Library / Laws / 113th / s / S. 1028 / Introduced in Senate
II
113th CONGRESS
1st Session
S. 1028
IN THE SENATE OF THE UNITED STATES
May 23, 2013
Mr. Sanders (for
himself, Ms. Klobuchar,
Ms. Warren, Ms.
Baldwin, Mrs. Boxer,
Mr. Merkley, Mr. Blumenthal, Mr.
Franken, Mr. Schatz,
Mr. Johnson of South Dakota,
Mr. Cardin, Mrs. Gillibrand, Mr.
Leahy, Mr. Casey, and
Mr. Nelson) introduced the following
bill; which was read twice and referred to the
Committee on Health, Education, Labor,
and Pensions
A BILL
To reauthorize and improve the Older Americans Act of
1965, and for other purposes.
1.
Short
title; table of contents
(a)
Short
title
This Act may be cited
as the Older Americans Act Amendments
of 2013.
(b)
Table of
contents
Sec. 1. Short title; table of
contents.
Sec. 2. Findings.
TITLE I—Declaration of objectives; definitions
Sec. 101. Declaration of objectives.
Sec. 102. Definitions.
TITLE II—Administration on aging
Sec. 201. Establishment of Administration on Aging.
Sec. 202. Functions of Assistant Secretary.
Sec. 203. Federal agency consultation.
Sec. 204. Evaluation.
Sec. 205. Reports.
Sec. 206. Conforming amendments.
Sec. 207. Authorization of appropriations.
Sec. 208. Advisory Committee to Assess, Coordinate, and Improve
Legal Assistance Activities.
Sec. 209. Consumer Price Index.
Sec. 210. Sense of the Senate regarding appropriation
levels.
TITLE III—Grants for state and community programs on
aging
Sec. 301. Purpose; administration.
Sec. 302. Definition.
Sec. 303. Authorization of appropriations.
Sec. 304. Allotments.
Sec. 305. Organization.
Sec. 306. Area plans.
Sec. 307. State plans.
Sec. 308. Planning, coordination, evaluation, and
administration of State plans.
Sec. 309. Nutrition services incentive program.
Sec. 310. Consumer contributions.
Sec. 311. Supportive services and senior centers
program.
Sec. 312. Nutrition services.
Sec. 313. Disease prevention and health promotion
services.
Sec. 314. National family caregiver support
program.
TITLE IV—Activities for health, independence, and
longevity
Sec. 401. Grant programs.
Sec. 402. Community innovations for aging in place.
Sec. 403. Multipurpose senior center modernization, training,
and support.
Sec. 404. Demonstration program on care coordination and
service delivery.
Sec. 405. Grants or contracts to facilitate low-income access
to dental care.
Sec. 406. National Resource Center on Family
Caregiving.
Sec. 407. Conforming amendment.
TITLE V—Community service senior opportunities
Sec. 501. Older American Community Service Employment
Program.
Sec. 502. Interagency cooperation.
Sec. 503. Authorization of appropriations.
Sec. 504. Study on feasibility of transfer of
program.
TITLE VI—Grants for native americans
Sec. 601. Technical amendment.
Sec. 602. Conforming amendment.
Sec. 603. Reauthorization of funding for grants for Native
Americans.
TITLE VII—Vulnerable elder rights protection
activities
Sec. 701. Establishment.
Sec. 702. Authorization of appropriations.
Sec. 703. Grants.
Sec. 704. Eligibility.
Sec. 705. Additional State plan requirements.
Sec. 706. Definitions.
Sec. 707. State Long-Term Care Ombudsman program.
Sec. 708. Prevention of elder abuse, neglect, and
exploitation.
Sec. 709. State legal assistance development.
Sec. 710. State Home Care Ombudsman Programs.
TITLE VIII—Geriatrics and gerontology
Sec. 801. Primary health services.
2.
Findings
Congress finds the following:
(1) Older adults are
the fastest growing segment of the Nation’s population.
(2) Every day, 10,000
Baby Boomers turn 65.
(3) One in 5 of those
individuals age 65 and older survives on an average of $7,500 a year.
(4) Federal funding
to support older adults and their caregivers has not kept pace with
inflation.
(5) Only 7 percent of
individuals who are food insecure get a home-delivered meal.
(6) For every
reported incident of elder abuse, neglect, exploitation, or self-neglect,
approximately 25 go unreported.
(7) By making
significant improvements through the Older Americans Act Amendments of 2013, it
is possible to improve the lives of millions of older adults, and ensure that
they receive the supports and services that they need to stay healthy and
active in their homes and communities.
I
Declaration of
objectives; definitions
101.
Declaration of
objectives
Section 101 of the
Older Americans Act of 1965 (42 U.S.C. 3001) is amended—
(1) by striking paragraph (1) and inserting the
following:
(1) An adequate
income and economic security in later life in accordance with the American
standard of
living.
;
(2) in paragraph (4),
by inserting care coordination and after
including;
(3) by striking
paragraphs (9) and (10) and inserting the following:
(9) Immediate benefit
from proven research knowledge which can sustain and improve health, happiness,
and economic security.
(10) Freedom,
independence, economic security, and the free exercise of individual initiative
for older individuals 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.
;
and
(4) by adding at the
end the following:
(11) Acquiring
high-quality services in a manner that is culturally and linguistically
responsive to older individuals and family
caregivers.
.
102.
Definitions
(a)
In
general
Section 102 of the
Older Americans Act of 1965 (42 U.S.C. 3002) is amended—
(1) by amending
paragraph (1) to read as follows:
(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) by redesignating
paragraphs (4) through (14) and (15) through (54) as paragraphs (5) through
(15) and (17) through (56), respectively;
(3) by inserting after paragraph (3) the
following:
(4) 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 case work and services; and
(D) providing,
arranging for, or facilitating the provision of services, such as medical,
social, economic, legal, housing, law enforcement, or other protective,
emergency, or support services.
;
(4) in subparagraph
(B)(i) of paragraph (12), as redesignated by paragraph (2) of this subsection,
by striking comprehensive and all that follows through
psychological, and inserting comprehensive
person-centered assessment of the older individual (including the physical,
psychological, economic,;
(5) in subparagraph
(C) of paragraph (15), as redesignated by paragraph (1) of this subsection, by
inserting , their family members, before and their
primary;
(6) by inserting
after that paragraph (15) the following:
(16)
(A) The term economic
security means access to the assets, income, and community-based
services necessary to provide for adequate and unsubsidized housing, health
care, transportation, food and adequate nutrition, long-term care, and goods
and services to meet other basic human needs. Such access shall be measured in
a manner that shall be geographically based, and take into account an
individual’s life circumstances.
(B) The term economic security and
benefits counseling means a supportive service that provides, to an
older individual, a comprehensive assessment of the Federal, State, and
community benefits and services for which the individual qualifies, along with
assistance in applying for and obtaining benefits and
services.
;
(7) by amending
paragraph (19), as redesignated by paragraph (2) of this subsection, to read as
follows:
(19) 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.
;
(8) in paragraph
(20)(A), as redesignated by paragraph (2) of this subsection, by striking
The term exploitation means and inserting
The terms exploitation and financial
exploitation mean;
(9) in paragraph
(25), as redesignated by paragraph (2) of this subsection, by striking
at or below the poverty line. and inserting that is not
more than 200 percent of the poverty line.;
(10) by striking
paragraph (26), as redesignated by paragraph (2) of this subsection, and
inserting the following:
(26) The term
greatest social need means need caused by noneconomic
factors—
(A) that—
(i) restrict the
ability of an individual to perform normal daily tasks; or
(ii) threaten the
capacity of the individual to live independently; and
(B) which
include—
(i) physical and
mental disabilities;
(ii) language
barriers including limited English proficiency;
(iii) cultural,
social, or geographic isolation (such as residence in a rural area), including
isolation caused by racial, minority, or ethnic status, or status as an LGBT
individual;
(iv) HIV-positive health status or Alzheimer's
disease or a related disorder with neurological and organic brain
dysfunction;
(v) greatest health service need, particularly
a need posed by multiple chronic health conditions or a condition that places
an individual at risk for falls;
(vi) abuse, neglect (including self-neglect), or
financial exploitation, including factors that are the basis of a referral to
adult protective services;
(vii) status as a veteran; and
(viii) status as a Holocaust
survivor.
;
(11) in paragraph
(30), as redesignated by paragraph (2) of this subsection—
(A) in subparagraph
(C), by inserting , including opportunities for paid work and volunteer
service in the community after available; and
(B) in subparagraph
(E)—
(i) in
the matter preceding clause (i), by inserting , in a culturally and
linguistically competent manner, before the entire community of
older individuals; and
(ii) in
clause (i), by inserting after social need the following:
(with particular attention to individuals with factors listed in
paragraph (26)(B));
(12) in paragraph
(31), as redesignated by paragraph (2) of this subsection, by striking
information and referral and inserting information and
referral assistance;
(13) in paragraph
(35), as redesignated by paragraph (2) of this subsection—
(A) by redesignating
clauses (i) and (ii) of subparagraph (B) as subclauses (I) and (II),
respectively, and aligning the margins of the subclauses with the margins of
subclause (I) of subparagraph (A)(i) of paragraph (34), as so
redesignated;
(B) by redesignating
subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and aligning
the margins of the clauses with the margins of clause (ii) of subparagraph (A)
of that paragraph (34);
(C) by inserting
(A) before The term; and
(D) by adding at the
end the following:
(B) The term integrated legal assistance
delivery system means a collaboratively run, statewide network that is
established to provide direct legal assistance, in the most efficient and
impactful manner possible, targeted at older individuals with greatest economic
need and older individuals with greatest social need (with particular attention
to individuals with factors listed in paragraph (26)(B)), in coordination with
the legal assistance developer for the State and all State, regional, and local
service providers engaged in promoting or supporting elder
rights.
