,i  #aac? ,,congress  #b;d ,session  ,h4
 ,r4 #dabb  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,febru>y #bh1 #bjad   
,ms4 ,bonamici 7= h]self1 ,mr4 ,h9ojosa1
 & ,mr4 ,george ,mill] ( ,cali=nia7     
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,education & ! ,work=ce
  ,a ,,bill  ,to reau?orize ! ,old]     
,am]icans ,act ( #aife1 & = o!r         
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,old] ,am]icans ,act       
,reau?orization ,act ( #bjad4  #b4      
,objectives ,section #aja ( ! ,old]     
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjja7 is am5d$--  7#a7 by am5d+        
p>agraph 7#a7 to read z foll[s3  7#a7   
,an adequate income & economic security 
9 lat] life 9 accordance ) ! ,am]ican   
/&>d ( liv+4  2  7#b7 9 p>agraph 7#d71  
by ins]t+ c>e coord9ation & aft]        
includ+2  7#c7 9 p>agraph 7#h71 by      
ins]t+ & supports1 (f]$ 9 a culturally &
 l+ui/ically compet5t mann] aft]        
community s]vices12  7#d7 by /rik+      
p>agraphs 7#i7 & 7#aj7 & ins]t+ !       

foll[+3  7#i7 ,imm$iate b5efit f prov5  
rese>* k :i* c su/a9 & improve heal?1   
happ9ess1 & economic security4  7#aj7   
,fre$om1 indep5d5ce1 economic security1 
& ! free ex]cise ( individual initiative
 = old] individuals 9 plann+ & manag+ _!
 own lives1 full p>ticipation 9 ! plann+
 & op]ation ( community-bas$ s]vices &  
programs provid$ = _! b5efit1 &         
protection aga9/ abuse1 neglect1 &      
exploitation4  2 &  7#e7 by add+ at !   
end ! foll[+3  7#aa7 ,acquir+           
high-quality s]vices 9 a mann] t is     
culturally & l+ui/ically responsive to  
old] individuals & family c>egiv]s4  4  
#c4 ,def9itions ,section #ajb ( ! ,old] 
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjjb7 is am5d$--  7#a7 by /rik+        
p>agraph 7#a7 & ins]t+ ! foll[+3  7#a7  
,! t]m abuse means ! kn[+ infliction (  
physical or psy*ological h>m or ! kn[+  
deprivation ( goods or s]vices t are    
necess>y to meet ess5tial ne$s or to    
avoid physical or psy*ological h>m4  2  
7#b7 by /rik+ p>agraph 7#c7 & ins]t+ !  

foll[+3  7#c7 ,! t]m adult protective   
s]vices means su* s]vices provid$ to    
adults z ! ,secret>y may specify &      
includes s]vices su* z--  7,a7 receiv+  
reports ( adult abuse1 neglect1 or      
exploitation2  7,b7 inve/igat+ ! reports
 describ$ 9 subp>agraph 7,a72  7,c7 case
 plann+1 monitor+1 evaluation1 & o!r    
casework & s]vices2 &  7,d7 provid+1    
arrang+ =1 or facilitat+ ! provision (  
m$ical1 social s]vice1 economic1 legal1 
h\s+1 law en=cem5t1 or o!r protective1  
em]g5cy1 or support s]vices4  2  7#c7 by
 /rik+ p>agraph 7#d7 & ins]t+ ! foll[+3 
7#d7 ,! t]m ,ag+ & ,disability ,res\rce 
,c5t] means an entity1 network1 or      
consortium e/abli%$ by a ,/ate z "p ( ! 
,/ate sy/em ( long-t]m c>e1 to provide a
 coord9at$ & integrat$ sy/em = old]     
individuals & individuals ) disabilities
 7z def9$ 9 section #c ( ! ,am]icans )  
,disabilities ,act ( #aiij 7#db         
,u4,s4,c4 #abajb771 & ! c>egiv]s ( old] 
individuals & individuals )             
disabilities1 t provides--  7,a7        

compreh5sive in=mation on ! full range (
 available public & private long-t]m c>e
 programs1 options1 s]vice provid]s1 &  
res\rces )9 a community1 includ+        
in=mation on ! availability ( integrat$ 
long-t]m c>e s]vices1 & ,f$]al or ,/ate 
programs t provide long-t]m c>e s]vices 
& supports ?r\gh home & community-bas$  
s]vice programs2  7,b7 p]son-c5t]$      
c\nsel+ to assi/ individuals 9 assess+  
_! exi/+ or anticipat$ long-t]m c>e ne$s
 & goals1 & develop+ & implem5t+ a      
p]son-c5t]$ plan = long-t]m c>e t is    
consi/5t ) ! desires ( su* an individual
 & design$ to meet ! individual's       
specific ne$s1 goals1 & circum/ances2   
7,c7 access = individuals to ! full     
range ( publicly-support$ long-t]m c>e  
s]vices & supports = :i* ! individuals  
may be eligible1 includ+ home &         
community-bas$ s]vice options1 by s]v+ z
 a conv5i5t po9t ( entry = su* programs 
& supports2 &  7,d7 9 coop]ation ) area 
ag5cies on ag+1 c5t]s = indep5d5t liv+  
describ$ 9 "p ,c ( title ,,vii ( !      

,rehabilitation ,act ( #aigc 7#bi       
,u4,s4,c4 #gif;f et seq471 & o!r        
community-bas$ entities1 in=mation &    
ref]rals reg>d+ available home &        
community-bas$ s]vices = individuals :o 
are at risk = resid+ 91 or :o reside 91 
in/itutional sett+s1 s t ! individuals h
 ! *oice to rema9 9 or to return to !   
community4  2  7#d7 9 p>agraph          
7#ad77;,b71 by ins]t+ oral heal?1 aft]  
bone d5sity12  7#e7 by am5d+ p>agraph   
7#ag7 to read z foll[s3  7#ag7 ,! t]m   
eld] ju/ice means--  7,a7 f a societal  
p]spective1 ef=ts to--  7i7 prev5t1     
detect1 treat1 int]v5e 91 & prosecute   
eld] abuse1 neglect1 & exploitation2 &  
7ii7 protect old] individuals ) dim9i%$ 
capacity :ile maximiz+ _! autonomy2 &   
7,b7 f an individual p]spective1 !      
recognition ( an old] individual's      
rights1 includ+ ! "r to be free ( abuse1
 neglect1 & exploitation4  2  7#f7 9    
p>agraph 7#ah77;,a71 by /rik+ t]m       
exploitation means & ins]t+ t]ms        
exploitation & f9ancial exploitation    

mean2  7#g7 9 p>agraph 7#bd7--  7,a7 9  
subp>agraph 7,b71 by /rik+ & at ! end2  
7,b7 9 subp>agraph 7,c71 by /rik+ !     
p]iod at ! end & ins]t+ 2 &2 &  7,c7 by 
add+ at ! end ! foll[+3  7,d7 /atus z an
 ,,lgbt individual4  2  7#h7 by         
r$esignat+ p>agraphs 7#cd7 ?r\gh 7#ed7 z
 p>agraphs 7#cf7 ?r\gh 7#ef71           
respectively2  7#i7 by r$esignat+       
p>agraphs 7#ac7 ?r\gh 7#cc7 z p>agraphs 
7#ad7 ?r\gh 7#cd71 respectively2  7#aj7 
by ins]t+ aft] p>agraph 7#ab7 ! foll[+3 
7#ac7 ,! t]m cultural & l+ui/ic         
compet5ce means compet5ce 9 a set (     
behaviors1 attitudes1 & policies t--    
7,a7 is us$ by an organization or among 
pr(essionals2 &  7,b7 enables effective 
"w 9 cross-cultural situations4  2 &    
7#aa7 by ins]t+ aft] p>agraph 7#cd71 z s
 r$esignat$ ! foll[+3  7#ce7 ,! t]m     
,,lgbt1 us$ ) respect to an individual1 
means a lesbian1 gay1 bisexual1 or      
transg5d] individual4  4  #d4           
,adm9i/ration on ,ag+  7a7 ,be/         
practices ,section #bja ( ! ,old]       

,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjaa7 is am5d$--  7#a7 9 subsection    
7d77#c7--  7,a7 9 subp>agraph 7,j71 by  
ins]t+ be=e ! semicolon ! foll[+3 1     
includ+ ! effectiv5ess ( su* s]vices 9  
meet+ ! ne$s ( ,,lgbt old] individuals2 
7,b7 9 subp>agraph 7,k71 by /rik+ & at !
 end2  7,c7 9 subp>agraph 7,l7--  7i7 by
 /rik+ ,old] ,am]icans ,act ,am5dm5ts ( 
#aiib & ins]t+ ,old] ,am]icans ,act     
,reau?orization ,act ( #bjad2 &  7ii7 by
 /rik+ #gab7;h77#d74 & ins]t+           
#gab7;h77#e72 &2 &  7,d7 by add+ at !   
end ! foll[+3  7,m7 collect & analyze   
be/ practices relat$ to respond+ to eld]
 abuse1 neglect1 & exploitation 9       
long-t]m c>e facilities1 & publi% a     
report ( su* be/ practices4  2 &  7#b7 9
 subsection 7e77#b7--  7,a7 9 ! matt]   
prec$+ subp>agraph 7,a71 by ins]t+ 1 & 9
 coord9ation ) ! heads ( ,/ate adult    
protective s]vices programs & !         
,director ( ! ,(fice ( ,long-,t]m ,c>e  
,ombudsman ,programs aft] & s]vices2 &  
7,b7 9 subp>agraph 7,a77iv7 by ins]t+   

