,,ii  #aacth ,,congress  #ast ,session  
,s4 #aefb  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,september #cj1
 #bjac,mr4 ,sanders 7for himself1 ,mr4  
,alexander1 and ,mr4 ,harkin7 introduced
 the following bill2 which was read     
twice and referred to the ,committee on 
,health1 ,education1 ,labor1 and        
,pensions  ,a ,,bill  ,to reauthorize   
the ,older ,americans ,act of #aife1 and
 for other purposes4  #a4 ,short title  
,this ,act may be cited as the ,older   
,americans ,act ,reauthorization ,act of
 #bjac4  #b4 ,definitions ,section #ajb 
of the ,older ,americans ,act of #aife  
7#db ,u4,s4,c4 #cjjb7 is amended-- 7#a7 
by striking paragraph 7#a7 and inserting
 the following3  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 striking paragraph    
7#d7 and inserting the following3  7#d7 

,the term ,aging and ,disability        
,resource ,center means an entity1      
network1 or consortium established by a 
,state as part of the ,state system of  
long-term care1 to provide a coordinated
 and integrated system for older        
individuals and individuals with        
disabilities 7as defined in section #c  
of the ,americans with ,disabilities    
,act of #aiij 7#db ,u4,s4,c4 #abajb771  
and the caregivers of older individuals 
and individuals with disabilities1 that 
provides-- 7,a7 comprehensive           
information on the full range of        
available public and private long-term  
care programs1 options1 service         
providers1 and resources within a       
community1 including information on the 
availability of integrated long-term    
care services1 and ,federal or ,state   
programs that provide long-term care    
services and supports through home and  
community-based service programs2  7,b7 
person-centered counseling to assist    
individuals in assessing their existing 

or anticipated long-term care needs and 
goals1 and developing and implementing a
 person-centered plan for long-term care
 that is consistent with the desires of 
such an individual and designed to meet 
the individual's specific needs1 goals1 
and circumstances2  7,c7 access for     
individuals to the full range of        
publicly supported long-term care       
services and supports for which the     
individuals may be eligible1 including  
home and community-based service        
options1 by serving as a convenient     
point of entry for such programs and    
supports2 and  7,d7 in cooperation with 
area agencies on aging1 centers for     
independent living described in part ,c 
of title ,,vii of the ,rehabilitation   
,act of #aigc 7#bi ,u4,s4,c4 #gif;f et  
seq471 and other community-based        
entities1 information and referrals     
regarding available home and            
community-based services for individuals
 who are at risk for residing in1 or who
 reside in1 institutional settings1 so  

that the individuals have the choice to 
remain in or to return to the community4
  2  7#c7 in paragraph 7#ad77;,b71 by   
inserting oral health1 after bone       
density12  7#d7 by striking paragraph   
7#ag7 and inserting the following3      
7#ag7 ,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#e7 in 
paragraph 7#ah77;,a71 by striking term  
exploitation means and inserting terms  
exploitation and financial exploitation 
mean2 and  7#f7 by adding at the end the
 following3  7#ee7 ,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       
casework and services2 and  7,d7        
providing1 arranging for1 or            
facilitating the provision of medical1  
social service1 economic1 legal1        
housing1 law enforcement1 or other      
protective1 emergency1 or support       
services4  4  #c4 ,administration on    
,aging  7a7 ,best practices ,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 and at   
the end2  7,b7 in subparagraph 7,l7--   
7i7 by striking ,older ,americans ,act  
,amendments of #aiib and inserting      
,older ,americans ,act ,reauthorization 
,act 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   
responding to elder abuse1 neglect1 and 
exploitation in long-term care          
facilities1 and publish a report of such
 best practices4  2 and  7#b7 in        
subsection 7e77#b71 in the matter       
preceding subparagraph 7,a71 by         
inserting 1 and in coordination with the
 heads of ,state adult protective       
services programs and the ,director of  
the ,office of ,long-,term ,care        
,ombudsman ,programs after and services4
  7b7 ,training ,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 health and economic before
 needs of older individuals2  7,b7 in   
paragraph 7#g71 by inserting health and 
economic before welfare2  7,c7 in       
paragraph 7#ad71 by inserting 7including
 the ,health ,resources and ,services   
,administration7 after other agencies2  
7,d7 in paragraph 7#bg71 by striking and