;
(14) in paragraph
(36), as redesignated by paragraph (2) of this subsection—
(A) in subparagraph
(A), by adding and at the end;
(B) in subparagraph
(B), by striking ; and at the end and inserting a period;
and
(C) by striking
subparagraph (C);
(15) in paragraph
(37), as redesignated by paragraph (2) of this subsection, by striking
sections 307(a)(12) and and inserting the activities
carried out under section 307(a)(9);
(16) in paragraph
(38), as redesignated by paragraph (2) of this subsection, by inserting
(including elder abuse and neglect screening) after
educational services;
(17) in paragraph
(50)(B), as redesignated by paragraph (2) of this subsection, by striking
subparagraphs (A) through (G) of paragraph (8) and inserting
subparagraphs (A) through (I) of paragraph (14); and
(18) by adding at the
end the following:
(57) The term care coordination
means a person- and family-centered, assessment-based, and interdisciplinary
approach, to meet the needs and preferences of an older individual and a family
caregiver while enhancing the capabilities of the older individual (including
the ability to self-direct services), that integrates health care, long-term
services and supports, and social services in a high-quality and cost-effective
manner.
(58) The term
cultural and linguistic competence means competence in a set of
behaviors, attitudes, and policies that is—
(A) used by an
organization or among professionals; and
(B) enables effective
work in cross-cultural situations.
(59) 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 with Alzheimer's disease or a related disorder with neurological and
organic brain dysfunction.
(60) The term
Holocaust survivor means an individual who—
(A) lived in or fled
from, between 1933 and 1945, a country under a Nazi regime, under Nazi
occupation, or under the control of Nazi collaborators;
(B) was persecuted
between 1933 and 1945 on the basis of race, religion, physical or mental
disability, sexual orientation, political affiliation, ethnicity, or other
basis; and
(C) was a member of a
group that was persecuted by the Nazis.
(61) The term
LGBT, used with respect to an individual, means a lesbian, gay,
bisexual, or transgender individual.
(62) The term
person-centered, used with respect to a service for an individual,
means a service provided with an approach designed to ensure that an outcome
reflects the needs, preferences, and situations of the individual.
(63) The term
veteran has the meaning given the term in section 101 of title 38,
United States
Code.
.
(b)
Conforming
amendments
Section 102 of the Older Americans Act of 1965 (42
U.S.C. 3002), as redesignated by subsection (a)(2), is amended—
(1) in paragraph
(39)(A), by striking as defined in paragraph (5) and inserting
as defined in paragraph (28);
(2) in paragraph
(40), by striking (as defined in paragraph (18)(B)) and
inserting (as defined in paragraph (20)(B)); and
(3) in paragraph
(48)(D), by striking (as defined in paragraph (18)(B)) and
inserting (as defined in paragraph (20)(B)).
II
Administration
on aging
201.
Establishment
of Administration on Aging
Section 201 of the Older Americans Act of
1965 (42 U.S.C. 3011) is amended—
(1) in subsection
(d)(3)—
(A) in subparagraph
(K), by striking ; and and inserting a semicolon;
(B) in subparagraph
(L)—
(i) by striking Older Americans Act
Amendments of 1992 and inserting Older Americans Act Amendments
of 2013; and
(ii) by striking
712(h)(4). and inserting 712(h)(5); and;
and
(C) by adding at the
end the following:
(M) collect and
analyze best practices related to screening for elder abuse and publish a
report of such best
practices.
;
(2) in subsection
(e)(2)—
(A) in the matter
preceding subparagraph (A), by inserting , and in coordination with the
heads of State adult protective services programs and the State Long-Term Care
Ombudsmen after and services;
(B) in subparagraph (A), by striking
and at the end;
(C) in subparagraph
(B), by striking the period and inserting ; and; and
(D) by adding at the
end the following:
(C) to assist States
with the development of Home Care Consumer Bills of Rights and Plans for
Enforcement, to ensure that home care consumers, as defined in section 736,
have basic protections as outlined in subsections (b) and (c) of section
705.
;
and
(3) by adding at the
end the following:
(g) The Assistant
Secretary is authorized to use funds appropriated to carry out this Act to
implement activities authorized under part I of subtitle B of title XX of the
Social Security Act (42 U.S.C. 1397k et seq.), including the establishment of
the Advisory Board on Elder Abuse, Neglect, and Exploitation, and to continue
the work of the Elder Justice Coordinating
Council.
.
202.
Functions of
Assistant Secretary
Section
202 of the Older Americans Act of 1965 (42 U.S.C. 3012) is amended—
(1) in subsection (a)—
(A) in paragraph (5), by inserting
economic security, after nutrition,;
(B) in paragraph (7), by inserting ,
including economic security trends among such individuals after
older individuals;
(C) in paragraph (8),
by striking older individuals and inserting the health
and economic security of older individuals;
(D) in paragraph (14), by inserting for
working with the Administrator of the Health Resources and Services
Administration and the Secretary of Labor to identify and address workforce
shortages involving such personnel, after field of
aging,;
(E) by striking paragraph (15) and inserting
the following:
(15)
(A) as needed, provide
technical assistance, training through training packages, and other forms of
instruction to entities consisting of State agencies, area agencies on aging,
service providers, and community-based organizations, to ensure that the
entities develop and implement, in a culturally and linguistically competent
manner, programming, services, and outreach for older individuals with greatest
economic need and older individuals with greatest social need (with particular
attention to providing services to individuals with factors listed in section
102(26)(B); and
(B) consult with national and
community-based organizations representing minority individuals to develop the
capacity of the Administration to provide such technical assistance, training,
and
instruction.
;
(F) in paragraph
(16)(C), by striking paragraphs (2) and (5)(A) and inserting
paragraphs (2) and (4)(A);
(G) in paragraph (18), by amending subparagraph
(B) to read as follows:
(B) make available to
the Center—
(i) for fiscal year
2014, not less than $2,000,000; and
(ii) for each
subsequent fiscal year, not less than the amount made available under this
subparagraph for fiscal year
2014.
;
(H) by striking
paragraph (22) and inserting the following:
(22) develop
guidelines for area agencies on aging to follow in choosing and evaluating
providers of legal assistance with the capacity to work within an integrated
legal assistance delivery
system;
;
(I) in paragraph
(23), by striking all text following developers and inserting
referred to in section 307(a)(13) and section 731;;
(J) in paragraph
(27), by striking and at the end;
(K) in paragraph
(28), by striking the period and inserting a semicolon; and
(L) by adding at the
end the following:
(29)
(A) encourage, provide
technical assistance to and share best practices with, States, area agencies on
aging, Aging and Disability Resource Centers, and service providers to carry
out outreach and coordinate activities with health care entities, such as
Federally qualified health centers, in order to assure better care coordination
for individuals with multiple chronic illnesses; and
(B) coordinate activities with other
Federal agencies that are working to improve care coordination and developing
new models and best practices for that
coordination.
;
(2) in subsection
(b)—
(A) in paragraph (8)—
(i) in subparagraph (D)—
(I) by inserting
, and with future planning for eligible care recipients (as defined in
section 372(a)) who are individuals with disabilities described in section
372(a)(2)(B) and who are living with older relative caregivers (as so
defined) after needs; and
(II) by striking and at the
end;
(ii) in subparagraph (E), by striking the
semicolon at the end and inserting ; and; and
(iii) by adding at the end the following:
(F) to provide
information relating to the quality measures identified under paragraph
(11)(A), using the methods described in paragraph (11)(B), about home and
community-based long-term care programs, service providers, and resources, when
referring consumers to those programs, providers, or
resources;
;
(B) in paragraph
(10), by striking and at the end;
(C) by redesignating
paragraph (11) as paragraph (12); and
(D) by inserting
after paragraph (10) the following:
(11) identify, in
consultation with States (either directly or by entering into a contract under
this subparagraph and considering the recommendation of the contract recipient)
quality measures for home and community-based long-term care programs, service
providers, and resources that—
(A) protect the
health, safety, and welfare of consumers who are referred to such programs;
and
(B) shall be
identified after the Assistant Secretary takes into account, at a minimum,
information regarding—
(i) background checks
of service providers;
(ii) licensure of
agencies and certification and training of service providers; and
(iii) consumer
satisfaction regarding programs, service providers, and resources, in cases in
which consumer satisfaction information is available;
and
;
(3) in subsection
(e)(2)(B)—
(A) in clause (viii),
by striking and;
(B) by redesignating
clause (ix) as clause (x); and
(C) by inserting
after clause (viii) the following:
(ix) organizations with expertise on
economic security, asset accumulation, and retirement planning;
and
;
and
(4) by adding at the
end the following:
(g) The Assistant
Secretary shall ensure, where appropriate, that all programs funded 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)
(1) The Assistant Secretary
shall establish and operate a National Resource Center for Women and Retirement
(referred to in this subsection as the Center).
(2) 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, which shall be an
amount not less than $279,000 for fiscal year 2014. In subsequent fiscal years,
the Assistant Secretary shall make available to the Center not less than the
amount of resources made available to the Center under this paragraph for
fiscal year 2014.
(i)
(1) Aging and Disability
Resource Centers implemented under subsection (b)(8) may carry out an
assessment program, with respect to informal caregivers and care recipients,
that shall be modeled on the family caregiver assessment program established
under section 373(b).
(2) For purposes of an informal caregiver
assessment carried out in accordance with paragraph (1), the following
definitions shall apply:
(A) The term care recipient
means—
(i) an older individual;
(ii) an individual with a disability;
or
(iii) an individual with a special
need.
(B) The term informal
caregiver means an adult family member, or another individual, who is an
informal provider of in-home and community care to a care recipient.