7includ+ data & /ati/ics on ! incid5ce &
 preval5ce ( eld] abuse1 neglect1 &     
exploitation7 aft] exploitation4  7b7   
,functions ( ,assi/ant ,secret>y        
,section #bjb ( ! ,old] ,am]icans ,act (
 #aife 7#db ,u4,s4,c4 #cjab7 is am5d$-- 
7#a7 9 subsection 7a7--  7,a7 9 p>agraph
 7#e71 by ins]t+ heal? & economic be=e  
ne$s ( old] individuals2  7,b7 9        
p>agraph 7#g71 by ins]t+ heal? &        
economic be=e welf>e2  7,c7 9 p>agraph  
7#ad71 by ins]t+ 7includ+ ! ,heal?      
,res\rces & ,s]vices ,adm9i/ration7 aft]
 o!r ag5cies2  7,d7 by am5d+ p>agraph   
7#ae7 to read z foll[s3  7#ae7  7,a7 z  
ne$$1 provide te*nical assi/ance1 tra9+ 
?r\gh tra9+ packages1 & o!r =ms (       
in/ruction to entities consi/+ ( ,/ate  
ag5cies1 area ag5cies on ag+1 s]vice    
provid]s1 & community-bas$              
organizations1 to ensure t ! entities   
develop & implem5t1 9 a culturally &    
l+ui/ically compet5t mann]1 programm+1  
s]vices1 & outrea* = old] individuals ) 
greate/ economic ne$ & old] individuals 

) greate/ social ne$1 ) p>ticul>        
att5tion to & specific objectives =     
provid+ s]vices to l[-income m9ority    
individuals & old] individuals resid+ 9 
rural areas2 &  7,b7 consult ) national 
& community-bas$ organizations repres5t+
 m9ority individuals to develop !       
capacity ( ! ,adm9i/ration to provide   
su* te*nical assi/ance1 tra9+1 &        
in/ruction4  2  7,e7 9 p>agraph         
7#af77;,a77ii71 by ins]t+ 1 & sep>ately 
specify+ ! numb] ( su* individuals :o   
are ,,lgbt individuals be=e ! semicolon2
  7,f7 9 p>agraph 7#bg71 by /rik+ & at !
 end2  7,g7 9 p>agraph 7#bh71 by /rik+ !
 p]iod & ins]t+ a semicolon2 &  7,h7 by 
add+ at ! end ! foll[+3  7#bi7 provide  
in=mation & te*nical assi/ance to       
,/ates1 area ag5cies on ag+1 & s]vice   
provid]s1 9 collaboration ) relevant    
,f$]al ag5cies1 on provid+ effici5t1    
p]son-c5t]$ transportation s]vices1     
includ+ across geographic b\nd>ies2     
7#cj7 id5tify model programs & provide  
in=mation & te*nical assi/ance to       

,/ates1 area ag5cies on ag+1 & s]vice   
provid]s 7includ+ provid]s op]at+       
multipurpose s5ior c5t]s71 to support ! 
mod]nization ( multipurpose s5ior c5t]s2
  7#ca7 provide te*nical assi/ance to & 
%>e be/ practices ) ,/ates1 area ag5cies
 on ag+1 & ,ag+ & ,disability ,res\rce  
,c5t]s1 on h[ to collaborate & coord9ate
 s]vices ) heal? c>e entities1 su* z    
,f$]ally-qualifi$ heal? c5t]s1 z def9$ 9
 section #aije7l77#b77;,b7 ( ! ,social  
,security ,act 7#db ,u4,s4,c4           
#acif;d7l77#b77;,b771 9 ord] to improve 
c>e coord9ation = individuals ) multiple
 *ronic illnesses2  7#cb7 conduct /udies
 & collect data to det]m9e ! s]vices t  
are ne$$ by ,,lgbt old] individuals2 &  
7#cc7 ensure ?r\gh regulation 7or o!r   
communications ) programs c>ri$ out "u  
?is ,act7 & ?r\gh ov]sight t all        
programs fund$ ?r\gh ?is ,act :]e /aff1 
includ+ volunte]s1 come into direct     
contact ) old] adults1 h receiv$        
appropriate tra9+ 9 eld] abuse prev5tion
 & detection1 & to regul>ly evaluate !  

ne$ = & b5efit ( su* tra9+ relat$ to    
abuse1 neglect1 & exploitation ( old]   
adults4  2  7#b7 9 subsection 7b7--     
7,a7 9 p>agraph 7#e7--  7i7 9           
subp>agraph 7,b71 by /rik+ & aft] !     
semicolon2  7ii7 9 subp>agraph 7,c71 by 
ins]t+ & aft] ! semicolon2 &  7iii7 by  
add+ at ! end ! foll[+3  7,d7 :5        
feasible1 develop+1 9 consultation )    
,/ates & national organizations1 a      
consum]-fri5dly tool to assi/ old]      
individuals & _! families 9 *oos+ home &
 community-bas$ s]vices1 ) a p>ticul>   
focus on ways = consum]s to assess h[   
provid]s protect ! heal?1 safety1       
welf>e1 & rights1 includ+ ! rights      
provid$ "u section #cad1 ( old]         
individuals2  2 &  7,b7 9 p>agraph      
7#h7--  7i7 9 subp>agraph 7,b71 by      
ins]t+ to id5tify & articulate goals (  
c>e & aft] individuals2  7ii7 9         
subp>agraph 7,d7--  7,i7 by ins]t+      
respond to or be=e plan2 &  7,,ii7 by   
/rik+ future long-t]m c>e ne$s2 & &     
ins]t+ long-t]m c>e ne$s22  7iii7 9     

subp>agraph 7,e71 by add+ & at ! end2 & 
7iv7 by add+ at ! end ! foll[+3  7,f7 to
 provide in=mation & ref]rals reg>d+    
available home & community-bas$ s]vices 
= individuals :o are at risk = resid+ 91
 or :o reside 91 in/itutional sett+s1 s 
t ! individuals h ! *oice to rema9 9 or 
to return to ! community2  2 &  7#c7 by 
add+ at ! end ! foll[+3  7g7 ,!         
,assi/ant ,secret>y %all ensure1 :]e    
appropriate1 t all programs fund$ "u ?is
 ,act include appropriate tra9+ 9 !     
prev5tion ( abuse1 neglect1 &           
exploitation & provision ( s]vices t    
address eld] ju/ice & ! exploitation (  
old] individuals4  7h7  7#a7 ,!         
,assi/ant ,secret>y %all e/abli% &      
op]ate a ,national ,res\rce ,c5t] =     
,wom5 & ,retirem5t 7ref]r$ to 9 ?is     
subsection z ! ,c5t]74  7#b7 ,!         
,assi/ant ,secret>y %all make available 
to ! ,c5t] su* res\rces z are necess>y =
 ! ,c5t] to c>ry out effectively !      
functions ( ! ,c5t] "u ?is ,act1 :i*    
%all be an am\nt n less ?an #bgi1jjj =  

fiscal ye> #bjad4 ,9 subsequ5t fiscal   
ye>s1 ! ,assi/ant ,secret>y %all make   
available to ! ,c5t] n less ?an ! am\nt 
( res\rces made available to ! ,c5t] "u 
?is p>agraph = fiscal ye> #bjad4  7i7 ,!
 ,assi/ant ,secret>y %all1 directly or  
by grant or contract1 e/abli% & op]ate a
 ,national ,adult ,protective ,s]vices  
,res\rce ,c5t]4  7j7  7#a7 ,! ,assi/ant 
,secret>y %all1 directly or by grant or 
contract1 e/abli% & op]ate ! ,national  
,res\rce ,c5t] on ,lesbian1 ,gay1       
,bisexual1 & ,transg5d] ,ag+4  7#b7 ,!  
,assi/ant ,secret>y %all develop & issue
 op]at+ /&>ds & report+ requirem5ts = ! 
,c5t] e/abli%$ "u p>agraph 7#a74  7#c7  
,! ,assi/ant ,secret>y %all make        
available to ! ,c5t] su* res\rces z are 
necess>y = ! ,c5t] to c>ry out          
effectively ! functions ( ! ,c5t] "u ?is
 ,act = fiscal ye> #bjad4 ,9 subsequ5t  
fiscal ye>s1 ! ,assi/ant ,secret>y %all 
make available to ! ,c5t] n less ?an !  
am\nt ( res\rces made available to !    
,c5t] "u ?is p>agraph = fiscal ye>      

