individuals; and
(F) evaluation of the activities authorized
under this title.
(3) Consultation.--To the extent practicable,
entities carrying out projects under this subsection
shall consult with appropriate area agencies on aging,
with the State workforce development board and local
workforce development board, and with other appropriate
agencies and entities to promote coordination of
activities under this title.
SEC. 503. ADMINISTRATION.
(a) State Plan.--
(1) Governor.--For a State to be eligible to receive
an allotment under section 506, the Governor of the
State shall submit to the Secretary for consideration
and approval, a single State plan (referred to in this
title as the ``State plan'') that outlines a 4-year
strategy for the statewide provision of community
service employment and other authorized activities for
eligible individuals under this title. The plan shall
contain such provisions as the Secretary may require,
consistent with this title, including a description of
the process used to ensure the participation of
individuals described in paragraph (2). Not less often
than every 2 years, the Governor shall review the State
plan and submit an update to the State plan to the
Secretary for consideration and approval.
(2) Recommendations.--In developing the State plan
prior to its submission to the Secretary, the Governor
shall seek the advice and recommendations of--
(A) individuals representing the State agency
and the area agencies on aging in the State,
and the State and local workforce development
boards established under title I of the
Workforce Innovation and Opportunity Act;
(B) individuals representing public and
nonprofit private agencies and organizations
providing employment services, including each
grantee operating a project under this title in
the State; and
(C) individuals representing social service
organizations providing services to older
individuals, grantees under title III of this
Act, affected communities, unemployed older
individuals, community-based organizations
serving the needs of older individuals,
business organizations, and labor
organizations.
(3) Comments.--Any State plan submitted by the
Governor in accordance with paragraph (1) shall be
accompanied by copies of public comments relating to
the plan received pursuant to paragraph (8), and a
summary of the comments.
(4) Plan provisions.--The State plan shall identify
and address--
(A) the relationship that the number of
eligible individuals in each area bears to the
total number of eligible individuals,
respectively, in the State;
(B) the relative distribution of eligible
individuals residing in rural and urban areas
in the State; and
(C) the relative distribution of--
(i) eligible individuals who are
individuals with greatest economic
need;
(ii) eligible individuals who are
minority individuals;
(iii) eligible individuals who are
limited English proficient; [and]
(iv) eligible individuals who are
individuals with greatest social need;
and
(v) eligible individuals who have
been incarcerated or are under
supervision following the release from
prison or jail within the last 5 years;
(D) the current and projected employment
opportunities in the State (such as by
providing information available under section
15 of the Wagner-Peyser Act (29 U.S.C. 49l-2)
by occupation), and the type of skills
possessed by local eligible individuals;
(E) the localities and populations for which
projects of the type authorized by this title
are most needed; and
(F) how the activities of grantees in the
State under this title will be coordinated with
activities carried out in the State under title
I of the Workforce Innovation and Opportunity
Act (29 U.S.C. 3111 et seq.) and other related
programs (referred to in this subparagraph as
``WIOA and related activities''), and how the
State will reduce unnecessary duplication
between the activities carried out under this
title and the WIOA and related activities.
(5) Governor's recommendations.--Before a proposal
for a grant under this title for any fiscal year is
submitted to the Secretary, the Governor of the State
in which projects are proposed to be conducted under
such grant shall be afforded a reasonable opportunity
to submit to the Secretary--
(A) recommendations regarding the anticipated
effect of each such proposal upon the overall
distribution of enrollment positions under this
title in the State (including such distribution
among urban and rural areas), taking into
account the total number of positions to be
provided by all grantees in the State;
(B) any recommendations for redistribution of
positions to underserved areas as vacancies
occur in previously encumbered positions in
other areas; and
(C) in the case of any increase in funding
that may be available for use in the State
under this title for the fiscal year, any
recommendations for distribution of newly
available positions in excess of those
available during the preceding year to
underserved areas.
(6) Combined state plan.--In lieu of the plan
described in paragraph (1), a State may develop and
submit a combined State plan in accordance with section
103 of the Workforce Innovation and Opportunity Act (29
U.S.C. 3113). For a State that obtains approval of such
a combined State plan, that section 103 shall apply in
lieu of this subsection and a reference in any other
provision of this title (other than this subsection) to
a State plan shall be considered to be a reference to
that combined State plan.
(7) Disruptions.--In developing a plan or considering
a recommendation under this subsection, the Governor
shall avoid disruptions in the provision of services
for participants to the greatest possible extent.
(8) Determination; review.--
(A) Determination.--In order to effectively
carry out this title, each State shall make the
State plan available for public comment. The
Secretary, in consultation with the Assistant
Secretary, shall review the plan and make a
written determination with findings and a
decision regarding the plan.
(B) Review.--The Secretary may review, on the
Secretary's own initiative or at the request of
any public or private agency or organization or
of any agency of the State, the distribution of
projects and services under this title in the
State, including the distribution between urban
and rural areas in the State. For each proposed
reallocation of projects or services in a
State, the Secretary shall give notice and
opportunity for public comment.
(9) Exemption.--The grantees that serve eligible
individuals who are older Indians or Pacific Island and
Asian Americans with funds reserved under section
506(a)(3) may not be required to participate in the
State planning processes described in this section but
shall collaborate with the Secretary to develop a plan
for projects and services to eligible individuals who
are Indians or Pacific Island and Asian Americans,
respectively.
(b) Coordination With Other Federal Programs.--
(1) In general.--The Secretary and the Assistant
Secretary shall coordinate the program carried out
under this title with programs carried out under other
titles of this Act, to increase employment
opportunities available to older individuals.
(2) Programs.--
(A) In general.--The Secretary shall
coordinate programs carried out under this
title with the program carried out under the
Workforce Innovation and Opportunity Act, the
Community Services Block Grant Act (42 U.S.C.
9901 et seq.), the Rehabilitation Act of 1973
(29 U.S.C. 701 et seq.), the Carl D. Perkins
Career and Technical Education Act of 2006 (20
U.S.C. 2301 et seq.), the National and
Community Service Act of 1990 (42 U.S.C. 12501
et seq.), and the Domestic Volunteer Service
Act of 1973 (42 U.S.C. 4950 et seq.). The
Secretary shall coordinate the administration
of this title with the administration of other
titles of this Act by the Assistant Secretary
to increase the likelihood that eligible
individuals for whom employment opportunities
under this title are available and who need
services under such titles receive such
services.
