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S. 3570 (109th): Older Americans Act Amendments of 2006

The text of the bill below is as of Sep 19, 2006 (Reported by Senate Committee).


II

Calendar No. 616

109th CONGRESS

2d Session

S. 3570

IN THE SENATE OF THE UNITED STATES

June 27, 2006

(for himself, Mr. Kennedy, Mr. DeWine, Ms. Mikulski, and Mr. Johnson) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

September 19, 2006

Reported by , with an amendment

Strike out all after the enacting clause and insert the part printed in italic

A BILL

To amend the Older Americans Act of 1965 to authorize appropriations for fiscal years 2007 through 2011, and for other purposes.

1.

Short title

This Act may be cited as the Older Americans Act Amendments of 2006.

2.

Definitions

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended—

(1)

in paragraph (12)(D), to read as follows:

(D)

evidence-based health promotion programs, including programs related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity, and improved nutrition;

;

(2)

by striking paragraph (24) and inserting the following:

(24)

The term exploitation means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver or fiduciary (as such terms are defined in section 751), that uses the resources of an older individual for monetary or personal benefit, profit, or gain, or that results in depriving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets.

;

(3)

in paragraph (29)(E)—

(A)

in clause (i), by striking and at the end;

(B)

in clause (ii), by striking the period at the end and inserting ; and; and

(C)

by adding at the end the following:

(iii)

older individuals at risk for institutional placement.

;

(4)

in paragraph (32)(D), by inserting , including an assisted living facility, after home;

(5)

by striking paragraph (34) and inserting the following:

(5)
(A)

The term neglect means—

(i)

the failure of a caregiver or fiduciary (as such terms are defined in section 751) to provide the goods or services that are necessary to maintain the health or safety of an older individual; or

(ii)

self-neglect.

(B)

The term self-neglect means an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including—

(i)

obtaining essential food, clothing, shelter, and medical care;

(ii)

obtaining goods and services necessary to maintain physical health, mental health, or general safety; or

(iii)

managing one’s own financial affairs.

; and

(6)

by adding at the end the following:

(44)

The term Aging and Disability Resource Center means a center established by a State as part of the State's system of long-term care, to provide a coordinated system for providing—

(A)

comprehensive information on available public and private long-term care programs, options, and resources;

(B)

personal counseling to assist individuals in assessing their existing or anticipated long-term care needs, and developing and implementing a plan for long-term care designed to meet their specific needs and circumstances; and

(C)

consumer access to the range of publicly-supported long-term care programs for which consumers may be eligible, by serving as a convenient point of entry for such programs.

(45)

The term at risk for institutional placement means, with respect to an older individual, that such individual is unable to perform at least two activities of daily living without substantial assistance (including verbal reminding, physical cuing, or supervision), including such an older individual that is determined by the State involved to be in need of placement in a long-term care facility.

(46)

The term Hispanic-serving institution has the meaning given the term in section 502 of the Higher Education Act of 1965 (20 U.S.C. 1101a).

(47)

The term long-term care means any services, care, or items (including assistive devices) that are—

(A)

intended to assist individuals in coping with, and to the extent practicable compensating for, functional impairments in carrying out activities of daily living;

(B)

furnished at home, in a community care setting (including a small community care setting as defined in subsection (g)(1), and a large community care setting as defined in subsection (h)(1), of section 1929 of the Social Security Act (42 U.S.C. 1396t)), or in a long-term care facility; and

(C)

not furnished to diagnose, treat, or cure a medical disease or condition.

(48)

The term self-directed care means an approach to providing services (including programs, benefits, supports, and technology) under this Act intended to assist an older individual with activities of daily living, in which—

(A)

such services (including the amount, duration, scope, provider, and location of such services) are planned, budgeted, and purchased under the direction and control of such individual;

(B)

such individual is provided with such information and assistance as is necessary and appropriate to enable such individual to make informed decisions about the individual's service options;

(C)

the needs, capabilities, and preferences of such individual with respect to such services, and such individual's ability to direct and control the individual's receipt of such services, are assessed by the area agency on aging involved or the local provider agency;

(D)

based on the assessment made under subparagraph (C), upon request, the area agency on aging assists such individual and the individual's family, caregiver, or legal representative in developing—

(i)

a plan of services for such individual that specifies which services such individual will be responsible for directing;

(ii)

a determination of the role of family members (and others whose participation is sought by such individual) in providing services under such plan; and

(iii)

a budget for such services; and

(E)

the area agency on aging or State agency involved provides for oversight of such individual's self-directed receipt of services, including steps to ensure the quality of services provided and the appropriate use of funds under this Act.

(49)

The term State system of long-term care means the Federal, State, and local programs and activities administered by a State that provide, support, or facilitate access to long-term care to individuals in such State.

.

3.

Office of Elder Abuse Prevention and Services

Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is amended by adding at the end the following:

(e)
(1)

In this subsection, the terms defined in section 751 shall have the meanings given those terms in that section.

(2)

The Secretary is authorized to establish or designate within the Administration (as defined in section 102) an Office of Elder Abuse Prevention and Services.

(3)

It shall be the duty of the Assistant Secretary, acting through the head of the Office of Elder Abuse Prevention and Services to—

(A)

develop objectives, priorities, policy, and a long-term plan for—

(i)

carrying out elder justice programs and activities relating to—

(I)

elder abuse prevention, detection, treatment, and intervention, and response;

(II)

training of individuals regarding the matters described in subclause (I); and

(III)

the improvement of the elder justice system in the United States;

(ii)

annually collecting, maintaining, and disseminating data relating to the abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults), including collecting, maintaining, and disseminating such data under section 753 after consultation with the Attorney General and working with experts from the Department of Justice described in section 753(b)(1);

(iii)

disseminating information concerning best practices regarding, and providing training on, carrying out activities related to abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults);

(iv)

in conjunction with the necessary experts, conducting research related to abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults);

(v)

providing technical assistance to States and other eligible entities that provide or fund the provision of the services described in subtitle B of title VII; and

(vi)

carrying out a study to determine the national incidence and prevalence of elder abuse, neglect, and exploitation in all settings;

(B)

implement the overall policy and a strategy to carry out the plan described in subparagraph (A); and

(C)

provide advice to the Secretary on elder justice issues and administer such programs relating to elder abuse, neglect, and exploitation as the Secretary determines to be appropriate.

(4)

The Secretary, acting through the Assistant Secretary, may issue such regulations as may be necessary to carry out this subsection and subtitle B of title VII.

.

4.

Functions of the Assistant Secretary

Section 202 of the Older Americans Act of 1965 (42 U.S.C. 3012) is amended—

(1)

in subsection (a)—

(A)

in paragraph (12)—

(i)

by striking carry on and inserting the following:

(B)

carry on

; and

(ii)

by striking (12) and inserting the following:

(12)
(A)

consult and coordinate activities with the Administrator of the Centers for Medicare & Medicaid Services to implement and build awareness of programs providing new benefits affecting older individuals; and

;

(B)

by striking paragraph (20) and inserting the following:

(20)
(A)

provide technical assistance and support for outreach and benefits enrollment assistance to support efforts—

(i)

to inform older individuals with greatest economic need, who may be eligible to participate, but who are not participating, in Federal and State programs for which the individuals are eligible, about the programs; and

(ii)

to enroll the individuals in the programs;

(B)

in cooperation with related Federal agency partners administering the Federal programs, make a grant to or enter into a contract with a qualified, experienced entity to establish a National Center on Senior Benefits Outreach and Enrollment, which shall—

(i)

maintain and update web-based decision support and enrollment tools, and integrated, person-centered systems, designed to inform older individuals about the full range of benefits for which the individuals may be eligible under Federal and State programs;

(ii)

utilize cost-effective strategies to find older individuals with greatest economic need and enroll the individuals in the programs;

(iii)

create and support efforts for Aging and Disability Resource Centers, and other public and private State and community-based organizations, including faith-based organizations and coalitions, to serve as benefits enrollment centers for the programs;

(iv)

develop and maintain an information clearinghouse on best practices and the most cost-effective methods for finding and enrolling older individuals with greatest economic need in the programs; and

(v)

provide, in collaboration with related Federal agency partners administering the Federal programs, training and technical assistance on the most effective outreach, screening, enrollment, and follow-up strategies for the Federal and State programs.

;

(C)

in paragraph (26)(D)—

(i)

by striking gaps in;

(ii)

by inserting (including services that would permit such individuals to receive long-term care in home and community-based settings) after individuals; and

(iii)

by striking and at the end;

(D)

in paragraph (27), by striking the period at the end and inserting ; and; and

(E)

by adding at the end the following:

(28)

make available to States information and technical assistance to support the provision of evidence-based disease prevention and health promotion services.

; and

(2)

by striking subsection (b) and inserting the following:

(b)

To promote the development and implementation of comprehensive, coordinated systems at Federal, State, and local levels for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers, the Assistant Secretary shall, consistent with the applicable provisions of this title—

(1)

collaborate, coordinate, and consult with other Federal agencies and departments (other than the Administration on Aging) responsible for formulating and implementing programs, benefits, and services related to providing long-term care, and may make grants, contracts, and cooperative agreements with funds received from those other Federal agencies and departments;

(2)

conduct research and demonstration projects to identify innovative, cost-effective strategies for modifying State systems of long-term care to—

(A)

respond to the needs and preferences of older individuals and family caregivers;

(B)

target services to individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings; and

(C)

establish criteria for and promote the implementation (through area agencies on aging, service providers, and such other entities as the Assistant Secretary determines to be appropriate) of evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals;

(3)

facilitate, in coordination with the Administrator of the Centers for Medicare & Medicaid Services, including the provision of such care through self-directed care models that—

(A)

provide for the assessment of the needs and preferences of an individual at risk for institutional placement to help such individual avoid unnecessary institutional placement and depletion of income and assets to qualify for benefits under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);

(B)

respond to the needs and preferences of such individual and provide the option—

(i)

for the individual to direct and control the receipt of supportive services provided; or

(ii)

as appropriate, for a person who was appointed by the individual, or is legally acting on the individual’s behalf, in order to represent or advise the individual in financial or service coordination matters (referred to in this paragraph as a representative of the individual), to direct and control the receipt of those services; and

(C)

assist an older individual (or, as appropriate, a representative of the individual) to develop a plan for long-term support, including selecting, budgeting for, and purchasing home and community-based long-term care and supportive services;

(4)

provide for the Administration to play a lead role with respect to issues concerning home and community-based long-term care, including—

(A)

directing (as the Secretary or the President determines to be appropriate) or otherwise participating in departmental and interdepartmental activities concerning long-term care; and

(B)

reviewing and commenting on departmental rules, regulations, and policies related to providing long-term care; and

(C)

making recommendations to the Secretary with respect to home and community-based long-term care, including recommendations based on findings made through projects conducted under paragraph (2);

(5)

promote, in coordination with other appropriate Federal agencies—

(A)

enhanced awareness by the public of the importance of planning in advance for long-term care; and

(B)

the availability of information and resources to assist in such planning;

(6)

establish, either directly or through grants or contracts, a national technical assistance program to assist State agencies, area agencies on aging, and community-based service providers funded under this Act in implementing home and community-based long-term care systems, including evidence-based programs;

(7)

develop, in collaboration with the Administrator of the Centers for Medicare & Medicaid Services, performance standards and measures for use by States to determine the extent to which their systems of long-term care fulfill the objectives described in this subsection; and

(8)

conduct such other activities as the Assistant Secretary determines to be appropriate.