#bjad4  4  7c7 ,reports ,section #bjg ( 
! ,old] ,am]icans ,act ( #aife 7#db     
,u4,s4,c4 #cjah7 is am5d$--  7#a7 9     
subsection 7a77#c71 by ins]t+ ,,lgbt    
individuals1 aft] l[-income             
individuals12  7#b7 9 subsection 7c7--  
7,a7 9 p>agraph 7#a71 by ins]t+ 1 &     
sep>ately specify ! numb] ( su*         
individuals :o are ,,lgbt individuals   
be=e ! semicolon2  7,b7 by r$esignat+   
p>agraphs 7#d7 & 7#e7 z p>agraphs 7#e7 &
 7#f71 respectively2 &  7,c7 by ins]t+  
aft] p>agraph 7#c7 ! foll[+3  7#d7 !    
effectiv5ess ( su* activities 9 assi/+  
,,lgbt individuals2  2 &  7#c7 by add+  
at ! end ! foll[+3  7d7 ,! ,assi/ant    
,secret>y %all ensure t--  7#a7 no      
individual w be requir$ to provide      
in=mation reg>d+ ! sexual ori5tation or 
g5d] id5tity ( ! individual z a         
condition ( p>ticipat+ 9 activities or  
receiv+ s]vices "u ?is ,act2 &  7#b7 no 
ag5cy or o!r entity provid+ activities  
or s]vices "u ?is ,act1 t receives1 = ! 
purposes ( ?is ,act1 in=mation reg>d+ ! 

sexual ori5tation or g5d] id5tity ( an  
individual w disclose ! in=mation 9 any 
=m t w\ld p]mit su* individual to be    
id5tifi$4  7e7 ,! ,assi/ant ,secret>y   
%all develop appropriate protocols1     
demon/rations1 tools1 or guidance = use 
by ,/ate ag5cies & area ag5cies on ag+1 
to ensure successful implem5tation (    
data collection requirem5ts "u section  
#bja7;d77#c77;,j71 p>agraphs            
7#af77;,a77ii7 & 7#bi7 ( section        
#bjb7;a71 subsections 7a77#c71 7c77#a71 
& 7c77#d71 & section #cjg7;a77#f71      
relat+ to ,,lgbt individuals4  7f7 ,!   
,assi/ant ,secret>y %all det]m9e :5 su* 
data collection requirem5ts %all apply1 
tak+ into consid]ation ! complexity &   
importance ( ea* requirem5t1 b ea*      
requirem5t %all apply n lat] ?an #a ye> 
aft] ! date ( enactm5t ( ! ,old]        
,am]icans ,act ,reau?orization ,act (   
#bjad4  4  7d7 ,au?orization (          
appropriations ,section #baf ( ! ,old]  
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjbj;f7 is am5d$--  7#a7 9 subsection  

7a71 by /rik+ #bjjg1 #bjjh1 #bjji1      
#bjaj1 & #bjaa & ins]t+ #bjad1 #bjae1   
#bjaf1 #bjag1 & #bjah2  7#b7 9          
subsection 7b7--  7,a7 by /rik+         
#bjb7;a77#bd7 & ins]t+ #bjb7;a77#ba72 & 
7,b7 by /rik+ #bjjg1 #bjjh1 #bjji1      
#bjaj1 & #bjaa & ins]t+ #bjad1 #bjae1   
#bjaf1 #bjag1 & #bjah2 &  7#c7 9        
subsection 7c71 by /rik+ #bjjg1 #bjjh1  
#bjji1 #bjaj1 & #bjaa & ins]t+ #bjad1   
#bjae1 #bjaf1 #bjag1 & #bjah4  7e7      
,advisory ,committee ,to ,assess1       
,coord9ate1 & ,improve ,legal ,assi/ance
 ,activities  7#a7 ,advisory committee  
,title ,,ii ( ! ,old] ,am]icans ,act (  
#aife 7#db ,u4,s4,c4 #cjaa-cjbj;f7 is   
am5d$--  7,a7 by r$esignat+ section #baf
 z section #bag2 &  7,b7 by ins]t+ aft] 
section #bae ! foll[+3  #baf4 ,advisory 
,committee to ,assess1 ,coord9ate1 &    
,improve ,legal ,assi/ance ,activities  
7a7 ,e/abli%m5t ,!re is e/abli%$ an     
,advisory ,committee to ,assess1        
,coord9ate1 & ,improve ,legal ,assi/ance
 ,activities 7ref]r$ to 9 ?is section z 

! ,committee74  7b7 ,memb]%ip2 duties ,!
 ,assi/ant ,secret>y %all appo9t memb]s 
to ! ,committee & det]m9e ! activities (
 ! ,committee 7:i* %all include ! /udy &
 report describ$ 9 subsection 7c774  7c7
 ,/udy2 report ,! ,committee %all       
conduct a /udy on ! legal s]vices       
activities assi/ance sy/em = old]       
individuals4 ,n lat] ?an #a ye> aft] !  
date ( ! e/abli%m5t ( ! ,committee1 !   
,committee %all submit to ! ,presid5t1  
,congress1 & ! ,assi/ant ,secret>y a    
report t conta9s a detail$ /atem5t ( !  
f9d+s & conclusions ( su* /udy1 includ+ 
! ,committee's recomm5dations improv+ ! 
legal s]vices activities assi/ance sy/em
 = old] individuals4  7d7 ,regulations  
,n lat] ?an #ahj days aft] receiv+ !    
report describ$ 9 subsection 7c71 !     
,assi/ant ,secret>y %all issue          
regulations or guidance tak+ into       
consid]ation ! recomm5dations ( !       
,committee4  7e7 ,def9ition ,9 ?is      
subsection1 ! t]m legal assi/ance       
activities includes--  7#a7 legal       

assi/ance made available to old]        
individuals ) greate/ economic ne$ or ) 
greate/ social ne$2  7#b7 activities ( !
 ,national ,legal ,res\rce ,c5t] c>ri$  
out "u section #dbj7;a72  7#c7 ,/ate    
legal assi/ance develop] activities     
c>ri$ out "u section #gca2 &  7#d7 any  
o!r directly relat$ activity or program 
z det]m9$ appropriate by ! ,assi/ant    
,secret>y4  4  7#b7 ,con=m+ am5dm5t     
,section #bae7;j7 ( ! ,old] ,am]icans   
,act ( #aife 7#db ,u4,s4,c4             
#cjbj;e-#a7;j77 is am5d$ by /rik+       
section #baf & ins]t+ section #bag4     
7#c7 ,au?orization ( appropriations     
,section #bag ( ! ,old] ,am]icans ,act (
 #aife 7#db ,u4,s4,c4 #cjbj;f71 z s     
r$esignat$ by subsection 7c71 is am5d$  
by add+ at ! end ! foll[+3  7d7         
,advisory ,committee ,to ,assess1       
,coord9ate1 & ,improve ,legal ,assi/ance
 ,activities ,!re is au?oriz$ to be     
appropriat$ to c>ry out section #baf    
#cjj1jjj = ea* ( ! fiscal ye>s #bjad1   
#bjae1 #bjaf1 #bjag1 & #bjah4  4  #e4   

,/ate & community programs on ag+  7a7  
,au?orization ( appropriations ,section 
#cjc ( ! ,old] ,am]icans ,act ( #aife   
7#db ,u4,s4,c4 #cjbc7 is am5d$--  7#a7 9
 subsection 7a77#a71 by /rik+ fiscal    
ye>s #bjjg & all t foll[s & ins]t+ ea* (
 ! fiscal ye>s #bjad ?r\gh #bjah42  7#b7
 9 subsection 7b7--  7,a7 9 p>agraph    
7#a71 by /rik+ fiscal ye>s #bjjg & all t
 foll[s & ins]t+ ea* ( ! fiscal ye>s    
#bjad ?r\gh #bjah42 &  7,b7 9 p>agraph  
7#b71 by /rik+ fiscal ye>s #bjjg & all t
 foll[s & ins]t+ ea* ( ! fiscal ye>s    
#bjad ?r\gh #bjah42  7#c7 9 subsection  
7d71 by /rik+ fiscal ye>s #bjjg & all t 
foll[s & ins]t+ ea* ( ! fiscal ye>s     
#bjad ?r\gh #bjah42 &  7#d7 9 subsection
 7e77#b71 by /rik+ #bjaa & ins]t+ #bjaa 
& ea* ( ! fiscal ye>s #bjad ?r\gh #bjah4
  7b7 ,con=m+ am5dm5t ,section #cjd7;b7 
( ! ,old] ,am]icans ,act ( #aife 7#db   
,u4,s4,c4 #cjbd7;b77 is am5d$ by /rik+  
subp>t #a (4  7c7 ,plann+ & s]vice areas
 ,section #cje7;b77#e77;,c77i77,,iii7 ( 
! ,old] ,am]icans ,act ( #aife 7#db     