(j)
(1) The Assistant Secretary
shall, directly or by grant or contract, establish and operate the National
Resource Center on Lesbian, Gay, Bisexual, and Transgender Aging.
(2) The Assistant Secretary shall develop
and issue operating standards and reporting requirements for the Center
established under paragraph (1).
(3) 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 for fiscal year
2014. In subsequent fiscal years, the Assistant Secretary shall make available
to the Center not less than the amount of resources made available to the
Center under this paragraph for fiscal year 2014.
(k) The Assistant
Secretary shall, directly or by grant or contract, establish and operate a
National Adult Protective Services Resource
Center.
.
203.
Federal agency
consultation
Section 203 of
the Older Americans Act of 1965 (42 U.S.C. 3013) is amended—
(1) in subsection
(a)(3)(A), by striking 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 inserting older individuals, older
individuals with greatest economic need, older individuals with greatest social
need (with particular attention to individuals with factors listed in section
102(26)(B)),;
(2) in subsection
(b)—
(A) in paragraph
(18), by striking , and and inserting a comma;
(B) in paragraph
(19), by striking the period at the end and inserting , and;
and
(C) by adding at the
end the following:
(20) the Patient
Protection and Affordable Care Act, including the amendments made by that Act
(Public Law 111–148), including programs that increase integration with
community health centers, as
practicable.
;
and
(3) in subsection
(c)(6)—
(A) in subparagraph
(A)—
(i) in clause
(iii)—
(I) by inserting
and economic after demographic; and
(II) 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 and addressing
workforce shortages related to services and supports for older individuals, and
leveraging the resources of Federal programs that are related to the programs
carried out under this Act, to address the
shortages;
;
(B) in subparagraph
(B)—
(i) in the matter
preceding clause (i), by inserting economic security, after
housing,; and
(ii) in clause (i),
by inserting economic security, after
housing,;
(C) in subparagraph
(D), by inserting economic security, after
housing,;
(D) in subparagraph
(E), by inserting and economic security after public
health;
(E) in subparagraph
(F), by striking and at the end;
(F) in subparagraph
(G)—
(i) in the matter
preceding clause (i), by inserting economic security, after
health care,; and
(ii) in clause (iii),
by striking the period at the end and inserting ; and;
and
(G) by adding at the
end the following:
(H)
(i) identify model Federal
programs to assist older individuals with achieving economic security;
and
(ii) propose greater coordination of
efforts to provide such assistance, including by creating an inventory of all
Federal programs aimed at reducing poverty and increasing the economic security
of older
adults.
.
204.
Evaluation
Section 206 of the Older Americans Act of
1965 (42 U.S.C. 3017) is amended—
(1) in subsection
(a), by striking greatest economic need and all that follows
through areas), and inserting greatest economic need and
unserved older individuals with greatest social need (with particular attention
to individuals with factors listed in section 102(26)(B)),;
(2) in subsection
(c), by striking minority individuals and all that follows
through disabilities and inserting individuals with
greatest economic need and greatest social need (with particular attention to
individuals with factors listed in section 102(26)(B));
(3) in subsection
(d), by striking including, as appropriate, health and nutrition
education demonstration projects conducted under section 307(f) the full
contents of which shall be and inserting and the full contents
of those summaries and analyses shall be;
(4) by redesignating
subsections (e) through (g) as subsections (f) through (h),
respectively;
(5) by inserting
after paragraph (d) the following:
(e) The Secretary
shall prepare and submit to Congress an annual report evaluating the impact of
the programs and services provided under this Act on the economic security of
older individuals.
; and
(6) in subsection (h), as redesignated by
paragraph (2), by striking 1/2 of.
205.
Reports
Section 207 of the Older Americans Act of
1965 (42 U.S.C. 3018) is amended—
(1) in subsection (a)—
(A) in paragraph (2),
by striking section 202(a)(19) and inserting section
202(a)(16);
(B) in paragraph (3), by striking , with
particular attention and all that follows through the semicolon and
inserting (with particular attention to individuals with factors listed
in section 102(26)(B));; and
(C) in paragraph (4),
by striking section 202(a)(17) and inserting section
202(a)(14);
(2) in subsection (b)—
(A) in paragraph (1)(C), by inserting
and the adult protection services programs of the States after
of the States; and
(B) in paragraph
(3)(A), by striking Health Care Finance Administration and
inserting Centers for Medicare & Medicaid Services;
(3) in subsection
(c)(5)—
(A) by striking
economic need (including low-income minority individuals and older
individuals residing in rural areas) and inserting economic
need; and
(B) by striking
social need (including low-income minority individuals and older
individuals residing in rural areas) and inserting social need
(with particular attention to individuals with factors listed in section
102(26)(B)); and
(4) by adding at the
end the following:
(d) The Assistant
Secretary shall ensure that no individual will be required to provide
information regarding the sexual orientation or gender identity of the
individual as a condition of participating in activities or receiving services
under this
Act.
.
206.
Conforming
amendments
(a)
Appropriate use
of funds
Section 212(b)(3) of the Older Americans Act of 1965 (42
U.S.C. 3020c(b)(3)) is amended—
(1) by striking
social need, and inserting social need (with particular
attention to individuals with factors listed in section 102(26)(B)) or;
and
(2) by striking
, or an older and all that follows through
placement.
(b)
Administrative
expenses
Section 215(j) of
the Older Americans Act of 1965 (42 U.S.C. 3020e–1(j)) is amended by striking
section 216 and inserting section 217.
207.
Authorization
of appropriations
Section 216
of the Older Americans Act of 1965 (42 U.S.C. 3020f) is amended—
(1) in subsection
(a), by striking 2007, 2008, 2009, 2010, and 2011 and inserting
2014, 2015, 2016, 2017, and 2018;
(2) in subsection
(b)—
(A) by striking
section 202(a)(24) and inserting section
202(a)(21); and
(B) by striking
2007, 2008, 2009, 2010, and 2011 and inserting 2014,
2015, 2016, 2017, and 2018;
(3) in subsection
(c), by striking 2007, 2008, 2009, 2010, and 2011 and inserting
2014, 2015, 2016, 2017, and 2018; and
(4) by adding at the
end the following:
(d)
National Adult Protective Services Resource
Center
There are authorized
to be appropriated to carry out section 201(i) (relating to the National Adult
Protective Services Resource Center), such sums as may be necessary for fiscal
years 2014, 2015, 2016, 2017, and 2018.
(e)
Advisory
Committee To Assess, Coordinate, and Improve Legal Assistance
Activities
There is authorized to be appropriated to carry out
section 216, not less than $300,000 for fiscal year
2014.
.
208.
Advisory
Committee to Assess, Coordinate, and Improve Legal Assistance
Activities
Title II of the
Older Americans Act of 1965 is amended—
(1) by redesignating
section 216 (42 U.S.C. 3020f) as section 217; and
(2) by inserting
after section 215 (42 U.S.C. 3020e–1) the following:
216.
Advisory
Committee to Assess, Coordinate, and Improve Legal Assistance
Activities
(a)
Establishment
There
is established an Advisory Committee to Assess, Coordinate, and Improve Legal
Assistance Activities (referred to in this section as the
Committee).
(b)
Membership;
duties
The Assistant Secretary shall appoint members to the
Committee and determine the activities of the Committee (which shall include
the study and report described in subsection (c)).
(c)
Study;
report
The Committee shall conduct a study on the legal services
activities assistance system for older individuals. Not later than 1 year after
the date of the establishment of the Committee, the Committee shall submit to
the President, Congress, and the Assistant Secretary a report that contains a
detailed statement of the findings and conclusions of such study, including the
Committee’s recommendations improving the legal services activities assistance
system for older individuals.
(d)
Regulations
Not
later than 180 days after receiving the report described in subsection (c), the
Assistant Secretary shall issue regulations or guidance taking into
consideration the recommendations of the Committee.
(e)
Definition
In
this subsection, the term legal assistance activities
includes—
(1) legal assistance
made available to older individuals with greatest economic need or with
greatest social need;
(2) activities of the
National Legal Resource Center carried out under section 420(a);
(3) State legal
assistance developer activities carried out under section 731; and
(4) any other
directly related activity or program as determined appropriate by the Assistant
Secretary.
.
209.
Consumer Price
Index
(a)
In
general
The Secretary of
Labor, through the Bureau of Labor Statistics and in consultation with the
Assistant Secretary for Aging, shall revise and improve the Experimental Price
Index for the Elderly published by the Bureau of Labor Statistics (commonly
referred to as the CPI–E) in order for the CPI–E to be
considered a reliable measure in determining future cost of living adjustments
that impact Americans who are 62 years of age or older.
(b)
Revision
requirements
In carrying out
subsection (a), the Secretary of Labor shall—
(1) increase the number of individuals in the
United States who are 62 years of age and older (referred to in this section as
older adults) sampled in the consumer expenditure survey used to
establish the CPI–E;
(2) establish samples of market-based items,
stores, and prices to represent the purchasing patterns of older adults;
and
(3) examine the medical care component,
including the cost and usage of prescription drugs, of the CPI–E taking into
account that older adults have different illnesses and health care expenses,
including dental expenses, than individuals in the United States who are under
62 years of age.
(c)
Report to
Congress
Not later than 2 years after the date of enactment of
this Act, the Secretary of Labor shall submit to Congress a report that
describes the revised CPI–E and the activities carried out by the Secretary
under this section.
210.
Sense of the
Senate regarding appropriation levels
Title II of the Older Americans Act of 1965
(42 U.S.C. 3011 et seq.), as amended by section 208, is further amended by
adding at the end the following:
218.
Sense of the
Senate regarding appropriation levels
It is the sense of the Senate that the
amount appropriated under this Act should be not less than $2,675,000,000 for
fiscal year 2014 and each subsequent
year.
.
III
Grants for
state and community programs on aging
301.