(c)

The Assistant Secretary, after consultation with the Chief Executive Officer of the Corporation for National and Community Service, shall—

(1)

encourage and permit volunteer groups (including organizations carrying out national service programs and including organizations of youth in secondary or postsecondary school) that are active in supportive services and civic engagement to participate and be involved individually or through representative groups in supportive service and civic engagement programs or activities to the maximum extent feasible;

(2)

develop a comprehensive strategy for utilizing older individuals to address critical local needs of national concern; and

(3)

encourage other community capacity-building initiatives involving older individuals.

.

5.

Federal agency consultation

Section 203 of the Older Americans Act of 1965 (42 U.S.C. 3013) is amended—

(1)

in subsection (a)(3)(A)—

(A)

by striking (with particular attention to low-income minority older individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(B)

by striking section 507 and inserting section 516;

(2)

in subsection (b), by adding at the end the following:

(19)

Sections 4 and 5 of the Assistive Technology Act of 1998 (29 U.S.C. 3003, 3004).

; and

(3)

by adding at the end the following:

(c)
(1)

The Secretary, in collaboration with the Secretary of Housing and Urban Development and with the other Federal officials specified in paragraph (2), shall establish an interagency coordinating committee (referred to in this subsection as the Committee) focusing on the coordination of agencies with respect to aging issues, particularly issues related to demographic changes and housing needs among older individuals.

(2)

The officials referred to in paragraph (1) are the Secretary of Labor, the Secretary of Housing and Urban Development, the Attorney General, the Secretary of Transportation, the Secretary of the Treasury, the Secretary of Agriculture, the Commissioner of Social Security, the Surgeon General, the Administrator of the Centers for Medicare & Medicaid Services, the Director of the Centers for Disease Control and Prevention, the Director of the National Institutes of Health, the Assistant Secretary for Children and Families, the Administrator of the National Highway Traffic Safety Administration, and such other Federal officials as the Secretary of Health and Human Services determines to be appropriate.

(3)

The Secretary of Health and Human Services shall serve as the first chairperson of the Committee, for an initial period of 2 years. After that initial period, the Secretary of Housing and Urban Development and the Secretary of Health and Human Services shall alternate as chairpersons of the Committee, each serving as chairperson for a period of 2 years.

(4)

The Committee shall—

(A)

review all Federal programs and services that assist older individuals in finding and affording housing, health care, and other services, including those Federal programs and services that assist older individuals in accessing health care, transportation, supportive services, and assistance with daily activities, at the place or close to the place where the older individuals live;

(B)

monitor, evaluate, and recommend improvements in programs and services administered, funded, or financed by Federal, State, and local agencies to assist older individuals in meeting their housing, health care, and other service needs and make any recommendations about how the agencies can better carry out and provide the programs and services to house and serve older individuals;

(C)

recommend ways to—

(i)

facilitate aging in place of older individuals, by identifying and making available the programs and services necessary to enable older individuals to remain in their homes as the individuals age;

(ii)

reduce duplication by Federal agencies of programs and services to assist older individuals in meeting their housing, health care, and other service needs;

(iii)

ensure collaboration among and within agencies in providing and making available the programs and services so that older individuals are able to easily access needed programs and services;

(iv)

work with States to better provide housing, health care, and other services to older individuals by—

(I)

holding individual meetings with State representatives;

(II)

providing ongoing technical assistance to States about better meeting the needs of older individuals; and

(III)

working with States to designate State liaisons for the Committee;

(v)

identify model programs and services to assist older individuals in meeting their housing, health care, and other service needs, including model—

(I)

programs linking housing, health care, and other services;

(II)

financing products offered by government, quasi-government, and private sector entities; and

(III)

innovations in technology applications that give older individuals access to information on available services or that help in providing services to older individuals;

(vi)

collect and disseminate information about older individuals and the programs and services available to the individuals to ensure that the individuals can access comprehensive information; and

(vii)

work with the Federal Interagency Forum on Aging-Related Statistics, the Bureau of the Census, and member agencies—

(I)

to collect and maintain data relating to the housing, health care, and other service needs of older individuals so that all such data can be accessed in one place on a designated website; and

(II)

to identify and address unmet data needs;

(D)

make recommendations to guide policy and program development across Federal agencies with respect to demographic changes among older individuals; and

(E)

actively seek input from and consult with all appropriate and interested parties, including public health interest and research groups and foundations about the activities described in subparagraphs (A) through (D).

(5)

Each year, the Committee shall prepare and submit to the President, the Committee on Financial Services of the House of Representatives, the Committee on Education and the Workforce of the House of Representatives, the Committee on Banking, Housing, and Urban Affairs of the Senate, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Special Committee on Aging of the Senate, a report that—

(A)

describes the activities and accomplishments of the Committee in working with Federal, State, and local governments, and private organizations, in coordinating programs and services to meet the requirements of paragraph (4);

(B)

assesses the level of Federal assistance required to meet the needs described in paragraph (4);

(C)

incorporates an analysis from the head of each agency that is a member of the interagency coordinating committee established under paragraph (1) that describes the barriers and impediments, including barriers and impediments in statutory and regulatory law, to the access and use by older individuals of programs and services administered by such agency; and

(D)

makes recommendations for appropriate legislative and administrative actions to meet the needs described in paragraph (4) and for coordinating programs and services designed to meet those needs.

(6)
(A)

The Secretary of Health and Human Services, after consultation with the Secretary of Housing and Urban Development, shall appoint an executive director of the Committee.

(B)

On the request of the Committee, any Federal Government employee may be detailed to the Committee without reimbursement, and such detail shall be without interruption or loss of civil service status or privilege.

.

6.

Administration

Section 205 of the Older Americans Act of 1965 (42 U.S.C. 3016) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)—

(i)

in subparagraph (C), by adding and at the end;

(ii)

in subparagraph (D), by striking ; and at the end and inserting a period; and

(iii)

by striking subparagraph (E); and

(B)

in paragraph (2)—

(i)

in subparagraph (A)—

(I)

by amending clause (i) to read as follows:

(i)

designing, implementing, and evaluating evidence-based programs to support improved nutrition and regular physical activity for older individuals;

;

(II)

by amending clause (iii) to read as follows:

(iii)

conducting outreach and disseminating evidence-based information to nutrition service providers about the benefits of healthful diets and regular physical activity, including information about the most current Dietary Guidelines for Americans published under section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341), the Food Guide Pyramid published by the Secretary of Agriculture, and advances in nutrition science;

;

(III)

in clause (vii) by striking and at the end; and

(IV)

by striking clause (viii) and inserting the following:

(viii)

disseminating guidance that describes strategies for improving the nutritional quality of meals provided under title III; and

(ix)

providing technical assistance to the regional offices of the Administration with respect to each duty described in clauses (i) through (viii).

; and

(ii)

by amending subparagraph (C)(i) to read as follows:

(i)

have expertise in nutrition and meal planning; and

.

7.

Evaluation

Section 206(g) of the Older Americans Act of 1965 (42 U.S.C. 3017(g)) is amended by striking the first sentence and inserting the following: From the total amount appropriated for each fiscal year to carry out title III, the Secretary may use such sums as may be necessary, but not more than 1/2 of 1 percent of such amount, for purposes of conducting evaluations under this section, either directly or by grant or contract..

8.

Reports

Section 207(b)(2) of the Older Americans Act of 1965 (42 U.S.C. 3018(b)(2)) is amended—

(1)

in subparagraph (B), by striking Labor and inserting the Workforce; and

(2)

in subparagraph (C), by striking Labor and Human Resources and inserting Health, Education, Labor, and Pensions.

9.

Contractual, commercial and private pay relationships; appropriate use of Act funds

(a)

Private pay relationships; appropriate use of act funds

Section 212 of the Older Americans Act (42 U.S.C. 3020c) is amended to read as follows:

212.

Contracting and grant authority; private pay relationships; appropriate use of funds

(a)

In general

Subject to subsection (b), this Act shall not be construed to prevent a recipient of a grant or a contract under this Act from entering into an agreement—

(1)

with a profitmaking organization;

(2)

under which funds provided under such grant or contract are used to pay part or all of a cost (including an administrative cost) incurred by such recipient to carry out a contract or commercial relationship for the benefit of older individuals or their family caregivers, whether such contract or relationship is carried out to implement a provision of this Act or to conduct activities inherently associated with implementing such provision; or

(3)

under which any individual, regardless of age or income (including the family caregiver of such individual), who seeks to receive 1 or more services may voluntarily pay, at their own private expense, to receive such services based on the fair market value of such services.

(b)

Ensuring appropriate use of funds

An agreement described in subsection (a) may not—

(1)

be made without the prior approval of the State agency (or, in the case of a grantee under title VI, without the prior recommendation of the Director of the Office for American Indian, Alaska Native, and Native Hawaiian Aging and the prior approval of the Assistant Secretary);

(2)

directly or indirectly provide for, or have the effect of, paying, reimbursing, or otherwise compensating an entity under such agreement in an amount that exceeds the fair market value of the goods or services furnished by such entity under such agreement;

(3)

result in the displacement of services otherwise available to an older individual with greatest social need, an older individual with greatest economic need, or an older individual who is at risk for institutional placement; or

(4)

in any other way compromise, undermine, or be inconsistent with the objective of serving the needs of older individuals, as determined by the Assistant Secretary.

.

10.

Nutrition education

Section 214 of the Older Americans Act of 1965 (42 U.S.C. 3020e) is amended to read as follows:

214.

Nutrition education

The Assistant Secretary, in consultation with the Secretary of Agriculture, shall conduct outreach and provide technical assistance to agencies and organizations that serve older individuals to assist such agencies and organizations to carry out integrated health promotion and disease prevention programs that—

(1)

are designed for older individuals; and

(2)

include—

(A)

nutrition education;

(B)

physical activity; and

(C)

other activities to modify behavior and to improve health literacy, including providing information on optimal nutrient intake, through education and counseling in accordance with section 339(2)(J).

.

11.

Pension counseling and information programs

Section 215 of the Older Americans Act of 1965 (42 U.S.C. 3020e–1) is amended—

(1)

in subsection (e)(1)(J), by striking and low income retirees and inserting , low-income retirees, and older individuals with limited English proficiency;

(2)

in subsection (f), by amending paragraph (2) to read as follows:

(2)

The ability of the entity to perform effective outreach to affected populations, particularly populations with limited English proficiency and other populations that are identified as in need of special outreach.

; and

(3)

in subsection (h)(2), by inserting (including individuals with limited English proficiency) after individuals.

12.

Authorization of appropriations

Section 216 of the Older Americans Act of 1965 (42 U.S.C. 3020f) is amended—

(1)

in subsection (a) by striking 2001, 2002, 2003, 2004, and 2005 and inserting 2007, 2008, 2009, 2010, and 2011.; and

(2)

in subsections (b) and (c) by striking year and all that follows through years, and inserting years 2007, 2008, 2009, 2010, and 2011.

13.

Purpose; administration

Section 301(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 3021(a)(2)) is amended—

(1)

in subparagraph (D), by striking and at the end;

(2)

in subparagraph (E), by striking the period at the end and inserting ; and; and

(3)

by adding at the end the following:

(F)

organizations with experience in providing senior volunteer services, such as Federal volunteer programs administered by the Corporation for National and Community Service and designed to provide training, placement, and stipends for volunteers in community service settings.

.

14.