(B) Use of funds.--
(i) Prohibition.--Funds appropriated
to carry out this title may not be used
to carry out any program under the
Workforce Innovation and Opportunity
Act, the Community Services Block Grant
Act, the Rehabilitation Act of 1973,
the Carl D. Perkins Career and
Technical Education Act of 2006, the
National and Community Service Act of
1990, or the Domestic Volunteer Service
Act of 1973.
(ii) Joint activities.--Clause (i)
shall not be construed to prohibit
carrying out projects under this title
jointly with programs, projects, or
activities under any Act specified in
clause (i), or from carrying out
section 511.
(3) Informational materials on age discrimination.--
The Secretary shall distribute to grantees under this
title, for distribution to program participants, and at
no cost to grantees or participants, informational
materials developed and supplied by the Equal
Employment Opportunity Commission and other appropriate
Federal agencies that the Secretary determines are
designed to help participants identify age
discrimination and to understand their rights under the
Age Discrimination in Employment Act of 1967 (29 U.S.C.
621 et seq.).
(c) Use of Services, Equipment, Personnel, and Facilities.--
In carrying out this title, the Secretary may use the services,
equipment, personnel, and facilities of Federal and other
agencies, with their consent, with or without reimbursement,
and on a similar basis cooperate with other public and
nonprofit private agencies and organizations in the use of
services, equipment, and facilities.
(d) Payments.--Payments under this title may be made in
advance or by way of reimbursement and in such installments as
the Secretary may determine.
(e) No Delegation of Functions.--The Secretary shall not
delegate any function of the Secretary under this title to any
other Federal officer or entity.
(f) Compliance.--
(1) Monitoring.--The Secretary shall monitor projects
for which grants are made under this title to determine
whether the grantees are complying with rules and
regulations issued to carry out this title (including
the statewide planning, consultation, and coordination
requirements of this title).
(2) Compliance with uniform cost principles and
administrative requirements.--Each grantee that
receives funds under this title shall comply with the
applicable uniform cost principles and appropriate
administrative requirements for grants and contracts
that are applicable to the type of entity that receives
funds, as issued as circulars or rules of the Office of
Management and Budget.
(3) Reports.--Each grantee described in paragraph (2)
shall prepare and submit a report in such manner and
containing such information as the Secretary may
require regarding activities carried out under this
title.
(4) Records.--Each grantee described in paragraph (2)
shall keep records that--
(A) are sufficient to permit the preparation
of reports required by this title;
(B) are sufficient to permit the tracing of
funds to a level of expenditure adequate to
ensure that the funds have not been spent
unlawfully; and
(C) contain any other information that the
Secretary determines to be appropriate.
(g) Evaluations.--The Secretary shall establish by rule and
implement a process to evaluate, in accordance with section
513, the performance of projects carried out and services
provided under this title. The Secretary shall report to
Congress, and make available to the public, the results of each
such evaluation and shall use such evaluation to improve
services delivered by, or the operation of, projects carried
out under this title.
* * * * * * *
SEC. 514. COMPETITIVE REQUIREMENTS RELATING TO GRANT AWARDS.
(a) Program Authorized.--
(1) Initial approval of grant applications.--From the
funds available for national grants under section
506(d), the Secretary shall award grants under section
502(b) to eligible applicants, through a competitive
process that emphasizes meeting performance
requirements, to carry out projects under this title
for a period of 4 years, except as provided in
paragraph (2). The Secretary may not conduct a grant
competition under this title until the day described in
section 513(e).
(2) Continuation of approval based on performance.--
If the recipient of a grant made under paragraph (1)
meets the expected levels of performance described in
section 513(d)(2)(A) for each year of such 4-year
period with respect to a project, the Secretary may
award a grant under section 502(b) to such recipient to
continue such project beyond such 4-year period for 1
additional year without regard to such process.
(b) Eligible Applicants.--An applicant shall be eligible to
receive a grant under section 502(b) in accordance with
subsections (a), (c), and (d).
(c) Criteria.--For purposes of subsection (a)(1), the
Secretary shall select the eligible applicants to receive
grants based on the following:
(1) The applicant's ability to administer a project
that serves the greatest number of eligible
individuals, giving particular consideration to
individuals with greatest economic need, individuals
with greatest social need, and individuals described in
subsection (a)(3)(B)(ii) or (b)(2) of section 518.
(2) The applicant's ability to administer a project
that provides employment for eligible individuals in
the communities in which such individuals reside, or in
nearby communities, that will contribute to the general
welfare of the communities involved.
(3) The applicant's ability to administer a project
that moves eligible individuals into unsubsidized
employment.
(4) The applicant's prior performance, if any, in
meeting core measures of performance under this title
and the applicant's ability to address core indicators
of performance under this title and under other Federal
or State programs in the case of an applicant that has
not previously received a grant under this title.
(5) The applicant's ability to move individuals with
multiple barriers to employment, including individuals
described in subsection (a)(3)(B)(ii) or (b)(2) of
section 518, into unsubsidized employment.
(6) The applicant's ability to coordinate activities
with other organizations at the State and local level.
(7) The applicant's plan for fiscal management of the
project to be administered with funds received in
accordance with this section.
(8) The applicant's ability to administer a project
that provides community service.
(9) The applicant's ability to minimize disruption in
services for participants and in community services
provided.
(10) Any additional criteria that the Secretary
considers to be appropriate in order to minimize
disruption in services for participants.
(d) Responsibility Tests.--
(1) In general.--Before final selection of a grantee,
the Secretary shall conduct a review of available
records to assess the applicant's overall
responsibility to administer Federal funds.
(2) Review.--As part of the review described in
paragraph (1), the Secretary may consider any
information, including the applicant's history with
regard to the management of other grants.
(3) Failure to satisfy test.--The failure to satisfy
a responsibility test with respect to any 1 factor that
is listed in paragraph (4), excluding those listed in
subparagraphs (A) and (B) of such paragraph, does not
establish that the applicant is not responsible unless
such failure is substantial or persists for 2 or more
consecutive years.
(4) Test.--The responsibility tests include review of
the following factors:
(A) Unsuccessful efforts by the applicant to
recover debts, after 3 demand letters have been
sent, that are established by final agency
action, or a failure to comply with an approved
repayment plan.
(B) Established fraud or criminal activity of
a significant nature within the organization or
agency involved.
(C) Serious administrative deficiencies
identified by the Secretary, such as failure to
maintain a financial management system as
required by Federal rules or regulations.
(D) Willful obstruction of the audit process.