 at the end2  7,e7 in paragraph 7#bh71  
by striking the period and inserting a  
semicolon2 and  7,f7 by adding at the   
end the following3  7#bi7 provide       
information and technical assistance to 
,states1 area agencies on aging1 and    
service providers1 in collaboration with
 relevant ,federal agencies1 on         
providing efficient1 person-centered    
transportation services1 including      
across geographic boundaries2  7#cj7    
identify model programs and provide     
information and technical assistance to 
,states1 area agencies on aging1 and    
service providers 7including providers  
operating multipurpose senior centers71 
to support the modernization of         
multipurpose senior centers2 and  7#ca7 
provide technical assistance to and     
share best practices with ,states1 area 
agencies on aging1 and ,aging and       
,disability ,resource ,centers1 on how  
to collaborate and coordinate services  
with health care entities1 such as      
,federally-qualified health centers1 as 

defined in section #aije7l77#b77;,b7 of 
the ,social ,security ,act 7#db         
,u4,s4,c4 #acif;d7l77#b77;,b771 in order
 to improve care coordination for       
individuals with multiple chronic       
illnesses4  2  7#b7 in subsection 7b7-- 
7,a7 in paragraph 7#e7-- 7i7 in         
subparagraph 7,b71 by striking and after
 the semicolon2  7ii7 in subparagraph   
7,c71 by inserting and after the        
semicolon2 and  7iii7 by adding at the  
end the following3  7,d7 when feasible1 
developing1 in consultation with ,states
 and national organizations1 a          
consumer-friendly tool to assist older  
individuals and their families in       
choosing home and community-based       
services1 with a particular focus on    
ways for consumers to assess how        
providers protect the health1 safety1   
welfare1 and rights1 including the      
rights provided under section #cad1 of  
older individuals2  2 and  7,b7 in      
paragraph 7#h7-- 7i7 in subparagraph    
7,b71 by inserting to identify and      

articulate goals of care and after      
individuals2  7ii7 in subparagraph      
7,d7-- 7,i7 by inserting respond to or  
before plan2 and  7,,ii7 by striking    
future long-term care needs2 and and    
inserting long-term care needs22  7iii7 
in subparagraph 7,e71 by adding and at  
the end2 and  7iv7 by adding at the end 
the following3  7,f7 to provide         
information and referrals regarding     
available home and community-based      
services for individuals who are at risk
 for residing in1 or who reside in1     
institutional settings1 so that the     
individuals have the choice to remain in
 or to return to the community4  2 and  
7#c7 by adding at the end the following3
  7g7 ,the ,assistant ,secretary shall1 
as appropriate1 ensure that programs    
authorized 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  4  7c7 ,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 #bjb7;a77#bd7 and      
inserting #bjb7;a77#ba72 and  7,b7 by   
striking #bjjg1 #bjjh1 #bjji1 #bjaj1 and
 #bjaa and inserting #bjad1 #bjae1      
#bjaf1 #bjag1 and #bjah2 and  7#c7 in   
subsection 7c71 by striking #bjjg1      
#bjjh1 #bjji1 #bjaj1 and #bjaa and      
inserting #bjad1 #bjae1 #bjaf1 #bjag1   
and #bjah4  #d4 ,state and community    
programs on aging  7a7 ,authorization of
 appropriations ,section #cjc of the    
,older ,americans ,act of #aife 7#db    
,u4,s4,c4 #cjbc7 is amended-- 7#a7 in   
subsection 7a77#a71 by striking fiscal  
years #bjjg and all that follows and    
inserting each of fiscal years #bjad    
through #bjah42  7#b7 in subsection     
7b7-- 7,a7 in paragraph 7#a71 by        