Authorization of appropriations; uses of funds

Section 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) is amended—

(1)

in subsections (a)(1), (b), and (d), by striking year 2001 and all that follows through years each place it appears, and inserting years 2007, 2008, 2009, 2010, and 2011; and

(2)

in subsection (e)—

(A)

in paragraph (1) by striking $125,000,000 and all that follows and inserting $160,000,000 for fiscal year 2007.; and

(B)

in paragraph (2), by striking such sums and all that follows and inserting $170,000,000 for fiscal year 2008, $180,000,000 for fiscal year 2009, $190,000,000 for fiscal year 2010, and $200,000,000 for fiscal year 2011..

15.

Allotments

Section 304(d)(1)(A) of the Older Americans Act of 1965 (42 U.S.C. 3024(d)(1)(A)) is amended to read as follows:

(A)
(i)

such amount as the State agency determines, but not more than 10 percent thereof, shall be available for paying such percentage as the agency determines, but not more than 75 percent, of the cost of administration of area plans; and

(ii)

in addition to that amount, for any fiscal year among fiscal years 2007 through 2011 for which the amount appropriated under subsections (a) through (d) of section 303 is not less than 110 percent of that appropriated amount for fiscal year 2006, an amount equal to 1 percent of the State's allotment shall be used by the area agencies on aging in the State to carry out the assessment described in section 306(b);

.

16.

Organization

Section 305 of the Older Americans Act of 1965 (42 U.S.C. 3025) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)(E)—

(i)

by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(ii)

by striking and at the end;

(B)

in paragraph (2)—

(i)

in subparagraph (E), by striking , with particular attention to low-income minority individuals and older individuals residing in rural areas and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(ii)

in subparagraph (G), by striking the period and inserting ; and; and

(C)

by adding at the end the following:

(3)

the State agency shall, consistent with this section, promote the development and implementation of a comprehensive, coordinated system in such State for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers, by—

(A)

collaborating, coordinating, and consulting with other agencies in such State responsible for formulating, implementing, and administering programs, benefits, and services related to providing long-term care;

(B)

participating in any State government activities concerning long-term care, including reviewing and commenting on any State rules, regulations, and policies related to long-term care;

(C)

conducting analyses and making recommendations with respect to strategies for modifying the State’s system of long-term care to better—

(i)

respond to the needs and preferences of older individuals and family caregivers;

(ii)

facilitate the provision, by service providers, of long-term care in home and community-based settings;

(iii)

target services to older individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings; and

(iv)

implement (through area agencies on aging, service providers, and such other entities as the State determines to be appropriate) programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; and

(D)

providing for the availability and distribution (through public education campaigns, Aging and Disability Resource Centers, area agencies on aging, and other appropriate means) of information relating to—

(i)

the need to plan in advance for long-term care; and

(ii)

the range of available public and private long-term care programs, options, and resources.

; and

(2)

in subsection (b), by adding at the end the following:

(6)

Nothing in this section shall prevent the Commonwealth of Puerto Rico from designating, with the approval of the Assistant Secretary, a single planning and service area to cover all the older individuals in the Commonwealth.

.

17.

Area plans

Section 306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)—

(i)

by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas);

(ii)

by striking (with particular attention to low-income minority individuals) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(iii)

by inserting the number of older individuals at risk for institutional placement residing in such area, after individuals) residing in such area,;

(B)

in paragraph (2)(A)—

(i)

by inserting after transportation, the following: health services (including mental health services),; and

(ii)

by inserting after information and assistance the following: (which may include information and assistance to consumers on availability of services under part B and how to receive benefits under and participate in publicly supported programs for which the consumer may be eligible);

(C)

in paragraph (4)—

(i)

in subparagraph (A)—

(I)

by amending clause (i) to read as follows:

(i)

provide assurances that the area agency on aging will—

(I)

set specific objectives, consistent with State policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement;

(II)

include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas; and

(III)

include in the area plan proposed methods to achieve such objectives;

; and

(II)

in clause (ii) by inserting (including older individuals with limited English proficiency) after low income minority individuals each place it appears; and

(ii)

in subparagraph (B)—

(I)

by moving the left margin of each of subparagraph (B), clauses (i) and (ii), and subclauses (I) through (VI) of clause (i), 2 ems to the left; and

(II)

in clause (i)—

(aa)

in subclause (V) by striking with limited English-speaking ability; and and inserting with limited English proficiency;; and

(bb)

by adding at the end the following:

(VII)

older individuals at risk for institutional placement; and

;

(D)

in paragraph (5), by inserting and individuals at risk for institutional placement after severe disabilities;

(E)

in paragraph (6)—

(i)

in subparagraph (C)—

(I)

in clause (i), by striking and at the end;

(II)

in clause (ii), by adding and at the end; and

(III)

by inserting after clause (ii) the following:

(iii)

make use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services and, if possible, work in coordination with entities carrying out volunteer programs (including programs administered by the Corporation for National and Community Services) designed to provide training, placement, and stipends for volunteers in community service settings.

;

(ii)

in subparagraph (D)—

(I)

by inserting family caregivers of such individuals, after Act,; and

(II)

by inserting service providers, representatives of the business community, after individuals,; and

(iii)

in subparagraph (F), by inserting (including mental health screening) before provided each place it appears;

(F)

in paragraph (7), to read as follows:

(7)

provide that the area agency on aging shall, consistent with this section, facilitate the area-wide development and implementation of a comprehensive, coordinated system for providing long-term care in home and community-based settings, in a manner responsive to the needs and preferences of older individuals and their family caregivers, by—

(A)

collaborating, coordinating, and consulting with other local public and private agencies and organizations responsible for administering programs, benefits, and services related to providing long-term care;

(B)

conducting analyses and making recommendations with respect to strategies for modifying the local system of long-term care to better—

(i)

respond to the needs and preferences of older individuals and family caregivers;

(ii)

facilitate the provision, by service providers, of long-term care in home and community-based settings;

(iii)

target services to older individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings; and

(iv)

implement (through the agency or service providers), evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; and

(C)

providing for the availability and distribution (through public education campaigns, Aging and Disability Resource Centers, and other appropriate means) of information relating to—

(i)

the need to plan in advance for long-term care; and

(ii)

the range of available public and private long-term care programs, options, and resources.

;

(G)

by striking the 2 paragraphs (15);

(H)

by redesignating paragraph (16) as paragraph (15); and

(I)

by adding at the end the following:

(16)

provide assurances that funds received under this title will be used—

(A)

to provide benefits and services to older individuals giving priority to older individuals identified in paragraph (4)(A)(i); and

(B)

in compliance with the assurances specified in paragraph (13) and the limitations specified in section 212(b); and

(17)

provide, to the extent feasible, for the furnishing of services under this Act, consistent with self-directed care.

(18)

include information detailing how the area agency on aging will coordinate activities, and develop long-range emergency plans, with local and State emergency response agencies, relief organizations, local and State governments, and any other institutions that have responsibility for disaster relief service delivery.

;

(2)

by redesignating subsections (b), (c), (d), and (e) as subsections (c), (d), (e), and (f); and

(3)

by inserting after subsection (a) the following:

(b)
(1)

In any fiscal year, an area agency on aging may include in the area plan an assessment of how prepared the area agency on aging and service providers in the planning and service area are for a change in the number of older individuals during the 10-year period following the fiscal year for which the plan is submitted. In a fiscal year described in section 304(d)(1)(A)(ii), an area agency or aging shall include the assessment in the area plan.

(2)

Such assessment may include—

(A)

the projected change in the number of older individuals in the planning and service area;

(B)

an analysis of how such change may affect such individuals, including individuals with low incomes, individuals with greatest economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency;

(C)

an analysis of how the programs, policies, and services provided by such area agency can be improved, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the planning and service area; and

(D)

an analysis of how the change in the number of individuals age 85 and older in the planning and service area is expected to affect the need for supportive services.

(3)

An area agency on aging, in cooperation with government officials, State agencies, tribal organizations, or local entities, may make recommendations to government officials in the planning and service area and the State, on actions determined by the area agency to build the capacity in the planning and service area to meet the needs of older individuals for—

(A)

health and human services;

(B)

land use;

(C)

housing;

(D)

transportation;

(E)

public safety;

(F)

workforce and economic development;

(G)

recreation;

(H)

education;

(I)

civic engagement;

(J)

emergency preparedness; and

(K)

any other service as determined by such agency.

.

18.

State plans

Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 3027(a)) is amended—

(1)

in paragraph (2)(C), by striking section 306(b) and inserting section 306(c);

(2)

in paragraph (4), by striking , with particular attention to low-income minority individuals and older individuals residing in rural areas and inserting (with particular attention to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas);

(3)

by striking paragraph (15);

(4)

by redesignating paragraph (14) as paragraph (15);

(5)

by inserting after paragraph (13) the following:

(14)

The plan shall, with respect to the fiscal year preceding the fiscal year for which such plan is prepared—

(A)

identify the number of low-income minority older individuals in the State, including the number of low-income minority older individuals with limited English proficiency; and

(B)

describe the methods used to satisfy the service needs of the low-income minority older individuals described in subparagraph (A), including the plan to meet the needs of low-income minority older individuals with limited English proficiency.

;

(6)

in clauses (ii) and (iii) of paragraph (16)(A) by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(7)

by adding at the end the following:

(27)

The plan shall provide assurances that area agencies on aging will provide, to the extent feasible, for the furnishing of services under this Act, consistent with self-directed care.

(28)
(A)

The plan shall include, at the election of the State, an assessment of how prepared the State is, under the State's statewide service delivery model, for a change in the number of older individuals during the 10-year period following the fiscal year for which the plan is submitted.

(B)

Such assessment may include—

(i)

the projected change in the number of older individuals in the State;

(ii)

an analysis of how such change may affect such individuals, including individuals with low incomes, individuals with great economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency;

(iii)

an analysis of how the programs, policies, and services provided by the State can be improved, including coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the State; and

(iv)

an analysis of how the change in the number of individuals age 85 and older in the State is expected to affect the need for supportive services.

(29)

The plan shall include information detailing how the State will coordinate activities, and develop long-range emergency preparedness plans, with area agencies on aging, local emergency response agencies, relief organizations, local governments, and any other institutions that have responsibility for disaster relief service delivery.

(30)

The plan shall include information describing the involvement of the head of the State agency in the development, revision, and implementation of emergency preparedness plans, including the State Public Health Emergency Preparedness and Response Plan.

(31)

The plan shall provide that the State shall implement an Aging and Disability Resource Center—

(A)

to serve as a visible and trusted source of information on the full range of options for long-term care, including both institutional and home and community-based care, that are available in the State;

(B)

to provide personalized and consumer-friendly assistance to empower individuals to make informed decisions about their long-term care options;

(C)

to provide coordinated and streamlined access to all publicly funded long-term care options so that consumers can obtain the care they need through a single intake, assessment, and eligibility determination process;

(D)

to help individuals to plan ahead for their long-term care needs; and

(E)

to assist, in coordination with the entity carrying out the health insurance information, counseling, and assistance program (receiving funding under section 4360 of the Omnibus Budget Reconciliation Act of 1990 (42 U.S.C. 1395b–4)) in the State, beneficiaries, and prospective beneficiaries, under the Medicare program established under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) in understanding and accessing prescription drug and preventative health benefits under the provisions of, and amendments made by, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

.

19.

Payments

Section 309(b)(2) of the Older Americans Act of 1965 (42 U.S.C. 3029(b)(2)) is amended by striking the non-Federal share required prior to fiscal year 1981 and inserting 10 percent of the cost of the services specified in section 304(d)(1)(D).

20.

Nutrition services incentive program

Section 311 of the Older Americans Act of 1965 (42 U.S.C. 3030a) is amended—

(1)

in subsection (b), by adding at the end the following:

(3)

Each State agency and grantee under title VI shall promptly and equitably disburse amounts received under this subsection to recipients of grants and contracts.