(E) Failure to provide services to
participants for a current or recent grant or
to meet applicable core measures of performance
or address applicable indicators of
performance.
(F) Failure to correct deficiencies brought
to the grantee's attention in writing as a
result of monitoring activities, reviews,
assessments, or other activities.
(G) Failure to return a grant closeout
package or outstanding advances within 90 days
of the grant expiration date or receipt of the
closeout package, whichever is later, unless an
extension has been requested and granted.
(H) Failure to submit required reports.
(I) Failure to properly report and dispose of
Government property as instructed by the
Secretary.
(J) Failure to have maintained effective cash
management or cost controls resulting in excess
cash on hand.
(K) Failure to ensure that a subrecipient
complies with its Office of Management and
Budget Circular A-133 audit requirements
specified at section 667.200(b) of title 20,
Code of Federal Regulations.
(L) Failure to audit a subrecipient within
the required period.
(M) Final disallowed costs in excess of 5
percent of the grant or contract award if, in
the judgment of the grant officer, the
disallowances are egregious.
(N) Failure to establish a mechanism to
resolve a subrecipient's audit in a timely
fashion.
(5) Determination.--Applicants that are determined to
be not responsible shall not be selected as grantees.
(6) Disallowed costs.--Interest on disallowed costs
shall accrue in accordance with the Debt Collection
Improvement Act of 1996, including the amendments made
by that Act.
(e) Grantees Serving Individuals With Barriers to
Employment.--
(1) Definition.--In this subsection, the term
``individuals with barriers to employment'' means
minority individuals, Indian individuals, individuals
with greatest economic need, older individuals who have
been incarcerated or are under supervision following
the release from prison or jail, and individuals
described in subsection (a)(3)(B)(ii) or (b)(2) of
section 518.
(2) Special consideration.--In areas where a
substantial population of individuals with barriers to
employment exists, a grantee that receives a national
grant in accordance with this section shall, in
selecting subgrantees, give special consideration to
organizations (including former recipients of such
national grants) with demonstrated expertise in serving
individuals with barriers to employment.
(f) Minority-Serving Grantees.--The Secretary may not
promulgate rules or regulations affecting grantees in areas
where a substantial population of minority individuals exists,
that would significantly compromise the ability of the grantees
to serve their targeted population of minority older
individuals.
* * * * * * *
SEC. 517. AUTHORIZATION OF APPROPRIATIONS.
[(a) In General.--There are authorized to be appropriated to
carry out this title $445,189,405 for fiscal year 2017,
$454,499,494 for fiscal year 2018, and $463,809,605 for fiscal
year 2019.]
(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.
(b) Obligation.--Amounts appropriated under this section for
any fiscal year shall be available for Federal obligation
during the annual period that begins on April 1 of the calendar
year immediately following the beginning of such fiscal year
and that ends on June 30 of the following calendar year. Such
amounts obligated to grantees shall be available for obligation
and expenditure by grantees during the program year that begins
on July 1 of the calendar year immediately following the
beginning of the fiscal year in which the amounts are
appropriated and that ends on June 30 of the following calendar
year. The Secretary may extend the period during which such
amounts may be obligated or expended in the case of a
particular organization or agency that receives funds under
this title if the Secretary determines that such extension is
necessary to ensure the effective use of such funds by such
organization or agency.
(c) Recapturing Funds.--At the end of the program year, the
Secretary may recapture any unexpended funds for the program
year, and reobligate such funds within the 2 succeeding program
years for--
(1) incentive grants to entities that are State
grantees or national grantees under section 502(b);
(2) technical assistance; or
(3) grants or contracts for any other activity under
this title.
SEC. 518. DEFINITIONS AND RULE.
(a) Definitions.--For purposes of this title:
(1) Community service.--The term ``community
service'' means--
(A) social, health, welfare, and educational
services (including literacy tutoring), legal
and other counseling services and assistance,
including tax counseling and assistance and
financial counseling, and library,
recreational, and other similar services;
(B) conservation, maintenance, or restoration
of natural resources;
(C) community betterment or beautification;
(D) antipollution and environmental quality
efforts;
(E) weatherization activities;
(F) economic development; and
(G) such other services essential and
necessary to the community as the Secretary
determines by rule to be appropriate.
(2) Community service employment.--The term
``community service employment'' means part-time,
temporary employment paid with grant funds in projects
described in section 502(b)(1)(D), through which
eligible individuals are engaged in community service
and receive work experience and job skills that can
lead to unsubsidized employment.
(3) Eligible individual.--
(A) In general.--The term ``eligible
individual'' means an individual who is age 55
or older and who has a low income (including
any such individual whose income is not more
than 125 percent of the poverty line),
excluding any income that is unemployment
compensation, a benefit received under title
XVI of the Social Security Act (42 U.S.C. 1381
et seq.), a payment made to or on behalf of
veterans or former members of the Armed Forces
under the laws administered by the Secretary of
Veterans Affairs, or 25 percent of a benefit
received under title II of the Social Security
Act (42 U.S.C. 401 et seq.), subject to
subsection (b).
(B) Participation.--
(i) Exclusion.--Notwithstanding any
other provision of this paragraph, the
term ``eligible individual'' does not
include an individual who has
participated in projects under this
title for a period of 48 months in the
aggregate (whether or not consecutive)
after July 1, 2007, unless the period
was increased as described in clause
(ii).
(ii) Increased periods of
participation.--The Secretary shall
authorize a grantee for a project to
increase the period of participation
described in clause (i), pursuant to a
request submitted by the grantee, for
individuals who--
(I) have a severe disability;
(II) are frail or are age 75
or older;
(III) meet the eligibility
requirements related to age
for, but do not receive,
benefits under title II of the
Social Security Act (42 U.S.C.
401 et seq.);
(IV) live in an area with
persistent unemployment and are
individuals with severely
limited employment prospects;
[or]
(V) have limited English
proficiency or low literacy
skills[.]; or
(VI) have been incarcerated
or are under supervision
following the release from
prison or jail within the last
5 years.
(4) Income.--In this section, the term ``income''
means income received during the 12-month period (or,
at the option of the grantee involved, the annualized
income for the 6-month period) ending on the date an
eligible individual submits an application to
participate in a project carried out under this title
by such grantee.
(5) Local workforce development board; state
workforce development board.--The terms ``local
workforce development board'' and ``State workforce
development board'' have the meanings given the terms
``local board'' and ``State board'', respectively, in
section 3 of the Workforce Innovation and Opportunity
Act (29 U.S.C. 3102).