Purpose;
administration
Section
301(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 3021(a)(2)) is
amended—
(1) in subparagraph
(E), by striking and at the end;
(2) in subparagraph
(F), by striking the period and inserting ; and; and
(3) by adding at the
end the following:
(G) Federally
qualified health centers, as defined in sections 1861(aa)(4) and 1905(l)(2)(B)
of the Social Security Act (42 U.S.C. 1395x(aa)(4),
1396d(l)(2)(B)).
.
302.
Definition
Section 302 of the Older Americans Act of
1965 (42 U.S.C. 3022) is amended—
(1) by striking
paragraph (3); and
(2) by redesignating
paragraph (4) as paragraph (3).
303.
Authorization
of appropriations
Section 303
of the Older Americans Act of 1965 (42 U.S.C. 3023) is amended—
(1) in subsection (a), by striking paragraph
(1) and inserting the following:
(1) There are authorized to be
appropriated to carry out part B (relating to supportive services) such sums as
may be necessary for each of fiscal years 2014 through
2018.
;
(2) by striking
subsection (b) and inserting the following:
(b)
(1) There are authorized to
be appropriated to carry out subpart 1 of part C (relating to congregate
nutrition services) such sums as may be necessary for each of fiscal years 2014
through 2018.
(2) There are authorized to be
appropriated to carry out subpart 2 of part C (relating to home delivered
nutrition services) such sums as may be necessary for fiscal years 2014 through
2018.
;
(3) by striking
subsection (d) and inserting the following:
(d) There are
authorized to be appropriated to carry out part D (relating to disease
prevention and health promotion services) such sums as may be necessary for
each of fiscal years 2014 through 2018.
;
and
(4) by striking
subsection (e) and inserting the following:
(e) There are
authorized to be appropriated to carry out part E (relating to family caregiver
support) such sums as may be necessary for each of fiscal years 2014 through
2018.
.
304.
Allotments
Section 304(b) of such Act (42 U.S.C.
3024(b)) is amended, in the first sentence, by striking part B
and all that follows through part E, and inserting part
B, C, or E.
305.
Organization
Section 305 of the Older Americans Act of
1965 (42 U.S.C. 3025) is amended—
(1) in subsection
(a)—
(A) in paragraph
(1)(E)—
(i) by
striking greatest economic need and all that follows through
rural areas) the first place it appears and inserting
greatest economic need; and
(ii) by striking
greatest social need and all that follows through rural
areas) and inserting greatest social need (with particular
attention to individuals with factors listed in section 102(26)(B));
and
(B) in paragraph
(2)—
(i) in
subparagraph (C)(ii), by striking areas and all that follows and
inserting areas of older individuals with greatest economic need and
older individuals with greatest social need (with particular attention to
individuals with factors listed in section 102(26)(B)); and;
(ii) in subparagraph
(E), by striking services to and all that follows through
rural areas) and inserting services to older individuals
with greatest economic need and older individuals with greatest social need
(with particular attention to individuals with factors listed in section
102(26)(B); and
(iii) in subparagraph
(G), by striking clause (ii) and inserting the following:
(ii) provide an
assurance that the State agency will undertake specific program development,
advocacy, and outreach efforts focused on the needs of older individuals with
greatest social need (with particular attention to individuals with factors
listed in section 102(26)(B)) and older individuals with greatest economic
need; and
;
(2) in subsection
(b)(5)(C)(i)(III), by striking planning and services areas and
inserting planning and service areas; and
(3) in subsection
(d)(1), by striking greatest economic or social need and
inserting greatest economic need and greatest social need (with
particular attention to individuals with factors listed in section
102(26)(B)).
306.
Area
plans
Section 306 of the Older
Americans Act of 1965 (42 U.S.C. 3026) is amended—
(1) in subsection
(a)—
(A) in paragraph
(1)—
(i) by
striking maintenance, or construction of multipurpose senior
centers and inserting maintenance, modernization, or
construction of multipurpose senior centers (which system includes a plan to
use the skills and services of older individuals in paid and unpaid work,
including multigenerational work and older individual-to-older individual
service activities, relating to such maintenance, modernization, or
construction, or activities at the centers);
(ii) by striking
greatest economic need and all that follows through rural
areas) the first place it appears and inserting greatest
economic need; and
(iii) by striking
greatest social need and all that follows through rural
areas) residing in such area, and inserting greatest social need
(with particular attention to individuals with factors listed in section
102(26)(B)) residing in such area,;
(B) in paragraph
(2)(A)—
(i) by
striking mental health services and inserting
evidence-based behavioral health services, evidence-based chronic
condition self-care management programs, and evidence-based falls prevention
programs; and
(ii) by
striking eligible) and inserting eligible and shall
include information on paid and unpaid work opportunities for older
individuals, as available);
(C) in paragraph
(4)—
(i) in subparagraph
(A)—
(I) in clause (i)(I),
by striking will— and all that follows and inserting will
set specific objectives, consistent with State policy, for providing services
to older individuals with greatest economic need, older individuals with
greatest social need (with particular attention to individuals with factors
listed in section 102(26)(B)), and older individuals at risk for institutional
placement; and;
(II) in clause
(i)(II), by striking items (aa) and (bb) of; and
(III) in subclauses
(I), (II), and (III) of clause (ii), by striking low-income and
all that follows through rural areas and inserting
individuals with greatest economic need and individuals with greatest
social need (with particular attention to individuals with factors listed in
section 102(26)(B)); and
(ii) in subparagraph
(B)(i)—
(I) in subclause
(II), by striking economic need and all that follows through
rural areas) and inserting economic need;
(II) in subclause
(III), by striking social need and all that follows through
rural areas) and inserting social need (with particular
attention to individuals with factors listed in section 102(26)(B));
and
(III) in subclause
(VII), by inserting with multiple chronic illnesses or after
older individuals;
(D) in paragraph
(6)—
(i) in
subparagraph (D), by inserting (including acute care providers)
after service providers;
(ii) in
subparagraph (E)(ii), by inserting and Federally qualified health
centers, as defined in sections 1861(aa)(4) and 1905(l)(2)(B) of the Social
Security Act (42 U.S.C. 1395x(aa)(4), 1396d(l)(2)(B)) after
203(b); and
(iii) by adding at
the end the following:
(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 elder abuse education, prevention,
investigation, and treatment; and
(I) serve as an
advocate in the corresponding planning and service area for evidence-based
falls prevention programs and policies for older individuals and, if possible,
enter into partnerships with State government agencies (such as the State
health agency and State transportation agency), local agencies, and
community-based organizations that implement evidence-based falls prevention
programs and
policies;
;
(E) in paragraph
(7)—
(i) in
subparagraph (B)(iii), by striking placement, to permit such
individuals and inserting placement, with particular attention
to individuals with factors listed in section 102(26)(B), to permit such
at-risk individuals;
(ii) in
subparagraph (C)—
(I) by inserting
(including falls) after injury; and
(II) by striking
and at the end; and
(iii) in subparagraph
(D), by adding and at the end;
(F) by striking
paragraph (9) and inserting the following:
(9) provide
assurances that the area agency on aging, in carrying out the State Long-Term
Care Ombudsman program described in section 307(a)(9), will—
(A) provide adequate
funding to carry out an effective Ombudsman program in compliance with this
Act; and
(B) expend to carry
out the program not less than the total amount of funds appropriated under this
Act or made available through other resources, and expended by the agency in
fiscal year 2010, in carrying out such a program under this
Act;
;
(G) in paragraph
(16), by striking and at the end;
(H) in paragraph
(17)—
(i) by
inserting and revise after develop;
(ii) by
inserting and health after State emergency
response; and
(iii) by striking the
period and inserting ; and; and
(I) by adding at the
end the following:
(18) include
information describing—
(A) how the area
agency on aging will engage in outreach to veterans who are eligible for
services under this Act; and
(B) effective and
efficient procedures for the coordination of services provided under this Act
with services provided to veterans by the Department of Veterans Affairs and
other providers.
;
and
(2) in subsection
(b)—
(A) in paragraph
(2)(B), by striking including individuals and all that follows
and inserting including older individuals with greatest economic need
and older individuals with greatest social need (with particular attention to
individuals with factors listed in section 102(26)(B));; and
(B) in paragraph
(3)—
(i) in
subparagraph (J), by striking and;
(ii) by
redesignating subparagraph (K) as subparagraph (L); and
(iii) by inserting
after subparagraph (J) the following:
(K) protection from
elder abuse, neglect, and exploitation;
and
.
307.
State
plans
Section 307(a) of the
Older Americans Act of 1965 (42 U.S.C. 3027(a)) is amended—
(1) in paragraph (2),
by striking subparagraph (A) and inserting the following:
(A) evaluate, using
uniform procedures described in section 202(a)(26), the need for supportive
services (including legal assistance pursuant to paragraph (11), information
and assistance services, care coordination, and transportation services),
nutrition services, economic security and benefits counseling, and multipurpose
senior centers within the
State;
;
(2) in paragraph (4),
by striking provided to individuals and all that follows and
inserting provided to individuals with greatest economic need and
individuals with greatest social need (with particular attention to individuals
with factors listed in section 102(26)(B)).;
(3) by striking
paragraph (9) and inserting the following:
(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, in carrying out the program,
will—
(A) provide adequate
funding to carry out an effective Ombudsman program in compliance with this
Act; and
(B) expend to carry
out the program not less than the total amount of funds appropriated under this
Act or made available through other resources, and expended by the agency in
fiscal year 2010, in carrying out such a program under this
Act.