;

(2)

in subsection (c)—

(A)

in paragraph (1), by inserting , including bonus commodities, after agricultural commodities;

(B)

in paragraph (2), by inserting , including bonus commodities, after food commodities; and

(C)

in paragraph (3), by inserting , including bonus commodities, after Dairy products;

(3)

in subsection (d)(4), by inserting and grantee under title VI after State agency; and

(4)

in subsection (e), by striking 2001 and inserting 2007.

21.

Consumer contributions

Section 315 of the Older Americans Act of 1965 (42 U.S.C. 3030c–2) is amended—

(1)

in subsection (b)—

(A)

in paragraph (1)—

(i)

by striking provided that and inserting if; and

(ii)

by adding at the end the following: Such contributions shall be encouraged for individuals whose self-declared income is at or above 200 percent of the poverty line, at contribution levels based on the actual cost of services.; and

(B)

in paragraph (4)(E), by inserting and to supplement (not supplant) funds received under this Act after given;

(2)

in subsection (c)(2), by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(3)

in subsection (d), by striking with particular attention to low-income and minority older individuals and older individuals residing in rural areas and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas).

22.

Supportive services and senior centers

Section 321(a) of the Older Americans Act of 1965 (42 U.S.C. 3030d(a)) is amended—

(1)

in paragraph (8), by inserting (including mental health screening) after screening;

(2)

in paragraph (11) by striking services and inserting provision of devices and services (including provision of assistive technology devices and assistive technology services);

(3)

in paragraph (14)(B) by inserting (including mental health) after health;

(4)

in paragraph (22) by striking the period at the end and inserting a semicolon;

(5)

by redesignating paragraph (23) as paragraph (24); and

(6)

by inserting after paragraph (22) the following:

(23)

services designed to support States, area agencies on aging, and local service providers in carrying out and coordinating activities for older individuals with respect to mental health services, including outreach for, education concerning, and screening for such services, and referral to such services for treatment; and

.

23.

Nutrition services

After the part heading of part C of title III of the Older Americans Act of 1965 (42 U.S.C. 3030e et seq.), insert the following:

330.

Purpose

It is the purpose of this part to promote socialization and the health and well-being of older individuals by assisting such individuals to gain access to nutrition services to delay the onset of adverse health conditions.

.

24.

Congregate nutrition program

Section 331 of the Older Americans Act of 1965 (42 U.S.C. 3030e) is amended—

(1)

by striking projects— and inserting projects that—;

(2)

in paragraph (1) by striking which the first place it appears;

(3)

in paragraph (2), by striking which; and

(4)

by striking paragraph (3) and inserting the following:

(3)

provide nutrition education, nutrition counseling, and other nutrition services, as appropriate, based on the needs of meal participants.

.

25.

Home delivered nutrition services

Section 336 of the Older Americans Act of 1965 (42 U.S.C. 3030f) is amended to read as follows:

336.

Program authorized

The Assistant Secretary shall establish and carry out a program to make grants to States under State plans approved under section 307 for the establishment and operation of nutrition projects for older individuals that provide—

(1)

on 5 or more days a week (except in a rural area where such frequency is not feasible (as defined by the Assistant Secretary by rule) and a lesser frequency is approved by the State agency) at least 1 home delivered meal per day, which may consist of hot, cold, frozen, dried, canned, fresh, or supplemental foods and any additional meals that the recipient of a grant or contract under this subpart elects to provide; and

(2)

nutrition education, nutrition counseling, and other nutrition services as appropriate, based on the needs of meal recipients.

.

26.

Criteria

Section 337 of the Older Americans Act of 1965 (42 U.S.C. 3030g) is amended to read as follows:

337.

Criteria

The Assistant Secretary, in consultation with recognized experts in the fields of nutrition science, dietetics, meal planning and food service management, and aging, shall develop minimum criteria of efficiency and quality for the furnishing of home delivered meal services for projects described in section 336.

.

27.

Nutrition

Section 339 of the Older Americans Act of 1965 (42 U.S.C. 3030g–21) is amended—

(1)

in paragraph (1), to read as follows:

(1)

solicit the advice and expertise of a dietitian or other individual with education and training in nutrition science or, if such an individual is not available, an individual with comparable expertise in the planning of nutritional services, and

; and

(2)

in paragraph (2)—

(A)

in subparagraph (A)(i), to read as follows:

(i)

comply with the most recent Dietary Guidelines for Americans, published by the Secretary and the Secretary of Agriculture, and

; and

(B)

in subparagraph (D), by inserting joint after encourages; and

(C)

in subparagraph (G), to read as follows:

(G)

ensures that meal providers solicit the advice and expertise of—

(i)

a dietitian or other individual described in paragraph (1),

(ii)

meal participants, and

(iii)

other individuals knowledgeable with regard to the needs of older individuals,

; and

(D)

in subparagraph (I), by striking and at the end; and

(E)

in subparagraph (J), to read as follows:

(J)

provides for nutrition screening and nutrition education, and nutrition assessment and counseling if appropriate; and

(K)

encourages individuals who distribute nutrition services under subpart 2 to provide, to homebound older individuals, available medical information approved by health care professionals, such as informational brochures and information on how to get vaccines, including vaccines for influenza, pneumonia, and shingles, in the individuals’ communities.

.

28.

Study of nutrition projects

(a)

Study

(1)

In general

The Assistant Secretary for Aging shall use funds allocated in section 206(g) of the Older Americans Act of 1965 (42 U.S.C. 3017(g)) to enter into a contract with the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences, for the purpose of establishing an independent panel of experts that will conduct an evidence-based study of the nutrition projects authorized under such Act.

(2)

Study

Such study shall, to the extent data are available, include—

(A)

an evaluation of the effect of the nutrition projects authorized by such Act on—

(i)

improvement of the health status, including nutritional status, of participants in the projects;

(ii)

prevention of hunger and food insecurity of the participants; and

(iii)

continuation of the ability of the participants to live independently;

(B)

a cost-benefit analysis of nutrition projects authorized by such Act, including the potential to affect costs of the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and

(C)

an analysis of how nutrition projects authorized by such Act may be modified to improve the outcomes described in subparagraph (A), including by improving the nutritional quality of the meals provided through the projects and undertaking other potential strategies to improve the nutritional status of the participants.

(b)

Reports

(1)

Report to the assistant secretary

The panel described in subsection (a) shall submit to the Assistant Secretary a report containing the results of the evidence-based study described in subsection (a), including any recommendations resulting from the analysis described in subsection (a)(2)(C).

(2)

Report to congress

The Assistant Secretary shall submit a report containing the results described in paragraph (1) to the Committee on Education and the Workforce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate.

(c)

Timing

The Food and Nutrition Board shall establish the independent panel of experts described in subsection (a) not later than 90 days after the date of the enactment of this Act. The panel shall submit the report described in subsection (b)(1) to the Assistant Secretary not later than 24 months after the date of the enactment of this Act.

29.

Improving indoor air quality in buildings where older individuals congregate

Section 361 of the Older Americans Act of 1965 (42 U.S.C. 3030m) is amended by adding at the end the following:

(c)

The Assistant Secretary shall work in consultation with qualified experts to provide information on methods of improving indoor air quality in buildings where older individuals congregate.

.

30.

Caregiver support program definitions

Section 372 of the Older Americans Act of 1965 (42 U.S.C. 3030s) is amended—

(1)

in paragraph (1), by inserting or an adult child with mental retardation or a related developmental disability after age;

(2)

in paragraph (2), by inserting before the period the following: or an individual with Alzheimer's disease or a related disorder with neurological and organic brain dysfunction who is 50 years of age or older;

(3)

in paragraph (3)—

(A)

by striking child the first place it appears and inserting child (including an adult child with mental retardation or a related developmental disability);

(B)

by striking a child by blood or marriage and inserting such a child by blood, marriage, or adoption; and

(C)

by striking 60 and inserting 55;

(4)

by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and

(5)

by inserting after paragraph (1) the following:

(2)

Developmental disability

The term developmental disability has the meaning given the term in section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15002).

.

31.

Caregiver support program

Section 373 of the National Family Support Caregiver Act (42 U.S.C. 3030s–1) is amended—

(1)

in subsection (b)(3), by striking caregivers to assist and all that follows through the end and inserting the following: assist the caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles;;

(2)

in subsection (c)(2)—

(A)

by striking (as defined and all that follows and inserting a period; and

(B)

by adding at the end the following: In providing services for family caregivers under this subpart, the State shall give priority for services to family caregivers who provide care for older individuals.; and

(3)

in subsection (d), to read as follows:

(d)

Use of volunteers

In carrying out this subpart, each area agency on aging shall make use of trained volunteers to expand the provision of the available services described in subsection (b) and shall, if possible, work in coordination with entities carrying out volunteer programs (including programs administered by the Corporation for National and Community Service) designed to provide training, placement, and stipends for volunteers in community service settings.

; and

(4)

in subsection (e)(3), by adding at the end the following: The reports shall describe any mechanisms used in the State to provide to persons who are family caregivers, or grandparents or older individuals who are relative caregivers, information about and access to various services so that the persons can better carry out their care responsibilities.; and

(5)

in subsection (f)(1), by striking 2001 through 2005 and inserting 2007, 2008, 2009, 2010, and 2011.

32.

Activities and programs of national significance

Section 376(a) of the National Family Support Caregiver Act (42 U.S.C. 3030s–12(a)) is amended—

(1)

by striking the title heading and inserting the following:

376.

Activities and programs of national significance

;

(2)

by striking (a) In general.—;

(3)

by striking shall and inserting may;

(4)

by striking program and inserting activities that include;

(5)

by striking research. and inserting “research, and programs that include—

(1)

multigenerational programs, including programs that provide supports for grandparents and other older individuals who are relative caregivers (as defined in section 372) raising children (such as kinship navigator programs), and programs that sustain and replicate innovative multigenerational family support programs involving volunteers who are older individuals;

(2)

programs providing support and information to families who have a child with a disability or chronic illness, and to other families in need of family support programs;

(3)

programs addressing unique issues faced by rural caregivers;

(4)

programs focusing on the needs of older individuals with Alzheimer’s disease and related dementia and their caregivers; and

(5)

programs supporting caregivers in the roles the caregivers carry out in health promotion and disease prevention.

; and

(6)

by striking subsection (b).

33.

Grant programs

Section 411 of the Older Americans Act of 1965 (42 U.S.C. 3032) is amended—

(1)

in subsection (a)—

(A)

in paragraph (8), by striking and at the end;

(B)

by redesignating paragraph (9) as paragraph (11); and

(C)

by inserting after paragraph (8) the following:

(9)

planning activities to prepare communities for the aging of the population, which activities may include—

(A)

efforts to assess the aging population;

(B)

activities to coordinate the activities of State and local agencies in order to meet the needs of older individuals; and

(C)

training and technical assistance to support States, area agencies on aging, and tribal organizations receiving grants under part A of title VI, in engaging in community planning activities; and

(10)

the development, implementation, and assessment of technology-based service models and best practices, to support the use of health monitoring and assessment technologies, communication devices, assistive technologies, and other technologies that may remotely connect family and professional caregivers to frail older individuals residing in home and community-based settings or rural areas.

.

34.

Career preparation for the field of aging

Section 412(a) of the Older Americans Act of 1965 (42 U.S.C. 3032a(a)) is amended to read as follows:

(a)

Grants

The Assistant Secretary shall make grants to institutions of higher education, including historically Black colleges or universities, Hispanic-serving institutions, Hispanic Centers of Excellence in Applied Gerontology, and other educational institutions that serve the needs of minority students, to provide education and training that prepare students for careers in the field of aging.

