,,ii #aacth ,,congress #ast ,session ,s4 #ajbh ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #bc1 #bjac ,mr4 ,sanders 7for himself1 ,ms4 ,klobuchar1 ,ms4 ,warren1 ,ms4 ,baldwin1 ,mrs4 ,boxer1 ,mr4 ,merkley1 ,mr4 ,blumenthal1 ,mr4 ,franken1 ,mr4 ,schatz1 ,mr4 ,johnson of ,south ,dakota1 ,mr4 ,cardin1 ,mrs4 ,gillibrand1 ,mr4 ,leahy1 ,mr4 ,casey1 and ,mr4 ,nelson7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to reauthorize and improve the ,older ,americans ,act of #aife1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,older ,americans ,act ,amendments of #bjac4 7b7 ,table of contents ,sec4 #a4 ,short title2 table of contents4 ,sec4 #b4 ,findings4 ,,title ,i--,declaration of objectives2 definitions ,sec4 #aja4 ,declaration of objectives4 ,sec4 #ajb4 ,definitions4 ,,title ,,ii--,administration on aging ,sec4 #bja4 ,establishment of ,administration on ,aging4 ,sec4 #bjb4 ,functions of ,assistant ,secretary4 ,sec4 #bjc4 ,federal agency consultation4 ,sec4 #bjd4 ,evaluation4 ,sec4 #bje4 ,reports4 ,sec4 #bjf4 ,conforming amendments4 ,sec4 #bjg4 ,authorization of appropriations4 ,sec4 #bjh4 ,advisory ,committee to ,assess1 ,coordinate1 and ,improve ,legal ,assistance ,activities4 ,sec4 #bji4 ,consumer ,price ,index4 ,sec4 #baj4 ,sense of the ,senate regarding appropriation levels4 ,,title ,,iii--,grants for state and community programs on aging ,sec4 #cja4 ,purpose2 administration4 ,sec4 #cjb4 ,definition4 ,sec4 #cjc4 ,authorization of appropriations4 ,sec4 #cjd4 ,allotments4 ,sec4 #cje4 ,organization4 ,sec4 #cjf4 ,area plans4 ,sec4 #cjg4 ,state plans4 ,sec4 #cjh4 ,planning1 coordination1 evaluation1 and administration of ,state plans4 ,sec4 #cji4 ,nutrition services incentive program4 ,sec4 #caj4 ,consumer contributions4 ,sec4 #caa4 ,supportive services and senior centers program4 ,sec4 #cab4 ,nutrition services4 ,sec4 #cac4 ,disease prevention and health promotion services4 ,sec4 #cad4 ,national family caregiver support program4 ,,title ,,iv--,activities for health1 independence1 and longevity ,sec4 #dja4 ,grant programs4 ,sec4 #djb4 ,community innovations for aging in place4 ,sec4 #djc4 ,multipurpose senior center modernization1 training1 and support4 ,sec4 #djd4 ,demonstration program on care coordination and service delivery4 ,sec4 #dje4 ,grants or contracts to facilitate low-income access to dental care4 ,sec4 #djf4 ,national ,resource ,center on ,family ,caregiving4 ,sec4 #djg4 ,conforming amendment4 ,,title ,v--,community service senior opportunities ,sec4 #eja4 ,older ,american ,community ,service ,employment ,program4 ,sec4 #ejb4 ,interagency cooperation4 ,sec4 #ejc4 ,authorization of appropriations4 ,sec4 #ejd4 ,study on feasibility of transfer of program4 ,,title ,,vi--,grants for native americans ,sec4 #fja4 ,technical amendment4 ,sec4 #fjb4 ,conforming amendment4 ,sec4 #fjc4 ,reauthorization of funding for grants for ,native ,americans4 ,,title ,,vii--,vulnerable elder rights protection activities ,sec4 #gja4 ,establishment4 ,sec4 #gjb4 ,authorization of appropriations4 ,sec4 #gjc4 ,grants4 ,sec4 #gjd4 ,eligibility4 ,sec4 #gje4 ,additional ,state plan requirements4 ,sec4 #gjf4 ,definitions4 ,sec4 #gjg4 ,state ,long-,term ,care ,ombudsman program4 ,sec4 #gjh4 ,prevention of elder abuse1 neglect1 and exploitation4 ,sec4 #gji4 ,state legal assistance development4 ,sec4 #gaj4 ,state ,home ,care ,ombudsman ,programs4 ,,title ,,viii--,geriatrics and gerontology ,sec4 #hja4 ,primary health services4 #b4 ,findings ,congress finds the following3 7#a7 ,older adults are the fastest growing segment of the ,nation's population4 7#b7 ,every day1 #aj1jjj ,baby ,boomers turn #fe4 7#c7 ,one in #e of those individuals age #fe and older survives on an average of #g1ejj a year4 7#d7 ,federal funding to support older adults and their caregivers has not kept pace with inflation4 7#e7 ,only #g percent of individuals who are food insecure get a home-delivered meal4 7#f7 ,for every reported incident of elder abuse1 neglect1 exploitation1 or self-neglect1 approximately #be go unreported4 7#g7 ,by making significant improvements through the ,older ,americans ,act ,amendments of #bjac1 it is possible to improve the lives of millions of older adults1 and ensure that they receive the supports and services that they need to stay healthy and active in their homes and communities4 ,i ,declaration of objectives2 definitions #aja4 ,declaration of objectives ,section #aja of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjja7 is amended-- 7#a7 by striking paragraph 7#a7 and inserting the following3 7#a7 ,an adequate income and economic security in later life in accordance with the ,american standard of living4 2 7#b7 in paragraph 7#d71 by inserting care coordination and after including2 7#c7 by striking paragraphs 7#i7 and 7#aj7 and inserting the following3 7#i7 ,immediate benefit from proven research knowledge which can sustain and improve health1 happiness1 and economic security4 7#aj7 ,freedom1 independence1 economic security1 and the free exercise of individual initiative for older individuals in planning and managing their own lives1 full participation in the planning and operation of community-based services and programs provided for their benefit1 and protection against abuse1 neglect1 and exploitation4 2 and 7#d7 by adding at the end the following3 7#aa7 ,acquiring high-quality services in a manner that is culturally and linguistically responsive to older individuals and family caregivers4 4 #ajb4 ,definitions 7a7 ,in general ,section #ajb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjjb7 is amended-- 7#a7 by amending paragraph 7#a7 to read as follows3 7#a7 ,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 harm4 2 7#b7 by redesignating paragraphs 7#d7 through 7#ad7 and 7#ae7 through 7#ed7 as paragraphs 7#e7 through 7#ae7 and 7#ag7 through 7#ef71 respectively2 7#c7 by inserting after paragraph 7#c7 the following3 7#d7 ,the term adult protective services means such services provided to adults as the ,secretary may specify and includes services such as-- 7,a7 receiving reports of adult abuse1 neglect1 or exploitation2 7,b7 investigating the reports described in subparagraph 7,a72 7,c7 case planning1 monitoring1 evaluation1 and other case work and services2 and 7,d7 providing1 arranging for1 or facilitating the provision of services1 such as medical1 social1 economic1 legal1 housing1 law enforcement1 or other protective1 emergency1 or support services4 2 7#d7 in subparagraph 7,b77i7 of paragraph 7#ab71 as redesignated by paragraph 7#b7 of this subsection1 by striking comprehensive and all that follows through psychological1 and inserting comprehensive person-centered assessment of the older individual 7including the physical1 psychological1 economic12 7#e7 in subparagraph 7,c7 of paragraph 7#ae71 as redesignated by paragraph 7#a7 of this subsection1 by inserting 1 their family members1 before and their primary2 7#f7 by inserting after that paragraph 7#ae7 the following3 7#af7 7,a7 ,the term economic security means access to the assets1 income1 and community-based services necessary to provide for adequate and unsubsidized housing1 health care1 transportation1 food and adequate nutrition1 long-term care1 and goods and services to meet other basic human needs4 ,such access shall be measured in a manner that shall be geographically based1 and take into account an individual's life circumstances4 7,b7 ,the term economic security and benefits counseling means a supportive service that provides1 to an older individual1 a comprehensive assessment of the ,federal1 ,state1 and community benefits and services for which the individual qualifies1 along with assistance in applying for and obtaining benefits and services4 2 7#g7 by amending paragraph 7#ai71 as redesignated by paragraph 7#b7 of this subsection1 to read as follows3 7#ai7 ,the term elder justice means-- 7,a7 from a societal perspective1 efforts to-- 7i7 prevent1 detect1 treat1 intervene in1 and prosecute elder abuse1 neglect1 and exploitation2 and 7ii7 protect older individuals with diminished capacity while maximizing their autonomy2 and 7,b7 from an individual perspective1 the recognition of an older individual's rights1 including the right to be free of abuse1 neglect1 and exploitation4 2 7#h7 in paragraph 7#bj77;,a71 as redesignated by paragraph 7#b7 of this subsection1 by striking ,the term exploitation means and inserting ,the terms exploitation and financial exploitation mean2 7#i7 in paragraph 7#be71 as redesignated by paragraph 7#b7 of this subsection1 by striking at or below the poverty line4 and inserting that is not more than #bjj percent of the poverty line42 7#aj7 by striking paragraph 7#bf71 as redesignated by paragraph 7#b7 of this subsection1 and inserting the following3 7#bf7 ,the term greatest social need means need caused by noneconomic factors-- 7,a7 that-- 7i7 restrict the ability of an individual to perform normal daily tasks2 or 7ii7 threaten the capacity of the individual to live independently2 and 7,b7 which include-- 7i7 physical and mental disabilities2 7ii7 language barriers including limited ,english proficiency2 7iii7 cultural1 social1 or geographic isolation 7such as residence in a rural area71 including isolation caused by racial1 minority1 or ethnic status1 or status as an ,,lgbt individual2 7iv7 ,,hiv-positive health status or ,alzheimer's disease or a related disorder with neurological and organic brain dysfunction2 7v7 greatest health service need1 particularly a need posed by multiple chronic health conditions or a condition that places an individual at risk for falls2 7vi7 abuse1 neglect 7including self-neglect71 or financial exploitation1 including factors that are the basis of a referral to adult protective services2 7vii7 status as a veteran2 and 7viii7 status as a ,holocaust survivor4 2 7#aa7 in paragraph 7#cj71 as redesignated by paragraph 7#b7 of this subsection-- 7,a7 in subparagraph 7,c71 by inserting 1 including opportunities for paid work and volunteer service in the community after available2 and 7,b7 in subparagraph 7,e7-- 7i7 in the matter preceding clause 7i71 by inserting 1 in a culturally and linguistically competent manner1 before the entire community of older individuals2 and 7ii7 in clause 7i71 by inserting after social need the following3 7with particular attention to individuals with factors listed in paragraph 7#bf77;,b772 7#ab7 in paragraph 7#ca71 as redesignated by paragraph 7#b7 of this subsection1 by striking information and referral and inserting information and referral assistance2 7#ac7 in paragraph 7#ce71 as redesignated by paragraph 7#b7 of this subsection-- 7,a7 by redesignating clauses 7i7 and 7ii7 of subparagraph 7,b7 as subclauses 7,i7 and 7,,ii71 respectively1 and aligning the margins of the subclauses with the margins of subclause 7,i7 of subparagraph 7,a77i7 of paragraph 7#cd71 as so redesignated2 7,b7 by redesignating subparagraphs 7,a7 and 7,b7 as clauses 7i7 and 7ii71 respectively1 and aligning the margins of the clauses with the margins of clause 7ii7 of subparagraph 7,a7 of that paragraph 7#cd72 7,c7 by inserting 7,a7 before ,the term2 and 7,d7 by adding at the end the following3 7,b7 ,the term integrated legal assistance delivery system means a collaboratively run1 statewide network that is established to provide direct legal assistance1 in the most efficient and