striking fiscal years #bjjg and all that
 follows and inserting each of fiscal   
years #bjad through #bjah42 and  7,b7 in
 paragraph 7#b71 by striking fiscal     
years #bjjg and all that follows and    
inserting each of fiscal years #bjad    
through #bjah42  7#c7 in subsection 7d71
 by striking fiscal years #bjjg and all 
that follows and inserting each of      
fiscal years #bjad through #bjah42 and  
7#d7 in subsection 7e77#b71 by striking 
#bjaa and inserting #bjaa and each of   
fiscal years #bjad through #bjah4  7b7  
,conforming amendment ,section #cjd7;b7 
of the ,older ,americans ,act of #aife  
7#db ,u4,s4,c4 #cjbd7;b77 is amended by 
striking subpart #a of4  7c7 ,planning  
and service areas ,section              
#cje7;b77#e77;,c77i77,,iii7 of the      
,older ,americans ,act of #aife 7#db    
,u4,s4,c4 #cjbe7;b77#e77;,c77i77,,iii77 
is amended by striking planning and     
services areas and inserting planning   
and service areas4  7d7 ,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#a71 by striking          
establishment1 maintenance1 or          
construction of multipurpose senior     
centers1 and inserting establishment1   
maintenance1 modernization1 or          
construction of multipurpose senior     
centers 7including a plan to use the    
skills and services of older individuals
 in paid and unpaid work1 including     
multigenerational and older individual  
to older individual work712 and  7,b7 in
 paragraph 7#f7-- 7i7 in subparagraph   
7,g71 by adding and at the end2 and     
7ii7 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 education1       
prevention1 investigation1 and treatment
 of elder abuse neglect1 and            
exploitation education1 as appropriate2 

2 and  7#b7 in subsection 7b77#c7-- 7,a7
 in subparagraph 7,j71 by striking and  
at the end2  7,b7 by redesignating      
subparagraph 7,k7 as subparagraph 7,l72 
and  7,c7 by inserting after            
subparagraph 7,j7 the following3  7,k7  
protection from elder abuse1 neglect1   
and exploitation2 and  4  7e7 ,nutrition
 services incentive program ,section    
#caa7;e7 of the ,older ,americans ,act  
of #aife 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 #bjah44   
7f7 ,supportive services ,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#a71 by striking or referral 
services and inserting referral1 chronic
 condition self-care management1 or     
falls prevention services2  7,b7 in     
paragraph 7#h71 by striking 7including  
and all that follows and inserting the  
following3 7including mental and        

behavioral health screening and falls   
prevention services screening7 to detect
 or prevent 7or both7 illnesses and     
injuries that occur most frequently in  
older individuals2 and  7,c7 in         
paragraph 7#ae71 by inserting before the
 semicolon the following3 1 and         
screening for elder abuse1 neglect1 and 
exploitation2  7#b7 in subsection       
7b77#a71 by inserting or modernization  
after construction2 and  7#c7 in        
subsection 7c71 by inserting before the 
period the following3 1 and pursue      
opportunities for the development of    
intergenerational shared site models for
 programs or projects1 consistent with  
the purposes of this ,act4  7g7 ,home   
delivered nutrition services program    
,section #ccf7;a77#a7 of the ,older     
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjcj;f7a77#a77 is amended by striking  
canned and all that follows through     
meals and inserting canned1 or fresh    
foods and1 as appropriate1 supplemental 
foods1 and any additional meals4  7h7   

,nutrition services ,section #cci of the
 ,older ,americans ,act of #aife 7#db   
,u4,s4,c4 #cjcj;g-#ba7 is amended-- 7#a7
 in paragraph 7#a71 by striking solicit 
and inserting utilize2 and  7#b7 in     
paragraph 7#b7-- 7,a7 in subparagraph   
7,j71 by striking and at the end2  7,b7 
in subparagraph 7,k71 by striking the   
period and inserting 2 and2 and  7,c7 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    
7i7 ,evidence-,based disease prevention 
and health promotion services program   
,part ,d of title ,,iii of the ,older   
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjcjm et seq47 is amended-- 7#a7 in the
 part heading1 by inserting             
,evidence-,based before ,disease2 and   
7#b7 in section #cfa7;a71 by inserting  
evidence-based after to provide4  7j7   
,older relative caregivers  7#a7        