(6) Pacific island and asian americans.--The term
``Pacific Island and Asian Americans'' means Americans
having origins in any of the original peoples of the
Far East, Southeast Asia, the Indian Subcontinent, or
the Pacific Islands.
(7) Program.--The term ``program'' means the older
American community service employment program
established under this title.
(8) Supportive services.--The term ``supportive
services'' means services, such as transportation,
child care, dependent care, housing, and needs-related
payments, that are necessary to enable an individual to
participate in activities authorized under this title,
consistent with the provisions of this title.
(9) Unemployed.--The term ``unemployed'', used with
respect to a person or individual, means an individual
who is without a job and who wants and is available for
work, including an individual who may have occasional
employment that does not result in a constant source of
income.
(b) Rule.--Pursuant to regulations prescribed by the
Secretary, an eligible individual shall have priority for the
community service employment and other authorized activities
provided under this title if the individual--
(1) is 65 years of age or older; or
(2)(A) has a disability;
(B) has limited English proficiency or low literacy
skills;
(C) resides in a rural area;
(D) is a veteran;
(E) has low employment prospects;
(F) has failed to find employment after utilizing
services provided under title I of the Workforce
Innovation and Opportunity Act; [or]
(G) is homeless or at risk for homelessness[.]; or
(H) has been incarcerated or is under supervision
following the release from prison or jail within the
last 5 years.
TITLE VI--GRANTS FOR NATIVE AMERICANS
* * * * * * *
Part A--Indian Program
findings
Sec. 611. [(a)] The Congress finds that the older individuals
who are Indians of the United States--
(1) are a rapidly increasing population;
(2) suffer from high unemployment;
(3) live in poverty at a rate estimated to be as high
as 61 percent;
(4) have a life expectancy between 3 and 4 years less
than the general population;
(5) lack sufficient nursing homes, other long-term
care facilities, and other health care facilities;
(6) lack sufficient Indian area agencies on aging;
(7) frequently live in substandard and over-crowded
housing;
(8) receive less than adequate health care;
(9) are served under this title at a rate of less
than 19 percent of the total national population of
older individuals who are Indians living on Indian
reservations; and
(10) are served under title III at a rate of less
than 1 percent of the total participants under that
title.
* * * * * * *
applications
Sec. 614. (a) No grant may be made under this part unless the
eligible tribal organization submits an application to the
Assistant Secretary which meets such criteria as the Assistant
Secretary may by regulation prescribe. Each such application
shall--
(1) provide that the eligible tribal organization
will evaluate the need for supportive and nutrition
services among older individuals who are Indians to be
represented by the tribal organizations;
(2) provide for the use of such methods of
administration as are necessary for the proper and
efficient administration of the program to be assisted;
(3) provide that the tribal organization will make
such reports in such form and containing such
information, as the Assistant Secretary may reasonably
require, and comply with such requirements as the
Assistant Secretary may impose to assure the
correctness of such reports;
(4) provide for periodic evaluation of activities and
projects carried out under the application;
(5) establish objectives consistent with the purposes
of this part toward which activities under the
application will be directed, identify obstacles to the
attainment of such objectives, and indicate the manner
in which the tribal organization proposes to overcome
such obstacles;
(6) provide for establishing and maintaining
information and assistance services to assure that
older individuals who are Indians to be served by the
assistance made available under this part will have
reasonably convenient access to such services;
(7) provide a preference for older individuals who
are Indians for full or part-time staff positions
whenever feasible;
(8) provide assistance that either directly or by way
of grant or contract with appropriate entities
nutrition services will be delivered to older
individuals who are Indians represented by the tribal
organization substantially in compliance with the
provisions of part C of title III, except that in any
case in which the need for nutritional services for
older individuals who are Indians represented by the
tribal organization is already met from other sources,
the tribal organization may use the funds otherwise
required to be expended under this paragraph for
supportive services;
(9) provide that any legal or ombudsman services made
available to older individuals who are Indians
represented by the tribal organization will be
substantially in compliance with the provisions of
title III relating to the furnishing of similar
services;
(10) provide satisfactory assurance that fiscal
control and fund accounting procedures will be adopted
as may be necessary to assure proper disbursement of,
and accounting for, Federal funds paid under this part
to the tribal organization, including any funds paid by
the tribal organization to a recipient of a grant or
contract; and
(11) contain assurances that the tribal organization
will coordinate services provided under this part with
services provided under title III in the same
geographical area.
(b) For the purpose of any application submitted under this
part, the tribal organization may develop its own population
statistics, with approval from the Bureau of Indian Affairs, in
order to establish eligibility.
(c)(1) The Assistant Secretary shall approve any application
which complies with the provisions of subsection (a).
(2) The Assistant Secretary shall provide waivers and
exemptions of the reporting requirements of subsection (a)(3)
for applicants that serve Indian populations in geographically
isolated areas, or applicants that serve small Indian
populations, where the small scale of the project, the nature
of the applicant, or other factors make the reporting
requirements unreasonable under the circumstances. The
Assistant Secretary shall consult with such applicants in
establishing appropriate waivers and exemptions.
(3) The Assistant Secretary shall approve any application
that complies with the provisions of subsection (a), except
that in determining whether an application complies with the
requirements of subsection (a)(8), the Assistant Secretary
shall provide maximum flexibility to an applicant that seeks to
take into account subsistence needs, local customs, and other
characteristics that are appropriate to the unique cultural,
regional, and geographic needs of the Indian populations to be
served.
(4) In determining whether an application complies with the
requirements of subsection [(a)(12)] (a)(11), the Assistant
Secretary shall require only that an applicant provide an
appropriate narrative description of the geographic area to be
served and an assurance that procedures will be adopted to
ensure against duplicate services being provided to the same
recipients.
(d) Whenever the Assistant Secretary determines not to
approve an application submitted under subsection (a) the
Assistant Secretary shall--
(1) state objections in writing to the tribal
organization within 60 days after such decision;
(2) provide to the extent practicable technical
assistance to the tribal organization to overcome such
stated objections; and
(3) provide the tribal organization with a hearing,
under such rules and regulations as the Assistant
Secretary may prescribe.
(e) Whenever the Assistant Secretary approves an application
of a tribal organization under this part, funds shall be
awarded for not less than 12 months.
* * * * * * *
PART D--SUPPORTIVE SERVICES FOR HEALTHY AGING AND INDEPENDENCE
SEC. 636. PROGRAM.