impactful manner possible1 targeted at older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to individuals with factors listed in paragraph 7#bf77;,b771 in coordination with the legal assistance developer for the ,state and all ,state1 regional1 and local service providers engaged in promoting or supporting elder rights4 2 7#ad7 in paragraph 7#cf71 as redesignated by paragraph 7#b7 of this subsection-- 7,a7 in subparagraph 7,a71 by adding and at the end2 7,b7 in subparagraph 7,b71 by striking 2 and at the end and inserting a period2 and 7,c7 by striking subparagraph 7,c72 7#ae7 in paragraph 7#cg71 as redesignated by paragraph 7#b7 of this subsection1 by striking sections #cjg7;a77#ab7 and and inserting the activities carried out under section #cjg7;a77#i72 7#af7 in paragraph 7#ch71 as redesignated by paragraph 7#b7 of this subsection1 by inserting 7including elder abuse and neglect screening7 after educational services2 7#ag7 in paragraph 7#ej77;,b71 as redesignated by paragraph 7#b7 of this subsection1 by striking subparagraphs 7,a7 through 7,g7 of paragraph 7#h7 and inserting subparagraphs 7,a7 through 7,i7 of paragraph 7#ad72 and 7#ah7 by adding at the end the following3 7#eg7 ,the term care coordination means a person- and family-centered1 assessment-based1 and interdisciplinary approach1 to meet the needs and preferences of an older individual and a family caregiver while enhancing the capabilities of the older individual 7including the ability to self-direct services71 that integrates health care1 long-term services and supports1 and social services in a high-quality and cost-effective manner4 7#eh7 ,the term cultural and linguistic competence means competence in a set of behaviors1 attitudes1 and policies that is-- 7,a7 used by an organization or among professionals2 and 7,b7 enables effective work in cross-cultural situations4 7#ei7 ,the term family caregiver means an adult family member1 or another individual1 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 dysfunction4 7#fj7 ,the term ,holocaust survivor means an individual who-- 7,a7 lived in or fled from1 between #aicc and #aide1 a country under a ,nazi regime1 under ,nazi occupation1 or under the control of ,nazi collaborators2 7,b7 was persecuted between #aicc and #aide on the basis of race1 religion1 physical or mental disability1 sexual orientation1 political affiliation1 ethnicity1 or other basis2 and 7,c7 was a member of a group that was persecuted by the ,nazis4 7#fa7 ,the term ,,lgbt1 used with respect to an individual1 means a lesbian1 gay1 bisexual1 or transgender individual4 7#fb7 ,the term person-centered1 used with respect to a service for an individual1 means a service provided with an approach designed to ensure that an outcome reflects the needs1 preferences1 and situations of the individual4 7#fc7 ,the term veteran has the meaning given the term in section #aja of title #ch1 ,united ,states ,code4 4 7b7 ,conforming amendments ,section #ajb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjjb71 as redesignated by subsection 7a77#b71 is amended-- 7#a7 in paragraph 7#ci77;,a71 by striking as defined in paragraph 7#e7 and inserting as defined in paragraph 7#bh72 7#b7 in paragraph 7#dj71 by striking 7as defined in paragraph 7#ah77;,b77 and inserting 7as defined in paragraph 7#bj77;,b772 and 7#c7 in paragraph 7#dh77;,d71 by striking 7as defined in paragraph 7#ah77;,b77 and inserting 7as defined in paragraph 7#bj77;,b774 ,,ii ,administration on aging #bja4 ,establishment of ,administration on ,aging ,section #bja of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjaa7 is amended-- 7#a7 in subsection 7d77#c7-- 7,a7 in subparagraph 7,k71 by striking 2 and and inserting a semicolon2 7,b7 in subparagraph 7,l7-- 7i7 by striking ,older ,americans ,act ,amendments of #aiib and inserting ,older ,americans ,act ,amendments of #bjac2 and 7ii7 by striking #gab7;h77#d74 and inserting #gab7;h77#e72 and2 and 7,c7 by adding at the end the following3 7,m7 collect and analyze best practices related to screening for elder abuse and publish a report of such best practices4 2 7#b7 in subsection 7e77#b7-- 7,a7 in the matter preceding subparagraph 7,a71 by inserting 1 and in coordination with the heads of ,state adult protective services programs and the ,state ,long-,term ,care ,ombudsmen after and services2 7,b7 in subparagraph 7,a71 by striking and at the end2 7,c7 in subparagraph 7,b71 by striking the period and inserting 2 and2 and 7,d7 by adding at the end the following3 7,c7 to assist ,states with the development of ,home ,care ,consumer ,bills of ,rights and ,plans for ,enforcement1 to ensure that home care consumers1 as defined in section #gcf1 have basic protections as outlined in subsections 7b7 and 7c7 of section #gje4 2 and 7#c7 by adding at the end the following3 7g7 ,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 7#db ,u4,s4,c4 #acigk et seq471 including the establishment of the ,advisory ,board on ,elder ,abuse1 ,neglect1 and ,exploitation1 and to continue the work of the ,elder ,justice ,coordinating ,council4 4 #bjb4 ,functions of ,assistant ,secretary ,section #bjb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjab7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#e71 by inserting economic security1 after nutrition12 7,b7 in paragraph 7#g71 by inserting 1 including economic security trends among such individuals after older individuals2 7,c7 in paragraph 7#h71 by striking older individuals and inserting the health and economic security of older individuals2 7,d7 in paragraph 7#ad71 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 personnel1 after field of aging12 7,e7 by striking paragraph 7#ae7 and inserting the following3 7#ae7 7,a7 as needed1 provide technical assistance1 training through training packages1 and other forms of instruction to entities consisting of ,state agencies1 area agencies on aging1 service providers1 and community-based organizations1 to ensure that the entities develop and implement1 in a culturally and linguistically competent manner1 programming1 services1 and outreach for older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to providing services to individuals with factors listed in section #ajb7bf77;,b72 and 7,b7 consult with national and community-based organizations representing minority individuals to develop the capacity of the ,administration to provide such technical assistance1 training1 and instruction4 2 7,f7 in paragraph 7#af77;,c71 by striking paragraphs 7#b7 and 7#e77;,a7 and inserting paragraphs 7#b7 and 7#d77;,a72 7,g7 in paragraph 7#ah71 by amending subparagraph 7,b7 to read as follows3 7,b7 make available to the ,center-- 7i7 for fiscal year #bjad1 not less than #b1jjj1jjj2 and 7ii7 for each subsequent fiscal year1 not less than the amount made available under this subparagraph for fiscal year #bjad4 2 7,h7 by striking paragraph 7#bb7 and inserting the following3 7#bb7 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 system2 2 7,i7 in paragraph 7#bc71 by striking all text following developers and inserting referred to in section #cjg7;a77#ac7 and section #gca22 7,j7 in paragraph 7#bg71 by striking and at the end2 7,k7 in paragraph 7#bh71 by striking the period and inserting a semicolon2 and 7,l7 by adding at the end the following3 7#bi7 7,a7 encourage1 provide technical assistance to and share best practices with1 ,states1 area agencies on aging1 ,aging and ,disability ,resource ,centers1 and service providers to carry out outreach and coordinate activities with health care entities1 such as ,federally qualified health centers1 in order to assure better care coordination for individuals with multiple chronic illnesses2 and 7,b7 coordinate activities with other ,federal agencies that are working to improve care coordination and developing new models and best practices for that coordination4 2 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#h7-- 7i7 in subparagraph 7,d7-- 7,i7 by inserting 1 and with future planning for eligible care recipients 7as defined in section #cgb7;a77 who are individuals with disabilities described in section #cgb7;a77#b77;,b7 and who are living with older relative caregivers 7as so defined7 after needs2 and 7,,ii7 by striking and at the end2 7ii7 in subparagraph 7,e71 by striking the semicolon at the end and inserting 2 and2 and 7iii7 by adding at the end the following3 7,f7 to provide information relating to the quality measures identified under paragraph 7#aa77;,a71 using the methods described in paragraph 7#aa77;,b71 about home and community-based long-term care programs1 service providers1 and resources1 when referring consumers to those programs1 providers1 or resources2 2 7,b7 in paragraph 7#aj71 by striking and at the end2 7,c7 by redesignating paragraph 7#aa7 as paragraph 7#ab72 and 7,d7 by inserting after paragraph 7#aj7 the following3 7#aa7 identify1 in consultation with ,states 7either directly or by entering into a contract under this subparagraph and considering the recommendation of the contract recipient7 quality measures for home and community-based long-term care programs1 service providers1 and resources that-- 7,a7 protect the health1 safety1 and welfare of consumers who are referred to such programs2 and 7,b7 shall be identified after the ,assistant ,secretary takes into account1 at a minimum1 information regarding-- 7i7 background checks of service providers2 7ii7 licensure of agencies and certification and training of service providers2 and 7iii7 consumer satisfaction regarding programs1 service providers1 and resources1 in cases in which consumer satisfaction information is available2 and 2 7#c7 in subsection 7e77#b77;,b7-- 7,a7 in clause 7viii71 by striking and2 7,b7 by redesignating clause 7ix7 as clause 7x72 and 7,c7 by inserting after clause 7viii7 the following3 7ix7 organizations with expertise on economic security1 asset accumulation1 and retirement planning2 and 2 and 7#d7 by adding at the end the following3 7g7 ,the ,assistant ,secretary shall ensure1 where appropriate1 that all programs funded under this ,act include appropriate training in the prevention of abuse1 neglect1 and exploitation and provision of services that address elder justice and the exploitation of older individuals4 7h7 7#a7 ,the ,assistant ,secretary shall establish and operate a ,national ,resource ,center for ,women and ,retirement 7referred to in this subsection as the ,center74 7#b7 ,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 ,act1 which shall be an amount not less than #bgi1jjj for fiscal year #bjad4 ,in subsequent fiscal years1 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 #bjad4 7i7 7#a7 ,aging and ,disability ,resource ,centers implemented under subsection 7b77#h7 may carry out an assessment program1 with respect to informal caregivers and care recipients1 that shall be modeled on the family caregiver assessment program established under section #cgc7;b74 7#b7 ,for purposes of an informal caregiver assessment carried out in accordance with paragraph 7#a71 the following definitions shall apply3 7,a7 ,the term care recipient means-- 7i7 an older individual2 7ii7 an individual with a disability2 or 7iii7 an individual with a special need4 7,b7 ,the term informal caregiver means an adult family member1 or another individual1 who is an informal provider of in-home and community care to a care