,technical amendment ,part ,e of title  
,,iii of the ,older ,americans ,act of  
#aife 7#db ,u4,s4,c4 #cjcjs et seq47 is 
amended by striking the subpart heading 
for subpart #a4  7#b7 ,definitions      
,section #cgb of such ,act 7#db         
,u4,s4,c4 #cjcjs7 is amended-- 7,a7 in  
subsection 7a7-- 7i7 in paragraph 7#a71 
by striking or who is an individual with
 a disability2 and  7ii7 by striking    
paragraph 7#b7 and inserting the        
following3  7#b7 ,individual with a     
disability ,the term individual with a  
disability means an individual with a   
disability1 as defined in section #c of 
the ,americans with ,disabilities ,act  
of #aiij 7#db ,u4,s4,c4 #abajb71 who is 
not less than #ah and not more than #ei 
years of age4  7#c7 ,older relative     
caregiver ,the term older relative      
caregiver means a caregiver who-- 7,a7  
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 a 

child or an individual with a           
disability2  7,b7 in the case of a      
caregiver for a child-- 7i7 is the      
grandparent1 stepgrandparent1 or other  
relative 7other than the parent7 by     
blood1 marriage1 or adoption1 of the    
child2  7ii7 is the primary caregiver of
 the child because the biological or    
adoptive parents are unable or unwilling
 to serve as the primary caregivers of  
the child2 and  7iii7 has a legal       
relationship to the child1 such as legal
 custody1 adoption1 or guardianship1 or 
is raising the child informally2 and    
7,c7 in the case of a caregiver for an  
individual with a disability1 is the    
parent1 grandparent1 or other relative  
by blood1 marriage1 or adoption1 of the 
individual with a disability4  2 and    
7,b7 in subsection 7b7-- 7i7 by striking
 subpart and all that follows through   
family caregivers and inserting part1   
for family caregivers2  7ii7 by striking
 2 and and inserting a period2 and      
7iii7 by striking paragraph 7#b74  7k7  

,national family caregiver support      
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 in    
subsection 7c7-- 7,a7 in paragraph 7#a71
 in the matter preceding subparagraph   
7,a71 by striking grandparents and older
 individuals who are relative           
caregivers1 and who and inserting older 
relative caregivers1 who2 and  7,b7 in  
paragraph 7#b77;,b71 by striking to     
older individuals providing care to     
individuals with severe disabilities1   
including children with severe          
disabilities and inserting to older     
relative caregivers of children with    
severe disabilities1 or individuals with
 disabilities who have severe           
disabilities2  7#c7 in subsection       
7e77#c71 by striking grandparents or    
older individuals who are relative      

caregivers and inserting older relative 
caregivers2  7#d7 in subsection         
7f77#a77;,a71 by striking for fiscal    
years #bjjg1 #bjjh1 #bjji1 #bjaj1 and   
#bjaa and inserting for a fiscal year2  
and  7#e7 in subsection 7g77#b77;,c71 by
 striking grandparents and older        
individuals who are relative caregivers 
of a child who is not more than #ah     
years of age and inserting older        
relative caregivers4  7l7 ,conforming   
amendment ,part ,e of title ,,iii is    
amended by striking this subpart each   
place it appears and inserting this     
part4  #e4 ,activities for health1      
independence1 and longevity  7a7 ,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 and at the end2  7,b7 by       
redesignating paragraph 7#ac7 as        
paragraph 7#ad72 and  7,c7 by inserting 
after paragraph 7#ab7 the following3    
7#ac7 continuing support for program    