;
(4) in paragraph
(11)—
(A) in the matter
preceding subparagraph (A), by striking legal assistance— and
inserting legal assistance, which shall be provided through an
integrated legal assistance delivery system—; and
(B) in subparagraph
(B), by striking individuals with the greatest such need; and
inserting individuals with greatest economic need and individuals with
greatest social need (with particular attention to individuals with factors
listed in section 102(26)(B)),;
(5) by striking
paragraph (15) and inserting the following:
(15) The plan shall
provide assurances that programming and services will be provided in a
culturally and linguistically competent manner to older individuals with
greatest social
need.
;
(6) in paragraph
(16)—
(A) in subparagraph
(A), by striking clauses (i) through (vi) and inserting the following:
(i) older individuals
with greatest economic need;
(ii) older
individuals with greatest social need (with particular attention to individuals
with factors listed in section 102(26)(B)); and
(iii) caregivers of
individuals described in clause (i) or (ii);
and
;
and
(B) in subparagraph
(B)—
(i) by
striking through (vi) and inserting and (ii);
and
(ii) by
striking caretakers and inserting
caregivers;
(7) in paragraph
(23)(A), by striking with other State services and inserting
with other Federal and State health care programs and
services;
(8) in paragraph
(28)(B)—
(A) by striking
clause (i) and inserting the following:
(i) the projected
change in the number of older individuals in the State, and information
indicating the dispersal and growth in the number of older individuals with
greatest social need in each planning and service area in the
State;
;
and
(B) in clause (ii),
by striking including individuals and all that follows and
inserting including older individuals with greatest economic need and
older individuals with greatest social need (with particular attention to
individuals with factors listed in section 102(26)(B));; and
(9) by adding at the
end the following:
(31) The plan shall
include information describing—
(A) how the State
agency will engage in outreach to veterans who are eligible for services under
this Act; and
(B) effective and
efficient procedures for the coordination of services provided under this Act
with services provided to veterans by the Department of Veterans Affairs and
other providers.
(32) The plan shall
include an assurance that the State has made efforts to train relevant staff to
recognize the common signs and symptoms of possible
dementia.
.
308.
Planning,
coordination, evaluation, and administration of state plans
Section 308(a)(1) of the Older Americans Act
of 1965 (42 U.S.C. 3028(a)(1)) is amended—
(1) by striking
this Act, and and inserting this Act,; and
(2) by inserting
before the period the following: , and the modernization of such senior
centers.
309.
Nutrition
services incentive program
Section 311(e) of the Older Americans Act of
1973 (42 U.S.C. 3030a(e)) is amended by striking fiscal year
2007 and all that follows and inserting each of fiscal years
2014 through 2018.
310.
Consumer
contributions
Section 315 of
the Older Americans Act of 1965 (42 U.S.C. 3030c–2) is amended—
(1) in subsection
(b)—
(A) in paragraph (1),
by striking 185 percent and inserting 200
percent; and
(B) in paragraph (3),
by adding at the end the following: Contributions under this section
shall be used to supplement, and not to supplant, any other funds expended for
activities described in this Act.;
(2) in subsection
(c)(2), by striking participation of and all that follows
through rural areas) and inserting participation of older
individuals with greatest economic need and older individuals with greatest
social need (with particular attention to individuals with factors listed in
section 102(26)(B)); and
(3) in subsection
(d)—
(A) by striking
Not later and all that follows through shall
conduct and inserting Not later than January 1, 2015, and
annually thereafter, the Assistant Secretary shall conduct, and submit to the
appropriate committees of Congress a report containing the results of,;
and
(B) by striking
(with particular and all that follows through rural
areas) and inserting , including participation rates for
individuals with greatest economic need and individuals with greatest social
need (with particular attention to individuals with factors listed in section
102(26)(B)).
311.
Supportive
services and senior centers program
Section 321 of the Older Americans Act of
1965 (42 U.S.C. 3030d) is amended—
(1) in subsection
(a)—
(A) in paragraph
(5)(C), by striking and letter writing services and inserting
evidence-based chronic condition self-care management, letter writing
services, and evidence-based falls prevention programs;
(B) in paragraph
(8)—
(i) by
inserting , screening for elder abuse and neglect, and falls prevention
screening after mental health screening; and
(ii) by
striking illness, or both, and inserting illnesses and
injuries; and
(C) in paragraph
(15), by inserting before the semicolon the following: and elder abuse
and neglect screening, chronic condition self-care management, and falls
prevention services; and
(2) in subsection
(b)(1), by inserting or modernization after
construction.
312.
Nutrition
services
(a)
In
general
Section 339 of the Older Americans Act of 1965 (42 U.S.C.
3030g–21) is amended—
(1) in paragraph
(1)—
(A) by striking
solicit and inserting utilize; and
(B) by inserting
, to help achieve development of evidenced-based and cost-effective
nutrition services after nutritional services;
and
(2) in paragraph
(2)—
(A) in subparagraph
(A), by amending clause (iii) to read as follows:
(iii) to the maximum
extent practicable, are adjusted and appropriately funded to meet any special
health-related or other dietary needs of program participants, including needs
based on religious, cultural, or ethnic
requirements,
;
(B) in subparagraph
(J), by striking and at the end;
(C) in subparagraph
(K), by striking the period and inserting ; and; and
(D) by adding at the
end the following:
(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.
.
(b)
Special
rule
Section 339 of the Older Americans Act of 1965 (42 U.S.C.
3030g–21) is amended—
(1) by inserting
before A State the following:
(a)
In
general
;
and
(2) by adding at the
end the following:
(b)
Transportation
Funds
appropriated to carry out this part may be used for transportation costs that
can be demonstrated to be directly related to the provision of services
specified in this
part.
.
313.
Disease
prevention and health promotion services
(a)
Program
Section
361 of the Older Americans Act of 1965 (42 U.S.C. 3030m) is amended—
(1) in subsection
(a), in the first sentence—
(A) by inserting
evidence-based after to provide;
(B) by inserting
(including cognitive health promotion services) after
health promotion services; and
(C) by inserting
before or at the following: at Federally qualified health
centers (as defined in sections 1861(aa)(4) and 1905(l)(2)(B) of the Social
Security Act (42 U.S.C. 1395x(aa)(4), 1396d(l)(2)(B))),.
(2)
Clinical
preventive services
Part D of title III of the Older Americans
Act of 1965 (42 U.S.C. 3030m et seq.) is amended by adding at the end the
following:
363.
Clinical
preventive services
Congress
finds that—
(1) there are clinical preventive services (as
defined in a manner consistent with the recommendations of the U.S. Preventive
Services Task Force) covered under the Medicare program carried out under title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); and
(2) older adults should receive the clinical
preventive services described in paragraph
(1).
.
314.
National
family caregiver support program
(a)
Older relative
caregiver
Section 372 of such Act (42 U.S.C. 3030s) is
amended—
(1) in subsection
(a)—
(A) by striking
this subpart: and inserting this part:;
and
(B) by striking
paragraphs (1) and (2) and inserting the following:
(1)
Child
The
term child means an individual who is not more than 18 years of
age.
(2)
Eligible care
recipient
The term eligible care recipient means a
relative, of an older relative caregiver, who is—
(A) a child;
or
(B) an individual
with a disability who is not less than 19 and not more than 59 years of
age.
(3)
Older relative
caregiver
(A)
In
general
The term older relative caregiver means a
caregiver, as defined in subparagraph (B) or (C), who—
(i) is 55 years of
age or older; and
(ii) lives with, is
the informal provider of in-home and community care to, and is the primary
caregiver for, an eligible care recipient who is described in subparagraph (B)
or (C), respectively.
(B)
Caregiver for
child
For purposes of subparagraph (A), the term
caregiver, used with respect to an eligible care recipient who is
a child, means an individual who—
(i) is the
grandparent, stepgrandparent, or other relative (other than the parent) by
blood, marriage, or adoption, of the eligible care recipient;
(ii) is the primary
caregiver of the eligible care recipient because the biological or adoptive
parents are unable or unwilling to serve as the primary caregiver of the
eligible care recipient; and
(iii) has a legal
relationship to the eligible care recipient, such as legal custody or
guardianship, or is raising the eligible care recipient informally.
(C)
Caregiver of
individual with a disability
For purposes of subparagraph (A),
the term caregiver, used with respect to an eligible care
recipient who is an individual with a disability described in paragraph (2)(B)
means an individual who is the parent, grandparent, or other relative by blood,
marriage, or adoption, of the eligible care
recipient.
;
and
(2) in subsection
(b)(2)—
(A) by striking
grandparents or older individuals who are relative caregivers
and inserting older relative caregivers; and
(B) by striking
children and inserting eligible care
recipients.
(b)
Program
Section
373 of the Older Americans Act of 1965 (42 U.S.C. 3030s–1) is amended—
(1) in subsection
(a)(2), by striking grandparents or older individuals who are relative
caregivers. and inserting older relative
caregivers.;
(2) by redesignating
subsections (b) through (g) as subsections (c) through (h),
respectively;
(3) by inserting
after subsection (a) the following:
(b)
Assessment
program of needs of family caregivers
(1)
In
general
The Assistant Secretary may make grants to States to
establish a program, in accordance with the program requirements described in
paragraph (4), to assess the needs of family caregivers for targeted support
services.
(2)
Application by
states
Each State seeking a grant under this subsection shall
submit an application to the Assistant Secretary at such time, in such manner,
and containing such information and assurances as the Assistant Secretary
determines appropriate.
(3)
Program
administration
A State receiving a grant under this subsection
may enter into an agreement with area agencies on aging in the State, or an
Aging and Disability Resource Center in the State, to administer the program,
using such grant funds.
(4)
Program
requirements
(A)
Voluntary
questionnaire
Assessments under a program established as
described in paragraph (1) shall include asking the family caregiver relevant
questions in order to determine whether the family caregiver would benefit from
any targeted support services.