(a) In General.--The Assistant Secretary shall carry out a
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 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.
Part [D] E--General Provisions
administration
Sec. 641. In establishing regulations for the purpose of part
A the Assistant Secretary shall consult with the Secretary of
the Interior.
payments
Sec. 642. Payments may be made under this title (after
necessary adjustments, in the case of grants, on account of
previously made overpayments or underpayments) in advance or by
way of reimbursement in such installments and on such
conditions as the Assistant Secretary may determine.
[SEC. 643. AUTHORIZATION OF APPROPRIATIONS.
[There are authorized to be appropriated to carry out this
title--
[(1) for parts A and B, $31,934,018 for fiscal year
2017, $32,601,843 for fiscal year 2018, and $33,269,670
for fiscal year 2019; and
[(2) for part C, $6,500,000 for fiscal year 2007,
$6,800,000 for fiscal year 2008, $7,200,000 for fiscal
year 2009, $7,500,000 for fiscal year 2010, and
$7,900,000 for fiscal year 2011.]
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.
SEC. 644. FUNDING SET ASIDE.
Of the funds appropriated under section 643(1) for a fiscal
year, 5 percent shall be made available to carry out part D for
such fiscal year.
TITLE VII--ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES
Subtitle A--State Provisions
CHAPTER 1--GENERAL STATE PROVISIONS
* * * * * * *
[SEC. 702. AUTHORIZATION OF APPROPRIATIONS.
[(a) Ombudsman Program.--There are authorized to be
appropriated to carry out chapter 2, $16,280,630 for fiscal
year 2017, $16,621,101 for fiscal year 2018, and $16,961,573
for fiscal year 2019.
[(b) Other Programs.--There are authorized to be appropriated
to carry out chapters 3 and 4, $4,891,876 for fiscal year 2017,
$4,994,178 for fiscal year 2018, and $5,096,480 for fiscal year
2019.]
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.
* * * * * * *
CHAPTER 2--OMBUDSMAN PROGRAMS
SEC. 711. DEFINITIONS.
As used in this chapter:
(1) Office.--The term ``Office'' means the office
established in section 712(a)(1)(A).
(2) Ombudsman.--The term ``Ombudsman'' means the
individual described in section 712(a)(2).
(3) Local ombudsman entity.--The term ``local
Ombudsman entity'' means an entity designated under
section 712(a)(5)(A) to carry out the duties described
in section 712(a)(5)(B) with respect to a planning and
service area or other substate area.
(4) Program.--The term ``program'' means the State
Long-Term Care Ombudsman program established in section
712(a)(1)(B).
(5) Representative.--The term ``representative''
includes an employee or volunteer who represents an
entity designated under section 712(a)(5)(A) and who is
individually designated by the Ombudsman.
(6) Resident.--The term ``resident'' means an
individual of any age who resides in a long-term care
facility.
* * * * * * *
SEC. 712. STATE LONG-TERM CARE OMBUDSMAN PROGRAM.
(a) Establishment.--
(1) In general.--In order to be eligible to receive
an allotment under section 703 from funds appropriated
under section 702 and made available to carry out this
chapter, a State agency shall, in accordance with this
section--
(A) establish and operate an Office of the
State Long-Term Care Ombudsman; and
(B) carry out through the Office a State
Long-Term Care Ombudsman program.
(2) Ombudsman.--The Office shall be headed by an
individual, to be known as the State Long-Term Care
Ombudsman, who shall be selected from among individuals
with expertise and experience in the fields of long-
term care and advocacy. The Ombudsman shall be
responsible for the management, including the fiscal
management, of the Office.
(3) Functions.--The Ombudsman shall serve on a full-
time basis, and shall, personally or through
representatives of the Office--
(A) identify, investigate, and resolve
complaints that--
(i) are made by, or on behalf of,
residents, including residents with
limited or no decisionmaking capacity
and who have no known legal
representative, and if such a resident
is unable to communicate consent for an
Ombudsman to work on a complaint
directly involving the resident, the
Ombudsman shall seek evidence to
indicate what outcome the resident
would have communicated (and, in the
absence of evidence to the contrary,
shall assume that the resident wishes
to have the resident's health, safety,
welfare, and rights protected) and
shall work to accomplish that outcome;
and
(ii) relate to action, inaction, or
decisions, that may adversely affect
the health, safety, welfare, or rights
of the residents (including the welfare
and rights of the residents with
respect to the appointment and
activities of guardians and
representative payees), of--
(I) providers, or
representatives of providers,
of long-term care services;
(II) public agencies; or
(III) health and social
service agencies;
(B) provide services to assist the residents
in protecting the health, safety, welfare, and
rights of the residents;
(C) inform the residents about means of
obtaining services provided by providers or
agencies described in subparagraph (A)(ii) or
services described in subparagraph (B);
(D) ensure that the residents have regular,
timely, private, and unimpeded access to the
services provided through the Office and that
the residents and complainants receive timely
responses from representatives of the Office to
complaints;
(E) represent the interests of the residents
before governmental agencies and seek
administrative, legal, and other remedies to
protect the health, safety, welfare, and rights
of the residents;
(F) provide administrative and technical
assistance to entities designated under
paragraph (5) to assist the entities in
participating in the program;
(G)(i) analyze, comment on, and monitor the
development and implementation of Federal,
State, and local laws, regulations, and other
governmental policies and actions, that pertain
to the health, safety, welfare, and rights of
the residents, with respect to the adequacy of
long-term care facilities and services in the
State;
(ii) recommend any changes in such laws,
regulations, policies, and actions as the
Office determines to be appropriate; and
(iii) facilitate public comment on the laws,
regulations, policies, and actions;
(H)(i) provide for training representatives
of the Office;
(ii) promote the development of citizen
organizations, to participate in the program;
and
(iii) provide technical support for, actively
encourage, and assist in the development of
resident and family councils to protect the
well-being and rights of residents;
(I) when feasible, continue to carry out the
functions described in this section on behalf
of residents transitioning from a long-term
care facility to a home care setting; and
(J) carry out such other activities as the
Assistant Secretary determines to be
appropriate.
(4) Contracts and arrangements.--
(A) In general.--Except as provided in
subparagraph (B), the State agency may
establish and operate the Office, and carry out
the program, directly, or by contract or other
arrangement with any public agency or nonprofit
private organization.