integrity initiatives concerning the    
,medicare program under title ,,xviii of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acie et seq47 that train     
senior volunteers to prevent and        
identify health care fraud and abuse2   
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  7b7 ,native american programs   
,section #dah7;b7 of the ,older         
,americans ,act of #aife 7#db ,u4,s4,c4 
#cjcb;g7b77 is amended by striking a    
national meeting to train and inserting 
national trainings for4  7c7 ,legal     
assistance for older americans ,section 
#dbj7;c7 of the ,older ,americans ,act  
of #aife 7#db ,u4,s4,c4 #cjcb;i7c77 is  
amended by striking national4  7d7      
,repeals ,sections #dae1 #dai1 and #dba 
of the ,older ,americans ,act of #aife  
7#db ,u4,s4,c4 #cjcb;d1 #cjcb;h1        
#cjcb;j7 is repealed4  7e7 ,conforming  
amendment ,section #dag7;a77#a7 of the  

,older ,americans ,act of #aife 7#db    
,u4,s4,c4 #cjcb;f7a77#a77 is amended by 
striking grandparents and other older   
individuals who are relative caregivers 
and inserting older relative caregivers 
7as defined in section #cgb74  #f4      
,community service senior opportunities 
,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  #g4 ,grants for  
,native ,americans ,section #fdc7b7 of  
the ,older ,americans ,act of #aife 7#db
 ,u4,s4,c4 #cjegn7#b77 is amended by    
striking fiscal year #bjaa and inserting
 each of fiscal years #bjad through     
#bjah4  #h4 ,vulnerable elder rights    
protection activities  7a7 ,ombudsman   
definitions ,section #gaa7f7 of the     
,older ,americans ,act of #aife 7#db    
,u4,s4,c4 #cjeh;f7#f77 is amended by    
striking older4  7b7 ,ombudsman programs
 ,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 by1 or on behalf of1 residents1
 including residents with limited or no 
decision-making 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 communicated 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 that       
outcome2 and  2  7ii7 in subparagraph   

7,d71 by striking regular and timely and
 inserting regular1 timely1 private1 and
 unimpeded2  7iii7 in subparagraph      
7,h77iii7-- 7,i7 by inserting 1 actively
 encourage1 and assist in after provide 
technical support for2 and  7,,ii7 by   
striking and after the semicolon2  7iv7 
by redesignating subparagraph 7,i7 as   
subparagraph 7,j72 and  7v7 by inserting
 after subparagraph 7,h7 the following3 
7,i7 when feasible1 continue to carry   
out the functions described in this     
section on behalf of residents          
transitioning from a long-term care     
facility to a home care setting2 and  2 
and  7,c7 in paragraph 7#e77;,b7-- 7i7  
in clause 7vi7-- 7,i7 by inserting 1    
actively encourage1 and assist in after 
support2 and  7,,ii7 by striking and    
after the semicolon2  7ii7 by           
redesignating clause 7vii7 as clause    
7viii72 and  7iii7 by inserting after   
clause 7vi7 the following3  7vii7       
identify1 investigate1 and resolve      
complaints described in clause 7iii7    

that are made by or on behalf of        
residents with limited or no            
decision-making 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 communicated 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 that       
outcome2 and  2  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 and  7ii7 in subparagraph 7,b7--
 7,i7 in clause 7i7-- 7aa7 in the matter
 preceding subclause 7,i71 by striking  
the medical and social records of a and 
inserting all files1 records1 and other 
information concerning a2 and  7bb7 in  

subclause 7,,ii71 by striking to consent
 and inserting to communicate consent2  
and  7,,ii7 in clause 7ii71 in the      
matter before subclause 7,i71 by        
striking the records and inserting the  
files1 records1 and information2 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;,d71 are
 otherwise met4  2  7#c7 in subsection  
7d7-- 7,a7 in paragraph 7#a71 by        
striking files and inserting files1     