(B)
Referrals
In
the case where a questionnaire completed by a family caregiver under
subparagraph (A) indicates that the family caregiver would benefit from 1 or
more targeted support services, the agency administering the program
established under paragraph (1) shall provide referrals to the family caregiver
for State, local, nonprofit, and private-sector caregiver programs and other
resources that provide such targeted support services to such
caregivers.
(C)
Reporting
requirement
Each State with a program described in paragraph (1)
shall periodically submit to the Assistant Secretary a report containing
information on the number of caregivers assessed under the program, information
on the number of referrals made for targeted support services under the program
(disaggregated by type of service), demographic information on caregivers
assessed under the program, and other information required by the Assistant
Secretary.
;
(4) in subsection
(c), as redesignated by paragraph (2)—
(A) in paragraph (4),
by striking and at the end;
(B) in paragraph (5),
by striking the period and inserting ; and; and
(C) by adding at the
end the following:
(6) the efforts of
the Ombudsman to facilitate the activities of, and support, the State Long-Term
Care Ombudsman program under title VII and this title, and the efforts of the
Ombudsman to facilitate the activities of, and support, family and caregiver
councils in long-term care
facilities.
;
(5) in subsection
(d), as redesignated by paragraph (2)—
(A) in paragraph
(1)—
(i) in
the matter preceding subparagraph (A), by striking and grandparents and
older individuals who are relative caregivers, and inserting and
older relative caregivers,;
(ii) in
subparagraph (A), by striking paragraph (1) or (2) of;
and
(iii) in subparagraph
(B)—
(I) by striking
subsection (b), in the case of a caregiver described in paragraph
(1) and inserting subsection (c), in the case of a caregiver
described in subsection (a)(1); and
(II) by striking
section 102(22). and inserting section 102(24).;
and
(B) in paragraph
(2)—
(i) in subparagraph
(A)—
(I) by inserting
(with particular attention to individuals with factors listed in section
102(26)(B)) after social need; and
(II) by striking
economic need and all that follows and inserting economic
need; and;
(6) in subsection
(e), as redesignated by paragraph (2), by striking subsection
(b) and inserting subsection (c);
(7) in subsection
(f)(3), as redesignated by paragraph (2), in the second sentence, by striking
or grandparents or older individuals who are relative
caregivers, and inserting older relative
caregivers,;
(8) in subsection
(g)(1), as redesignated by paragraph (2)—
(A) in subparagraph
(A), by striking for fiscal years 2007, 2008, 2009, 2010, and
2011 and inserting for each of fiscal years 2014 through
2018; and
(B) in subparagraph
(B), by striking under section 303 and inserting under
section 303(e); and
(9) in subsection
(h), as redesignated by paragraph (2)—
(A) in paragraph (2),
by striking subparagraph (C) and inserting the following:
(C)
Limitation
A
State may use not more than 10 percent of the total Federal and non-Federal
share available to the State under this part to provide support services
to—
(i) older relative
caregivers who provide care for children; and
(ii) older relative
caregivers—
(I) who provide care
for individuals described in section 372(a)(2)(B); and
(II) who are the
parents of the individuals.
;
and
(B) by adding at the
end the following:
(3)
Use of funds
for ombudsman program
Amounts made available to a State to carry
out the State program under this part may be used to support the Office of the
State Long-Term Care Ombudsman, including supporting the development of
resident and family
councils.
.
(c)
Elimination of
superfluous subpart designation
(1)
Heading
Part
E of title III of such Act (42 U.S.C. 3030s et seq.) is amended by striking the
subpart heading for subpart 1.
(2)
Conforming
amendments
Sections 373 (as amended by subsection (b)) and 374 of
such Act (42 U.S.C. 3030s–1, 3030s–2) are further amended by striking
this subpart in each place it appears and inserting this
part.
IV
Activities for
health, independence, and longevity
401.
Grant
programs
Section 411 of the
Older Americans Act of 1965 (42 U.S.C. 3032) is amended—
(1) in subsection
(a)—
(A) in paragraph
(12), by striking ; and and inserting a semicolon;
(B) by redesignating
paragraph (13) as paragraph (14); and
(C) by inserting
after paragraph (12) the following:
(13) supporting
programs that enable the mobility and self-sufficiency of older individuals
with the greatest economic need and older individuals with the greatest social
need by providing transportation services and resources;
and
;
and
(2) in subsection (b), by striking for
fiscal years 2007 and all that follows through 2011 and
inserting for each of fiscal years 2014 through 2018.
402.
Community
innovations for aging in place
Section 422 of the Older Americans Act of
1965 (42 U.S.C. 3032k) is amended by adding at the end the following:
(g)
Authorization
of appropriations
There is authorized to be appropriated to carry
out this section $5,000,000 for each of fiscal years 2014 through
2018.
.
403.
Multipurpose
senior center modernization, training, and support
Part
A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3032 et seq.) is
amended by adding at the end the following:
423.
Multipurpose
senior center modernization, training, and support
(a)
Program
authorized
The Assistant Secretary shall award grants and enter
into contracts with eligible entities to carry out projects to—
(1) support and
promote modern multipurpose senior center models which yield vibrant,
multiservice, multigenerational centers for older individuals, families of
older individuals, and others in the community to gain skills, resources, and
connections needed to meet the challenges that occur with continuum of care and
quality of life;
(2) build an evidence
base of modern, replicable practices that allow senior centers to serve a
diverse array of older individuals, as well as their families and other
caregivers, leveraging innovative partnerships and public and private resources
to develop and expand programs; and
(3) mobilize services
and leverage resources to support the role of multipurpose senior centers as
community focal points, as provided in section 306(a)(3), and for the
establishment, construction, maintenance, and operation of centers, as
described in sections 303(c)(2) and 306(a)(1), including development of
intergenerational shared site models, consistent with the purposes of this
Act.
(b)
Use of
funds
An eligible entity shall use funds made available under a
grant awarded, or a contract entered into, under subsection (a) to—
(1) carry out a
project described in subsection (a); and
(2) evaluate the
project in accordance with subsection (e).
(c)
Eligible
entity
For purposes of this section, the term eligible
entity means—
(1) a multipurpose
senior center that has met national accreditation and fiduciary standards;
and
(2) a regional
partnership or collaboration of multipurpose senior centers or State
association of senior centers in which not less than 2 centers are
accredited.
(d)
Competitive
grants for technical assistance
(1)
Grants
The
Assistant Secretary shall make a grant, on a competitive basis, to an eligible
nonprofit organization described in paragraph (2), to enable the organization
to—
(A) provide training
and technical assistance to recipients of grants under this section and other
multipurpose senior centers to adopt and tailor evidence-based modernization
strategies and practices to respond to the economic and health needs of the
diverse and growing aging populations in their own communities; and
(B) carry out other
duties, as determined by the Assistant Secretary.
(2)
Eligible
nonprofit organization
To be eligible to receive a grant under
this subsection, an organization shall be a nonprofit organization (including a
partnership of nonprofit organizations), that—
(A) has experience
and expertise in providing technical assistance to a range of multipurpose
senior centers and experience evaluating and reporting on programs; and
(B) has demonstrated
knowledge of and expertise in multipurpose senior center accreditation or other
standards of excellence.
(e)
Local
evaluation and report
(1)
Evaluation
Each
entity receiving a grant or a contract under subsection (a) to carry out a
project described in subsection (a) shall evaluate the project, leadership, and
resources for the modernization of multipurpose senior centers.
(2)
Report
The
entity described in paragraph (1) 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.
(f)
Report to
Congress
Not later than 6 months after the Assistant Secretary
receives the reports described in subsection (e)(2), the Assistant Secretary
shall prepare and submit to Congress a report that describes the results of the
evaluations.
.
404.
Demonstration
program on care coordination and service delivery
Part A of title IV of the Older Americans
Act of 1965 (42 U.S.C. 3032 et seq.), as amended by section 403, is further
amended by adding at the end the following:
424.
Demonstration
program on care coordination and service delivery
(a)
Establishment
of demonstration program
(1)
In
general
The Assistant Secretary shall carry out a demonstration
program in accordance with this section. The Assistant Secretary shall award
grants to eligible entities (as determined by the Secretary) to implement
demonstration projects that focus on care coordination and service delivery
redesign for older individuals with chronic illness or at risk of institutional
placement by—
(A) designing and
testing new models of care coordination and service delivery that thoughtfully
and effectively deploy advanced aides to improve efficiency and quality of care
for frail older individuals; and
(B) giving
direct-care workers opportunities for career advancement through additional
training, an expanded role, and increased compensation.
(2)
Direct-care
worker
In this section, the term direct-care worker
has the meaning given that term in the 2010 Standard Occupational
Classifications of the Department of Labor for Home Health Aides [31–1011],
Psychiatric Aides [31–1013], Nursing Assistants [31–1014], and Personal Care
Aides [39–9021].
(b)
Planning and
implementation awards under the program
(1)
In
general
Each eligible entity that receives a grant under this
section shall receive a grant for planning and implementation activities
related to the demonstration project to be carried out by the entity.
(2)
Amount
The
amount awarded under paragraph (1) for all grants—
(A) for planning
activities, shall not exceed $600,000; and
(B) for
implementation activities, shall not exceed $2,900,000.
(3)
Terms
Planning
activities carried out under a grant awarded under paragraph (1) shall be
completed not later than 1 year after the grant is awarded. Implementation
activities carried out under such a grant shall be completed not later than 2
years after the grant is awarded.
(4)
Evaluation and
report
Each recipient of a grant under paragraph (1), in
consultation with an independent evaluation contractor, shall conduct an
evaluation and submit to the Secretary a report on the implementation of
activities conducted under the demonstration project, including such
information as the Secretary may
require.
.
405.
Grants or
contracts to facilitate low-income access to dental care
Part A of title IV of the Older Americans
Act of 1965, as amended by section 404, is further amended by adding at the end
the following:
425.