(B) Licensing and certification
organizations; associations.--The State agency
may not enter into the contract or other
arrangement described in subparagraph (A)
with--
(i) an agency or organization that is
responsible for licensing or certifying
long-term care services in the State;
or
(ii) an association (or an affiliate
of such an association) of long-term
care facilities, or of any other
residential facilities for older
individuals.
(5) Designation of local ombudsman entities and
representatives.--
(A) Designation.--In carrying out the duties
of the Office, the Ombudsman may designate an
entity as a local Ombudsman entity, and may
designate an employee or volunteer to represent
the entity.
(B) Duties.--An individual so designated
shall, in accordance with the policies and
procedures established by the Office and the
State agency--
(i) provide services to protect the
health, safety, welfare and rights of
residents;
(ii) ensure that residents in the
service area of the entity have
regular, timely access to
representatives of the program and
timely responses to complaints and
requests for assistance;
(iii) identify, investigate, and
resolve complaints made by or on behalf
of residents that relate to action,
inaction, or decisions, that may
adversely affect the health, safety,
welfare, or rights of the residents;
(iv) represent the interests of
residents before government agencies
and seek administrative, legal, and
other remedies to protect the health,
safety, welfare, and rights of the
residents;
(v)(I) review, and if necessary,
comment on any existing and proposed
laws, regulations, and other government
policies and actions, that pertain to
the rights and well-being of residents;
and
(II) facilitate the ability of the
public to comment on the laws,
regulations, policies, and actions;
(vi) support, actively encourage, and
assist in the development of resident
and family councils;
(vii) identify, investigate, and
resolve complaints described in clause
(iii) that are made by or on behalf of
residents with limited or no
decisionmaking capacity and who have no
known legal representative, and if such
a resident is unable to communicate
consent for an Ombudsman to work on a
complaint directly involving the
resident, the Ombudsman shall seek
evidence to indicate what outcome the
resident would have communicated (and,
in the absence of evidence to the
contrary, shall assume that the
resident wishes to have the resident's
health, safety, welfare, and rights
protected) and shall work to accomplish
that outcome; and
(viii) carry out other activities
that the Ombudsman determines to be
appropriate.
(C) Eligibility for designation.--Entities
eligible to be designated as local Ombudsman
entities, and individuals eligible to be
designated as representatives of such entities,
shall--
(i) have demonstrated capability to
carry out the responsibilities of the
Office;
(ii) be free of conflicts of interest
and not stand to gain financially
through an action or potential action
brought on behalf of individuals the
Ombudsman serves;
(iii) in the case of the entities, be
public or nonprofit private entities;
and
(iv) meet such additional
requirements as the Ombudsman may
specify.
(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.
[(D)] (E) Policies and procedures.--
(i) In general.--The State agency
shall establish, in accordance with the
Office, policies and procedures for
monitoring local Ombudsman entities
designated to carry out the duties of
the Office.
(ii) Policies.--In a case in which
the entities are grantees, or the
representatives are employees, of area
agencies on aging, the State agency
shall develop the policies in
consultation with the area agencies on
aging. The policies shall provide for
participation and comment by the
agencies and for resolution of concerns
with respect to case activity.
(iii) Confidentiality and
disclosure.--The State agency shall
develop the policies and procedures in
accordance with all provisions of this
subtitle regarding confidentiality and
conflict of interest.
(b) Procedures for Access.--
(1) In general.--The State shall ensure that
representatives of the Office shall have--
(A) private and unimpeded access to long-term
care facilities and residents;
(B)(i) appropriate access to review all
files, records, and other information
concerning a resident, if--
(I) the representative has the
permission of the resident, or the
legal representative of the resident;
or
(II) the resident is unable to
communicate consent to the review and
has no legal representative; or
(ii) access to the files, records, and
information as is necessary to investigate a
complaint if--
(I) a legal guardian of the resident
refuses to give the permission;
(II) a representative of the Office
has reasonable cause to believe that
the guardian is not acting in the best
interests of the resident; and
(III) the representative obtains the
approval of the Ombudsman;
(C) access to the administrative records,
policies, and documents, to which the residents
have, or the general public has access, of
long-term care facilities; and
(D) access to and, on request, copies of all
licensing and certification records maintained
by the State with respect to long-term care
facilities.
(2) Procedures.--The State agency shall establish
procedures to ensure the access described in paragraph
(1).
(3) Health oversight agency.--For purposes of section
264(c) of the Health Insurance Portability and
Accountability Act of 1996 (including regulations
issued under that section) (42 U.S.C. 1320d-2 note),
the Ombudsman and a representative of the Office shall
be considered a ``health oversight agency,'' so that
release of residents' individually identifiable health
information to the Ombudsman or representative is not
precluded in cases in which the requirements of clause
(i) or (ii) of paragraph (1)(B), or the requirements of
paragraph (1)(D), are otherwise met.
(c) Reporting System.--The State agency shall establish a
statewide uniform reporting system to--
(1) collect and analyze data relating to complaints
and conditions in long-term care facilities and to
residents for the purpose of identifying and resolving
significant problems; and
(2) submit the data, on a regular basis, to--
(A) the agency of the State responsible for
licensing or certifying long-term care
facilities in the State;
(B) other State and Federal entities that the
Ombudsman determines to be appropriate;
(C) the Assistant Secretary; and
(D) the National Ombudsman Resource Center
established in section 202(a)(18).
(d) Disclosure.--
(1) In general.--The State agency shall establish
procedures for the disclosure by the Ombudsman or local
Ombudsman entities of files, records, and other
information maintained by the program, including
records described in subsection (b)(1) or (c).
(2) Identity of complainant or resident.--The
procedures described in paragraph (1) shall--
(A) provide that, subject to subparagraph
(B), the files, records, and other information
described in paragraph (1) may be disclosed
only at the discretion of the Ombudsman (or the
person designated by the Ombudsman to disclose
the files, records, and other information);
(B) prohibit the disclosure of the identity
of any complainant or resident with respect to
whom the Office maintains such files, records,
or other information unless--
(i) the complainant or resident, or
the legal representative of the
complainant or resident, consents to
the disclosure and the consent is given
in writing;
(ii)(I) the complainant or resident
gives consent orally; and
(II) the consent is documented
contemporaneously in a writing made by
a representative of the Office in
accordance with such requirements as
the State agency shall establish; or
(iii) the disclosure is required by
court order; and
(C) notwithstanding subparagraph (B), ensure
that the Ombudsman may disclose information as
needed in order to best serve residents with
limited or no decisionmaking capacity who have
no known legal representative and are unable to
communicate consent, in order for the Ombudsman
to carry out the functions and duties described
in paragraphs (3)(A) and (5)(B) of subsection
(a).