records1 and other information2 and     
7,b7 in paragraph 7#b7-- 7i7 in         
subparagraph 7,a7-- 7,i7 by striking    
files and records each place such term  
appears and inserting files1 records1   
and other information2 and  7,,ii7 by   
striking and after the semicolon2  7ii7 
in subparagraph 7,b7-- 7,i7 by striking 
files or records and inserting files1   
records1 or other information2 and      
7,,ii7 in clause 7iii71 by striking the 
period at the end and inserting 2 and2  
and  7iii7 by adding at the end the     
following3  7,c7 notwithstanding        
subparagraph 7,b71 ensure that the      
,ombudsman may disclose information as  
needed in order to best serve residents 
with limited or no decision-making      
capacity who have no known legal        
representative and are unable to        
communicate consent1 in order for the   
,ombudsman to carry out the functions   
and duties described in paragraphs      
7#c77;,a77i7 and 7#e77;,b77vi7 of       
subsection 7a74  2  7#d7 by striking    

subsection 7f7 and inserting the        
following3  7f7 ,conflict of interest   
7#a7 ,individual conflict of interest   
,the ,state agency shall-- 7,a7 ensure  
that no individual1 or member of the    
immediate family of an individual1      
involved in the designation of the      
,ombudsman 7whether by appointment or   
otherwise7 or the designation of an     
entity designated under subsection      
7a77#e71 is subject to a conflict of    
interest2  7,b7 ensure that no officer  
or employee of the ,office1             
representative of a local ,ombudsman    
entity1 or member of the immediate      
family of the officer1 employee1 or     
representative1 is subject to a conflict
 of interest2 and  7,c7 ensure that the 
,ombudsman-- 7i7 does not have a direct 
involvement in the licensing or         
certification of a long-term care       
facility or of a provider of a long-term
 care service2  7ii7 does not have an   
ownership or investment interest        
7represented by equity1 debt1 or other  

financial relationship7 in a long-term  
care facility or a long-term care       
service2  7iii7 is not employed by1 or  
participating in the management of1 a   
long-term care facility or a related    
organization1 and has not been employed 
by such a facility or organization      
within #a year before the date of the   
determination involved2  7iv7 does not  
receive1 or have the right to receive1  
directly or indirectly1 remuneration 7in
 cash or in kind7 under a compensation  
arrangement with an owner or operator of
 a long-term care facility2  7v7 does   
not have management responsibility for1 
or operate under the supervision of an  
individual with management              
responsibility for1 adult protective    
services2 and  7vi7 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     
fiduciary for a family member1 in a     
personal capacity74  7#b7               

,organizational conflict of interest    
7,a7 ,in general ,the ,state agency     
shall comply with subparagraph 7,b77i7  
in a case in which the ,office poses an 
organizational conflict of interest1    
including a situation in which the      
,office is placed in an organization    
that-- 7i7 is responsible for licensing1
 certifying or surveying 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 ,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 or discharge of     
individuals to or from such facilities4 
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     
7within the meaning of subparagraph     
7,a77 unless such conflict of interest  

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 ,assistant ,secretary ,in a 
case in which a potential or actual     
organizational conflict of interest     
7within the meaning of subparagraph     
7,a77 involving the ,office is disclosed
 or reported to the ,assistant          
,secretary by any person or entity1 the 
,assistant ,secretary shall require that
 the ,state agency1 in accordance with  
the policies and procedures established 
by the ,state agency under section      
#gje7;a77#e77;,d77iii7-- 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 subsection
 7a77#c74  2 and  7#e7 in subsection    
7h7-- 7,a7 in paragraph 7#c77;,a77i71 by

 striking older2  7,b7 in paragraph     
7#d71 by striking all that precedes     
procedures and inserting the following3 
7#d7 strengthen and update  2  7,c7 by  
redesignating paragraphs 7#d7 through   
7#i7 as paragraphs 7#e7 through 7#aj71  
respectively2  7,d7 by inserting after  
paragraph 7#c7 the following3  7#d7     
ensure that the ,ombudsman or a designee
 participates in training provided by   
the ,national ,ombudsman ,resource      
,center established in section          
#bjb7;a77#ah72  2  7,e7 in paragraph    
7#f77;,a71 as redesignated by           
subparagraph 7,b7 of this paragraph1 by 
striking paragraph 7#d7 and inserting   
paragraph 7#e72  7,f7 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,g7 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#h74  7c7  