Grants or
contracts to facilitate low-income access to dental care
(a)
Definition
In
this section, the term medically recommended dental care means
treatment of an oral disease or other oral condition, on the referral of a
physician or other health care professional, to sustain or improve overall
health, prevent exacerbation of a co-morbid condition, or as a prerequisite to
a required medical therapy.
(b)
Grants
The
Secretary shall award competitive grants to, or enter into contracts with,
eligible entities to fund the employment costs of professionals who will use
grant or contract funds to—
(1) coordinate the
provision of medically recommended dental care to eligible individuals by
volunteer dentists in a manner consistent with State licensing laws; and
(2) verify the
medical, dental, and financial needs of eligible individuals who may be
eligible for free medically recommended dental care.
(c)
Eligibility
(1)
Eligible
entity
To be eligible to receive a grant or contract under
subsection (b), an entity shall be a nonprofit organization that provides for
the participation of eligible individuals in a free dental services program on
a national basis.
(2)
Eligible
individual
To be eligible to participate in a program described
in paragraph (1), individuals shall be those with greatest economic need and
individuals with greatest social need (with particular attention to individuals
with factors listed in section 102(26)(B)).
(d)
Use of
funds
An entity shall use amounts received under a grant or
contract under this section to establish, expand, or operate a program to
coordinate the provision of free medically recommended dental care through
volunteer dentists to eligible individuals.
(e)
Evaluation and
report
(1)
Evaluation
Each
entity that receives a grant or contract under this section shall evaluate the
number of patients served under the grant or contract, and the effectiveness of
the program described in subsection (d) in reducing medical expenses associated
with the disease or condition for which care described in subsection (d) was
provided.
(2)
Report
The
entity shall submit a report containing the results of the evaluation to the
Assistant Secretary, not later than 6 months after the end of the period of the
grant or contract.
(f)
Authorization
of appropriations
There is authorized to be appropriated to carry
out this section, $2,000,000 for each of fiscal years 2014 through
2018.
.
406.
National
resource center on family caregiving
Part A of title IV of the Older Americans
Act of 1965 (42 U.S.C. 3032 et seq.), as amended by section 405, is further
amended by adding at the end the following:
426.
National
Resource Center on Family Caregiving
(a)
Establishment
The
Secretary of Health and Human Services shall award a grant to or enter into a
cooperative agreement with a public or private nonprofit entity to establish a
National Resource Center on Family Caregiving (referred to in this section as
the Center).
(b)
Development
The
Assistant Secretary shall develop and issue operating standards and reporting
requirements for the Center established under subsection (a).
(c)
Authorization
There
is authorized to be appropriated to carry out this section, $2,000,000 for each
of fiscal years 2014 through
2018.
.
407.
Conforming
amendment
Section 417(c)(2) of
the Older Americans Act of 1965 (42 U.S.C. 3032f(c)(2)) is amended by striking
older individuals and communities and all that follows and
inserting communities with greatest need, older individuals with
greatest economic need, and older individuals with greatest social need (with
particular attention to individuals with factors listed in section
102(26)(B));.
V
Community service
senior opportunities
501.
Older american
community service employment program
Section 502 of the Older Americans Act of
1965 (42 U.S.C. 3056) is amended—
(1) in subsection
(a)(1)—
(A) by striking
To foster individual economic self-sufficiency and and inserting
To further the goal of economic security, foster individual economic
self-sufficiency, grow local economies, improve the quality of life in local
communities, and; and
(B) by striking
persons who are age 55 and inserting persons who are not
economically secure and who are age 55; and
(2) in subsection
(b)(1)—
(A) in subparagraph (E), by striking
support for children, and inserting support for adults,
children,; and
(B) in subparagraph
(M), by striking and eligible individuals with greatest economic
need and inserting eligible individuals with disabilities,
eligible individuals with greatest economic need, and eligible individuals with
greatest social need.
502.
Interagency
cooperation
Section 514 of the
Older Americans Act of 1965 (42 U.S.C. 3056l) is amended—
(1) in subsection
(c)(1), by striking individuals with greatest economic need, individuals
with greatest social need, and inserting individuals with
greatest economic need, individuals with greatest social need (with particular
attention to individuals with factors listed in section 102(26)(B)),;
and
(2) in subsection
(e)(1), by striking minority and all that follows through
economic need, and inserting individuals with greatest
economic need, individuals with greatest social need,.
503.
Authorization
of appropriations
Section
517(a) of the Older Americans Act of 1965 (42 U.S.C. 3056o(a)) is amended by
striking fiscal years 2007, 2008, 2009, 2010, and 2011 and
inserting each of fiscal years 2014 through 2018.
504.
Study on
feasibility of transfer of program
(a)
Study
The
Assistant Secretary for Aging of the Department of Health and Human Services,
and the Secretary of Labor, shall study the feasibility of transferring the
program carried out under title V of the Older Americans Act of 1965 (42 U.S.C.
3056 et seq.) to the Administration on Aging.
(b)
Report
Not
later than 2 years after the date of enactment of this Act, the Assistant
Secretary and the Secretary shall submit a report containing the results of the
study to the appropriate committees of Congress.
VI
Grants for
native americans
601.
Technical
amendment
Section 611 of such
Act (42 U.S.C. 3057b) is amended by striking (a) in the matter
preceding paragraph (1).
602.
Conforming
amendment
Section 631(b) of
the Older Americans Act of 1965 (42 U.S.C. 3057k–11(b)) is amended by striking
subsections (c), (d), and (e) and inserting subsections
(d), (e), and (f).
603.
Reauthorization of
funding for grants for Native Americans
Section 643(2) of the Older Americans Act of
1965 (42 U.S.C. 3057n(2)) is amended by striking part C, and all
that follows and inserting part C, not less than $8,400,000 for each of
fiscal years 2014 through 2018..
VII
Vulnerable
elder rights protection activities
701.
Establishment
Section 701 of the Older Americans Act of
1965 (42 U.S.C. 3058) is amended—
(1) by inserting
and grants after allotments; and
(2) by adding at the
end the following: The Assistant Secretary, to the maximum extent
practicable, shall ensure that education and public awareness activities under
this title are fully integrated with programs under this Act..
702.
Authorization
of appropriations
Chapter 1 of
subtitle A of title VII of the Older Americans Act of 1965 is amended by
inserting after section 702 (42 U.S.C. 3058a) the following:
702A.
Authorization
of appropriations for State Home Care Ombudsman Program
There are authorized to be appropriated to
carry out chapter 5 such sums as may be necessary for fiscal year 2014 and each
subsequent fiscal
year.
.
703.
Grants
Section 703 of the Older Americans Act of
1965 (42 U.S.C. 3058b) is amended by adding at the end the following:
(d)
Grants for
State home care ombudsman programs
The Assistant Secretary shall
use funds made available under section 702A to award grants, on a competitive
basis, to States for State Home Care Ombudsman
Programs.
.
704.
Eligibility
Section 704 of the Older Americans Act of
1965 (42 U.S.C. 3058c) is amended, in the matter preceding paragraph (1), by
inserting or grants after allotments.
705.
Additional
State plan requirements
Section 705 of the Older Americans Act of
1965 (42 U.S.C. 3058d) is amended—
(1) in subsection
(a)—
(A) in the matter
preceding paragraph (1), by inserting or grant after
allotment;
(B) in paragraph (1),
by striking requirements of the chapter and this chapter and
inserting requirements of this chapter and this subtitle;
(C) in paragraph (2),
by inserting family caregivers, after title
VI,;
(D) in paragraph (4),
by striking enactment of this subtitle and inserting
enactment of the chapter;
(E) in paragraph (6),
by striking and at the end;
(F) in paragraph (7),
by striking the period and inserting ; and; and
(G) by adding at the
end the following:
(8) an assurance that
the State has—
(A) a Home Care
Consumer Bill of Rights and a Plan for Enforcement of such a Bill, developed in
accordance with the procedures described under paragraph (2) and as approved by
the Assistant Secretary, and the State shall include a copy of the Bill and
Plan; or
(B) a waiver of
subparagraph (A) from the Assistant Secretary and a proposal for developing and
submitting for approval a Home Care Consumer Bill of Rights and Plan for
Enforcement.
;
(2) by redesignating
subsection (b) as subsection (d);
(3) by inserting
after subsection (a) the following:
(b)
Home Care
Consumer Bill of Rights
The Home Care Consumer Bill of Rights
referred to in subsection (a)(8) shall, at a minimum—
(1) address a home
care consumer’s right to basic safety;
(2) address a home
care consumer’s right to access information about the cost of home care
services prior to receiving those services;
(3) address a home
care consumer’s right to choice, participation, and self-determination;
(4) address a home
care consumer’s right to redress grievances; and
(5) meet any other
guidelines determined to be appropriate by the Assistant Secretary.
(c)
Plan for
enforcement
The Plan for Enforcement referred to in subsection
(a)(8) shall include a description of how State entities with a role in
protecting older individuals will coordinate activities to enforce the Home
Care Consumer Bill of Rights.
;
and
(4) by adding at the
end the following:
(e)
Definition
In
this section, the term home care consumer and home care
services have the meanings given the terms in section
736.
.
706.
Definitions
Section 711(6) of the Older Americans Act of
1965 (42 U.S.C. 3058f(6)) is amended by striking older
individual and inserting individual.
707.
State
Long-Term Care Ombudsman program
Section 712 of the Older Americans Act of
1965 (42 U.S.C. 3058g) is amended—
(1) in subsection
(a)—
(A) in paragraph (2),
by adding at the end the following: The Ombudsman shall be responsible
for the management, including the fiscal management, of the
Office.;
(B) in paragraph
(3)—
(i) in
subparagraph (A), by striking clause (i) and inserting the following:
(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 desired (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 the desired
outcome;
;
(ii) in
subparagraph (D), by striking regular and timely and inserting
regular, timely, private, and unimpeded; and
(iii) in subparagraph
(H)(iii), by striking provide technical support for and
inserting actively encourage and assist in;
(C) in paragraph
(4)—
(i) in
the paragraph header, by striking Contracts and arrangements and inserting
Organizational
placement; and
(ii) by
striking subparagraph (B) and inserting the following:
(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 unless such conflict 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
administration
In a case in which a potential or actual
organizational conflict of interest 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—
(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 paragraph (3).