,u4,s4,c4 #cjbe7;b77#e77;,c77i77,,iii77 
is am5d$ by /rik+ plann+ & s]vices areas
 & ins]t+ plann+ & s]vice areas4  7d7   
,area plans ,section #cjf ( ! ,old]     
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjbf7 is am5d$--  7#a7 9 subsection    
7a7--  7,a7 9 p>agraph 7#a71 by /rik+   
e/abli%m5t1 ma9t5ance1 or con/ruction ( 
multipurpose s5ior c5t]s1 & ins]t+      
e/abli%m5t1 ma9t5ance1 mod]nization1 or 
con/ruction ( multipurpose s5ior c5t]s  
7includ+ a plan to use ! skills &       
s]vices ( old] individuals 9 paid &     
unpaid "w1 includ+ multig5]ational &    
old] individual to old] individual "w712
 &  7,b7 9 p>agraph 7#f7--  7i7 9       
subp>agraph 7,g71 by add+ & at ! end2 & 
7ii7 by add+ at ! end ! foll[+3  7,h7 9 
coord9ation ) ! ,/ate ag5cy & ) ! ,/ate 
ag5cy responsible = eld] abuse prev5tion
 s]vices1 increase public aw>5ess ( eld]
 abuse1 neglect1 & exploitation1 &      
remove b>ri]s to education1 prev5tion1  
inve/igation1 & treatm5t ( eld] abuse1  
neglect1 & exploitation1 z appropriate2 

2 &  7#b7 9 subsection 7b77#c7--  7,a7 9
 subp>agraph 7,j71 by /rik+ & at ! end2 
7,b7 by r$esignat+ subp>agraph 7,k7 z   
subp>agraph 7,l72 &  7,c7 by ins]t+ aft]
 subp>agraph 7,j7 ! foll[+3  7,k7       
protection f eld] abuse1 neglect1 &     
exploitation2 &  4  7e7 ,nutrition      
s]vices inc5tive program ,section       
#caa7;e7 ( ! ,old] ,am]icans ,act (     
#aife 7#db ,u4,s4,c4 #cjcj;a7e77 is     
am5d$ by /rik+ fiscal ye> #bjjg & all t 
foll[s & ins]t+ ea* ( ! fiscal ye>s     
#bjad ?r\gh #bjah44  7f7 ,supportive    
s]vices ,section #cba ( ! ,old]         
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjcj;d7 is am5d$--  7#a7 9 subsection  
7a7--  7,a7 9 p>agraph 7#a71 by /rik+ or
 ref]ral s]vices & ins]t+ ref]ral1      
*ronic condition self-c>e managem5t1 or 
falls prev5tion s]vices2  7,b7 9        
p>agraph 7#h71 by /rik+ 7includ+ & all t
 foll[s & ins]t+ ! foll[+3 7includ+     
m5tal & behavioral heal? scre5+ & falls 
prev5tion s]vices scre5+7 to detect or  
prev5t 7or bo?7 illnesses & injuries t  

occur mo/ frequ5tly 9 old] individuals2 
&  7,c7 9 p>agraph 7#ae71 by ins]t+ be=e
 ! semicolon ! foll[+3 1 & scre5+ = eld]
 abuse1 neglect1 & exploitation2  7#b7 9
 subsection 7b77#a71 by ins]t+ or       
mod]nization aft] con/ruction2  7#c7 9  
subsection 7c71 by ins]t+ be=e ! p]iod !
 foll[+3 1 & pursue opportunities = !   
developm5t ( int]g5]ational %>$ site    
models = programs or projects1 consi/5t 
) ! purposes ( ?is ,act2 &  7#d7 by add+
 at ! end ! foll[+3  7e7 ,9 ?is section1
 ! t]m adult *ild ) a disability means a
 *ild :o--  7#a7 is age #ah or old]2    
7#b7 is f9ancially dep5d5t on an old]   
individual :o is a p>5t ( ! *ild2 &     
7#c7 has a disability4  4  7g7 ,home    
deliv]$ nutrition s]vices program       
,section #ccf7a7 ( ! ,old] ,am]icans    
,act ( #aife 7#db ,u4,s4,c4 #cjcj;f7#a77
 is am5d$ by /rik+ cann$ & all t foll[s 
?r\gh meals & ins]t+ cann$1 or fre%     
foods &1 z appropriate1 supplem5tal     
foods & any additional meals4  7h7      
,nutrition s]vices ,section #cci ( !    

,old] ,am]icans ,act ( #aife 7#db       
,u4,s4,c4 #cjcj;g-#ba7 is am5d$--  7#a7 
9 p>agraph 7#a71 by /rik+ solicit &     
ins]t+ utilize2 &  7#b7 9 p>agraph      
7#b7--  7,a7 9 subp>agraph 7,j7--  7i7  
by /rik+ if appropriate2 &  7ii7 by     
/rik+ & at ! end2  7,b7 9 subp>agraph   
7,k71 by /rik+ ! p]iod & ins]t+ 1 &2 &  
7,c7 by add+ at ! end ! foll[+3  7,l7   
:]e feasible1 enc\rages ! use ( organic 
or locally gr[n foods 9 meal programs & 
id5tifies pot5tial p>tn]%ips & contracts
 ) local produc]s & provid]s ( organic  
or locally gr[n foods4  4  7i7          
,evid5ce-,bas$ disease prev5tion & heal?
 promotion s]vices program ,"p ,d (     
title ,,iii ( ! ,old] ,am]icans ,act (  
#aife 7#db ,u4,s4,c4 #cjcjm et seq47 is 
am5d$--  7#a7 9 ! "p head+1 by ins]t+   
,evid5ce-,bas$ be=e ,disease2 &  7#b7 9 
section #cfa7;a71 by ins]t+ evid5ce-bas$
 aft] to provide4  7j7 ,old] relative   
c>egiv]s  7#a7 ,te*nical am5dm5t ,"p ,e 
( title ,,iii ( ! ,old] ,am]icans ,act (
 #aife 7#db ,u4,s4,c4 #cjcjs et seq47 is

 am5d$ by /rik+ ! subp>t head+ = subp>t 
#a4  7#b7 ,def9itions ,section #cgb (   
su* ,act 7#db ,u4,s4,c4 #cjcjs7 is      
am5d$--  7,a7 9 subsection 7a7--  7i7 9 
p>agraph 7#a71 by /rik+ or :o is an     
individual ) a disability2 &  7ii7 by   
/rik+ p>agraph 7#b7 & ins]t+ ! foll[+3  
7#b7 ,individual ) a disability ,! t]m  
individual ) a disability means an      
individual ) a disability1 z def9$ 9    
section #c ( ! ,am]icans ) ,disabilities
 ,act ( #aiij 7#db ,u4,s4,c4 #abajb71 :o
 is n less ?an age #ah & n m ?an age    
#ei4  7#c7 ,old] relative c>egiv] ,! t]m
 old] relative c>egiv] means a c>egiv]  
:o--  7,a7  7i7 is age #ee or old]2 &   
7ii7 lives )1 is ! in=mal provid] (     
9-home & community c>e to1 & is ! prim>y
 c>egiv] =1 a *ild or an individual ) a 
disability2  7,b7 9 ! case ( a c>egiv] =
 a *ild--  7i7 is ! gr&p>5t1 /epgr&p>5t1
 or o!r relative 7o!r ?an ! p>5t7 by    
blood1 m>riage1 or adoption1 ( ! *ild2  
7ii7 is ! prim>y c>egiv] ( ! *ild       
because ! biological or adoptive p>5ts  

are unable or unwill+ to s]ve z ! prim>y
 c>egiv]s ( ! *ild2 &  7iii7 has a legal
 relation%ip to ! *ild1 su* z legal     
cu/ody1 adoption1 or gu>dian%ip1 or is  
rais+ ! *ild in=mally2 &  7,c7 9 ! case 
( a c>egiv] = an individual ) a         
disability1 is ! p>5t1 gr&p>5t1 or o!r  
relative by blood1 m>riage1 or adoption1
 ( ! individual ) a disability4  2 &    
7,b7 9 subsection 7b7--  7i7 by /rik+   
subp>t & all t foll[s ?r\gh family      
c>egiv]s & ins]t+ "p1 = family c>egiv]s2
  7ii7 by /rik+ 2 & & ins]t+ a p]iod2 & 
7iii7 by /rik+ p>agraph 7#b74  7k7      
,national family c>egiv] support program
 ,section #cgc ( ! ,old] ,am]icans ,act 
( #aife 7#db ,u4,s4,c4 #cjcjs-#a7 is    
am5d$--  7#a7 9 subsection 7a77#b71 by  
/rik+ gr&p>5ts or old] individuals :o   
are relative c>egiv]s4 & ins]t+ old]    
relative c>egiv]s42  7#b7 9 subsection  
7c7--  7,a7 9 p>agraph 7#a71 9 ! matt]  
prec$+ subp>agraph 7,a71 by /rik+       
gr&p>5ts & old] individuals :o are      
relative c>egiv]s1 & :o & ins]t+ old]   