,ombudsman regulations ,section #gac of 
the ,older ,americans ,act of #aife 7#db
 ,u4,s4,c4 #cjeh;h7 is amended-- 7#a7 in
 paragraph 7#a71 by striking paragraphs 
7#a7 and 7#b7 of section #gab7;f7 and   
inserting subparagraphs 7,a7 and 7,b7 of
 section #gab7;f77#a72 and  7#b7 in     
paragraph 7#b71 by striking             
subparagraphs 7,a7 through 7,d7 of      
section #gab7;f77#c7 and inserting      
clauses 7i7 through 7vi7 of section     
#gab7;f77#a77;,c74  7d7 ,prevention of  
elder abuse1 neglect1 and exploitation  
,section #gba of the ,older ,americans  
,act of #aife 7#db ,u4,s4,c4 #cjeh;i7 is
 amended-- 7#a7 in subsection 7b7-- 7,a7
 by redesignating paragraphs 7#e7       
through 7#ab7 as paragraphs 7#f7 through
 7#ac71 respectively2  7,b7 by inserting
 after paragraph 7#d7 the following3    
7#e7 promoting the submission of data on
 elder abuse1 neglect1 and exploitation 
for the appropriate database of the     
,administration or another database     
specified by the ,assistant ,secretary2 

2  7,c7 in paragraph 7#aj77;,c71 as     
redesignated by paragraph 7#a7 of this  
subsection-- 7i7 in clause 7ii71 by     
inserting 1 such as forensic            
specialists1 after such personnel2 and  
7ii7 in clause 7v71 by inserting before 
the comma the following3 1 including    
programs and arrangements that protect  
against financial exploitation2 and     
7,d7 in paragraph 7#ab71 as redesignated
 by paragraph 7#a7 of this subsection-- 
7i7 in subparagraph 7,d71 by striking   
and at the end2 and  7ii7 by adding at  
the end the following3  7,f7 supporting 
and studying innovative practices in    
communities to develop partnerships     
across disciplines for the prevention1  
investigation1 and prosecution of abuse1
 neglect1 and exploitation2 and  2 and  
7#b7 in subsection 7e77#b71 in the      
matter preceding subparagraph 7,a7--    
7,a7 by striking subsection             
7b77#i77;,b77i7 and inserting subsection
 7b77#aj77;,b77i72 and  7,b7 by striking
 subsection 7b77#i77;,b77ii7 and        

inserting subsection 7b77#aj77;,b77ii74 
#i4 ,behavioral health ,the ,older      
,americans ,act of #aife is amended--   
7#a7 in section #ajb 7#db ,u4,s4,c4     
#cjjb7-- 7,a7 in paragraph 7#ad77;,g71  
by inserting and behavioral after       
mental2  7,b7 in paragraph 7#cf71 by    
inserting and behavioral after mental2  
and  7,c7 in paragraph 7#dg77;,b71 by   
inserting and behavioral after mental2  
7#b7 in section #bja7;f77#a7 7#db       
,u4,s4,c4 #cjaa7;f77#a771 by inserting  
and behavioral after mental2  7#c7 in   
section #bjb7;a77#e7 7#db ,u4,s4,c4     
#cjab7;a77#e771 by inserting and        
behavioral after mental2  7#d7 in       
section #cjf7;a7 7#db ,u4,s4,c4         
#cjbf7;a77-- 7,a7 in paragraph          
7#b77;,a71 by inserting and behavioral  
after mental2 and  7,b7 in paragraph    
7#f77;,f71 by striking mental health    
services each place such term appears   
and inserting mental and behavioral     
health services2 and  7#e7 in section   
#cba7;a7 7#db ,u4,s4,c4 #cjcj;d7-- 7,a7 