(e) Consultation.--In planning and operating the program, the
State agency shall consider the views of area agencies on
aging, older individuals, and providers of long-term care.
(f) Conflict of Interest.--
(1) Individual conflict of interest.--The State
agency shall--
(A) ensure that no individual, or member of
the immediate family of an individual, involved
in the designation of the Ombudsman (whether by
appointment or otherwise) or the designation of
an entity designated under subsection (a)(5),
is subject to a conflict of interest;
(B) ensure that no officer or employee of the
Office, representative of a local Ombudsman
entity, or member of the immediate family of
the officer, employee, or representative, is
subject to a conflict of interest; and
(C) ensure that the Ombudsman--
(i) does not have a direct
involvement in the licensing or
certification of a long-term care
facility or of a provider of a long-
term care service;
(ii) does not have an ownership or
investment interest (represented by
equity, debt, or other financial
relationship) in a long-term care
facility or a long-term care service;
(iii) is not employed by, or
participating in the management of, a
long-term care facility or a related
organization, and has not been employed
by such a facility or organization
within 1 year before the date of the
determination involved;
(iv) does not receive, or have the
right to receive, directly or
indirectly, remuneration (in cash or in
kind) under a compensation arrangement
with an owner or operator of a long-
term care facility;
(v) does not have management
responsibility for, or operate under
the supervision of an individual with
management responsibility for, adult
protective services; and
(vi) does not serve as a guardian or
in another fiduciary capacity for
residents of long-term care facilities
in an official capacity (as opposed to
serving as a guardian or fiduciary for
a family member, in a personal
capacity).
(2) Organizational conflict of interest.--
(A) In general.--The State agency shall
comply with subparagraph (B)(i) in a case in
which the Office poses an organizational
conflict of interest, including a situation in
which the Office is placed in an organization
that--
(i) is responsible for licensing,
certifying, or surveying long-term care
services in the State;
(ii) is an association (or an
affiliate of such an association) of
long-term care facilities, or of any
other residential facilities for older
individuals;
(iii) provides long-term care
services, including programs carried
out under a Medicaid waiver approved
under section 1115 of the Social
Security Act (42 U.S.C. 1315) or under
subsection (b) or (c) of section 1915
of the Social Security Act (42 U.S.C.
1396n), or under a Medicaid State plan
amendment under subsection (i), (j), or
(k) of section 1915 of the Social
Security Act (42 U.S.C. 1396n);
(iv) provides long-term care case
management;
(v) sets rates for long-term care
services;
(vi) provides adult protective
services;
(vii) is responsible for eligibility
determinations for the Medicaid program
carried out under title XIX of the
Social Security Act (42 U.S.C. 1396 et
seq.);
(viii) conducts preadmission
screening for placements in facilities
described in clause (ii); or
(ix) makes decisions regarding
admission or discharge of individuals
to or from such facilities.
(B) Identifying, removing, and remedying
organizational conflict.--
(i) In general.--The State agency may
not operate the Office or carry out the
program, directly, or by contract or
other arrangement with any public
agency or nonprofit private
organization, in a case in which there
is an organizational conflict of
interest (within the meaning of
subparagraph (A)) unless such conflict
of interest has been--
(I) identified by the State
agency;
(II) disclosed by the State
agency to the Assistant
Secretary in writing; and
(III) remedied in accordance
with this subparagraph.
(ii) Action by assistant secretary.--
In a case in which a potential or
actual organizational conflict of
interest (within the meaning of
subparagraph (A)) involving the Office
is disclosed or reported to the
Assistant Secretary by any person or
entity, the Assistant Secretary shall
require that the State agency, in
accordance with the policies and
procedures established by the State
agency under subsection
(a)(5)(D)(iii)--
(I) remove the conflict; or
(II) submit, and obtain the
approval of the Assistant
Secretary for, an adequate
remedial plan that indicates
how the Ombudsman will be
unencumbered in fulfilling all
of the functions specified in
subsection (a)(3).
(g) Legal Counsel.--The State agency shall ensure that--
(1)(A) adequate legal counsel is available, and is
able, without conflict of interest, to--
(i) provide advice and consultation needed to
protect the health, safety, welfare, and rights
of residents; and
(ii) assist the Ombudsman and representatives
of the Office in the performance of the
official duties of the Ombudsman and
representatives; and
(B) legal representation is provided to any
representative of the Office against whom suit or other
legal action is brought or threatened to be brought in
connection with the performance of the official duties
of the Ombudsman or such a representative; and
(2) the Office pursues administrative, legal, and
other appropriate remedies on behalf of residents.
(h) Administration.--The State agency shall require the
Office to--
(1) prepare an annual report--
(A) describing the activities carried out by
the Office in the year for which the report is
prepared;
(B) containing and analyzing the data
collected under subsection (c);
(C) evaluating the problems experienced by,
and the complaints made by or on behalf of,
residents;
(D) containing recommendations for--
(i) improving quality of the care and
life of the residents; and
(ii) protecting the health, safety,
welfare, and rights of the residents;
(E)(i) analyzing the success of the program
including success in providing services to
residents of board and care facilities and
other similar adult care facilities; and
(ii) identifying barriers that prevent the
optimal operation of the program; and
(F) providing policy, regulatory, and
legislative recommendations to solve identified
problems, to resolve the complaints, to improve
the quality of care and life of residents, to
protect the health, safety, welfare, and rights
of residents, and to remove the barriers;
(2) analyze, comment on, and monitor the development
and implementation of Federal, State, and local laws,
regulations, and other government policies and actions
that pertain to long-term care facilities and services,
and to the health, safety, welfare, and rights of
residents, in the State, and recommend any changes in
such laws, regulations, and policies as the Office
determines to be appropriate;
(3)(A) provide such information as the Office
determines to be necessary to public and private
agencies, legislators, and other persons, regarding--
(i) the problems and concerns of individuals
residing in long-term care facilities; and
(ii) recommendations related to the problems
and concerns; and
(B) make available to the public, and submit to the
Assistant Secretary, the chief executive officer of the
State, the State legislature, the State agency
responsible for licensing or certifying long-term care
facilities, and other appropriate governmental
entities, each report prepared under paragraph (1);
(4) ensure that the Ombudsman or a designee
participates in training provided by the National
Ombudsman Resource Center established in section
202(a)(18);
(5) strengthen and update proceduresfor the training
of the representatives of the Office, including unpaid
volunteers, based on model standards established by the
Director of the Office of Long-Term Care Ombudsman
Programs, in consultation with representatives of
citizen groups, long-term care providers, and the
Office, that--
(A) specify a minimum number of hours of
initial training;
(B) specify the content of the training,
including training relating to--
(i) Federal, State, and local laws,
regulations, and policies, with respect
to long-term care facilities in the
State;
(ii) investigative techniques; and
(iii) such other matters as the State
determines to be appropriate; and
(C) specify an annual number of hours of in-
service training for all designated
representatives;
(6) prohibit any representative of the Office (other
than the Ombudsman) from carrying out any activity
described in subparagraphs (A) through (G) of
subsection (a)(3) unless the representative--
(A) has received the training required under
paragraph (5); and
(B) has been approved by the Ombudsman as
qualified to carry out the activity on behalf
of the Office;
(7) coordinate ombudsman services with the protection
and advocacy systems for individuals with developmental
disabilities and mental illnesses established under--
(A) subtitle C of title I of the
Developmental Disabilities Assistance and Bill
of Rights Act of 2000; and
(B) the Protection and Advocacy for Mentally
Ill Individuals Act of 1986 (42 U.S.C. 10801 et
seq.);
(8) coordinate, to the greatest extent possible,
ombudsman services with legal assistance provided under
section 306(a)(2)(C), through adoption of memoranda of
understanding and other means;
(9) coordinate services with State and local law
enforcement agencies and courts of competent
jurisdiction; and
(10) permit any local Ombudsman entity to carry out
the responsibilities described in paragraph (1), (2),
(3), (7), or (8).