.

35.

Health care service demonstration projects in rural areas

Section 414 of the Older Americans Act of 1965 (42 U.S.C. 3032c) is amended—

(1)

in subsection (a), by inserting mental health care, after adult day health care,; and

(2)

in subsection (b)(1)(B)(i), by inserting mental health, after public health,.

36.

Technical assistance and innovation to improve transportation for older individuals

Section 416 of the Older Americans Act of 1965 (42 U.S.C. 3032e) is amended to read as follows:

416.

Technical assistance and innovation to improve transportation for older individuals

(a)

In general

The Secretary may award grants or contracts to nonprofit organizations to improve transportation services for older individuals.

(b)

Use of funds

(1)

In general

A nonprofit organization receiving a grant or contract under subsection (a) shall use the funds received through such grant or contract to carry out a demonstration project, or to provide technical assistance to assist local transit providers, area agencies on aging, senior centers, and local senior support groups, to encourage and facilitate coordination of Federal, State, and local transportation services and resources for older individuals. The organization may use the funds to develop and carry out an innovative transportation demonstration project to create transportation services for older individuals.

(2)

Specific activities

In carrying out a demonstration project or providing technical assistance under paragraph (1) the organization may carry out activities that include—

(A)

developing innovative approaches for improving access by older individuals to transportation services, including volunteer driver programs, economically sustainable transportation programs, and programs that allow older individuals to transfer their automobiles to a provider of transportation services in exchange for the services;

(B)

preparing information on transportation options and resources for older individuals and organizations serving such individuals, and disseminating the information by establishing and operating a toll-free telephone number;

(C)

developing models and best practices for providing comprehensive integrated transportation services for older individuals, including services administered by the Secretary of Transportation, by providing ongoing technical assistance to agencies providing services under title III and by assisting in coordination of public and community transportation services; and

(D)

providing special services to link seniors to transportation services not provided under title III.

(c)

Economically sustainable transportation

In this section, the term economically sustainable transportation means demand responsive transportation for older individuals—

(1)

that may be provided through volunteers; and

(2)

that the provider will provide without receiving Federal or other public financial assistance, after a period of not more than 5 years of providing the services under this section.

.

37.

Community planning

Title IV of the Older Americans Act of 1965 is amended by inserting after section 416 (42 U.S.C. 3032e) the following:

416A.

Community planning for the aging population

The Secretary may establish, either directly or through grants or contracts, a national technical assistance program to assist States and area agencies on aging funded under this Act in planning efforts to prepare communities for the aging of the population.

.

38.

Demonstration, support, and research projects for multigenerational activities and civic engagement activities

Section 417 of the Older Americans Act of 1965 (42 U.S.C. 3032f) is amended to read as follows:

417.

Demonstration, support, and research projects for multigenerational activities and civic engagement activities

(a)

Grants and contracts

The Assistant Secretary shall award grants and enter into contracts with eligible organizations to—

(1)

conduct productivity and cost-benefit research to determine the effectiveness of engaging older individuals in paid and unpaid positions with public and nonprofit organizations;

(2)

develop a national agenda and blueprint for creating paid and unpaid positions for older individuals with public and nonprofit organizations to increase the capacity of the organizations to provide needed services to communities;

(3)

carry out demonstration and support projects to provide older individuals with multigenerational activities, and civic engagement activities, designed to meet critical community needs; and

(4)

carry out demonstration projects to coordinate multigenerational activities and civic engagement activities, and facilitate development of and participation in multigenerational activities.

(b)

Use of funds

An eligible organization shall use funds made available under a grant awarded, or a contract entered into, under subsection (a)—

(1)
(A)

to conduct the research described in subsection (a)(1);

(B)

to develop the national agenda and blueprint described in subsection (a)(2); or

(C)

to carry out a demonstration or support project described in subsection (a)(3);

(D)

to carry out a demonstration project described in subsection (a)(4); and

(2)

to evaluate the project involved in accordance with subsection (f).

(c)

Preference

In awarding grants and entering into contracts under subsection (a) to carry out a demonstration or support project described in subsection (a)(3), the Assistant Secretary shall give preference to—

(1)

eligible organizations with a demonstrated record of carrying out multigenerational activities or civic engagement activities;

(2)

eligible organizations proposing multigenerational activity service projects that will serve older individuals and communities with the greatest need (with particular attention to low-income minority older individuals, older individuals with limited English proficiency, older individuals residing in rural areas, and low-income minority communities);

(3)

eligible organizations proposing civic engagement activity service projects that will serve communities with the greatest need; and

(4)

eligible organizations with the capacity to develop meaningful roles and assignments that use the time, skills, and experience of older individuals to serve public and nonprofit organizations.

(d)

Application

To be eligible to receive a grant or a contract under subsection (a), an organization shall submit an application to the Assistant Secretary at such time, in such manner, and accompanied by such information as the Assistant Secretary may reasonably require.

(e)

Eligible organizations

Organizations eligible to receive a grant or enter into a contract under subsection (a)—

(1)

to carry out activities described in subsection (a)(1) shall be research or academic organizations with the capacity to conduct productivity and cost-benefit research described in subsection (a)(1);

(2)

to carry out activities described in subsection (a)(2) shall be organizations with the capacity to develop the national agenda and blueprint described in subsection (a)(2);

(3)

to carry out activities described in subsection (a)(3) shall be organizations that provide paid or unpaid positions for older individuals to serve in multigenerational activities, or civic engagement activities, designed to meet critical community needs and use the full range of time, skills, and experience of older individuals; and

(4)

to carry out activities described in subsection (a)(4) shall be organizations with the capacity to facilitate and coordinate activities as described in subsection (a)(4), through the use of multigenerational coordinators.

(f)

Local evaluation and report

(1)

Evaluation

Each organization receiving a grant or a contract under subsection (a) to carry out a demonstration or support project under subsection (a)(3) shall evaluate the multigenerational activities or civic engagement activities assisted under the project to determine the effectiveness of the activities involved, the impact of such activities on the community being served and the organization providing the activities, and the impact of such activities on older individuals involved in such project.

(2)

Report

The organization shall submit a report to the Assistant Secretary containing the evaluation not later than 6 months after the expiration of the period for which the grant or contract is in effect.

(g)

Report to congress

Not later than 6 months after the Assistant Secretary receives the reports described in subsection (f)(2), the Assistant Secretary shall prepare and submit to the Speaker of the House of Representatives and the President pro tempore of the Senate a report that assesses the evaluations and includes, at a minimum—

(1)

the names or descriptive titles of the demonstration, support, and research projects funded under subsection (a);

(2)

a description of the nature and operation of the projects;

(3)

the names and addresses of organizations that conducted the projects;

(4)

in the case of demonstration and support projects carried out under subsection (a)(3), a description of the methods and success of the projects in recruiting older individuals as employees and volunteers to participate in the projects;

(5)

in the case of demonstration and support projects carried out under subsection (a)(3), a description of the success of the projects in retaining older individuals involved in the projects as employees and as volunteers;

(6)

in the case of demonstration and support projects carried out under subsection (a)(3), the rate of turnover of older individual employees and volunteers in the projects;

(7)

a strategy for disseminating the findings resulting from the projects described in paragraph (1); and

(8)

any policy change recommendations relating to the projects.

(h)

Definitions

As used in this section:

(1)

Civic engagement activity

The term civic engagement activity includes an opportunity that uses the time, skills, and experience of older individuals, in paid or unpaid positions with a public or nonprofit organization, to help address the unmet human, educational, health care, environmental, and public safety needs and nurture and sustain active participation in community affairs.

(2)

Multigenerational activity

The term multigenerational activity includes an opportunity that uses the time, skills, and experience of older individuals, in paid or unpaid positions with a public or nonprofit organization, to serve as a mentor or adviser in a child care program, a youth day care program, an educational assistance program, an at-risk youth intervention program, a juvenile delinquency treatment program, a before- or after-school program, or a family support program.

(3)

Multigenerational coordinator

The term multigenerational coordinator means a person who—

(A)

builds the capacity of public and nonprofit organizations to develop meaningful roles and assignments, that use the time, skill, and experience of older individuals to serve those organizations; and

(B)

nurtures productive, sustainable working relationships between—

(i)

individuals from the generations with older individuals; and

(ii)

individuals in younger generations.

.

39.

Native American Programs

Section 418(a)(2)(B)(i) of the Older Americans Act of 1965 (42 U.S.C. 3032g)(a)(2)(B)(i)) is amended by inserting (including mental health) after health.

40.

Multidisciplinary centers and multidisciplinary systems

Section 419 of the Older Americans Act of 1965 (42 U.S.C. 3032h) is amended—

(1)

by striking the title and inserting the following:

419.

Multidisciplinary centers and multidisciplinary systems

;

(2)
(A)

in subsection (b)(2), by redesignating subparagraphs (A) through (G) as clauses (i) through (vii), respectively;

(B)

in subsection (c)(2), by redesignating subparagraphs (A) through (D) as clauses (i) through (iv), respectively; and

(C)

by aligning the margins of the clauses described in subparagraphs (A) and (B) with the margins of clause (iv) of section 418(a)(2)(A) of such Act;

(3)
(A)

in subsection (b), by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;

(B)

in subsection (c), by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively; and

(C)

by aligning the margins of the subparagraphs described in subparagraphs (A) and (B) with the margins of subparagraph (D) of section 420(a)(1) of such Act;

(4)

in subsection (a), by striking (a) and all that follows through The and inserting the following:

(a)

Multidisciplinary centers

(1)

Program authorized

The

;

(5)

in subsection (b)—

(A)

by striking the following:

(b)

Use of Funds

and inserting the following:

(2)

Use of funds

; and

(B)

by striking subsection (a) each place it appears and inserting paragraph (1);

(6)

in subsection (c)—

(A)

by striking the following:

(c)

Data

and inserting the following:

(3)

Data

;

(B)

by striking subsection (a) and inserting paragraph (1);

(C)

by striking such subsection and inserting such paragraph; and

(D)

by striking paragraph (1) and inserting subparagraph (A); and

(7)

by adding at the end the following:

(b)

Multidisciplinary health services in communities

(1)

Program authorized

The Assistant Secretary shall make grants to States, on a competitive basis, for the development and operation of—

(A)

systems for the delivery of mental health screening and treatment services for older individuals who lack access to such services; and

(B)

programs to—

(i)

increase public awareness regarding the benefits of prevention and treatment of mental disorders in older individuals;

(ii)

reduce the stigma associated with mental disorders in older individuals and other barriers to the diagnosis and treatment of the disorders; and

(iii)

reduce age-related prejudice and discrimination regarding mental disorders in older individuals.

(2)

Application

To be eligible to receive a grant under this subsection for a State, a State agency shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

(3)

State allocation and priorities

A State agency that receives funds through a grant made under this subsection shall allocate the funds to area agencies on aging to carry out this subsection in planning and service areas in the State. In allocating the funds, the State agency shall give priority to planning and service areas in the State—

(A)

that are medically underserved; and

(B)

in which there are a large number of older individuals.

(4)

Area coordination of services with other providers

In carrying out this part, to more efficiently and effectively deliver services to older individuals, each area agency on aging shall—

(A)

coordinate services described in paragraph (1) with other community agencies, and voluntary organizations, providing similar or related services; and

(B)

to the greatest extent practicable, integrate outreach and educational activities with existing (as of the date of the integration) health care and social service providers serving older individuals in the planning and service area involved.