recipient4 7j7 7#a7 ,the ,assistant ,secretary shall1 directly or by grant or contract1 establish and operate the ,national ,resource ,center on ,lesbian1 ,gay1 ,bisexual1 and ,transgender ,aging4 7#b7 ,the ,assistant ,secretary shall develop and issue operating standards and reporting requirements for the ,center established under paragraph 7#a74 7#c7 ,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 #bjad4 ,in subsequent fiscal years1 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 #bjad4 7k7 ,the ,assistant ,secretary shall1 directly or by grant or contract1 establish and operate a ,national ,adult ,protective ,services ,resource ,center4 4 #bjc4 ,federal agency consultation ,section #bjc of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjac7 is amended-- 7#a7 in subsection 7a77#c77;,a71 by striking older individuals 7with particular attention to low-income older individuals1 including low-income minority older individuals1 older individuals with limited ,english proficiency1 and older individuals residing in rural areas7 and inserting older individuals1 older individuals with greatest economic need1 older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7712 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#ah71 by striking 1 and and inserting a comma2 7,b7 in paragraph 7#ai71 by striking the period at the end and inserting 1 and2 and 7,c7 by adding at the end the following3 7#bj7 the ,patient ,protection and ,affordable ,care ,act1 including the amendments made by that ,act 7,public ,law #aaa-adh71 including programs that increase integration with community health centers1 as practicable4 2 and 7#c7 in subsection 7c77#f7-- 7,a7 in subparagraph 7,a7-- 7i7 in clause 7iii7-- 7,i7 by inserting and economic after demographic2 and 7,,ii7 by striking and at the end2 7ii7 in clause 7iv71 by adding and at the end2 and 7iii7 by adding at the end the following3 7v7 identifying and addressing workforce shortages related to services and supports for older individuals1 and leveraging the resources of ,federal programs that are related to the programs carried out under this ,act1 to address the shortages2 2 7,b7 in subparagraph 7,b7-- 7i7 in the matter preceding clause 7i71 by inserting economic security1 after housing12 and 7ii7 in clause 7i71 by inserting economic security1 after housing12 7,c7 in subparagraph 7,d71 by inserting economic security1 after housing12 7,d7 in subparagraph 7,e71 by inserting and economic security after public health2 7,e7 in subparagraph 7,f71 by striking and at the end2 7,f7 in subparagraph 7,g7-- 7i7 in the matter preceding clause 7i71 by inserting economic security1 after health care12 and 7ii7 in clause 7iii71 by striking the period at the end and inserting 2 and2 and 7,g7 by adding at the end the following3 7,h7 7i7 identify model ,federal programs to assist older individuals with achieving economic security2 and 7ii7 propose greater coordination of efforts to provide such assistance1 including by creating an inventory of all ,federal programs aimed at reducing poverty and increasing the economic security of older adults4 4 #bjd4 ,evaluation ,section #bjf of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjag7 is amended-- 7#a7 in subsection 7a71 by striking greatest economic need and all that follows through areas71 and inserting greatest economic need and unserved older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7712 7#b7 in subsection 7c71 by striking minority individuals and all that follows through disabilities and inserting individuals with greatest economic need and greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 7#c7 in subsection 7d71 by striking including1 as appropriate1 health and nutrition education demonstration projects conducted under section #cjg7;f7 the full contents of which shall be and inserting and the full contents of those summaries and analyses shall be2 7#d7 by redesignating subsections 7e7 through 7g7 as subsections 7f7 through 7h71 respectively2 7#e7 by inserting after paragraph 7d7 the following3 7e7 ,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 individuals4 2 and 7#f7 in subsection 7h71 as redesignated by paragraph 7#b71 by striking #a_/b of4 #bje4 ,reports ,section #bjg of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjah7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#b71 by striking section #bjb7;a77#ai7 and inserting section #bjb7;a77#af72 7,b7 in paragraph 7#c71 by striking 1 with particular attention and all that follows through the semicolon and inserting 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7722 and 7,c7 in paragraph 7#d71 by striking section #bjb7;a77#ag7 and inserting section #bjb7;a77#ad72 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#a77;,c71 by inserting and the adult protection services programs of the ,states after of the ,states2 and 7,b7 in paragraph 7#c77;,a71 by striking ,health ,care ,finance ,administration and inserting ,centers for ,medicare ,medicaid ,services2 7#c7 in subsection 7c77#e7-- 7,a7 by striking economic need 7including low-income minority individuals and older individuals residing in rural areas7 and inserting economic need2 and 7,b7 by striking social need 7including low-income minority individuals and older individuals residing in rural areas7 and inserting social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and 7#d7 by adding at the end the following3 7d7 ,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 ,act4 4 #bjf4 ,conforming amendments 7a7 ,appropriate use of funds ,section #bab7;b77#c7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbj;c7b77#c77 is amended-- 7#a7 by striking social need1 and inserting social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b77 or2 and 7#b7 by striking 1 or an older and all that follows through placement4 7b7 ,administrative expenses ,section #bae7;j7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbj;e-#a7;j77 is amended by striking section #baf and inserting section #bag4 #bjg4 ,authorization of appropriations ,section #baf of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbj;f7 is amended-- 7#a7 in subsection 7a71 by striking #bjjg1 #bjjh1 #bjji1 #bjaj1 and #bjaa and inserting #bjad1 #bjae1 #bjaf1 #bjag1 and #bjah2 7#b7 in subsection 7b7-- 7,a7 by striking section #bjb7;a77#bd7 and inserting section #bjb7;a77#ba72 and 7,b7 by striking #bjjg1 #bjjh1 #bjji1 #bjaj1 and #bjaa and inserting #bjad1 #bjae1 #bjaf1 #bjag1 and #bjah2 7#c7 in subsection 7c71 by striking #bjjg1 #bjjh1 #bjji1 #bjaj1 and #bjaa and inserting #bjad1 #bjae1 #bjaf1 #bjag1 and #bjah2 and 7#d7 by adding at the end the following3 7d7 ,national ,adult ,protective ,services ,resource ,center ,there are authorized to be appropriated to carry out section #bja7;i7 7relating to the ,national ,adult ,protective ,services ,resource ,center71 such sums as may be necessary for fiscal years #bjad1 #bjae1 #bjaf1 #bjag1 and #bjah4 7e7 ,advisory ,committee ,to ,assess1 ,coordinate1 and ,improve ,legal ,assistance ,activities ,there is authorized to be appropriated to carry out section #baf1 not less than #cjj1jjj for fiscal year #bjad4 4 #bjh4 ,advisory ,committee to ,assess1 ,coordinate1 and ,improve ,legal ,assistance ,activities ,title ,,ii of the ,older ,americans ,act of #aife is amended-- 7#a7 by redesignating section #baf 7#db ,u4,s4,c4 #cjbj;f7 as section #bag2 and 7#b7 by inserting after section #bae 7#db ,u4,s4,c4 #cjbj;e-#a7 the following3 #baf4 ,advisory ,committee to ,assess1 ,coordinate1 and ,improve ,legal ,assistance ,activities 7a7 ,establishment ,there is established an ,advisory ,committee to ,assess1 ,coordinate1 and ,improve ,legal ,assistance ,activities 7referred to in this section as the ,committee74 7b7 ,membership2 duties ,the ,assistant ,secretary shall appoint members to the ,committee and determine the activities of the ,committee 7which shall include the study and report described in subsection 7c774 7c7 ,study2 report ,the ,committee shall conduct a study on the legal services activities assistance system for older individuals4 ,not later than #a year after the date of the establishment of the ,committee1 the ,committee shall submit to the ,president1 ,congress1 and the ,assistant ,secretary a report that contains a detailed statement of the findings and conclusions of such study1 including the ,committee's recommendations improving the legal services activities assistance system for older individuals4 7d7 ,regulations ,not later than #ahj days after receiving the report described in subsection 7c71 the ,assistant ,secretary shall issue regulations or guidance taking into consideration the recommendations of the ,committee4 7e7 ,definition ,in this subsection1 the term legal assistance activities includes-- 7#a7 legal assistance made available to older individuals with greatest economic need or with greatest social need2 7#b7 activities of the ,national ,legal ,resource ,center carried out under section #dbj7;a72 7#c7 ,state legal assistance developer activities carried out under section #gca2 and 7#d7 any other directly related activity or program as determined appropriate by the ,assistant ,secretary4 4 #bji4 ,consumer ,price ,index 7a7 ,in general ,the ,secretary of ,labor1 through the ,bureau of ,labor ,statistics and in consultation with the ,assistant ,secretary for ,aging1 shall revise and improve the ,experimental ,price ,index for the ,elderly published by the ,bureau of ,labor ,statistics 7commonly referred to as the ,,cpi-,e7 in order for the ,,cpi-,e to be considered a reliable measure in determining future cost of living adjustments that impact ,americans who are #fb years of age or older4 7b7 ,revision requirements ,in carrying out subsection 7a71 the ,secretary of ,labor shall-- 7#a7 increase the number of individuals in the ,united ,states who are #fb years of age and older 7referred to in this section as older adults7 sampled in the consumer expenditure survey used to establish the ,,cpi-,e2 7#b7 establish samples of market-based items1 stores1 and prices to represent the purchasing patterns of older adults2 and 7#c7 examine the medical care component1 including the cost and usage of prescription drugs1 of the ,,cpi-,e taking into account that older adults have different illnesses and health care expenses1 including dental expenses1 than individuals in the ,united ,states who are under #fb years of age4 7c7 ,report to ,congress ,not later than #b years after the date of enactment of this ,act1 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 section4 #baj4 ,sense of the ,senate regarding appropriation levels ,title ,,ii of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjaa et seq471 as amended by section #bjh1 is further amended by adding at the end the following3 #bah4 ,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 #b1fge1jjj1jjj for fiscal year #bjad and each subsequent year4 4 ,,iii ,grants for state and community programs on aging #cja4 ,purpose2 administration ,section #cja7;a77#b7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjba7;a77#b77 is amended-- 7#a7 in subparagraph 7,e71 by striking and at the end2 7#b7 in subparagraph 7,f71 by striking the period and inserting 2 and2 and 7#c7 by adding at the end the following3 7,g7 ,federally qualified health centers1 as defined in sections #ahfa7;aa77#d7 and #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#d71 #acif;d7l77#b77;,b774 4 #cjb4 ,definition ,section #cjb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbb7 is amended-- 7#a7 by striking paragraph 7#c72 and 7#b7 by redesignating paragraph 7#d7 as paragraph 7#c74 #cjc4 ,authorization of appropriations ,section #cjc of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbc7 is amended-- 7#a7 in subsection 7a71 by striking paragraph 7#a7 and inserting the following3 7#a7 ,there are authorized to be appropriated to carry out part ,b 7relating to supportive services7 such sums as may be necessary for each of fiscal years #bjad through #bjah4 2 7#b7 by striking subsection 7b7 and inserting the following3 7b7 7#a7 ,there are authorized to be appropriated to carry out subpart #a of part ,c 7relating to congregate nutrition services7 such sums as may be necessary for each of fiscal years #bjad through #bjah4 7#b7 ,there are authorized to be appropriated to carry out subpart #b of part ,c 7relating to home delivered nutrition services7 such sums as may be necessary for fiscal years #bjad through #bjah4 2 7#c7 by striking subsection 7d7 and inserting the following3 7d7 ,there are authorized to be appropriated to carry out part ,d 7relating to disease prevention and health promotion services7 such sums as may be necessary for each of fiscal years #bjad through #bjah4 2 and 7#d7 by striking subsection 7e7 and inserting the following3 7e7 ,there are authorized to be appropriated to carry out part ,e 7relating to family caregiver support7 such sums as may be necessary for each of fiscal years #bjad through #bjah4 4 #cjd4 ,allotments ,section #cjd7;b7 of such ,act 7#db ,u4,s4,c4 #cjbd7;b77 is amended1 in the first sentence1 by striking part ,b and all that follows through part ,e1 and inserting part ,b1 ,c1 or ,e4 #cje4 ,organization ,section #cje of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbe7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a77;,e7-- 7i7 by striking greatest economic need and all that follows through rural areas7 the first place it appears and inserting greatest economic need2 and 7ii7 by striking greatest social need and all that follows through rural areas7 and inserting greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,c77ii71 by striking areas and all that follows and inserting areas of older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and2 7ii7 in subparagraph 7,e71 by striking services to and all that follows through rural areas7 and inserting services to older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b72 and 7iii7 in subparagraph 7,g71 by striking clause 7ii7 and inserting the following3 7ii7 provide an assurance that the ,state agency will undertake specific program development1 advocacy1 and outreach efforts focused on the needs of older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b77 and older individuals with greatest economic need2 and 2 7#b7 in subsection 7b77#e77;,c77i77,,iii71 by striking planning and services areas and inserting planning and service areas2 and 7#c7 in subsection 7d77#a71 by striking greatest economic or social need and inserting greatest economic need and greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b774 #cjf4 ,area plans ,section #cjf of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbf7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a7-- 7i7 by striking maintenance1 or construction of multipurpose senior centers and inserting maintenance1 modernization1 or construction of multipurpose senior centers 7which system includes a plan to use the skills and services of older individuals in paid and unpaid work1 including multigenerational work and older individual-to-older individual service activities1 relating to such maintenance1 modernization1 or construction1 or activities at the centers72 7ii7 by striking greatest economic need and all that follows through rural areas7 the first place it appears and inserting greatest economic need2 and 7iii7 by striking greatest social need and all that follows through rural areas7 residing in such area1 and inserting greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b77 residing in such area12 7,b7 in paragraph 7#b77;,a7-- 7i7 by striking mental health services and inserting evidence-based behavioral health services1 evidence-based chronic condition self-care management programs1 and evidence-based falls prevention programs2 and 7ii7 by striking eligible7 and inserting eligible and shall include information on paid and unpaid work opportunities for older individuals1 as available72 7,c7 in paragraph 7#d7-- 7i7 in subparagraph 7,a7-- 7,i7 in clause 7i77,i71 by striking will-- and all that follows and inserting will set specific objectives1 consistent with ,state policy1 for providing services to older individuals with greatest economic need1 older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b771 and older individuals at risk for institutional placement2 and2 7,,ii7 in clause 7i77,,ii71 by striking items 7aa7 and 7bb7 of2 and 7,,iii7 in subclauses 7,i71 7,,ii71 and 7,,iii7 of clause 7ii71 by striking low-income and all that follows through rural areas and inserting individuals with greatest economic need and individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and 7ii7 in subparagraph 7,b77i7-- 7,i7 in subclause 7,,ii71 by striking economic need and all that follows through rural areas7 and inserting economic need2 7,,ii7 in subclause 7,,iii71 by striking social need and all that follows through rural areas7 and inserting social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and 7,,iii7 in subclause 7,,vii71 by inserting with multiple chronic illnesses or after older individuals2 7,d7 in paragraph 7#f7-- 7i7 in subparagraph 7,d71 by inserting 7including acute care providers7 after service providers2 7ii7 in subparagraph 7,e77ii71 by inserting and ,federally qualified health centers1 as defined in sections #ahfa7;aa77#d7 and #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#d71 #acif;d7l77#b77;,b77 after #bjc7;b72 and 7iii7 by adding at the end the following3 7,h7 in coordination with the ,state agency and with the ,state agency responsible for elder abuse prevention services1 increase public awareness of elder abuse1 neglect1 and exploitation1 and remove barriers to elder abuse education1 prevention1 investigation1 and treatment2 and 7,i7 serve as an advocate in the corresponding planning and service area for evidence-based falls prevention programs and policies for older individuals and1 if possible1 enter into partnerships with ,state government agencies 7such as the ,state health agency and ,state transportation agency71 local agencies1 and community-based organizations that implement evidence-based falls prevention programs and policies2 2 7,e7 in paragraph 7#g7-- 7i7 in subparagraph 7,b77iii71 by striking placement1 to permit such individuals and inserting placement1 with particular attention to individuals with factors listed in section #ajb7bf77;,b71 to permit such at-risk individuals2 7ii7 in subparagraph 7,c7-- 7,i7 by inserting 7including falls7 after injury2 and 7,,ii7 by striking and at the end2 and 7iii7 in subparagraph 7,d71 by adding and at the end2 7,f7 by striking paragraph 7#i7 and inserting the following3 7#i7 provide assurances that the area agency on aging1 in carrying out the ,state ,long-,term ,care ,ombudsman program described in section #cjg7;a77#i71 will-- 7,a7 provide adequate funding to carry out an effective ,ombudsman program in compliance with this ,act2 and 7,b7 expend to carry out the program not less than the total amount of funds appropriated under this ,act or made available through other resources1 and expended by the agency in fiscal year #bjaj1 in carrying out such a program under this ,act2 2 7,g7 in paragraph 7#af71 by striking and at the end2 7,h7 in paragraph 7#ag7-- 7i7 by inserting and revise after develop2 7ii7 by inserting and health after ,state emergency response2 and 7iii7 by striking the period and inserting 2 and2 and 7,i7 by adding at the end the following3 7#ah7 include information describing-- 7,a7 how the area agency on aging will engage in outreach to veterans who are eligible for services under this ,act2 and 7,b7 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 providers4 2 and 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#b77;,b71 by striking including individuals and all that follows and inserting including older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7722 and 7,b7 in paragraph 7#c7-- 7i7 in subparagraph 7,j71 by striking and2 7ii7 by redesignating subparagraph 7,k7 as subparagraph 7,l72 and 7iii7 by inserting after subparagraph 7,j7 the following3 7,k7 protection from elder abuse1 neglect1 and exploitation2 and 4 #cjg4 ,state plans ,section #cjg7;a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbg7;a77 is amended-- 7#a7 in paragraph 7#b71 by striking subparagraph 7,a7 and inserting the following3 7,a7 evaluate1 using uniform procedures described in section #bjb7;a77#bf71 the need for supportive services 7including legal assistance pursuant to paragraph 7#aa71 information and assistance services1 care coordination1 and transportation services71 nutrition services1 economic security and benefits counseling1 and multipurpose senior centers within the ,state2 2 7#b7 in paragraph 7#d71 by striking provided to individuals and all that follows and inserting provided to individuals with greatest economic need and individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7742 7#c7 by striking paragraph 7#i7 and inserting the following3 7#i7 ,the plan shall provide assurances that the ,state agency will carry out1 through the ,office of the ,state ,long-,term ,care ,ombudsman1 a ,state ,long-,term ,care ,ombudsman program in accordance with section #gab and this title1 and1 in carrying out the program1 will-- 7,a7 provide adequate funding to carry out an effective ,ombudsman program in compliance with this ,act2 and 7,b7 expend to carry out the program not less than the total amount of funds appropriated under this ,act or made available through other resources1 and expended by the agency in fiscal year #bjaj1 in carrying out such a program under this ,act4 2 7#d7 in paragraph 7#aa7-- 7,a7 in the matter preceding subparagraph 7,a71 by striking legal assistance-- and inserting legal assistance1 which shall be provided through an integrated legal assistance delivery system--2 and 7,b7 in subparagraph 7,b71 by striking individuals with the greatest such need2 and inserting individuals with greatest economic need and individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7712 7#e7 by striking paragraph 7#ae7 and inserting the following3 7#ae7 ,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 need4 2 7#f7 in paragraph 7#af7-- 7,a7 in subparagraph 7,a71 by striking clauses 7i7 through 7vi7 and inserting the following3 7i7 older individuals with greatest economic need2 7ii7 older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and 7iii7 caregivers of individuals described in clause 7i7 or 7ii72 and 2 and 7,b7 in subparagraph 7,b7-- 7i7 by striking through 7vi7 and inserting and 7ii72 and 7ii7 by striking caretakers and inserting caregivers2 7#g7 in paragraph 7#bc77;,a71 by striking with other ,state services and inserting with other ,federal and ,state health