in paragraph 7#a71 as amended by section
 #d7;f71 by inserting and behavioral    
after mental2  7,b7 in paragraph 7#h71  
as amended by section #d7;f71 by        
inserting and behavioral after mental2  
7,c7 in paragraph 7#ad77;,b71 by        
inserting and behavioral after mental2  
and  7,d7 in paragraph 7#bc71 by        
inserting and behavioral after mental4  
#aj4 ,study on transportation services  
7a7 ,study  7#a7 ,in general ,because   
access to transportation services is    
critical for millions of older          
individuals in the ,united ,states1 to  
allow them to maintain independence1    
health1 and quality of life1 the        
,comptroller ,general of the ,united    
,states shall conduct a study of        
transportation services for older       
individuals4  7#b7 ,contents ,in        
conducting the study1 the ,comptroller  
,general-- 7,a7 shall identify          
challenges and barriers affecting the   
aging network in providing1 accessing1  
or coordinating efficient and effective 

transportation services1 including      
challenges and barriers in coordinating 
services with ,federal agencies and     
programs such as the ,department of     
,transportation and ,medicaid program   
under title ,,xix of the ,social        
,security ,act 7#db ,u4,s4,c4 #acif et  
seq472 and  7,b7 shall examine any      
,federal program requirements that may  
result in challenges or barriers to the 
coordination of transportation services 
within the aging network at the local   
level4  7b7 ,report ,not later than #ah 
months after the date of enactment of   
this ,act1 the ,comptroller ,general    
shall issue a report4 ,the report shall 
contain a detailed description of the   
findings and conclusions of the study1  
including any recommendations for       
administrative and other changes to     
enhance transportation services provided
 by the aging network4 ,the ,comptroller
 ,general shall submit the report to the
 ,committee on ,education and the       
,workforce of the ,house of             

,representatives and the ,committee on  
,health1 ,education1 ,labor1 and        
,pensions of the ,senate4  #aa4         
,guidance on serving ,holocaust         
survivors  7a7 ,in general ,because the 
services under the ,older ,americans    
,act of #aife 7#db ,u4,s4,c4 #cjja et   
seq47 are critical to meeting the urgent
 needs of ,holocaust survivors to age in
 place with dignity1 comfort1 security1 
and quality of life1 the ,assistant     
,secretary for ,aging shall issue       
guidance to ,states1 that shall be      
applicable to ,states1 area agencies on 
aging1 and providers of services for    
older individuals1 with respect to      
serving ,holocaust survivors1 including 
guidance on promising practices for     
conducting outreach to that population4 
,in developing the guidance1 the        
,assistant ,secretary for ,aging shall  
consult with experts and organizations  
serving ,holocaust survivors1 and shall 
take into account the possibility that  
the needs of ,holocaust survivors may   

differ based on geography4  7b7         
,contents ,the guidance shall include   
the following3 7#a7 ,how nutrition      
service providers may meet the special  
health-related or other dietary needs of
 participants in programs under the     
,older ,americans ,act of #aife1        
including needs based on religious1     
cultural1 or ethnic requirements4  7#b7 
,how transportation service providers   
may address the urgent transportation   
needs of ,holocaust survivors4  7#c7    
,how ,state long-term care ombudsmen may
 address the unique needs of residents  
of long-term care facilities for whom   
institutional settings may produce      
sights1 sounds1 smells1 emotions1 and   
routines1 that can induce panic1        
anxiety1 and retraumatization as a      
result of experiences from the          
,holocaust4  7#d7 ,how supportive       
services providers may consider the     
unique needs of ,holocaust survivors4   
7#e7 ,how other services provided under 
that ,act1 as determined by the         

,assistant ,secretary for ,aging1 may   
serve ,holocaust survivors4  7c7 ,date  
of issuance ,the guidance described in  
subsection 7a7 shall be issued not later
 than #ahj days after the date of       
enactment of this ,act4