(5)

Relationship to other funding sources

Funds made available under this part shall supplement, and not supplant, any Federal, State, and local funds expended by a State or unit of general purpose local government (including an area agency on aging) to provide the services described in paragraph (1).

(6)

Definition

In this subsection, the term mental health screening and treatment services means patient screening, diagnostic services, care planning and oversight, therapeutic interventions, and referrals, that are—

(A)

provided pursuant to evidence-based intervention and treatment protocols (to the extent such protocols are available) for mental disorders prevalent in older individuals; and

(B)

coordinated and integrated with the services of social service, mental health, and health care providers in an area in order to—

(i)

improve patient outcomes; and

(ii)

ensure, to the maximum extent feasible, the continuing independence of older individuals who are residing in the area.

.

41.

Community innovations for aging in place

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3031 et seq.) is amended by adding at the end the following:

422.

Community innovations for aging in place

(a)

Definitions

In this section:

(1)

Eligible entity

The term eligible entity

(A)

means a nonprofit health or social service organization, a community-based nonprofit organization, an area agency on aging or other local government agency, a tribal organization, or another entity that—

(i)

the Assistant Secretary determines to be appropriate to carry out a project under this part; and

(ii)

demonstrates a record of, and experience in, providing or administering group and individual health and social services for older individuals; and

(B)

does not include an entity providing housing under the congregate housing services program carried out under section 802 of the Cranston-Gonzalez National Affordable Housing Act (42 U.S.C. 8011) or the multifamily service coordinator program carried out under section 202(g) of the Housing Act of 1959 (12 U.S.C. 1701q(g)).

(2)

Naturally Occurring Retirement Community

The term Naturally Occurring Retirement Community means a residential building, a housing complex, an area (including a rural area) of single family residences, or a neighborhood composed of age-integrated housing—

(A)

where—

(i)

40 percent of the heads of households are older individuals; or

(ii)

a critical mass of older individuals exists, based on local factors which, taken in total, allow an organization to achieve efficiencies in the provision of health and social services to older individuals living in the community; and

(B)

that is not an institutional care or assisted living setting.

(b)

Grants

(1)

In general

The Assistant Secretary shall make grants to eligible entities to enable the entities to pay for developing or carrying out model aging in place projects. The projects shall permit aging in place for older individuals, including such individuals who reside in Naturally Occurring Retirement Communities, which help to sustain the independence of older individuals in communities where the individuals have established personal, family, and professional supportive networks. The entities shall provide comprehensive and coordinated health and social services through the projects.

(2)

Grant periods

The Assistant Secretary shall make the grants for periods of 3 years.

(c)

Applications

(1)

In general

To be eligible to receive a grant under subsection (b) for a project, an entity shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

(2)

Contents

The application shall include—

(A)

a detailed description of the entity's experience in providing services to older individuals in age-integrated settings;

(B)

a definition of the contiguous service area and a description of the project boundaries in which the older individuals reside or carry out activities to sustain their well-being;

(C)

a description of how the entity will cooperate and coordinate planning and services, with agencies and organizations that provide publicly supported services for older individuals within the project boundaries, including the State agency and area agencies on aging with planning and service areas within the project boundaries;

(D)

an assurance that the entity will seek to establish cooperative relationships with interested local entities, including private agencies and businesses that provide health and social services, housing entities, community development organizations, philanthropic organizations, foundations, and other non-Federal entities;

(E)

a description of the entity’s protocol for referral of residents who may require long-term care services, including coordination with local information and referral agencies and Aging and Disability Resource Centers who serve as single points of entry to public services;

(F)

a description of how the entity will offer opportunities for older individuals to be involved in the governance, oversight, and operation of the project;

(G)

an assurance that the entity will submit to the Assistant Secretary such evaluations and reports as the Assistant Secretary may require; and

(H)

a plan for long-term sustainability of the project.

(d)

Use of funds

(1)

In general

An eligible entity that receives a grant under subsection (b) shall use the funds made available through the grant to provide and coordinate, through aging in place projects described in subsection (b), services that include a comprehensive and coordinated array of community-based health and social services, which may include mental health services, for eligible older individuals.

(2)

Services

The services described in paragraph (1) shall include—

(A)

providing—

(i)

case management, case assistance, and social work services;

(ii)

health care management and health care assistance, including disease prevention and health promotion services;

(iii)

education, socialization, and recreational activities; and

(iv)

volunteer opportunities for project participants; and

(B)

coordinating the services provided under title III for eligible older individuals served by the project.

(3)

Preference

In carrying out an aging in place project, an eligible entity shall, to the extent practicable, serve communities of low-income individuals and operate or locate projects and services in or in close proximity to locations where large concentrations of older individuals have aged in place and resided, such as Naturally Occurring Retirement Communities.

(4)

Supplement not supplant

Funds made available to an eligible entity under this section shall be used to supplement, not supplant, any Federal, State, or other funds otherwise available to the entity to provide health and social services to eligible older individuals.

(e)

Competitive grants for technical assistance

(1)

Grants

The Assistant Secretary shall (or shall make a grant, on a competitive basis, to an eligible nonprofit organization, to enable the organization to)—

(A)

provide technical assistance to recipients of grants under subsection (b); and

(B)

carry out other duties, as determined by the Assistant Secretary.

(2)

Eligible organization

To be eligible to receive a grant under this subsection, an organization shall be a nonprofit organization (including a partnership of nonprofit organizations), that—

(A)

has experience and expertise in providing technical assistance to a range of entities serving older individuals and experience evaluating and reporting on programs; and

(B)

has demonstrated knowledge of and expertise in community-based health and social services.

(3)

Application

To be eligible to receive a grant under this subsection, an organization (including a partnership of nonprofit organizations) shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require, including an assurance that the organization will submit to the Assistant Secretary such evaluations and reports as the Assistant Secretary may require.

(f)

Report

The Assistant Secretary shall annually prepare and submit a report to Congress that shall include—

(1)

the findings resulting from the evaluations of the model projects conducted under this section;

(2)

a description of recommended best practices regarding carrying out health and social service projects for older individuals aging in place; and

(3)

recommendations for legislative or administrative action, as the Assistant Secretary determines appropriate.

.

42.

Choices for independence demonstration projects

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3031 et seq.), as amended by section 41, is further amended by adding at the end the following:

423.

Choices for independence demonstration projects

(a)

Definitions

In this section:

(1)

Consumer

The term consumer means an older individual, a family member of such individual, and any other person seeking information or assistance with respect to long-term care.

(2)

High-risk individual

The term high-risk individual means an older individual who—

(A)

has a functional impairment affecting the individual’s activities of daily living;

(B)

is ineligible for the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and

(C)

meets such income and functional status criteria as are determined to be appropriate by the State involved and approved by the Assistant Secretary.

(3)

Qualified expenditures

The term qualified expenditures means reported expenditures of a State under this section that have been reviewed and approved by the Assistant Secretary.

(4)

Service coordination

The term service coordination means a coordinated approach taken on behalf of high-risk older individuals to facilitate the development and implementation of a long-term care plan and the choice and independence of the individuals in securing long-term care.

(b)

Authority

The Assistant Secretary shall make grants on a competitive basis, in accordance with this section, to States to enable the States to pay for the Federal share of the cost of modifying their systems of long-term care in order to promote and facilitate—

(1)

the choice and control of older individuals and their families in securing long-term care;

(2)

the coordination and cost-effectiveness of State systems of long-term care;

(3)

the provision of long-term care in home and community-based settings; and

(4)

the ability of individuals receiving long-term care to remain as independent and self-sufficient as possible.

(c)

Applications by States

For a State to be eligible to receive a grant under this section, the Governor of such State shall submit an application to the Assistant Secretary, at such time, in such manner, and containing such information as the Assistant Secretary may specify, containing a plan for implementation of the component strategies described in subsection (d) and such other information and assurances as the Secretary determines to be appropriate.

(d)

Use of funds by States

(1)

Component strategies

A State that receives funds through a grant made under subsection (b) shall use the funds to carry out a demonstration project under this section (directly or by grant or contract) by integrating into the State’s system of long-term care the component strategies described in paragraphs (2) through (5).

(2)

Public education

In carrying out the demonstration project, the State shall conduct activities that shall include media campaigns, targeted mailings, and related activities, to help ensure that consumers are aware of—

(A)

the need to plan in advance for long-term care;

(B)

available public and private long-term care options, including private long-term care insurance; and

(C)

sources of information and resources related to long-term care, including the resource centers described in paragraph (3).

(3)

Aging and disability resource centers

(A)

In general

The State shall provide for community-level Aging and Disability Resource Centers, which, consistent with section 102(47) and subsection (f), shall provide—

(i)

comprehensive information on available public and private long-term care programs, options, and resources;

(ii)

personal counseling and service coordination to assist consumers in assessing their existing or anticipated long-term care needs and circumstances, and developing and implementing a plan for long-term care designed to meet their specific needs and circumstances;

(iii)

a convenient point of entry to the range of publicly-supported long-term care programs for which an individual may be eligible, including the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), and to such other public benefit programs as the State determines to be appropriate;

(iv)

a single process for consumer intake, assessment, and application for benefits under the programs described in subparagraph (C), including, where appropriate and feasible, facilitating the determination of an individual’s eligibility (including facilitating that determination in compliance with the requirements of title XIX of the Social Security Act) under such programs by collaborating with the appropriate programmatic office; and

(v)

the ability—

(I)

to respond immediately to a request for assistance from an individual or a family member of the individual, in the event of a crisis situation that could result in placement of such individual in an institutional care setting; and

(II)

to provide (or coordinate the provision of), such available short-term assistance as would be necessary and appropriate to temporarily preclude the need for such institutional placement, until a plan for home and community-based long-term care can be developed and implemented.

(B)

Training

In providing for the Centers, the State shall ensure that the staff of the Centers is appropriately trained to understand the interactions between private long-term care insurance (especially insurance through long-term care partnership policies) and eligibility for benefits under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).

(4)

Healthy lifestyle choices

The State shall, in accordance with standards established by the Assistant Secretary, provide for low-cost, community-level, evidence-based prevention programs and related tools to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals.

(5)

Community living incentives

(A)

In general

The State shall provide funding toward and otherwise assist with the provision of home and community-based long-term care to individuals at high risk for placement in institutional care (referred to in this paragraph as high-risk individuals). The State shall ensure that individuals at greatest risk for becoming eligible for benefits under the Medicaid program receive priority for the home and community-based long-term care.

(B)

Long-term care plan

The State shall provide for assessments of the needs and preferences of high-risk individuals with respect to long-term care, and based on such assessments, shall develop with such individuals and their family members, caregivers, or legal representatives a plan for long-term care for such individuals, specifying the types of support, providers, budget, and, if the State elects, cost-sharing contributions involved.

(C)

Allocation of funds based on individual budgets

The State shall ensure that the funding described in subparagraph (A) will be allocated among, and disbursed for, the budgets of high-risk individuals under long-term care plans developed for such individuals.

(D)

Option to provide consumer-directed care

The State shall provide high-risk individuals with the option to receive home and community-based long-term care under this paragraph in a manner that permits such individuals to direct and control, in conjunction with a service coordinator, the selection, planning, budgeting, and purchasing of such care (including the amount, duration, scope, providers, and location of such care), to the extent determined appropriate and feasible under the long-term care plan developed under subparagraph (B). The service coordinator shall assist the high-risk individuals in purchasing a range of long-term care services or supplies, not otherwise available or eligible for payment through an entity carrying out a Federal or State program or a similar third party, from a qualified provider that are delivered in home and community-based settings and in a manner that best meets the individuals' needs and respects the individuals' preferences to remain in the least restrictive setting possible.