care programs and services2 7#h7 in paragraph 7#bh77;,b7-- 7,a7 by striking clause 7i7 and inserting the following3 7i7 the projected change in the number of older individuals in the ,state1 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 ,state2 2 and 7,b7 in clause 7ii71 by striking including individuals and all that follows and inserting including older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7722 and 7#i7 by adding at the end the following3 7#ca7 ,the plan shall include information describing-- 7,a7 how the ,state agency will engage in outreach to veterans who are eligible for services under this ,act2 and 7,b7 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 providers4 7#cb7 ,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 dementia4 4 #cjh4 ,planning1 coordination1 evaluation1 and administration of state plans ,section #cjh7;a77#a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbh7;a77#a77 is amended-- 7#a7 by striking this ,act1 and and inserting this ,act12 and 7#b7 by inserting before the period the following3 1 and the modernization of such senior centers4 #cji4 ,nutrition services incentive program ,section #caa7;e7 of the ,older ,americans ,act of #aigc 7#db ,u4,s4,c4 #cjcj;a7e77 is amended by striking fiscal year #bjjg and all that follows and inserting each of fiscal years #bjad through #bjah4 #caj4 ,consumer contributions ,section #cae of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcj;c-#b7 is amended-- 7#a7 in subsection 7b7-- 7,a7 in paragraph 7#a71 by striking #ahe percent and inserting #bjj percent2 and 7,b7 in paragraph 7#c71 by adding at the end the following3 ,contributions under this section shall be used to supplement1 and not to supplant1 any other funds expended for activities described in this ,act42 7#b7 in subsection 7c77#b71 by striking participation of and all that follows through rural areas7 and inserting participation of older individuals with greatest economic need and older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b772 and 7#c7 in subsection 7d7-- 7,a7 by striking ,not later and all that follows through shall conduct and inserting ,not later than ,january #a1 #bjae1 and annually thereafter1 the ,assistant ,secretary shall conduct1 and submit to the appropriate committees of ,congress a report containing the results of12 and 7,b7 by striking 7with particular and all that follows through rural areas7 and inserting 1 including participation rates for individuals with greatest economic need and individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b774 #caa4 ,supportive services and senior centers program ,section #cba of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcj;d7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#e77;,c71 by striking and letter writing services and inserting evidence-based chronic condition self-care management1 letter writing services1 and evidence-based falls prevention programs2 7,b7 in paragraph 7#h7-- 7i7 by inserting 1 screening for elder abuse and neglect1 and falls prevention screening after mental health screening2 and 7ii7 by striking illness1 or both1 and inserting illnesses and injuries2 and 7,c7 in paragraph 7#ae71 by inserting before the semicolon the following3 and elder abuse and neglect screening1 chronic condition self-care management1 and falls prevention services2 and 7#b7 in subsection 7b77#a71 by inserting or modernization after construction4 #cab4 ,nutrition services 7a7 ,in general ,section #cci of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcj;g-#ba7 is amended-- 7#a7 in paragraph 7#a7-- 7,a7 by striking solicit and inserting utilize2 and 7,b7 by inserting 1 to help achieve development of evidenced-based and cost-effective nutrition services after nutritional services2 and 7#b7 in paragraph 7#b7-- 7,a7 in subparagraph 7,a71 by amending clause 7iii7 to read as follows3 7iii7 to the maximum extent practicable1 are adjusted and appropriately funded to meet any special health-related or other dietary needs of program participants1 including needs based on religious1 cultural1 or ethnic requirements1 2 7,b7 in subparagraph 7,j71 by striking and at the end2 7,c7 in subparagraph 7,k71 by striking the period and inserting 2 and2 and 7,d7 by adding at the end the following3 7,l7 where feasible1 encourages the use of locally grown foods in meal programs and identifies potential partnerships and contracts with local producers and providers of locally grown foods4 4 7b7 ,special rule ,section #cci of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcj;g-#ba7 is amended-- 7#a7 by inserting before ,a ,state the following3 7a7 ,in general 2 and 7#b7 by adding at the end the following3 7b7 ,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 part4 4 #cac4 ,disease prevention and health promotion services 7a7 ,program ,section #cfa of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcjm7 is amended-- 7#a7 in subsection 7a71 in the first sentence-- 7,a7 by inserting evidence-based after to provide2 7,b7 by inserting 7including cognitive health promotion services7 after health promotion services2 and 7,c7 by inserting before or at the following3 at ,federally qualified health centers 7as defined in sections #ahfa7;aa77#d7 and #aije7l77#b77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7aa77#d71 #acif;d7l77#b77;,b77714 7#b7 ,clinical preventive services ,part ,d of title ,,iii of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcjm et seq47 is amended by adding at the end the following3 #cfc4 ,clinical preventive services ,congress finds that-- 7#a7 there are clinical preventive services 7as defined in a manner consistent with the recommendations of the ,u4,s4 ,preventive ,services ,task ,force7 covered under the ,medicare program carried out under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq472 and 7#b7 older adults should receive the clinical preventive services described in paragraph 7#a74 4 #cad4 ,national family caregiver support program 7a7 ,older relative caregiver ,section #cgb of such ,act 7#db ,u4,s4,c4 #cjcjs7 is amended-- 7#a7 in subsection 7a7-- 7,a7 by striking this subpart3 and inserting this part32 and 7,b7 by striking paragraphs 7#a7 and 7#b7 and inserting the following3 7#a7 ,child ,the term child means an individual who is not more than #ah years of age4 7#b7 ,eligible care recipient ,the term eligible care recipient means a relative1 of an older relative caregiver1 who is-- 7,a7 a child2 or 7,b7 an individual with a disability who is not less than #ai and not more than #ei years of age4 7#c7 ,older relative caregiver 7,a7 ,in general ,the term older relative caregiver means a caregiver1 as defined in subparagraph 7,b7 or 7,c71 who-- 7i7 is #ee years of age or older2 and 7ii7 lives with1 is the informal provider of in-home and community care to1 and is the primary caregiver for1 an eligible care recipient who is described in subparagraph 7,b7 or 7,c71 respectively4 7,b7 ,caregiver for child ,for purposes of subparagraph 7,a71 the term caregiver1 used with respect to an eligible care recipient who is a child1 means an individual who-- 7i7 is the grandparent1 stepgrandparent1 or other relative 7other than the parent7 by blood1 marriage1 or adoption1 of the eligible care recipient2 7ii7 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 recipient2 and 7iii7 has a legal relationship to the eligible care recipient1 such as legal custody or guardianship1 or is raising the eligible care recipient informally4 7,c7 ,caregiver of individual with a disability ,for purposes of subparagraph 7,a71 the term caregiver1 used with respect to an eligible care recipient who is an individual with a disability described in paragraph 7#b77;,b7 means an individual who is the parent1 grandparent1 or other relative by blood1 marriage1 or adoption1 of the eligible care recipient4 2 and 7#b7 in subsection 7b77#b7-- 7,a7 by striking grandparents or older individuals who are relative caregivers and inserting older relative caregivers2 and 7,b7 by striking children and inserting eligible care recipients4 7b7 ,program ,section #cgc of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcjs-#a7 is amended-- 7#a7 in subsection 7a77#b71 by striking grandparents or older individuals who are relative caregivers4 and inserting older relative caregivers42 7#b7 by redesignating subsections 7b7 through 7g7 as subsections 7c7 through 7h71 respectively2 7#c7 by inserting after subsection 7a7 the following3 7b7 ,assessment program of needs of family caregivers 7#a7 ,in general ,the ,assistant ,secretary may make grants to ,states to establish a program1 in accordance with the program requirements described in paragraph 7#d71 to assess the needs of family caregivers for targeted support services4 7#b7 ,application by states ,each ,state seeking a grant under this subsection shall submit an application to the ,assistant ,secretary at such time1 in such manner1 and containing such information and assurances as the ,assistant ,secretary determines appropriate4 7#c7 ,program administration ,a ,state receiving a grant under this subsection may enter into an agreement with area agencies on aging in the ,state1 or an ,aging and ,disability ,resource ,center in the ,state1 to administer the program1 using such grant funds4 7#d7 ,program requirements 7,a7 ,voluntary questionnaire ,assessments under a program established as described in paragraph 7#a7 shall include asking the family caregiver relevant questions in order to determine whether the family caregiver would benefit from any targeted support services4 7,b7 ,referrals ,in the case where a questionnaire completed by a family caregiver under subparagraph 7,a7 indicates that the family caregiver would benefit from #a or more targeted support services1 the agency administering the program established under paragraph 7#a7 shall provide referrals to the family caregiver for ,state1 local1 nonprofit1 and private-sector caregiver programs and other resources that provide such targeted support services to such caregivers4 7,c7 ,reporting requirement ,each ,state with a program described in paragraph 7#a7 shall periodically submit to the ,assistant ,secretary a report containing information on the number of caregivers assessed under the program1 information on the number of referrals made for targeted support services under the program 7disaggregated by type of service71 demographic information on caregivers assessed under the program1 and other information required by the ,assistant ,secretary4 2 7#d7 in subsection 7c71 as redesignated by paragraph 7#b7-- 7,a7 in paragraph 7#d71 by striking and at the end2 7,b7 in paragraph 7#e71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following3 7#f7 the efforts of the ,ombudsman to facilitate the activities of1 and support1 the ,state ,long-,term ,care ,ombudsman program under title ,,vii and this title1 and the efforts of the ,ombudsman to facilitate the activities of1 and support1 family and caregiver councils in long-term care facilities4 2 7#e7 in subsection 7d71 as redesignated by paragraph 7#b7-- 7,a7 in paragraph 7#a7-- 7i7 in the matter preceding subparagraph 7,a71 by striking and grandparents and older individuals who are relative caregivers1 and inserting and older relative caregivers12 7ii7 in subparagraph 7,a71 by striking paragraph 7#a7 or 7#b7 of2 and 7iii7 in subparagraph 