,i #aafth ,,congress #ast ,session ,h4 ,r4 #djgg ,,in ,,the ,,house ,,of ,,representatives ,july #be1 #bjai,ms4 ,wasserman ,schultz 7for herself1 ,ms4 ,shalala1 ,ms4 ,stefanik1 ,mr4 ,hastings1 ,mr4 ,weber of ,texas1 ,mr4 ,suozzi1 ,mr4 ,king of ,new ,york1 ,mr4 ,takano1 ,mr4 ,stivers1 ,ms4 ,wilson of ,florida1 ,mr4 ,fitzpatrick1 ,mr4 ,ted ,lieu of ,california1 ,mr4 ,joyce of ,ohio1 ,mr4 ,cohen1 ,mrs4 ,rodgers of ,washington1 ,ms4 ,jayapal1 ,mr4 ,bacon1 ,ms4 ,schakowsky1 ,mrs4 ,carolyn ,b4 ,maloney of ,new ,york1 ,mr4 ,espaillat1 ,mr4 ,deutch1 ,mr4 ,gottheimer1 ,mr4 ,raskin1 ,ms4 ,wild1 ,ms4 ,stevens1 and ,mr4 ,zeldin7 introduced the following bill2 which was referred to the ,committee on ,education and ,labor ,a ,,bill ,to amend the ,older ,americans ,act of #aife to provide social service agencies with the resources to provide services to meet the urgent needs of ,holocaust survivors to age in place with dignity1 comfort1 security1 and quality of life4 #a4 ,short title 7a7 ,short title ,this ,act may be cited as the ,trauma-,informed ,modernization of ,eldercare for ,holocaust ,survivors ,act or the ,,time for ,holocaust ,survivors ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4 ,sec4 #b4 ,findings4 ,sec4 #c4 ,purposes4 ,,title ,i--,responding to the needs of holocaust survivors ,subtitle ,a--,definitions1 grants for ,state and community programs1 and other programs ,sec4 #aja4 ,definitions4 ,sec4 #ajb4 ,organization4 ,sec4 #ajc4 ,area plans4 ,sec4 #ajd4 ,state plans4 ,sec4 #aje4 ,consumer contributions4 ,sec4 #ajf4 ,national ,family ,caregiver ,support ,program authorized4 ,sec4 #ajg4 ,prevention of elder abuse1 neglect1 and exploitation4 ,subtitle ,b--,functions within ,administration for community living ,to assist holocaust survivors ,sec4 #aaa4 ,designation of individual within the ,administration4 ,sec4 #aab4 ,annual report to ,congress4 ,sec4 #aac4 ,national ,resource ,center for ,older ,individuals ,experiencing the ,long-,term and ,adverse ,consequences of ,trauma4 ,sec4 #aad4 ,definitions4 ,,title ,,ii--,nutrition services for older individuals ,sec4 #bja4 ,nutrition services4 ,,title ,,iii--,transportation ,sec4 #cja4 ,transportation services and resources4 #b4 ,findings ,congress finds the following3 7#a7 ,during the ,holocaust1 which took place from #aicc through #aide1 an estimated #f1jjj1jjj ,jews1 as well as millions of victims from other targeted groups1 were murdered by the ,nazis and their collaborators4 7#b7 ,more than #bjj1jjj ,jews fleeing from ,nazi-occupied territory found refuge in the ,united ,states from #aicc through #aide1 and approximately #acg1jjj additional ,jewish refugees settled in the ,united ,states from #aide through #aieb4 7#c7 ,hundreds of thousands of additional ,jewish refugees continued to immigrate to the ,united ,states from ,europe and countries of the former ,soviet ,union during the subsequent decades4 7#d7 ,the number of ,holocaust survivors living in the ,united ,states at the end of #bjah was approximately #hj1jjj individuals1 down from an estimated #abg1jjj in #bjaj4 7#e7 ,every ,holocaust survivor is now at least #gd years old1 most are in at least their mid-to-late eighties1 and many are in their nineties and beyond4 7#f7 ,one-third of all ,holocaust survivors in the ,united ,states live at or below the official poverty threshold 7as defined by the ,bureau of the ,census71 including more than half of the ,holocaust survivors who emigrated from the countries of the former ,soviet ,union4 7#g7 ,holocaust survivors continue to live with the unique mental and physical scars of the unconscionable trauma caused by the ,holocaust1 and while institutionalized settings are beneficial for some1 certain aspects of institutionalization may have particularly adverse effects on ,holocaust survivors4 7#h7 ,for many ,holocaust survivors1 institutionalized settings produce sights1 sounds1 smells1 emotions1 and routines that can induce panic1 anxiety1 and re-traumatization as a result of experiences from the ,holocaust4 7#i7 ,holocaust survivors are more economically and socially vulnerable1 report poorer health and more health problems1 and have greater social service needs1 than other older individuals4 7#aj7 ,in comparison to most other older individuals1 low-income ,holocaust