(e)

Federal share

The Federal share of the cost of modifying systems of long-term systems care as described in subsection (b) shall be not more than 75 percent of such cost (calculated on an annual basis as the State’s qualified expenditures for such modifications for such year).

(f)

Special provisions relating to aging and disability resource centers

A State shall ensure that any Aging and Disability Resource Center shall—

(1)

fully coordinate its activities with any health insurance information, counseling, and assistance (receiving funding under section 4360 of the Omnibus Budget Reconciliation Act of 1990 (42 U.S.C. 1395b-4)) in the State;

(2)

be subject to such controls as the Assistant Secretary determines to be appropriate to ensure there is no conflict of interest with respect to any referrals, for information or otherwise, made by the Center for individuals receiving services through the Center; and

(3)

provide no long-term care services or supplies, with the exception of case management services provided through area agencies on aging as described in section 306(a)(8).

(g)

Special provisions relating to option to provide consumer-directed care

Payments made for a high-risk individual under subsection (d)(5)(D) shall not be included in the gross income of the high-risk individual for purposes of the Internal Revenue Code of 1986 or be treated as income, be treated as assets or benefits, or otherwise be taken into account, for purposes of determining the individual's eligibility for, the amount of benefits for the individual under, or the amount of cost-sharing required of the individual by, any other Federal or State program, other than the program carried out under this section.

(h)

Technical assistance to States

The Assistant Secretary, directly or by grant or contract, shall provide for technical assistance to and oversight of States carrying out demonstration projects under this section, for purposes of administration, quality assurance, and quality improvement.

(i)

Evaluation and report

The Assistant Secretary, directly or by grant or contract, shall provide for an evaluation of the demonstration projects carried out under this section. The Assistant Secretary shall submit to the President a report containing the findings resulting from such evaluation not later than 6 months after the termination of the demonstration projects.

.

43.

Responsibilities of Assistant Secretary

Section 432(c)(2)(B) of the Older Americans Act of 1965 (42 U.S.C. 3033a(c)(2)(B)) is amended by inserting before the period the following: , including preparing an analysis of such services, projects, and programs, and of how the evaluation relates to improvements in such services, projects, and programs and in the strategic plan of the Administration.

44.

Older American community service employment program

Section 502 of the Older Americans Act of 1965 (42 U.S.C. 3056) is amended—

(1)

in subsection (a)(1), by adding at the end the following: For purposes of this paragraph, an underemployed person shall be considered to be an unemployed person.;

(2)

in subsection (b)(1)(M), by striking minority, limited English-speaking, and Indian eligible individuals, and eligible individuals who have the greatest economic need, and inserting minority and Indian eligible individuals, eligible individuals with limited English proficiency, and eligible individuals with greatest economic need,; and

(3)

by adding at the end the following:

(g)
(1)

Except as provided in paragraphs (2) and (3), an eligible individual may participate in projects carried out under this title for a period of not more than 36 months (whether or not consecutive) in the aggregate.

(2)

A grantee for a project may extend the period of participation for not more than 20 percent of the project participants. In selecting participants for the extended period of participation, the grantee shall give priority to—

(A)

participants who are 65 years old or older or frail older individuals; and

(B)

individuals who have more than 1 of the following barriers to employment:

(i)

A disability.

(ii)

Limited English proficiency or low literacy skills.

(iii)

A residence in a rural area.

(iv)

A residence in an area of high unemployment.

(v)

Homelessness or a situation that puts the individual at risk for homelessness.

(vi)

A failure to find employment after utilizing services under title I of the Workforce Investment Act of 1998 (29 U.S.C. 2801 et seq.).

(3)

A grantee may petition for a waiver of the 36-month limit described in paragraph (1) if the grantee serves a high concentration of individuals who are hard-to-serve individuals because they have more than 1 barrier to employment as described in paragraph (2)(B), including a grantee who operates a project in an area in which at least 60 percent of the counties are rural counties, as defined by the Economic Research Service of the Department of Agriculture.

(h)

It is the sense of the Senate that—

(1)

the older American community service employment program was created with the intent of placing older individuals in community service positions to provide job training placements; and

(2)

placing older individuals in community service positions strengthens the ability of the individuals to become self-sufficient, provides much-needed volunteer support to organizations who benefit significantly from increased civic engagement, and strengthens the communities that are served by such organizations.

.

45.

Performance

Section 513 of the Older Americans Act of 1965 (42 U.S.C. 3056k) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)—

(i)

by striking the paragraph designation and all that follows through grantees and inserting the following:

(1)

Establishment and implementation of measures

The Secretary shall establish and implement, after consultation with the Assistant Secretary, grantees

; and

(ii)

by adding at the end the following: The Assistant Secretary shall provide recommendations to the Secretary on the establishment and implementation of the performance measures.;

(B)

in paragraph (2)(B), by adding at the end the following:

(iv)

Not less than 60 percent of the counties, in the areas served by the grantee, being rural counties as defined by the Economic Research Service of the Department of Agriculture.

(v)

The areas served by the grantee comprising a difficult to serve territory due to limited economies of scale.

; and

(C)

by adding at the end the following:

(6)

Special rules

(A)

Establishment and implementation

The Secretary shall establish and implement the performance measures described in this section, including all required indicators described in subsection (b), not later than 1 year after the date of enactment of the Older Americans Act Amendments of 2006.

(B)

Impact on grant competition

The Secretary may not publish a notice announcing a grant competition under this title, and soliciting proposals for grants, until the day that is the later of—

(i)

the date on which the Secretary implements all required indicators described in subsection (b); and

(ii)

January 1, 2010.

; and

(2)

by adding at the end the following:

(e)

Effect of Exemption

In implementing a performance measure under this section, the Secretary shall not reduce a score on the performance measure of—

(1)

a grantee that receives a waiver under section 502(g)(3) on the basis that the grantee is extending the period of participation for project participants under that section; and

(2)

a grantee on the basis that the grantee is extending the period of participation for project participants under section 502(g)(2).

.

46.

Competitive requirements

Section 514 of the Older Americans Act of 1965 (42 U.S.C. 3056l) is amended—

(1)

by striking subsection (a) and inserting the following:

(a)

Program authorized

In accordance with section 502(b), the Secretary shall award grants to eligible applicants, through a competitive process that emphasizes meeting performance measures, to carry out projects under this title for a 4-year period. The Secretary may not conduct a grant competition under this title until the day described in section 513(a)(6)(B).

;

(2)

by striking subsection (b) and inserting the following:

(b)

Eligible applicants

An applicant shall be eligible to receive a grant as described in subsection (a) if the applicant meets the requirements and criteria described in section 502(b)(1), subsections (c) and (d), and paragraphs (2) and (3) of subsection (e).

;

(3)

in subsection (c)—

(A)

by redesignating paragraphs (2) through (7) as paragraphs (4) through (9), respectively;

(B)

by inserting after paragraph (1) the following:

(2)

The applicant’s performance on the required indicators described in section 513(b), in the case of an applicant that has previously received a grant under this title, and the applicant’s ability to meet the required indicators, in the case of any other applicant.

(3)

The applicant's ability to administer a program that provides community service.

; and

(C)

by striking paragraph (9) and inserting the following:

(9)

The applicant’s ability to minimize disruption in services for project participants and the entities employing the participants.

(10)

Any additional criteria that the Secretary may determine to be appropriate.

;

(4)

in subsection (e)—

(A)

in paragraph (2), by striking subparagraphs (C) and (D); and

(B)

in paragraph (3)—

(i)

by striking (3) and all that follows through In and inserting the following:

(3)

Competition requirements for public and private nonprofit agencies and organizations in a State

In

;

(ii)

by striking subparagraphs (B) through (D); and

(iii)

by striking take corrective action and inserting provide technical assistance;

(C)

in paragraph (4), by striking paragraph (3)(A) and inserting paragraph (3);

(5)

in subsection (f), by striking paragraph (4);

(6)

by adding at the end the following:

(g)

Grantees serving individuals with barriers to employment

(1)

Definition

In this subsection, the term individuals with barriers to employment means minority and Indian individuals, individuals with limited English proficiency, and individuals with greatest economic need.

(2)

Special consideration

In areas where a substantial population of individuals with barriers to employment exists, a grantee that receives a national grant under this section shall, in selecting subgrantees, give special consideration to organizations (including former recipients of such national grants) with demonstrated expertise in serving individuals with barriers to employment.

(h)

Minority-serving grantees

The Secretary may not promulgate rules or regulations, affecting grantees in areas where a substantial population of minority individuals exists, that would significantly compromise the ability of the grantees to serve their targeted population of minority older individuals.

.

47.

Definitions

Section 516(2) of the Older Americans Act of 1965 (42 U.S.C. 3056n(2)) is amended—

(1)

in the header, by striking individuals and inserting individual ;

(2)

by inserting before The term the following:

(A)

In general

;

(3)

by striking individuals and inserting individual; and

(4)

by adding at the end the following:

(B)

Determination of low income

For purposes of determining income eligibility under subparagraph (A), the Secretary shall not include as income—

(i)

unemployment compensation;

(ii)

benefits received under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.);

(iii)

payments made to or on behalf of veterans or former members of the Armed Forces under the laws administered by the Secretary of Veterans Affairs; or

(iv)

25 percent of the old-age and survivors insurance benefits received under title II of the Social Security Act (42 U.S.C. 401 et seq.).

.

48.

Clarification of maintenance requirement

(a)

In general

Section 614A of the Older Americans Act of 1965 (42 U.S.C. 3057e–1) is amended by adding at the end the following:

(c)

Clarification

(1)

Definition

In this subsection, the term covered year means fiscal year 2006 or a subsequent fiscal year.

(2)

Consortia of tribal organizations

If a tribal organization received a grant under this part for fiscal year 1991 as part of a consortium, the Assistant Secretary shall consider the tribal organization to have received a grant under this part for fiscal year 1991 for purposes of subsections (a) and (b), and shall apply the provisions of subsections (a) and (b)(1) (under the conditions described in subsection (b)) to the tribal organization for each covered year for which the tribal organization submits an application under this part, even if the tribal organization submits—

(A)

a separate application from the remaining members of the consortium; or

(B)

an application as 1 of the remaining members of the consortium.

.

(b)

Effective date

Subsection (a) takes effect on October 1, 2005.

49.

Native Americans caregiver support program

Section 643 of the Older Americans Act of 1965 (42 U.S.C. 3057n) is amended—

(1)

in paragraph (1), by striking 2001 and inserting 2007; and

(2)

in paragraph (2), by striking $5,000,000 and all that follows and inserting $6,500,000 for fiscal year 2007, $7,000,000 for fiscal year 2008, $7,500,000 for fiscal year 2009, $8,000,000 for fiscal year 2010, and $8,500,000 for fiscal year 2011..

50.

Vulnerable elder rights protection activities

Section 702 of the Older Americans Act of 1965 (42 U.S.C. 3058a) is amended by striking 2001 each place it appears and inserting 2007.

51.

Elder abuse, neglect, and exploitation prevention amendment

Section 721 of the Older Americans Act of 1965 (42 U.S.C. 3058i) is amended—

(1)

in subsection (b)—

(A)

by redesignating paragraphs (2) through (8) as paragraphs (3) through (9), respectively; and

(B)

by inserting after paragraph (1) the following new paragraph:

(2)

providing for public education and outreach to promote financial literacy and prevent identity theft and financial exploitation of older individuals;

; and

(2)

in subsection (e)(2)—

(A)

by striking subsection (b)(8)(B)(i) and inserting subsection (b)(9)(B)(i); and

(B)

by striking subsection (b)(8)(B)(ii) and inserting subsection (b)(9)(B)(ii).