relative c>egiv]s1 :o2 &  7,b7 9        
p>agraph 7#b77;,b71 by /rik+ to old]    
individuals provid+ c>e to individuals )
 sev]e disabilities1 includ+ *ildr5 )   
sev]e disabilities & ins]t+ to old]     
relative c>egiv]s ( *ildr5 ) sev]e      
disabilities1 or individuals )          
disabilities :o h sev]e disabilities2   
7#c7 9 subsection 7e77#c71 by /rik+     
gr&p>5ts or old] individuals :o are     
relative c>egiv]s & ins]t+ old] relative
 c>egiv]s2  7#d7 9 subsection           
7f77#a77;,a71 by /rik+ = fiscal ye>s    
#bjjg1 #bjjh1 #bjji1 #bjaj1 & #bjaa &   
ins]t+ = a fiscal ye>2 &  7#e7 9        
subsection 7g77#b77;,c71 by /rik+       
gr&p>5ts & old] individuals :o are      
relative c>egiv]s ( a *ild :o is n m ?an
 #ah ye>s ( age & ins]t+ old] relative  
c>egiv]s4  7l7 ,con=m+ am5dm5t ,"p ,e ( 
title ,,iii is am5d$ by /rik+ ?is subp>t
 ea* place x appe>s & ins]t+ ?is "p4    
#f4 ,activities = heal?1 indep5d5ce1 &  
longevity  7a7 ,grant programs ,section 
#daa ( ! ,old] ,am]icans ,act ( #aife   

7#db ,u4,s4,c4 #cjcb7 is am5d$--  7#a7 9
 subsection 7a7--  7,a7 9 p>agraph      
7#ab71 by /rik+ & at ! end2  7,b7 by    
r$esignat+ p>agraph 7#ac7 z p>agraph    
7#ad72 &  7,c7 by ins]t+ aft] p>agraph  
7#ab7 ! foll[+3  7#ac7 cont9u+ support =
 program integrity initiatives conc]n+ !
 ,m$ic>e program "u title ,,xviii ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acie et seq47 t tra9 s5ior volunte]s to
 prev5t & id5tify heal? c>e fraud &     
abuse2 &  2 &  7#b7 9 subsection 7b71 by
 /rik+ = fiscal ye>s #bjjg & all t      
foll[s ?r\gh #bjaa & ins]t+ = ea* ( !   
fiscal ye>s #bjad ?r\gh #bjah4  7b7     
,native ,am]ican programs ,section      
#dah7;b7 ( ! ,old] ,am]icans ,act (     
#aife 7#db ,u4,s4,c4 #cjcb;g7b77 is     
am5d$ by /rik+ a national meet+ to tra9 
& ins]t+ national tra9+s =4  7c7 ,legal 
assi/ance = old] ,am]icans ,section     
#dbj7;c7 ( ! ,old] ,am]icans ,act (     
#aife 7#db ,u4,s4,c4 #cjcb;i7c77 is     
am5d$ by /rik+ national4  7d7 ,con=m+   
am5dm5t ,section #dag7;a77#a77;,a7 ( !  

,old] ,am]icans ,act ( #aife 7#db       
,u4,s4,c4 #cjcb;f7a77#a77;,a77 is am5d$ 
by /rik+ gr&p>5ts & o!r old] individuals
 :o are relative c>egiv]s & ins]t+ old] 
relative c>egiv]s 7z def9$ 9 section    
#cgb74  #g4 ,national res\rce c5t] on   
family c>egiv+ ,"p ,a ( title ,,iv ( !  
,old] ,am]icans ,act ( #aife 7#db       
,u4,s4,c4 #cjcb-cjcbk7 is am5d$ by add+ 
at ! end ! foll[+3  #dbc4 ,national     
,res\rce ,c5t] on ,family ,c>egiv+  7a7 
,e/abli%m5t ,! ,secret>y ( ,heal? &     
,human ,s]vices %all aw>d a grant to or 
ent] into a coop]ative agreem5t ) a     
public or private nonpr(it entity to    
e/abli% a ,national ,res\rce ,c5t] on   
,family ,c>egiv+ 7ref]r$ to 9 ?is       
section z ! ,c5t]74  7b7 ,developm5t ,! 
,assi/ant ,secret>y %all develop & issue
 op]at+ /&>ds & report+ requirem5ts = ! 
,c5t] e/abli%$ "u subsection 7a74  7c7  
,au?orization ,!re is au?oriz$ to be    
appropriat$ to c>ry out ?is section1    
#b1jjj1jjj = ea* ( ! fiscal ye>s #bjad  
?r\gh #bjah4  4  #h4 ,multipurpose s5ior

 c5t] mod]nization1 tra9+1 & support ,"p
 ,a ( title ,,iv ( ! ,old] ,am]icans    
,act ( #aife 7#db ,u4,s4,c4             
#cjcb-cjcbk71 z am5d$ by section #g1 is 
am5d$ by add+ at ! end ! foll[+3  #dbd4 
,multipurpose s5ior c5t] mod]nization1  
tra9+1 & support  7a7 ,program au?oriz$ 
,! ,assi/ant ,secret>y %all aw>d grants 
& ent] into contracts ) eligible        
entities to c>ry out projects to--  7#a7
 support & promote mod]n multipurpose   
s5ior c5t] models :i* yield vibrant1    
multis]vice1 multig5]ational c5t]s =    
old] individuals1 families ( old]       
individuals1 & o!rs 9 ! community to ga9
 skills1 res\rces1 & connections ne$$ to
 meet ! *all5ges t occur ) cont9uum (   
c>e & quality ( life2  7#b7 build an    
evid5ce base ( mod]n1 replicable        
practices t all[ s5ior c5t]s to s]ve a  
div]se array ( old] individuals1 z well 
z _! families & o!r c>egiv]s1 lev]ag+   
innovative p>tn]%ips & public & private 
res\rces to develop & exp& programs2 &  
7#c7 mobilize s]vices & lev]age res\rces

 to support ! role ( multipurpose s5ior 
c5t]s z community focal po9ts1 z provid$
 9 section #cjf7;a77#c71 & = !          
e/abli%m5t1 con/ruction1 ma9t5ance1 &   
op]ation ( c5t]s1 z describ$ 9 sections 
#cjc7;c77#b7 & #cjf7;a77#a71 includ+    
developm5t ( int]g5]ational %>$ site    
models1 consi/5t ) ! purposes ( ?is     
,act4  7b7 ,use ( funds ,an eligible    
entity %all use funds made available "u 
a grant aw>d$1 or a contract ent]$ into1
 "u subsection 7a7 to--  7#a7 c>ry out a
 project describ$ 9 subsection 7a72 &   
7#b7 evaluate ! project 9 accordance )  
subsection 7f74  7c7 ,application ,to be
 eligible to receive a grant or ent]    
into a contract "u subsection 7a71 an   
eligible entity %all submit an          
application to ! ,assi/ant ,secret>y at 
su* "t1 9 su* mann]1 & accompani$ by su*
 in=mation z ! ,assi/ant ,secret>y may  
reasonably require4  7d7 ,eligible      
entity ,= purposes ( ?is section1 ! t]m 
eligible entity means--  7#a7 a         
multipurpose s5ior c5t] t has met       

national accr$itation & fiduci>y /&>ds2 
or  7#b7 a regional p>tn]%ip or         
collaboration ( multipurpose s5ior c5t]s
 or ,/ate association ( s5ior c5t]s 9   
:i* n less ?an #b c5t]s are accr$it$4   
7e7 ,competitive grants = te*nical      
assi/ance  7#a7 ,grants ,! ,assi/ant    
,secret>y %all make a grant1 on a       
competitive basis1 to an eligible       
nonpr(it organization describ$ 9        
p>agraph 7#b71 to enable ! organization 
to--  7,a7 provide tra9+ & te*nical     
assi/ance to recipi5ts ( grants "u ?is  
section & o!r multipurpose s5ior c5t]s  
to adopt & tailor evid5ce-bas$          
mod]nization /rategies & practices to   
respond to ! economic & heal? ne$s ( !  
div]se & gr[+ ag+ populations 9 _! own  
communities2 &  7,b7 c>ry out o!r       
duties1 z det]m9$ by ! ,assi/ant        
,secret>y4  7#b7 ,eligible nonpr(it     
organization ,to be eligible to receive 
a grant "u ?is subsection1 an           
organization %all be a nonpr(it         
organization 7includ+ a p>tn]%ip (      

nonpr(it organizations71 t--  7,a7 has  
exp]i5ce & exp]tise 9 provid+ te*nical  
assi/ance to a range ( multipurpose     
s5ior c5t]s & exp]i5ce evaluat+ &       
report+ on programs2 &  7,b7 has        
demon/rat$ k ( & exp]tise 9 multipurpose
 s5ior c5t] accr$itation or o!r /&>ds ( 
excell5ce4  7#c7 ,application ,to be    
eligible to receive a grant "u ?is      
subsection1 an organization 7includ+ a  
p>tn]%ip ( nonpr(it organizations7 %all 
submit an application to ! ,assi/ant    
,secret>y at su* "t1 9 su* mann]1 &     
conta9+ su* in=mation z ! ,assi/ant     
,secret>y may require1 includ+ an       
assurance t ! organization w submit to !
 ,assi/ant ,secret>y su* evaluations &  
reports z ! ,assi/ant ,secret>y may     
require4  7f7 ,local evaluation & report
  7#a7 ,evaluation ,ea* entity receiv+ a
 grant or a contract "u subsection 7a7  
to c>ry out a project describ$ 9        
subsection 7a7 %all evaluate ! project1 
lead]%ip1 & res\rces = ! mod]nization ( 
multipurpose s5ior c5t]s to det]m9e--   