survivors are more reliant on social service programs that provide services such as personal care1 provision of home-delivered and congregate meals1 transportation1 counseling1 and mental health support to promote health and quality of life4 7#aa7 ,community organizations serving ,holocaust survivors report that approximately one-quarter of ,holocaust survivors live alone1 and living alone is a risk factor for hospitalization and nursing home admission1 poverty1 falls1 depression1 poor nutrition1 social isolation1 and loneliness1 which have been associated with poor health outcomes and an increased risk of death4 7#ab7 ,community organizations serving ,holocaust survivors report that transportation is vital to help ,holocaust survivors attend medical appointments1 shop and purchase necessary items1 visit family and friends1 and participate in cultural1 recreational1 or social events1 such as congregate meals or religious services4 7#ac7 ,as the general population of older individuals increases in the ,united ,states and many public or philanthropic resources remain constant1 providers serving ,holocaust survivors need additional capacity to cover needed services4 7#ad7 ,the ,administration for ,community ,living in the ,department of ,health and ,human ,services serves as the ,federal agency responsible for increasing access to community supports for1 focusing attention and resources on the unique needs of1 older individuals and individuals with disabilities across their lifespans4 7#ae7 ,the mission of the ,administration for ,community ,living is to maximize the independence1 well-being1 and health of older individuals1 individuals with disabilities1 and their families and caregivers4 7#af7 ,the ,administration for ,community ,living in #bjag issued guidance entitled ,,acl ,guidance for ,outreach and ,providing ,services for ,holocaust ,survivors in accordance with a requirement of the ,older ,americans ,act ,reauthorization ,act of #bjaf which states that 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 population44 7#ag7 ,many social service agencies that receive funding under the ,older ,americans ,act of #aife for home-delivered or congregate meals serve diverse seniors1 including ,holocaust survivors1 with specialized dietary needs based on religious1 cultural1 or ethnic requirements1 and the necessary special meals often cost more than other meals4 #c4 ,purposes ,the purposes of this ,act are-- 7#a7 to include older individuals who are ,holocaust survivors in the list of groups that receive preference1 as specified in section #cje7;a77#b77;,e7 of the ,older ,americans ,act of #aife1 for services provided under that ,act2 7#b7 to require the designation within the ,administration for ,community ,living of an individual to have responsibility for the provision of services to older individuals who are ,holocaust survivors2 7#c7 to promote technical assistance and training for agencies that serve older individuals experiencing the long-term and adverse consequences of trauma2 7#d7 to ensure that the providers of nutrition services through the ,older ,americans ,act of #aife can meet the special health-related or other dietary needs of program participants2 and 7#e7 to help meet the urgent transportation needs of ,holocaust survivors4 ,i ,responding to the needs of holocaust survivors ,a ,definitions1 grants for ,state and community programs1 and other programs #aja4 ,definitions ,section #ajb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjjb7 is amended-- 7#a7 in paragraph 7#bd7-- 7,a7 in subparagraph 7,b71 by striking and2 7,b7 in subparagraph 7,c77ii71 by striking the period at the end and inserting 2 and2 and 7,c7 by adding at the end the following3 7,d7 status as a ,holocaust survivor4 2 7#b7 by redesignating paragraphs 7#bf7 through 7#dj7 and paragraphs 7#da7 through 7#ed7 as paragraphs 7#bg7 through 7#da7 and paragraphs 7#dc7 through 7#ef71 respectively2 7#c7 by inserting after paragraph 7#be7 the following3 7#bf7 ,the term ,holocaust survivor means an individual who-- 7,a7 7i7 lived in a country in a year not earlier than #aicc and not later than #aide under a ,nazi regime1 under ,nazi occupation1 or under the control of ,nazi collaborators2 or 7ii7 fled from a country in a year described in clause 7i7 