7,b7-- 7,i7 by striking subsection 7b71 in the case of a caregiver described in paragraph 7#a7 and inserting subsection 7c71 in the case of a caregiver described in subsection 7a77#a72 and 7,,ii7 by striking section #ajb7bb74 and inserting section #ajb7bd742 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,a7-- 7,i7 by inserting 7with particular attention to individuals with factors listed in section #ajb7bf77;,b77 after social need2 and 7,,ii7 by striking economic need and all that follows and inserting economic need2 and2 7#f7 in subsection 7e71 as redesignated by paragraph 7#b71 by striking subsection 7b7 and inserting subsection 7c72 7#g7 in subsection 7f77#c71 as redesignated by paragraph 7#b71 in the second sentence1 by striking or grandparents or older individuals who are relative caregivers1 and inserting older relative caregivers12 7#h7 in subsection 7g77#a71 as redesignated by paragraph 7#b7-- 7,a7 in subparagraph 7,a71 by striking for fiscal years #bjjg1 #bjjh1 #bjji1 #bjaj1 and #bjaa and inserting for each of fiscal years #bjad through #bjah2 and 7,b7 in subparagraph 7,b71 by striking under section #cjc and inserting under section #cjc7;e72 and 7#i7 in subsection 7h71 as redesignated by paragraph 7#b7-- 7,a7 in paragraph 7#b71 by striking subparagraph 7,c7 and inserting the following3 7,c7 ,limitation ,a ,state may use not more than #aj percent of the total ,federal and non-,federal share available to the ,state under this part to provide support services to-- 7i7 older relative caregivers who provide care for children2 and 7ii7 older relative caregivers-- 7,i7 who provide care for individuals described in section #cgb7;a77#b77;,b72 and 7,,ii7 who are the parents of the individuals4 2 and 7,b7 by adding at the end the following3 7#c7 ,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 ,ombudsman1 including supporting the development of resident and family councils4 4 7c7 ,elimination of superfluous subpart designation 7#a7 ,heading ,part ,e of title ,,iii of such ,act 7#db ,u4,s4,c4 #cjcjs et seq47 is amended by striking the subpart heading for subpart #a4 7#b7 ,conforming amendments ,sections #cgc 7as amended by subsection 7b77 and #cgd of such ,act 7#db ,u4,s4,c4 #cjcjs-#a1 #cjcjs-#b7 are further amended by striking this subpart in each place it appears and inserting this part4 ,,iv ,activities for health1 independence1 and longevity #dja4 ,grant programs ,section #daa of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcb7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#ab71 by striking 2 and and inserting a semicolon2 7,b7 by redesignating paragraph 7#ac7 as paragraph 7#ad72 and 7,c7 by inserting after paragraph 7#ab7 the following3 7#ac7 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 resources2 and 2 and 7#b7 in subsection 7b71 by striking for fiscal years #bjjg and all that follows through #bjaa and inserting for each of fiscal years #bjad through #bjah4 #djb4 ,community innovations for aging in place ,section #dbb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcbk7 is amended by adding at the end the following3 7g7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #e1jjj1jjj for each of fiscal years #bjad through #bjah4 4 #djc4 ,multipurpose senior center modernization1 training1 and support ,part ,a of title ,,iv of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcb et seq47 is amended by adding at the end the following3 #dbc4 ,multipurpose senior center modernization1 training1 and support 7a7 ,program authorized ,the ,assistant ,secretary shall award grants and enter into contracts with eligible entities to carry out projects to-- 7#a7 support and promote modern multipurpose senior center models which yield vibrant1 multiservice1 multigenerational centers for older individuals1 families of older individuals1 and others in the community to gain skills1 resources1 and connections needed to meet the challenges that occur with continuum of care and quality of life2 7#b7 build an evidence base of modern1 replicable practices that allow senior centers to serve a diverse array of older individuals1 as well as their families and other caregivers1 leveraging innovative partnerships and public and private resources to develop and expand programs2 and 7#c7 mobilize services and leverage resources to support the role of multipurpose senior centers as community focal points1 as provided in section #cjf7;a77#c71 and for the establishment1 construction1 maintenance1 and operation of centers1 as described in sections #cjc7;c77#b7 and #cjf7;a77#a71 including development of intergenerational shared site models1 consistent with the purposes of this ,act4 7b7 ,use of funds ,an eligible entity shall use funds made available under a grant awarded1 or a contract entered into1 under subsection 7a7 to-- 7#a7 carry out a project described in subsection 7a72 and 7#b7 evaluate the project in accordance with subsection 7e74 7c7 ,eligible entity ,for purposes of this section1 the term eligible entity means-- 7#a7 a multipurpose senior center that has met national accreditation and fiduciary standards2 and 7#b7 a regional partnership or collaboration of multipurpose senior centers or ,state association of senior centers in which not less than #b centers are accredited4 7d7 ,competitive grants for technical assistance 7#a7 ,grants ,the ,assistant ,secretary shall make a grant1 on a competitive basis1 to an eligible nonprofit organization described in paragraph 7#b71 to enable the organization to-- 7,a7 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 communities2 and 7,b7 carry out other duties1 as determined by the ,assistant ,secretary4 7#b7 ,eligible nonprofit organization ,to be eligible to receive a grant under this subsection1 an organization shall be a nonprofit organization 7including a partnership of nonprofit organizations71 that-- 7,a7 has experience and expertise in providing technical assistance to a range of multipurpose senior centers and experience evaluating and reporting on programs2 and 7,b7 has demonstrated knowledge of and expertise in multipurpose senior center accreditation or other standards of excellence4 7e7 ,local evaluation and report 7#a7 ,evaluation ,each entity receiving a grant or a contract under subsection 7a7 to carry out a project described in subsection 7a7 shall evaluate the project1 leadership1 and resources for the modernization of multipurpose senior centers4 7#b7 ,report ,the entity described in paragraph 7#a7 shall submit a report to the ,assistant ,secretary containing the evaluation not later than #f months after the expiration of the period for which the grant or contract is in effect4 7f7 ,report to ,congress ,not later than #f months after the ,assistant ,secretary receives the reports described in subsection 7e77#b71 the ,assistant ,secretary shall prepare and submit to ,congress a report that describes the results of the evaluations4 4 #djd4 ,demonstration program on care coordination and service delivery ,part ,a of title ,,iv of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcb et seq471 as amended by section #djc1 is further amended by adding at the end the following3 #dbd4 ,demonstration program on care coordination and service delivery 7a7 ,establishment of demonstration program 7#a7 ,in general ,the ,assistant ,secretary shall carry out a demonstration program in accordance with this section4 ,the ,assistant ,secretary shall award grants to eligible entities 7as determined by the ,secretary7 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-- 7,a7 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 individuals2 and 7,b7 giving direct-care workers opportunities for career advancement through additional training1 an expanded role1 and increased compensation4 7#b7 ,direct-care worker ,in this section1 the term direct-care worker has the meaning given that term in the #bjaj ,standard ,occupational ,classifications of the ,department of ,labor for ,home ,health ,aides #ca-ajaa1 ,psychiatric ,aides #ca-ajac1 ,nursing ,assistants #ca-ajad1 and ,personal ,care ,aides #ci-ijba4 7b7 ,planning and implementation awards under the program 7#a7 ,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 entity4 7#b7 ,amount ,the amount awarded under paragraph 7#a7 for all grants-- 7,a7 for planning activities1 shall not exceed #fjj1jjj2 and 7,b7 for implementation activities1 shall not exceed #b1ijj1jjj4 7#c7 ,terms ,planning activities carried out under a grant awarded under paragraph 7#a7 shall be completed not later than #a year after the grant is awarded4 ,implementation activities carried out under such a grant shall be completed not later than #b years after the grant is awarded4 7#d7 ,evaluation and report ,each recipient of a grant under paragraph 7#a71 in consultation with an independent evaluation contractor1 shall conduct an evaluation and submit to the ,secretary a report on the implementation of activities conducted under the demonstration project1 including such information as the ,secretary may require4 4 #dje4 ,grants or contracts to facilitate low-income access to dental care ,part ,a of title ,,iv of the ,older ,americans ,act of #aife1 as amended by section #djd1 is further amended by adding at the end the following3 #dbe4 ,grants or contracts to facilitate low-income access to dental care 7a7 ,definition ,in this section1 the term medically recommended dental care means treatment of an oral disease or other oral condition1 on the referral of a physician or other health care professional1 to sustain or improve overall health1 prevent exacerbation of a co-morbid condition1 or as a prerequisite to a required medical therapy4 7b7 ,grants ,the ,secretary shall award competitive grants to1 or enter into contracts with1 eligible entities to fund the employment costs of professionals who will use grant or contract funds to-- 7#a7 coordinate the provision of medically recommended dental care to eligible individuals by volunteer dentists in a manner consistent with ,state licensing laws2 and 7#b7 verify the medical1 dental1 and financial needs of eligible individuals who may be eligible for free medically recommended dental care4 7c7 ,eligibility 7#a7 ,eligible entity ,to be eligible to receive a grant or contract under subsection 7b71 an entity shall be a nonprofit organization that provides for the participation of eligible individuals in a free dental services program on a national basis4 7#b7 ,eligible individual ,to be eligible to participate in a program described in paragraph 7#a71 individuals shall be those with greatest economic need and individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b774 7d7 ,use of funds ,an entity shall use amounts received under a grant or contract under this section to establish1 expand1 or operate a program to coordinate the provision of free medically recommended dental care through volunteer dentists to eligible individuals4 7e7 ,evaluation and report 7#a7 ,evaluation ,each entity that receives a grant or contract under this section shall evaluate the number of patients served under the grant or contract1 and the effectiveness of the program described in subsection 7d7 in reducing medical expenses associated with the disease or condition for which care described in subsection 7d7 was provided4 7#b7 ,report ,the entity shall submit a report containing the results of