7,a7 ! effectiv5ess ( ! project 9       
produc+ innovations & mobiliz+ res\rces2
  7,b7 ! impact on old] individuals1    
families ( old] individuals1 & !        
community be+ s]v$2 &  7,c7 ! pot5tial =
 ! project to be replicat$ by o!r       
multipurpose s5ior c5t]s1 not+ !        
necess>y res\rces & p>tn]%ips & ! types 
( populations & communities be/ suit$ = 
! model4  7#b7 ,report ,! entity        
describ$ 9 p>agraph 7#a7 %all submit a  
report to ! ,assi/ant ,secret>y conta9+ 
! evaluation n lat] ?an #f mon?s aft] ! 
expiration ( ! p]iod = :i* ! grant or   
contract is 9 effect4  7g7 ,report to   
,congress ,n lat] ?an #f mon?s aft] !   
,assi/ant ,secret>y receives ! reports  
describ$ 9 subsection 7f77#b71 !        
,assi/ant ,secret>y %all prep>e & submit
 to ,congress a report t assesses !     
evaluations & includes1 at a m9imum--   
7#a7 a description ( ! nature & op]ation
 ( ! projects fund$ "u ?is section & o!r
 activities conduct$ 9 support ( su*    
projects2  7#b7 ! f9d+s result+ f !     

evaluations ( ! model projects conduct$ 
"u ?is section2  7#c7 a description (   
recomm5d$ be/ practices ( mod]n         
multipurpose s5ior c5t]s2  7#d7 a       
/rategy = dissem9at+ ! f9d+s result+ f !
 projects describ$ 9 p>agraph 7#a72 &   
7#e7 recomm5dations = legislative or    
adm9i/rative action1 z ! ,assi/ant      
,secret>y det]m9es appropriate4  4  #i4 
,community s]vice s5ior opportunities   
,section #eag7;a7 ( ! ,old] ,am]icans   
,act ( #aife 7#db ,u4,s4,c4 #cjefo7a77  
is am5d$ by /rik+ fiscal ye>s #bjjg1    
#bjjh1 #bjji1 #bjaj1 & #bjaa & ins]t+   
ea* ( ! fiscal ye>s #bjad ?r\gh #bjah4  
#aj4 ,grants = ,native ,am]icans        
,section #fdc7b7 ( ! ,old] ,am]icans    
,act ( #aife 7#db ,u4,s4,c4 #cjegn7#b77 
is am5d$ by /rik+ fiscal ye> #bjaa &    
ins]t+ ea* ( ! fiscal ye>s #bjad ?r\gh  
#bjah4  #aa4 ,vuln]able eld] rights     
protection activities  7a7 ,ombudsman   
def9itions ,section #gaa7f7 ( ! ,old]   
,am]icans ,act ( #aife 7#db ,u4,s4,c4   
#cjeh;f7#f77 is am5d$ by /rik+ old]4    

7b7 ,ombudsman programs ,section #gab ( 
! ,old] ,am]icans ,act ( #aife 7#db     
,u4,s4,c4 #cjeh;g7 is am5d$--  7#a7 9   
subsection 7a7--  7,a7 9 p>agraph 7#b71 
by add+ at ! end ! foll[+3 ,! ,ombudsman
 %all be responsible = ! managem5t1     
includ+ ! fiscal managem5t1 ( ! ,(fice42
  7,b7 9 p>agraph 7#c7--  7i7 9         
subp>agraph 7,a71 by /rik+ clause 7i7 & 
ins]t+ ! foll[+3  7i7 are made by1 or on
 behalf (1 resid5ts1 includ+ resid5ts ) 
limit$ or no decisionmak+ capacity & :o 
h no kn[n legal repres5tative1 & if su* 
a resid5t is unable to communicate      
cons5t = an ,ombudsman to "w on a       
compla9t directly involv+ ! resid5t1 !  
,ombudsman %all seek evid5ce to indicate
 :at outcome ! resid5t w\ld h           
communicat$ 7&1 9 ! abs5ce ( evid5ce to 
! contr>y1 %all assume t ! resid5t wi%es
 to h ! resid5t's heal?1 safety1 welf>e1
 & rights protect$7 & %all "w to        
accompli% t outcome2 &  2  7ii7 9       
subp>agraph 7,d71 by /rik+ regul> &     
timely & ins]t+ regul>1 timely1 private1

 & unimp$$2  7iii7 9 subp>agraph        
7,h77iii7--  7,i7 by ins]t+ 1 actively  
enc\rage1 & assi/ 9 aft] provide        
te*nical support =2 &  7,,ii7 by /rik+ &
 aft] ! semicolon2  7iv7 by r$esignat+  
subp>agraph 7,i7 z subp>agraph 7,k72 &  
7v7 by ins]t+ aft] subp>agraph 7,h7 !   
foll[+3  7,i7 :5 feasible1 cont9ue to   
c>ry out ! functions describ$ 9 ?is     
section on behalf ( resid5ts transition+
 f a long-t]m c>e facility to a home c>e
 sett+2  7,j7 collect & analyze data1   
relat+ to discrim9ation aga9/ ,,lgbt    
old] individuals on ! basis ( actual or 
p]ceiv$ sexual ori5tation or g5d]       
id5tity 9 ! admission to1 transf] or    
dis*>ge f1 or lack ( adequate c>e       
provid$ 9 long-t]m c>e sett+s1 & %all   
include ! analyses 9 ! reports2 &  2 &  
7,c7 9 p>agraph 7#e77;,b7--  7i7 9      
clause 7vi7--  7,i7 by ins]t+ 1 actively
 enc\rage1 & assi/ 9 aft] support2 &    
7,,ii7 by /rik+ & aft] ! semicolon2     
7ii7 by r$esignat+ clause 7vii7 z clause
 7viii72 &  7iii7 by ins]t+ aft] clause 

7vi7 ! foll[+3  7vii7 id5tify1          
inve/igate1 & resolve compla9ts describ$
 9 clause 7iii7 t are made by or on     
behalf ( resid5ts ) limit$ or no        
decisionmak+ capacity & :o h no kn[n    
legal repres5tative1 & if su* a resid5t 
is unable to communicate cons5t = an    
,ombudsman to "w on a compla9t directly 
involv+ ! resid5t1 ! ,ombudsman %all    
seek evid5ce to indicate :at outcome !  
resid5t w\ld h communicat$ 7&1 9 !      
abs5ce ( evid5ce to ! contr>y1 %all     
assume t ! resid5t wi%es to h !         
resid5t's heal?1 safety1 welf>e1 &      
rights protect$7 & %all "w to accompli% 
t outcome2 &  2  7#b7 9 subsection 7b7--
  7,a7 9 p>agraph 7#a7--  7i7 9         
subp>agraph 7,a71 by /rik+ access &     
ins]t+ private & unimp$$ access2 &  7ii7
 9 subp>agraph 7,b7--  7,i7 9 clause    
7i7--  7aa7 9 ! matt] prec$+ subclause  
7,i71 by /rik+ ! m$ical & social records
 ( a & ins]t+ all files1 records1 & o!r 
in=mation conc]n+ a2 &  7bb7 9 subclause
 7,,ii71 by /rik+ to cons5t & ins]t+ to 