(C)
Organizational
conflict of interest
In this paragraph, the term
organizational conflict of interest includes a situation in which
the Office is placed in an organization that—
(i) is responsible
for licensing or certifying 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 (c) or (b) 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 Medicare program carried out under title
XVIII, or the Medicaid program carried out under title XIX, of the Social
Security Act (42 U.S.C. 1395 et seq., 1396 et seq.);
(viii) conducts
preadmission screening for placements in facilities described in clause (ii);
or
(ix) makes decisions
regarding admission of individuals to such
facilities.
;
and
(D) in paragraph
(5)(B)(vi), by striking support and inserting actively
encourage and assist in;
(2) in subsection
(b)—
(A) in paragraph
(1)—
(i) in
subparagraph (A), by striking access and inserting
private and unimpeded access;
(ii) in
subparagraph (B)(i)—
(I) in the matter
preceding subclause (I), by striking the medical and social records of
a and inserting all records concerning a; and
(II) in subclause
(II), by striking to consent and inserting to communicate
consent;
(iii) by
redesignating subparagraphs (C) and (D) as subparagraphs (E) and (F),
respectively; and
(iv) by
inserting after subparagraph (B) the following:
(C) such access as is
necessary to advocate for a resident’s desired outcome to the extent that the
resident can express the outcome desired, even if the resident is unable to
communicate consent;
(D) access to the
records of a resident who is unable to communicate consent in a case in
which—
(i) the access is
necessary to investigate and resolve a complaint described in subsection
(a)(3);
(ii) a legal guardian
of the resident refuses to give permission for the access;
(iii) a
representative of the Office has reasonable cause to believe that the guardian
is not acting in the best interests of the resident by refusing;
(iv) the resident has
no other known legal representative; and
(v) the
representative of the Office obtains the approval of the
Ombudsman;
;
and
(B) by adding at the
end the following:
(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.
;
(3) in subsection
(c)(2)(D), by striking section 202(a)(21) and inserting
section 202(a)(18);
(4) in subsection
(d)—
(A) in paragraph (1),
by striking files and inserting information;
and
(B) in paragraph
(2)—
(i) in
subparagraph (A), by striking files and records each place such
term appears and inserting information; and
(ii) in
subparagraph (B), by striking files or records and inserting
information;
(5) in subsection
(f)(3)—
(A) in subparagraph
(C), by striking facility; and and inserting facility or
a related organization, and has not been employed by such a facility or
organization within 2 years before the date of the determination
involved;;
(B) in subparagraph
(D), by striking and at the end; and
(C) by adding at the
end the following:
(E) does not have
management responsibility for, or operate under the supervision of, an agency
with responsibility for adult protective services; and
(F) 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);
and
;
(6) in subsection
(h)—
(A) in paragraph (4),
by striking all that precedes procedures and inserting the
following:
(4) strengthen and
update
;
(B) by redesignating
paragraphs (4) through (9) as paragraphs (5) through (10), respectively;
(C) by inserting
after paragraph (3) the following:
(4) ensure that the Ombudsman or a designee
attends training provided by the Administration through the National Ombudsman
Resource Center established in section
202(a)(18);
;
(D) in paragraph
(7)(A), as redesignated by subparagraph (B) of this paragraph, by striking
subtitle C of the and inserting subtitle C of title I of
the; and
(E) in paragraph
(10), as redesignated by subparagraph (B) of this paragraph, by striking
(6), or (7) and inserting (7), or (8); and
(7) by adding at the
end the following:
(k)
Ensuring
effective programs and residents' rights
The State agency shall
ensure the Office—
(1) provides
long-term care facility residents with private and unimpeded access to the
Office, including access to all records concerning the resident; and
(2) allows all
long-term care facility residents to receive services from the
Office.
.
708.
Prevention of
elder abuse, neglect, and exploitation
Section 721(b) of the Older Americans Act of
1965 (42 U.S.C. 3058i(b)) is amended—
(1) in paragraph (2),
by striking the semicolon and inserting the following: , including
education and outreach to professionals including postal carriers, employees of
financial institutions, firefighters, meter readers, and other community
professionals who are in a position to observe an older individual on a daily
or regular basis;;
(2) in paragraph (4),
by inserting before the semicolon the following: and submit data on the
prevalence of elder abuse, neglect, and exploitation for the appropriate
database of the Administration or another database specified by the Assistant
Secretary;
(3) by redesignating
paragraphs (8) through (12) as paragraphs (9) through (13),
respectively;
(4) by inserting
after paragraph (7) the following:
(8) conducting
appropriate training to ensure cultural sensitivity in the provision of elder
rights services, including training in cultural issues associated with
abuse;
;
(5) in subparagraph
(C) of paragraph (10), as redesignated by paragraph (3) of this section—
(A) in clause (ii),
by inserting , such as forensic accountants, after such
personnel; and
(B) in clause (v), by
striking the comma at the end and inserting , including programs and
arrangements that will safeguard victims' or potential victims' finances, such
as daily money management programs and conservatorships,;
(6) in paragraph (12), as redesignated by
paragraph (3) of this section—
(A) in subparagraph (D), by striking
and at the end; and
(B) by adding at the
end the following:
(F) supporting and
studying innovative practices in local communities, to develop partnerships
across disciplines for the prevention, investigation, and prosecution of
exploitation;
;
(7) in paragraph
(13), as redesignated by paragraph (3) of this section—
(A) in subparagraph
(B), by striking or at the end;
(B) in subparagraph
(C), by striking the period at the end and inserting ; or;
and
(C) by adding at the end the following:
(D) older individuals who are Holocaust
survivors; and
; and
(8) by adding at the
end the following:
(14) developing a
State Home Care Consumer Bill of Rights and Plan for Enforcement (as described
in section 705) to protect home care consumers (as defined in section 736) from
abuse, neglect, and exploitation.
.
709.
State legal
assistance development
Section
731 of the Older Americans Act of 1965 (42 U.S.C. 3058j) is amended by striking
A State agency and all that follows through to
ensure— and inserting the following:
(a)
State legal
services developer
A State
agency shall provide the services of an individual who shall be known as a
State legal services developer, who shall promote, and may facilitate, the
development and operation of an integrated legal assistance delivery system for
the State. To the maximum extent practicable, the individual selected to serve
as the developer shall—
(1) agree to serve as
the developer on a full-time basis;
(2) have a law degree
from an accredited law school or have been admitted to practice law in any
jurisdiction in the United States; and
(3) possess other
knowledge, skills, training, and education that reflect a comprehensive
understanding of legal services for older individuals.
(b)
Other
personnel
In addition to the State legal services developer, the
State agency shall provide the services of other personnel, sufficient to
ensure—
.
710.
State Home
Care Ombudsman Programs
Subtitle A of title VII of the Older
Americans Act of 1965 (42 U.S.C. 3058 et seq.) is amended by adding at the end
the following:
5
State Home Care
Ombudsman Programs
736.
Definitions
In this chapter:
(1)
Home care
consumer
The term home care consumer means a person
who receives services in the person’s home or community, which may include home
care services provided through this Act, the Medicare program under title XVIII
of the Social Security Act (42 U.S.C. 1395 et seq.), the Medicaid program under
title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), or another
public or private funding source.
(2)
Home care
ombudsman program
The term home care ombudsman
program means a State Home Care Ombudsman Program described in section
737(a)(1).
(3)
Home care
services
The term home care services means home and
community-based services, including personal care services designed to assist
an individual in the activities of daily living such as bathing, exercising,
personal grooming, and getting in and out of bed.
737.
Program
(a)
Establishment
(1)
In
general
In order to be eligible to receive a grant under section
703(d) from funds appropriated under section 702A and made available to carry
out this chapter, a State agency shall, in accordance with this section, agree
to carry out a State Home Care Ombudsman Program within the Office of the State
Long-Term Care Ombudsman.
(2)
Home care
ombudsman program
The home care ombudsman program shall be
carried out by the State Long-Term Care Ombudsman. The Ombudsman and other
entities carrying out the home care ombudsman program shall have authorities,
requirements, and functions with respect to that program, and home care
services provided and home care consumers served under that program, that are
equivalent (as determined by the Secretary) to the authorities, requirements,
and functions the Ombudsman and other entities have in carrying out the State
Long-Term Care Ombudsman Program under chapter 2, and long-term care provided
and long-term care consumers served under that program.
(b)
Maintenance of
effort
A State, in using the funds made available for a fiscal
year through a grant received under section 703(d), shall maintain the
expenditures of the State for home care ombudsman services at a level that is
not less than the level of such expenditures maintained by the State for the
preceding fiscal year.
(c)
Evaluation
The
Assistant Secretary shall—
(1) in conjunction
with the Director of the Office of Long-Term Care Ombudsman Programs and the
heads of other entities determined to be necessary by the Assistant Secretary,
collect from the States and analyze data from the home care ombudsman programs
relating to complaints and conditions concerning home care services and home
care consumers and within 1 year after receipt of the data, submit a report to
Congress outlining best practices for carrying out a home care ombudsman
program; and
(2) make the report
available to States.
.
VIII
Geriatrics and
gerontology
801.
Primary health
services
Section 331(a)(3)(D)
of the Public Health Service Act (42 U.S.C. 254d(a)(3)(D)) is amended by
inserting geriatrics, gerontology, after
pediatrics,.