under a ,nazi regime1 under ,nazi occupation1 or under the control of ,nazi collaborators2 7,b7 was persecuted in a year described in clause 7i7 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 2 and 7#d7 by inserting after paragraph 7#da7 the following3 7#db7 ,the term person-centered1 trauma-informed1 used with respect to care1 means care provided through an aging program1 policy1 or procedure1 that uses a holistic approach to service provision that promotes the dignity1 strength1 and empowerment of trauma victims by incorporating knowledge about the role of trauma in trauma victims' lives4 4 #ajb4 ,organization ,section #cje7;a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbe7;a77 is amended-- 7#a7 in paragraph 7#a77;,e71 by inserting older individuals who are ,holocaust survivors1 after proficiency1 each place it appears2 and 7#b7 in paragraph 7#b77;,e71 by inserting older individuals who are ,holocaust survivors1 after proficiency14 #ajc4 ,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 inserting older individuals who are ,holocaust survivors1 after proficiency1 each place it appears2 7,b7 in paragraph 7#d7-- 7i7 in subparagraph 7,a7-- 7,i7 in clause 7i77,i77bb71 by inserting older individuals who are ,holocaust survivors1 after proficiency12 and 7,,ii7 in clause 7ii71 by inserting older individuals who are ,holocaust survivors1 after proficiency1 each place it appears2 7ii7 in subparagraph 7,b77i7-- 7,i7 in subclause 7,,vi71 by striking and at the end2 and 7,,ii7 by inserting after subclause 7,,vii7 the following3 7,,viii7 older individuals who are ,holocaust survivors2 and 2 and 7iii7 in subparagraph 7,b77ii71 by striking subclauses 7,i7 through 7,,vi7 and inserting subclauses 7,i7 through 7,,viii72 and 7,c7 in paragraph 7#g77;,b77iii71 by inserting 1 in particular1 older individuals who are ,holocaust survivors1 after placement2 and 7#b7 in subsection 7b77#b77;,b71 by inserting older individuals who are ,holocaust survivors1 after areas14 #ajd4 ,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#d71 by inserting older individuals who are ,holocaust survivors1 after proficiency12 7#b7 in paragraph 7#af7-- 7,a7 in subparagraph 7,a7-- 7i7 in clause 7v71 by striking and at the end2 and 7ii7 by adding at the end the following3 7vii7 older individuals who are ,holocaust survivors2 and 2 and 7,b7 in subparagraph 7,b71 by striking clauses 7i7 through 7vi7 and inserting clauses 7i7 through 7vii72 and 7#c7 in paragraph 7#bh77;,b77ii71 by inserting older individuals who are ,holocaust survivors1 after areas14 #aje4 ,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 7c77#b71 by inserting older individuals who are ,holocaust survivors1 after proficiency12 and 7#b7 in subsection 7d71 by inserting older individuals who are ,holocaust survivors1 after proficiency14 #ajf4 ,national ,family ,caregiver ,support ,program authorized ,section #cgc7;c77#b77;,a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcjs-#a7;c77#b77;,a77 is amended by striking individuals7 and inserting individuals and older individuals who are ,holocaust survivors74 #ajg4 ,prevention of elder abuse1 neglect1 and exploitation ,section #gba7;b77#ac7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjeh;i7b77#ac77 is amended-- 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 survivors4 4 ,b ,functions within ,administration for community living ,to assist holocaust survivors #aaa4 ,designation of individual within the ,administration ,the ,administrator of the ,administration for ,community ,living is authorized to designate1 within the ,administration for ,community ,living1 a person who has specialized training1 background1 or experience with ,holocaust survivor issues-- 7#a7 to have responsibility within the ,administration for ,community ,living for implementing and coordinating services for older individuals who are ,holocaust survivors2 and 7#b7 to serve as a liaison on those issues1 and the provision of services for those individuals1 with other relevant agencies of the ,federal ,government4 #aab4 ,annual report to ,congress ,the ,administrator1 with assistance from the individual designated under section #aaa1 shall prepare and submit to ,congress an annual report on-- 7#a7 the status and needs1 including the priority areas