communicate cons5t2 &  7,,ii7 9 clause  
7ii71 9 ! matt] be=e subclause 7,i71 by 
/rik+ ! records & ins]t+ ! files1       
records1 & in=mation2 &  7,b7 by add+ at
 ! end ! foll[+3  7#c7 ,heal? ov]sight  
ag5cy ,= purposes ( section #bfd7;c7 ( !
 ,heal? ,insurance ,portability &       
,acc\ntability ,act ( #aiif 7includ+    
regulations issu$ "u t section7 7#db    
,u4,s4,c4 #acbj;d-#b note71 ! ,ombudsman
 & a repres5tative ( ! ,(fice %all be   
consid]$ a heal? ov]sight ag5cy1 s t    
release ( resid5ts' individually        
id5tifiable heal? in=mation to !        
,ombudsman or repres5tative is n        
preclud$ 9 cases 9 :i* ! requirem5ts (  
clause 7i7 or 7ii7 ( p>agraph 7#a77;,b71
 or ! requirem5ts ( p>agraph 7#a77;,d71 
are o!rwise met4  2  7#c7 9 subsection  
7d7--  7,a7 9 p>agraph 7#a71 by /rik+   
files & ins]t+ files1 records1 & o!r    
in=mation2 &  7,b7 9 p>agraph 7#b7--    
7i7 9 subp>agraph 7,a7--  7,i7 by /rik+ 
files & records ea* place su* t]m appe>s
 & ins]t+ files1 records1 & o!r         

in=mation2 &  7,,ii7 by /rik+ & aft] !  
semicolon2  7ii7 9 subp>agraph 7,b7--   
7,i7 by /rik+ files or records & ins]t+ 
files1 records1 or o!r in=mation2 &     
7,,ii7 9 clause 7iii71 by /rik+ ! p]iod 
at ! end & ins]t+ 2 &2 &  7iii7 by add+ 
at ! end ! foll[+3  7,c7 not)/&+        
subp>agraph 7,b71 ensure t ! ,ombudsman 
may disclose in=mation z ne$$ 9 ord] to 
be/ s]ve resid5ts ) limit$ or no        
decisionmak+ capacity :o h no kn[n legal
 repres5tative & are unable to          
communicate cons5t1 9 ord] = !          
,ombudsman to c>ry out ! functions &    
duties describ$ 9 p>agraphs 7#c77;,a7 & 
7#e77;,b7 ( subsection 7a74  2  7#d7 by 
/rik+ subsection 7f7 & ins]t+ ! foll[+3 
7f7 ,conflict ( int]e/  7#a7 ,individual
 conflict ( int]e/ ,! ,/ate ag5cy %all--
  7,a7 ensure t no individual1 or memb] 
( ! imm$iate family ( an individual1    
involv$ 9 ! designation ( ! ,ombudsman  
7:e!r by appo9tm5t or o!rwise7 or !     
designation ( an entity designat$ "u    
subsection 7a77#e71 is subject to a     

conflict ( int]e/2  7,b7 ensure t no    
(fic] or employee ( ! ,(fice1           
repres5tative ( a local ,ombudsman      
entity1 or memb] ( ! imm$iate family ( !
 (fic]1 employee1 or repres5tative1 is  
subject to a conflict ( int]e/2 &  7,c7 
ensure t ! ,ombudsman--  7i7 does n h a 
direct involvem5t 9 ! lic5s+ or         
c]tification ( a long-t]m c>e facility  
or ( a provid] ( a long-t]m c>e s]vice2 
7ii7 does n h an own]%ip or inve/m5t    
int]e/ 7repres5t$ by equity1 debt1 or   
o!r f9ancial relation%ip7 9 a long-t]m  
c>e facility or a long-t]m c>e s]vice2  
7iii7 is n employ$ by1 or p>ticipat+ 9 !
 managem5t (1 a long-t]m c>e facility or
 a relat$ organization1 & has n be5     
employ$ by su* a facility or            
organization )9 #a ye> be=e ! date ( !  
det]m9ation involv$2  7iv7 does n       
receive1 or h ! "r to receive1 directly 
or indirectly1 remun]ation 79 ca% or 9  
k9d7 "u a comp5sation arrangem5t ) an   
own] or op]ator ( a long-t]m c>e        
facility2  7v7 does n h managem5t       

responsibility =1 or op]ate "u !        
sup]vision ( an individual ) managem5t  
responsibility =1 adult protective      
s]vices2 &  7vi7 does n s]ve z a gu>dian
 or 9 ano!r fiduci>y capacity = resid5ts
 ( long-t]m c>e facilities 9 an (ficial 
capacity 7z oppos$ to s]v+ z a gu>dian  
or fiduci>y = a family memb]1 9 a       
p]sonal capacity74  7#b7 ,organizational
 conflict ( int]e/  7,a7 ,9 g5]al ,!    
,/ate ag5cy %all comply ) subp>agraph   
7,b77i7 9 a case 9 :i* ! ,(fice poses an
 organizational conflict ( int]e/1      
includ+ a situation 9 :i* ! ,(fice is   
plac$ 9 an organization t--  7i7 is     
responsible = lic5s+1 c]tify+1 or       
survey+ long-t]m c>e s]vices 9 ! ,/ate2 
7ii7 is an association 7or an affiliate 
( su* an association7 ( long-t]m c>e    
facilities1 or ( any o!r resid5tial     
facilities = old] individuals2  7iii7   
provides long-t]m c>e s]vices1 includ+  
programs c>ri$ out "u a ,m$icaid waiv]  
approv$ "u section #aaae ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acae7 or 

"u subsection 7b7 or 7c7 ( section #aiae
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acifn71 or "u a ,m$icaid     
,/ate plan am5dm5t "u subsection 7i71   
7j71 or 7k7 ( section #aiae ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #acifn72  
7iv7 provides long-t]m c>e case         
managem5t2  7v7 sets rates = long-t]m   
c>e s]vices2  7vi7 provides adult       
protective s]vices2  7vii7 is           
responsible = eligibility det]m9ations =
 ! ,m$icaid program c>ri$ out "u title  
,,xix ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif et seq472  7viii7       
conducts preadmission scre5+ = placem5ts
 9 facilities describ$ 9 clause 7ii72 or
  7ix7 makes decisions reg>d+ admission 
or dis*>ge ( individuals to or f su*    
facilities4  7,b7 ,id5tify+1 remov+1 &  
rem$y+ organizational conflict  7i7 ,9  
g5]al ,! ,/ate ag5cy may n op]ate !     
,(fice or c>ry out ! program1 directly1 
or by contract or o!r arrangem5t ) any  
public ag5cy or nonpr(it private        
organization1 9 a case 9 :i* !re is an  

organizational conflict ( int]e/ 7)9 !  
mean+ ( subp>agraph 7,a77 unless su*    
conflict ( int]e/ has be5--  7,i7       
id5tifi$ by ! ,/ate ag5cy2  7,,ii7      
disclos$ by ! ,/ate ag5cy to ! ,assi/ant
 ,secret>y 9 writ+2 &  7,,iii7 rem$i$ 9 
accordance ) ?is subp>agraph4  7ii7     
,action by ,assi/ant ,secret>y ,9 a case
 9 :i* a pot5tial or actual             
organizational conflict ( int]e/ 7)9 !  
mean+ ( subp>agraph 7,a77 involv+ !     
,(fice is disclos$ or report$ to !      
,assi/ant ,secret>y by any p]son or     
entity1 ! ,assi/ant ,secret>y %all      
require t ! ,/ate ag5cy1 9 accordance ) 
! policies & proc$ures e/abli%$ by !    
,/ate ag5cy "u subsection               
7a77#e77;,d77iii7--  7,i7 remove !      
conflict2 or  7,,ii7 submit1 & obta9 !  
approval ( ! ,assi/ant ,secret>y =1 an  
adequate rem$ial plan t indicates h[ !  
,ombudsman w be un5cumb]$ 9 fulfill+ all
 ( ! functions specifi$ 9 subsection    
7a77#c74  2 &  7#e7 9 subsection 7h7--  
7,a7 9 p>agraph 7#c77;,a77i71 by /rik+  

old]2  7,b7 9 p>agraph 7#d71 by /rik+   
all t prec$es proc$ures & ins]t+ !      
foll[+3  7#d7 /r5g!n & update  2  7,c7  
by r$esignat+ p>agraphs 7#d7 ?r\gh 7#i7 
z p>agraphs 7#e7 ?r\gh 7#aj71           
respectively2  7,d7 by ins]t+ aft]      
p>agraph 7#c7 ! foll[+3  7#d7 ensure t !
 ,ombudsman or a designee p>ticipates 9 
tra9+ provid$ by ! ,national ,ombudsman 
,res\rce ,c5t] e/abli%$ 9 section       
#bjb7;a77#ah72  2  7,e7 9 p>agraph      
7#f77;,a71 z s r$esignat$ by subp>agraph
 7,c7 ( ?is p>agraph1 by /rik+ p>agraph 
7#d7 & ins]t+ p>agraph 7#e72  7,f7 9    
p>agraph 7#g77;,a71 z s r$esignat$ by   
subp>agraph 7,c7 ( ?is p>agraph1 by     
/rik+ subtitle ,c ( ! & ins]t+ subtitle 
,c ( title ,i ( !2 &  7,g7 9 p>agraph   
7#aj71 z s r$esignat$ by subp>agraph    
7,c7 ( ?is p>agraph1 by /rik+ 7#f71 or  
7#g7 & ins]t+ 7#g71 or 7#h74  7c7       
,ombudsman regulations ,section #gac ( !
 ,old] ,am]icans ,act ( #aife 7#db      
,u4,s4,c4 #cjeh;h7 is am5d$--  7#a7 9   
p>agraph 7#a71 by /rik+ p>agraphs 7#a7 &