the evaluation to the ,assistant ,secretary1 not later than #f months after the end of the period of the grant or contract4 7f7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section1 #b1jjj1jjj for each of fiscal years #bjad through #bjah4 4 #djf4 ,national resource center on family caregiving ,part ,a of title ,,iv of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcb et seq471 as amended by section #dje1 is further amended by adding at the end the following3 #dbf4 ,national ,resource ,center on ,family ,caregiving 7a7 ,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 7referred to in this section as the ,center74 7b7 ,development ,the ,assistant ,secretary shall develop and issue operating standards and reporting requirements for the ,center established under subsection 7a74 7c7 ,authorization ,there is authorized to be appropriated to carry out this section1 #b1jjj1jjj for each of fiscal years #bjad through #bjah4 4 #djg4 ,conforming amendment ,section #dag7;c77#b7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcb;f7c77#b77 is amended by striking older individuals and communities and all that follows and inserting communities with greatest need1 older individuals with greatest economic need1 and older individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7724 ,v ,community service senior opportunities #eja4 ,older american community service employment program ,section #ejb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjef7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 by striking ,to foster individual economic self-sufficiency and and inserting ,to further the goal of economic security1 foster individual economic self-sufficiency1 grow local economies1 improve the quality of life in local communities1 and2 and 7,b7 by striking persons who are age #ee and inserting persons who are not economically secure and who are age #ee2 and 7#b7 in subsection 7b77#a7-- 7,a7 in subparagraph 7,e71 by striking support for children1 and inserting support for adults1 children12 and 7,b7 in subparagraph 7,m71 by striking and eligible individuals with greatest economic need and inserting eligible individuals with disabilities1 eligible individuals with greatest economic need1 and eligible individuals with greatest social need4 #ejb4 ,interagency cooperation ,section #ead of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjefl7 is amended-- 7#a7 in subsection 7c77#a71 by striking individuals with greatest economic need1 individuals with greatest social need1 and inserting individuals with greatest economic need1 individuals with greatest social need 7with particular attention to individuals with factors listed in section #ajb7bf77;,b7712 and 7#b7 in subsection 7e77#a71 by striking minority and all that follows through economic need1 and inserting individuals with greatest economic need1 individuals with greatest social need14 #ejc4 ,authorization of appropriations ,section #eag7;a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjefo7a77 is amended by striking fiscal years #bjjg1 #bjjh1 #bjji1 #bjaj1 and #bjaa and inserting each of fiscal years #bjad through #bjah4 #ejd4 ,study on feasibility of transfer of program 7a7 ,study ,the ,assistant ,secretary for ,aging of the ,department of ,health and ,human ,services1 and the ,secretary of ,labor1 shall study the feasibility of transferring the program carried out under title ,v of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjef et seq47 to the ,administration on ,aging4 7b7 ,report ,not later than #b years after the date of enactment of this ,act1 the ,assistant ,secretary and the ,secretary shall submit a report containing the results of the study to the appropriate committees of ,congress4 ,,vi ,grants for native americans #fja4 ,technical amendment ,section #faa of such ,act 7#db ,u4,s4,c4 #cjeg;b7 is amended by striking 7a7 in the matter preceding paragraph 7#a74 #fjb4 ,conforming amendment ,section #fca7;b7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjegk-#aa7;b77 is amended by striking subsections 7c71 7d71 and 7e7 and inserting subsections 7d71 7e71 and 7f74 #fjc4 ,reauthorization of funding for grants for ,native ,americans ,section #fdc7b7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjegn7#b77 is amended by striking part ,c1 and all that follows and inserting part ,c1 not less than #h1djj1jjj for each of fiscal years #bjad through #bjah44 ,,vii ,vulnerable elder rights protection activities #gja4 ,establishment ,section #gja of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh7 is amended-- 7#a7 by inserting and grants after allotments2 and 7#b7 by adding at the end the following3 ,the ,assistant ,secretary1 to the maximum extent practicable1 shall ensure that education and public awareness activities under this title are fully integrated with programs under this ,act44 #gjb4 ,authorization of appropriations ,chapter #a of subtitle ,a of title ,,vii of the ,older ,americans ,act of #aife is amended by inserting after section #gjb 7#db ,u4,s4,c4 #cjeh;a7 the following3 #gjb;,a4 ,authorization of appropriations for ,state ,home ,care ,ombudsman ,program ,there are authorized to be appropriated to carry out chapter #e such sums as may be necessary for fiscal year #bjad and each subsequent fiscal year4 4 #gjc4 ,grants ,section #gjc of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;b7 is amended by adding at the end the following3 7d7 ,grants for ,state home care ombudsman programs ,the ,assistant ,secretary shall use funds made available under section #gjb;,a to award grants1 on a competitive basis1 to ,states for ,state ,home ,care ,ombudsman ,programs4 4 #gjd4 ,eligibility ,section #gjd of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;c7 is amended1 in the matter preceding paragraph 7#a71 by inserting or grants after allotments4 #gje4 ,additional ,state plan requirements ,section #gje of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;d7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in the matter preceding paragraph 7#a71 by inserting or grant after allotment2 7,b7 in paragraph 7#a71 by striking requirements of the chapter and this chapter and inserting requirements of this chapter and this subtitle2 7,c7 in paragraph 7#b71 by inserting family caregivers1 after title ,,vi12 7,d7 in paragraph 7#d71 by striking enactment of this subtitle and inserting enactment of the chapter2 7,e7 in paragraph 7#f71 by striking and at the end2 7,f7 in paragraph 7#g71 by striking the period and inserting 2 and2 and 7,g7 by adding at the end the following3 7#h7 an assurance that the ,state has-- 7,a7 a ,home ,care ,consumer ,bill of ,rights and a ,plan for ,enforcement of such a ,bill1 developed in accordance with the procedures described under paragraph 7#b7 and as approved by the ,assistant ,secretary1 and the ,state shall include a copy of the ,bill and ,plan2 or 7,b7 a waiver of subparagraph 7,a7 from the ,assistant ,secretary and a proposal for developing and submitting for approval a ,home ,care ,consumer ,bill of ,rights and ,plan for ,enforcement4 2 7#b7 by redesignating subsection 7b7 as subsection 7d72 7#c7 by inserting after subsection 7a7 the following3 7b7 ,home ,care ,consumer ,bill of ,rights ,the ,home ,care ,consumer ,bill of ,rights referred to in subsection 7a77#h7 shall1 at a minimum-- 7#a7 address a home care consumer's right to basic safety2 7#b7 address a home care consumer's right to access information about the cost of home care services prior to receiving those services2 7#c7 address a home care consumer's right to choice1 participation1 and self-determination2 7#d7 address a home care consumer's right to redress grievances2 and 7#e7 meet any other guidelines determined to be appropriate by the ,assistant ,secretary4 7c7 ,plan for enforcement ,the ,plan for ,enforcement referred to in subsection 7a77#h7 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 ,rights4 2 and 7#d7 by adding at the end the following3 7e7 ,definition ,in this section1 the term home care consumer and home care services have the meanings given the terms in section #gcf4 4 #gjf4 ,definitions ,section #gaa7f7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;f7#f77 is amended by striking older individual and inserting individual4 #gjg4 ,state ,long-,term ,care ,ombudsman program ,section #gab of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;g7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#b71 by adding at the end the following3 ,the ,ombudsman shall be responsible for the management1 including the fiscal management1 of the ,office42 7,b7 in paragraph 7#c7-- 7i7 in subparagraph 7,a71 by striking clause 7i7 and inserting the following3 7i7 are made by or on behalf of residents1 including residents with limited or no decisionmaking capacity and who have no known legal representative1 and if such a resident is unable to communicate consent for an ,ombudsman to work on a complaint directly involving the resident1 the ,ombudsman shall seek evidence to indicate what outcome the resident would have desired 7and1 in the absence of evidence to the contrary1 shall assume that the resident wishes to have the resident's health1 safety1 welfare1 and rights protected7 and shall work to accomplish the desired outcome2 2 7ii7 in subparagraph 7,d71 by striking regular and timely and inserting regular1 timely1 private1 and unimpeded2 and 7iii7 in subparagraph 7,h77iii71 by striking provide technical support for and inserting actively encourage and assist in2 7,c7 in paragraph 7#d7-- 7i7 in the paragraph header1 by striking ,contracts and arrangements and inserting ,organizational placement2 and 7ii7 by striking subparagraph 7,b7 and inserting the following3 7,b7 ,identifying1 removing1 and remedying organizational conflict 7i7 ,in general ,the ,state agency may not operate the ,office or carry out the program1 directly1 or by contract or other arrangement with any public agency or nonprofit private organization1 in a case in which there is an organizational conflict of interest unless such conflict has been-- 7,i7 identified by the ,state agency2 7,,ii7 disclosed by the ,state agency to the ,assistant ,secretary in writing2 and 7,,iii7 remedied in accordance with this subparagraph4 7ii7 ,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 entity1 the ,assistant ,secretary shall require that the ,state agency-- 7,i7 remove the conflict2 or 7,,ii7 submit1 and obtain the approval of the ,assistant ,secretary for1 an adequate remedial plan that indicates how the ,ombudsman will be unencumbered in fulfilling all of the functions specified in paragraph 7#c74 7,c7 ,organizational conflict of interest ,in this paragraph1 the term organizational conflict of interest includes a situation in which the ,office is placed in an organization that-- 7i7 is responsible for licensing or certifying long-term care services in the ,state2 7ii7 is an association 7or an affiliate of such an association7 of long-term care facilities1 or of any other residential facilities for older individuals2 7iii7 provides long-term care services1 including programs carried out under a ,medicaid waiver approved under section #aaae of the ,social ,security ,act 7#db ,u4,s4,c4 #acae7 or under subsection 7c7 or 7b7 of section #aiae of the ,social ,security ,act 7#db ,u4,s4,c4 #acifn71 or under a ,medicaid ,state plan amendment under