of concern1 of older individuals who are ,holocaust survivors2 and 7#b7 how the aging network is identifying and serving older individuals experiencing the long-term and adverse consequences of trauma and how agencies within the aging network are promoting and advancing person-centered1 trauma-informed care to older individuals experiencing the long-term and adverse consequences of trauma4 #aac4 ,national ,resource ,center for ,older ,individuals ,experiencing the ,long-,term and ,adverse ,consequences of ,trauma 7a7 ,program authorized 7#a7 ,center ,the ,administrator shall establish and operate a ,national ,resource ,center on ,innovative ,services and ,supports for ,older ,individuals ,experiencing the ,long-,term and ,adverse ,consequences of ,trauma 7referred to in this section as the ,center74 7#b7 ,functions ,the ,center shall-- 7,a7 provide training and technical assistance to agencies in the aging network delivering services to older individuals experiencing the long-term and adverse consequences of trauma2 7,b7 share best practices with the aging network2 and 7,c7 make subgrants to the agencies best positioned to advance and improve the delivery of services for older individuals experiencing the long-term and adverse consequences of trauma4 7b7 ,assistance ,to carry out subsection 7a71 the ,administrator shall make grants to or enter into contracts with one or more nonprofit organization that are experienced-- 7#a7 in providing person-centered1 trauma-informed care2 and 7#b7 in providing support and technical assistance on a nationwide basis to agencies within the aging network that offer services to older individuals experiencing the long-term and adverse consequences of trauma4 #aad4 ,definitions ,in this subtitle3 7#a7 ,administrator ,the term ,administrator means the ,administrator of the ,administration for ,community ,living4 7#b7 ,other terms ,the terms ,holocaust survivor1 older individual1 and person-centered1 trauma-informed have the meanings given the terms in section #ajb of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjjb74 ,,ii ,nutrition services for older individuals #bja4 ,nutrition services 7a7 ,in general ,section #cci7b7 of the ,older ,americans ,act of #ajfe 7#db ,u4,s4,c4 #cjcj;g-#ba7b77 is amended-- 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 dietary needs1 and other dietary needs of program participants 7including needs based on religious1 cultural1 or ethnic requirements7 if for the special health-related or other dietary needs involved there is sufficient demand in a community to warrant special meals2 2 7#b7 in subparagraph 7,k71 by striking 1 and and inserting a comma2 7#c7 in subparagraph 7,l71 by striking the period and inserting 1 and2 and 7#d7 by adding at the end the following3 7,m7 encourages and educates individuals utilizing methodology that promotes person-centered1 trauma-informed care who distribute nutrition services under subpart #b to engage in conversation with homebound older individuals and to be aware of the warning signs of medical emergencies1 injury1 or abuse in order to reduce isolation and promote well-being4 4 7b7 ,authorization of appropriations ,section #cjc7;b7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjbc7;b77 is amended by adding at the end the following3 7#c7 ,there is authorized to be appropriated for special health related dietary needs and other dietary needs of program participants 7including needs based on religious1 cultural1 or ethnic requirements7 pursuant to paragraph 7#b77;,a77iii7 an additional #b percent of the funds authorized to be appropriated for congregate nutrition services in paragraph 7#a7 and home delivered nutrition services in paragraph 7#b74 4 ,,iii ,transportation #cja4 ,transportation services and resources ,section #daa7;a7 of the ,older ,americans ,act of #aife 7#db ,u4,s4,c4 #cjcb7;a77 is amended-- 7#a7 by redesignating paragraph 7#ad7 as paragraph 7#ae72 7#b7 in paragraph 7#ac71 by striking 2 and and inserting a semicolon2 and 7#c7 by inserting after paragraph 7#ac7 the following3 7#ad7 conducting programs that enable the mobility and self-sufficiency of older individuals with greatest economic need and older individuals with greatest social need by providing transportation services and resources2 and 4