 7#b7 ( section #gab7;f7 & ins]t+       
subp>agraphs 7,a7 & 7,b7 ( section      
#gab7;f77#a72 &  7#b7 9 p>agraph 7#b71  
by /rik+ subp>agraphs 7,a7 ?r\gh 7,d7 ( 
section #gab7;f77#c7 & ins]t+ clauses   
7i7 ?r\gh 7vi7 ( section                
#gab7;f77#a77;,c74  7d7 ,prev5tion (    
eld] abuse1 neglect1 & exploitation     
,section #gba ( ! ,old] ,am]icans ,act (
 #aife 7#db ,u4,s4,c4 #cjeh;i7 is       
am5d$--  7#a7 9 subsection 7b7--  7,a7 9
 ! matt] prec$+ p>agraph 7#a71 by /rik+ 
7includ+ f9ancial exploitation72  7,b7  
by r$esignat+ p>agraphs 7#e7 ?r\gh 7#ab7
 z p>agraphs 7#f7 ?r\gh 7#ac71          
respectively2  7,c7 by ins]t+ aft]      
p>agraph 7#d7 ! foll[+3  7#e7 promot+ ! 
submission ( data on eld] abuse1        
neglect1 & exploitation = ! appropriate 
database ( ! ,adm9i/ration or ano!r     
database specifi$ by ! ,assi/ant        
,secret>y2  2  7,d7 9 p>agraph          
7#aj77;,c71 z r$esignat$ by subp>agraph 
7,b7--  7i7 9 clause 7ii71 by ins]t+ 1  
su* z =5sic speciali/s1 aft] su*        

p]sonnel2 &  7ii7 9 clause 7v71 by      
ins]t+ be=e ! comma ! foll[+3 1 includ+ 
programs & arrangem5ts t protect aga9/  
f9ancial exploitation2 &  7,e7 9        
p>agraph 7#ab71 z r$esignat$ by         
subp>agraph 7,b7--  7i7 9 subp>agraph   
7,d71 by /rik+ & at ! end2 &  7ii7 by   
add+ at ! end ! foll[+3  7,f7 support+ &
 /udy+ innovative practices 9           
communities to develop p>tn]%ips across 
discipl9es = ! prev5tion1 inve/igation1 
& prosecution ( abuse1 neglect1 &       
exploitation2 &  2 &  7#b7 9 subsection 
7e77#b71 9 ! matt] prec$+ subp>agraph   
7,a7--  7,a7 by /rik+ subsection        
7b77#i77;,b77i7 & ins]t+ subsection     
7b77#aj77;,b77i72 &  7,b7 by /rik+      
subsection 7b77#i77;,b77ii7 & ins]t+    
subsection 7b77#aj77;,b77ii74  #ab4     
,behavioral heal? ,! ,old] ,am]icans    
,act ( #aife 7#db ,u4,s4,c4 #cjaa et    
seq47 is am5d$--  7#a7 9 section #ajb-- 
7,a7 9 p>agraph 7#ad77;,g71 by ins]t+ & 
behavioral aft] m5tal2  7,b7 9 p>agraph 
7#cf71 by ins]t+ & behavioral aft]      

m5tal2 &  7,c7 9 p>agraph 7#dg77;,b71 by
 ins]t+ & behavioral aft] m5tal2  7#b7 9
 section #bja7;f77#a71 by ins]t+ &      
behavioral aft] m5tal2  7#c7 9 section  
#bjb7;a77#e71 by ins]t+ & behavioral    
aft] m5tal2  7#d7 9 section #cjf7;a7--  
7,a7 9 p>agraph 7#b77;,a71 by ins]t+ &  
behavioral aft] m5tal2 &  7,b7 9        
p>agraph 7#f77;,f71 by /rik+ m5tal heal?
 s]vices ea* place su* t]m appe>s &     
ins]t+ m5tal & behavioral heal? s]vices2
 &  7#e7 9 section #cba7;a7--  7,a7 9   
p>agraph 7#a71 z am5d$ by section       
#d7;f71 by ins]t+ & behavioral aft]     
m5tal2  7,b7 9 p>agraph 7#ad77;,b71 by  
ins]t+ & behavioral aft] m5tal2 &  7,c7 
9 p>agraph 7#bc71 by ins]t+ & behavioral
 aft] m5tal4  #ac4 ,/udy on             
transportation s]vices  7a7 ,/udy  7#a7 
,9 g5]al ,because access to             
transportation s]vices is critical =    
millions ( old] individuals 9 ! ,unit$  
,/ates1 to all[ !m to ma9ta9 indep5d5ce1
 heal?1 & quality ( life1 ! ,comptroll] 
,g5]al ( ! ,unit$ ,/ates %all conduct a 

/udy ( transportation s]vices = old]    
individuals4  7#b7 ,cont5ts ,9 conduct+ 
! /udy1 ! ,comptroll] ,g5]al--  7,a7    
%all id5tify *all5ges & b>ri]s affect+ !
 ag+ network 9 provid+1 access+1 or     
coord9at+ effici5t & effective          
transportation s]vices1 includ+ *all5ges
 & b>ri]s 9 coord9at+ s]vices ) ,f$]al  
ag5cies & programs su* z ! ,dep>tm5t (  
,transportation & ! ,m$icaid program "u 
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq472 &  7,b7  
%all exam9e any ,f$]al program          
requirem5ts t may result 9 *all5ges or  
b>ri]s to ! coord9ation ( transportation
 s]vices )9 ! ag+ network at ! local    
level4  7b7 ,report ,n lat] ?an #ah     
mon?s aft] ! date ( enactm5t ( ?is ,act1
 ! ,comptroll] ,g5]al %all issue a      
report4 ,! report %all conta9 a detail$ 
description ( ! f9d+s & conclusions ( ! 
/udy1 includ+ any recomm5dations =      
adm9i/rative & o!r *anges to enhance    
transportation s]vices provid$ by ! ag+ 
network4 ,! ,comptroll] ,g5]al %all     

submit ! report to ! ,committee on      
,education & ! ,work=ce ( ! ,h\se (     
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate4  #ad4 ,guidance on s]v+      
,holocau/ survivors  7a7 ,9 g5]al       
,because ! s]vices "u ! ,old] ,am]icans 
,act ( #aife 7#db ,u4,s4,c4 #cjja et    
seq47 are critical to meet+ ! urg5t ne$s
 ( ,holocau/ survivors to age 9 place ) 
dignity1 com=t1 security1 & quality (   
life1 ! ,assi/ant ,secret>y = ,ag+ %all 
issue guidance to ,/ates1 t %all be     
applicable to ,/ates1 area ag5cies on   
ag+1 & provid]s ( s]vices = old]        
individuals1 ) respect to s]v+ ,holocau/
 survivors1 includ+ guidance on promis+ 
practices = conduct+ outrea* to t       
population4 ,9 develop+ ! guidance1 !   
,assi/ant ,secret>y = ,ag+ %all consult 
) exp]ts & organizations s]v+ ,holocau/ 
survivors1 & %all take into acc\nt !    
possibility t ! ne$s ( ,holocau/        
survivors may diff] bas$ on geography4  
7b7 ,cont5ts ,! guidance %all include ! 

foll[+3  7#a7 ,h[ nutrition s]vice      
provid]s may meet ! special heal?-relat$
 or o!r diet>y ne$s ( p>ticipants 9     
programs "u ! ,old] ,am]icans ,act (    
#aife1 includ+ ne$s bas$ on religi\s1   
cultural1 or e?nic requirem5ts4  7#b7   
,h[ transportation s]vice provid]s may  
address ! urg5t transportation ne$s (   
,holocau/ survivors4  7#c7 ,h[ ,/ate    
long-t]m c>e ombudsm5 may address !     
unique ne$s ( resid5ts ( long-t]m c>e   
facilities = :om in/itutional sett+s may
 produce sights1 s\nds1 smells1         
emotions1 & r\t9es1 t c induce panic1   
anxiety1 & retraumatization z a result (
 exp]i5ces f ! ,holocau/4  7#d7 ,h[     
supportive s]vices provid]s may consid] 
! unique ne$s ( ,holocau/ survivors4    
7#e7 ,h[ o!r s]vices provid$ "u t ,act1 
z det]m9$ by ! ,assi/ant ,secret>y =    
,ag+1 may s]ve ,holocau/ survivors4  7c7
 ,date ( issuance ,! guidance describ$ 9
 subsection 7a7 %all be issu$ n lat] ?an
 #ahj days aft] ! date ( enactm5t ( ?is 
,act4