subsection 7i71 7j71 or 7k7 of section #aiae of the ,social ,security ,act 7#db ,u4,s4,c4 #acifn72 7iv7 provides long-term care case management2 7v7 sets rates for long-term care services2 7vi7 provides adult protective services2 7vii7 is responsible for eligibility determinations for the ,medicare program carried out under title ,,xviii1 or the ,medicaid program carried out under title ,,xix1 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq41 #acif et seq472 7viii7 conducts preadmission screening for placements in facilities described in clause 7ii72 or 7ix7 makes decisions regarding admission of individuals to such facilities4 2 and 7,d7 in paragraph 7#e77;,b77vi71 by striking support and inserting actively encourage and assist in2 7#b7 in subsection 7b7-- 7,a7 in paragraph 7#a7-- 7i7 in subparagraph 7,a71 by striking access and inserting private and unimpeded access2 7ii7 in subparagraph 7,b77i7-- 7,i7 in the matter preceding subclause 7,i71 by striking the medical and social records of a and inserting all records concerning a2 and 7,,ii7 in subclause 7,,ii71 by striking to consent and inserting to communicate consent2 7iii7 by redesignating subparagraphs 7,c7 and 7,d7 as subparagraphs 7,e7 and 7,f71 respectively2 and 7iv7 by inserting after subparagraph 7,b7 the following3 7,c7 such access as is necessary to advocate for a resident's desired outcome to the extent that the resident can express the outcome desired1 even if the resident is unable to communicate consent2 7,d7 access to the records of a resident who is unable to communicate consent in a case in which-- 7i7 the access is necessary to investigate and resolve a complaint described in subsection 7a77#c72 7ii7 a legal guardian of the resident refuses to give permission for the access2 7iii7 a representative of the ,office has reasonable cause to believe that the guardian is not acting in the best interests of the resident by refusing2 7iv7 the resident has no other known legal representative2 and 7v7 the representative of the ,office obtains the approval of the ,ombudsman2 2 and 7,b7 by adding at the end the following3 7#c7 ,health oversight agency ,for purposes of section #bfd7;c7 of the ,health ,insurance ,portability and ,accountability ,act of #aiif 7including regulations issued under that section7 7#db ,u4,s4,c4 #acbj;d-#b note71 the ,ombudsman and a representative of the ,office shall be considered a health oversight agency1 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 7i7 or 7ii7 of paragraph 7#a77;,b71 or the requirements of paragraph 7#a77;,d7 are otherwise met4 2 7#c7 in subsection 7c77#b77;,d71 by striking section #bjb7;a77#ba7 and inserting section #bjb7;a77#ah72 7#d7 in subsection 7d7-- 7,a7 in paragraph 7#a71 by striking files and inserting information2 and 7,b7 in paragraph 7#b7-- 7i7 in subparagraph 7,a71 by striking files and records each place such term appears and inserting information2 and 7ii7 in subparagraph 7,b71 by striking files or records and inserting information2 7#e7 in subsection 7f77#c7-- 7,a7 in subparagraph 7,c71 by striking facility2 and and inserting facility or a related organization1 and has not been employed by such a facility or organization within #b years before the date of the determination involved22 7,b7 in subparagraph 7,d71 by striking and at the end2 and 7,c7 by adding at the end the following3 7,e7 does not have management responsibility for1 or operate under the supervision of1 an agency with responsibility for adult protective services2 and 7,f7 does not serve as a guardian or in another fiduciary capacity for residents of long-term care facilities in an official capacity 7as opposed to serving as a guardian or fiduciary1 for a family member1 in a personal capacity72 and 2 7#f7 in subsection 7h7-- 7,a7 in paragraph 7#d71 by striking all that precedes procedures and inserting the following3 7#d7 strengthen and update 2 7,b7 by redesignating paragraphs 7#d7 through 7#i7 as paragraphs 7#e7 through 7#aj71 respectively2 7,c7 by inserting after paragraph 7#c7 the following3 7#d7 ensure that the ,ombudsman or a designee attends training provided by the ,administration through the ,national ,ombudsman ,resource ,center established in section #bjb7;a77#ah72 2 7,d7 in paragraph 7#g77;,a71 as redesignated by subparagraph 7,b7 of this paragraph1 by striking subtitle ,c of the and inserting subtitle ,c of title ,i of the2 and 7,e7 in paragraph 7#aj71 as redesignated by subparagraph 7,b7 of this paragraph1 by striking 7#f71 or 7#g7 and inserting 7#g71 or 7#h72 and 7#g7 by adding at the end the following3 7k7 ,ensuring effective programs and residents' rights ,the ,state agency shall ensure the ,office-- 7#a7 provides long-term care facility residents with private and unimpeded access to the ,office1 including access to all records concerning the resident2 and 7#b7 allows all long-term care facility residents to receive services from the ,office4 4 #gjh4 ,prevention of elder abuse1 neglect1 and exploitation ,section #gba7;b7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;i7b77 is amended-- 7#a7 in paragraph 7#b71 by striking the semicolon and inserting the following3 1 including education and outreach to professionals including postal carriers1 employees of financial institutions1 firefighters1 meter readers1 and other community professionals who are in a position to observe an older individual on a daily or regular basis22 7#b7 in paragraph 7#d71 by inserting before the semicolon the following3 and submit data on the prevalence of elder abuse1 neglect1 and exploitation for the appropriate database of the ,administration or another database specified by the ,assistant ,secretary2 7#c7 by redesignating paragraphs 7#h7 through 7#ab7 as paragraphs 7#i7 through 7#ac71 respectively2 7#d7 by inserting after paragraph 7#g7 the following3 7#h7 conducting appropriate training to ensure cultural sensitivity in the provision of elder rights services1 including training in cultural issues associated with abuse2 2 7#e7 in subparagraph 7,c7 of paragraph 7#aj71 as redesignated by paragraph 7#c7 of this section-- 7,a7 in clause 7ii71 by inserting 1 such as forensic accountants1 after such personnel2 and 7,b7 in clause 7v71 by striking the comma at the end and inserting 1 including programs and arrangements that will safeguard victims' or potential victims' finances1 such as daily money management programs and conservatorships12 7#f7 in paragraph 7#ab71 as redesignated by paragraph 7#c7 of this section-- 7,a7 in subparagraph 7,d71 by striking and at the end2 and 7,b7 by adding at the end the following3 7,f7 supporting and studying innovative practices in local communities1 to develop partnerships across disciplines for the prevention1 investigation1 and prosecution of exploitation2 2 7#g7 in paragraph 7#ac71 as redesignated by paragraph 7#c7 of this section-- 7,a7 in subparagraph 7,b71 by striking or at the end2 7,b7 in subparagraph 7,c71 by striking the period at the end and inserting 2 or2 and 7,c7 by adding at the end the following3 7,d7 older individuals who are ,holocaust survivors2 and 2 and 7#h7 by adding at the end the following3 7#ad7 developing a ,state ,home ,care ,consumer ,bill of ,rights and ,plan for ,enforcement 7as described in section #gje7 to protect home care consumers 7as defined in section #gcf7 from abuse1 neglect1 and exploitation4 4 #gji4 ,state legal assistance development ,section #gca of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;j7 is amended by striking ,a ,state agency and all that follows through to ensure-- and inserting the following3 7a7 ,state legal services developer ,a ,state agency shall provide the services of an individual who shall be known as a ,state legal services developer1 who shall promote1 and may facilitate1 the development and operation of an integrated legal assistance delivery system for the ,state4 ,to the maximum extent practicable1 the individual selected to serve as the developer shall-- 7#a7 agree to serve as the developer on a full-time basis2 7#b7 have a law degree from an accredited law school or have been admitted to practice law in any jurisdiction in the ,united ,states2 and 7#c7 possess other knowledge1 skills1 training1 and education that reflect a comprehensive understanding of legal services for older individuals4 7b7 ,other personnel ,in addition to the ,state legal services developer1 the ,state agency shall provide the services of other personnel1 sufficient to ensure-- 4 #gaj4 ,state ,home ,care ,ombudsman ,programs ,subtitle ,a of title ,,vii of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh et seq47 is amended by adding at the end the following3 #e ,state ,home ,care ,ombudsman ,programs #gcf4 ,definitions ,in this chapter3 7#a7 ,home care consumer ,the term home care consumer means a person who receives services in the person's home or community1 which may include home care services provided through this ,act1 the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq471 the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq471 or another public or private funding source4 7#b7 ,home care ombudsman program ,the term home care ombudsman program means a ,state ,home ,care ,ombudsman ,program described in section #gcg7;a77#a74 7#c7 ,home care services ,the term home care services means home and community-based services1 including personal care services designed to assist an individual in the activities of daily living such as bathing1 exercising1 personal grooming1 and getting in and out of bed4 #gcg4 ,program 7a7 ,establishment 7#a7 ,in general ,in order to be eligible to receive a grant under section #gjc7;d7 from funds appropriated under section #gjb;,a and made available to carry out this chapter1 a ,state agency shall1 in accordance with this section1 agree to carry out a ,state ,home ,care ,ombudsman ,program within the ,office of the ,state ,long-,term ,care ,ombudsman4 7#b7 ,home care ombudsman program ,the home care ombudsman program shall be carried out by the ,state ,long-,term ,care ,ombudsman4 ,the ,ombudsman and other entities carrying out the home care ombudsman program shall have authorities1 requirements1 and functions with respect to that program1 and home care services provided and home care consumers served under that program1 that are equivalent 7as determined by the ,secretary7 to the authorities1 requirements1 and functions the ,ombudsman and other entities have in carrying out the ,state ,long-,term ,care ,ombudsman ,program under chapter #b1 and long-term care provided and long-term care consumers served under that program4 7b7 ,maintenance of effort ,a ,state1 in using the funds made available for a fiscal year through a grant received under section #gjc7;d71 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 year4 7c7 ,evaluation ,the ,assistant ,secretary shall-- 7#a7 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 ,secretary1 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 #a year after receipt of the data1 submit a report to ,congress outlining best practices for carrying out a home care ombudsman program2 and 7#b7 make the report available to ,states4 4 ,,viii ,geriatrics and gerontology #hja4 ,primary health services ,section #cca7;a77#c77;,d7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;d7a77#c77;,d77 is amended by inserting geriatrics1 gerontology1 after pediatrics14