(i) Liability.--The State shall ensure that no representative
of the Office will be liable under State law for the good faith
performance of official duties.
(j) Noninterference.--The State shall--
(1) ensure that willful interference with
representatives of the Office in the performance of the
official duties of the representatives (as defined by
the Assistant Secretary) shall be unlawful;
(2) prohibit retaliation and reprisals by a long-term
care facility or other entity with respect to any
resident, employee, or other person for filing a
complaint with, providing information to, or otherwise
cooperating with any representative of, the Office; and
(3) provide for appropriate sanctions with respect to
the interference, retaliation, and reprisals.
* * * * * * *
----------
RAISE FAMILY CAREGIVERS ACT
* * * * * * *
SEC. 6. SUNSET PROVISION.
The authority and obligations established by this Act shall
terminate on the date that is [3] 4 years after the date of
enactment of this Act.
* * * * * * *
----------
SECTION 3 OF THE SUPPORTING GRANDPARENTS RAISING GRANDCHILDREN ACT
SEC. 3. ADVISORY COUNCIL TO SUPPORT GRANDPARENTS RAISING GRANDCHILDREN.
(a) Establishment.--There is established an Advisory Council
to Support Grandparents Raising Grandchildren.
(b) Membership.--
(1) In general.--The Advisory Council shall be
composed of the following members, or their designee:
(A) The Secretary of Health and Human
Services.
(B) The Secretary of Education.
(C) The Administrator of the Administration
for Community Living.
(D) The Director of the Centers for Disease
Control and Prevention.
(E) The Assistant Secretary for Mental Health
and Substance Use.
(F) The Assistant Secretary for the
Administration for Children and Families.
(G) A grandparent raising a grandchild.
(H) An older relative caregiver of children.
(I) As appropriate, the head of other Federal
departments, or agencies, identified by the
Secretary of Health and Human Services as
having responsibilities, or administering
programs, relating to current issues affecting
grandparents or other older relatives raising
children.
(2) Lead agency.--The Department of Health and Human
Services shall be the lead agency for the Advisory
Council.
(c) Duties.--
(1) In general.--
(A) Information.--The Advisory Council shall
identify, promote, coordinate, and disseminate
to the public information, resources, and the
best practices available to help grandparents
and other older relatives--
(i) meet the health, educational,
nutritional, and other needs of the
children in their care; and
(ii) maintain their own physical and
mental health and emotional well-being.
(B) Opioid.--s In carrying out the duties
described in subparagraph (A), the Advisory
Council shall consider the needs of those
affected by the opioid crisis.
(C) Native Americans.--In carrying out the
duties described in subparagraph (A), the
Advisory Council shall consider the needs of
members of Native American tribes.
(2) Report.--
(A) In general.--Not later than 180 days
after the date of enactment of this Act, the
Advisory Council shall submit a report to--
(i) the appropriate committees;
(ii) the State agencies that are
responsible for carrying out family
caregiver programs; and
(iii) the public online in an
accessible format.
(B) Report format.--The report shall
include--
(i) best practices, resources, and
other useful information for
grandparents and other older relatives
raising children identified under
paragraph (1)(A) including, if
applicable, any information related to
the needs of children who have been
impacted by the opioid epidemic;
(ii) an identification of any gaps in
items under clause (i); and
(iii) where applicable,
identification of any additional
Federal legislative authority necessary
to implement the activities described
in clause (i) and (ii).
(3) Follow-up report.--Not later than 2 years after
the date on which the report required under paragraph
(2)(A) is submitted, the Advisory Council shall submit
a follow-up report that includes the information
identified in paragraph (2)(B) to--
(A) the appropriate committees;
(B) the State agencies that are responsible
for carrying out family caregiver programs; and
(C) the public online in an accessible
format.
(4) Public input.--
(A) In general.--The Advisory Council shall
establish a process for public input to inform
the development of, and provide updates to, the
best practices, resources, and other
information described in paragraph (1) that
shall include--
(i) outreach to States, local
entities, and organizations that
provide information to, or support for,
grandparents or other older relatives
raising children; and
(ii) outreach to grandparents and
other older relatives with experience
raising children.
(B) Nature of outreach.--Such outreach shall
ask individuals to provide input on--
(i) information, resources, and best
practices available, including
identification of any gaps and unmet
needs; and
(ii) recommendations that would help
grandparents and other older relatives
better meet the health, educational,
nutritional, and other needs of the
children in their care, as well as
maintain their own physical and mental
health and emotional well-being.
(d) FACA.--The Advisory Council shall be exempt from the
requirements of the Federal Advisory Committee Act (5 U.S.C.
App.).
(e) Funding.--No additional funds are authorized to be
appropriated to carry out this Act.
(f) Sunset.--The Advisory Council shall terminate on the date
that is [3] 4 years after the date of enactment of this Act.