52.

Native American organization provisions

Section 751(d) of the Older Americans Act of 1965 (42 U.S.C. 3058aa(d)) is amended by striking 2001 and inserting 2007.

53.

Elder justice programs

(a)

Purposes

The purposes of this section are as follows:

(1)

To assist States and Indian tribes in developing a comprehensive multi-disciplinary approach to elder justice.

(2)

To promote research and data collection that will fill gaps in knowledge about elder abuse, neglect, and exploitation.

(3)

To support innovative and effective activities of service providers and programs that are designed to address issues relating to elder abuse, neglect, and exploitation.

(4)

To assist States, Indian tribes, and local service providers in the development of short- and long-term strategic plans for the development and coordination of elder justice research, programs, studies, training, and other efforts.

(5)

To promote collaborative efforts and diminish overlap and gaps in efforts in developing the important field of elder justice.

(b)

Elder justice

Title VII of the Older Americans Act of 1965 (42 U.S.C. 3058 et seq.) is amended—

(1)

by redesignating subtitles B and C as subtitles C and D, respectively;

(2)

by redesignating sections 751, and 761 through 764, as sections 761, and 771 through 774, respectively; and

(3)

by inserting after subtitle A the following:

B

Elder Justice Programs

751.

Definitions

In this subtitle:

(1)

Caregiver

The term caregiver means an individual who has the responsibility for the care of an elder, either voluntarily, by contract, by receipt of payment for care, or as a result of the operation of law and means a family member or other individual who provides (on behalf of such individual or of a public or private agency, organization, or institution) compensated or uncompensated care to an elder.

(2)

Direct care

The term direct care means care by an employee or contractor who provides assistance or long-term care services to a recipient.

(3)

Elder

The term elder means an older individual, as defined in section 102.

(4)

Elder justice

The term elder justice means—

(A)

efforts to prevent, detect, treat, intervene in, and respond to elder abuse, neglect, and exploitation and to protect elders with diminished capacity while maximizing their autonomy; and

(B)

from an individual perspective, the recognition of an elder’s rights, including the right to be free of abuse, neglect, and exploitation.

(5)

Eligible entity

The term eligible entity means a State or local government agency, Indian tribe, or any other public or private entity, that is engaged in and has expertise in issues relating to elder justice.

(6)

Fiduciary

The term fiduciary

(A)

means a person or entity with the legal responsibility—

(i)

to make decisions on behalf of and for the benefit of another person; and

(ii)

to act in good faith and with fairness; and

(B)

includes a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee.

(7)

Grant

The term grant includes a contract, cooperative agreement, or other mechanism for providing financial assistance.

(8)

Law enforcement

The term law enforcement means the full range of potential responders to elder abuse, neglect, and exploitation including—

(A)

police, sheriffs, detectives, public safety officers, and corrections personnel;

(B)

prosecutors;

(C)

medical examiners;

(D)

investigators; and

(E)

coroners.

(9)

Long-term care

(A)

In general

The term long-term care means supportive and health services specified by the Secretary for individuals who need assistance because the individuals have a loss of capacity for self-care due to illness, disability, or vulnerability.

(B)

Loss of capacity for self-care

For purposes of subparagraph (A), the term loss of capacity for self-care means an inability to engage effectively in activities of daily living, including eating, dressing, bathing, and management of one’s financial affairs.

(10)

Long-term care facility

The term long-term care facility means a residential care provider that arranges for, or directly provides, long-term care.

(11)

Nursing facility

The term nursing facility has the meaning given such term under section 1919(a) of the Social Security Act (42 U.S.C. 1396r(a)).

(12)

State legal assistance developer

The term State legal assistance developer means an individual described in section 731.

(13)

State long-term care ombudsman

The term State Long-Term Care Ombudsman means the State Long-Term Care Ombudsman described in section 712(a)(2).

752.

State and tribal grants to strengthen long-term care and provide assistance for elder justice programs

(a)

Grants

The Assistant Secretary may award grants to States and Indian tribes to enable the States and tribes to strengthen long-term care and provide assistance for elder justice programs.

(b)

Application

To be eligible to receive a grant under this subtitle, a State or Indian tribe shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

(c)

Use of funds

A State or Indian tribe that receives a grant under this subtitle may use the funds made available through the grant to award grants—

(1)

to eligible entities for the prevention, detection, assessment, and treatment of, intervention in, investigation of, and response to elder abuse, neglect, and exploitation;

(2)

to eligible entities to examine various types of elder shelters (in this paragraph referred to as safe havens), and to test various safe haven models for establishing safe havens (at home or elsewhere), that—

(A)

recognize autonomy and self-determination, and fully protect the due process rights of elders; and

(B)
(i)

provide a comprehensive, culturally sensitive, and multidisciplinary team response to allegations of elder abuse, neglect, or exploitation;

(ii)

provide a dedicated, elder-friendly setting;

(iii)

have the capacity to meet the needs of elders for care; and

(iv)

provide various services including—

(I)

nursing and forensic evaluation;

(II)

therapeutic intervention;

(III)

victim support and advocacy; and

(IV)

case review and assistance to make the elders safer at home or to find appropriate placement in safer environments, including shelters, and, in some circumstances long-term care facilities, other residential care facilities, and hospitals;

(3)

to eligible entities to establish or continue volunteer programs that focus on the issues of elder abuse, neglect, and exploitation, or to provide related services;

(4)

to eligible entities to support multidisciplinary elder justice activities, such as—

(A)

supporting and studying team approaches for bringing a coordinated multidisciplinary or interdisciplinary response to elder abuse, neglect, and exploitation, including a response from individuals in social service, health care, public safety, and legal disciplines;

(B)

establishing a State or tribal coordinating council, which shall identify the individual State’s or Indian tribe’s needs and provide the Secretary with information and recommendations relating to efforts by the State or Indian tribe to combat elder abuse, neglect, and exploitation;

(C)

providing training, technical assistance, and other methods of support to groups carrying out multidisciplinary efforts at the State or Indian tribe level (referred to in some States as State Working Groups);

(D)

broadening and studying various models for elder fatality and serious injury review teams, to make recommendations about their composition, protocols, functions, timing, roles, and responsibilities, with a goal of producing models and information that will allow for replication based on the needs of other States, Indian tribes, and communities; or

(E)

carrying out such other interdisciplinary or multidisciplinary efforts as the Assistant Secretary determines to be appropriate;

(5)

to eligible entities to provide training for individuals with respect to issues of elder abuse, neglect, and exploitation, consisting of—

(A)

training within a discipline; or

(B)

cross-training activities that permit individuals in multiple disciplines to train together, fostering communication, coordinating efforts, and ensuring collaboration;

(6)

to eligible entities to address underserved populations of elders, such as—

(A)

elders living in rural locations;

(B)

elders in minority populations; or

(C)

low-income elders;

(7)

to eligible entities to provide incentives for individuals to train for, seek, and maintain employment providing direct care in a long-term care facility, such as—

(A)

to eligible entities to provide incentives to participants in programs carried out under part A of title IV, and section 403(a)(5), of the Social Security Act (42 U.S.C. 601 et seq., 603(a)(5)) to train for and seek employment providing direct care in a long-term care facility;

(B)

to long-term care facilities to carry out programs through which the facilities—

(i)

offer, to employees who provide direct care to residents of a long-term care facility, continuing training and varying levels of professional certification, based on observed clinical care practices and the amount of time the employees spend providing direct care; and

(ii)

provide, or make arrangements with employers to provide, bonuses or other increased compensation or benefits to employees who achieve professional certification under such a program; or

(C)

to long-term care facilities to enable the facilities to provide training and technical assistance to eligible employees regarding management practices using methods that are demonstrated to promote retention of employees of the facilities, such as—

(i)

the establishment of basic human resource policies that reward high performance, including policies that provide for improved wages and benefits on the basis of job reviews; or

(ii)

the establishment of other programs that promote the provision of high quality care, such as a continuing education program that provides additional hours of training, including on-the-job training, for employees who are certified nurse aides;

(8)

to encourage the establishment of eligible partnerships to develop collaborative and innovative approaches to improve the quality of, including preventing abuse, neglect, and exploitation in, long-term care; or

(9)

to eligible entities to establish multidisciplinary panels to address and develop best practices concerning methods of—

(A)

improving the quality of long-term care; and

(B)

addressing abuse, including resident-to-resident abuse, in long-term care.

(d)

Administrative expenses

A State or Indian tribe that receives a grant under this section shall not use more than 5 percent of the funds made available through the grant to pay for administrative expenses.

(e)

Supplement not supplant

Funds made available pursuant to this section shall be used to supplement and not supplant other Federal, State, and local (including tribal) funds expended to provide activities described in subsection (c).

(f)

Maintenance of effort

The State or Indian tribe, in using the proceeds of a grant received under this section, shall maintain the expenditures of the State or tribe for activities described in subsection (c) at a level equal to not less than the level of such expenditures maintained by the State or tribe for the fiscal year preceding the fiscal year for which the grant is received.

(g)

Accountability measures

The Assistant Secretary shall develop accountability measures to ensure the effectiveness of the activities conducted using funds made available under this section, including accountability measures to ensure that the activities described in subsection (c)(7) benefit eligible employees and increase the stability of the long-term care workforce.

(h)

Evaluating programs

The Assistant Secretary shall evaluate the activities conducted using funds made available under this section and shall use the results of such evaluation to determine the activities for which funds made available under this section may be used.

(i)

Compliance with applicable laws

In order to receive funds under this section, an entity shall comply with all applicable laws, regulations, and guidelines.

(j)

Eligible partnerships

In subsection (c)(8), the term eligible partnership means a multidisciplinary community partnership consisting of eligible entities or appropriate individuals, such as a partnership consisting of representatives in a community of nursing facility providers, State legal assistance developers, advocates for residents of long-term care facilities, State Long-Term Care Ombudsmen, surveyors, the State agency with responsibility for adult protective services, the State agency with responsibility for licensing long-term care facilities, law enforcement agencies, courts, family councils, residents, certified nurse aides, registered nurses, physicians, and other eligible entities and appropriate individuals.

(k)

Authorization of appropriations

There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2005 through 2008.

753.

Collection of uniform national data on elder abuse, neglect, and exploitation

(a)

Purpose

The purpose of this section is to improve, streamline, and promote uniform collection, maintenance, and dissemination of national data relating to the various types of elder abuse, neglect, and exploitation.

(b)

Phase I

(1)

In general

Not later than the date that is 1 year after the date of enactment of the Older Americans Act Amendments of 2006, the Assistant Secretary, acting through the head of the Office of Elder Abuse Prevention and Services, after consultation with the Attorney General and working with experts in relevant disciplines from the Bureau of Justice Statistics of the Office of Justice Programs of the Department of Justice, shall—

(A)

develop a method for collecting national data regarding elder abuse, neglect, and exploitation; and

(B)

develop uniform national data reporting forms adapted to each relevant entity or discipline (such as health, public safety, social and protective services, and law enforcement) reflecting—

(i)

the distinct manner in which each entity or discipline receives and maintains information; and

(ii)

the sequence and history of reports to or involvement of different entities or disciplines, independently, or the sequence and history of reports from 1 entity or discipline to another over time.

(2)

Forms

(A)

In general

Subject to subparagraph (B), the national data reporting forms described in paragraph (1)(B) shall incorporate the definitions of section 751, for use in determining whether an event is reportable.

(B)

Protection of privacy

In pursuing activities under this paragraph, the Secretary shall ensure the protection of individual health privacy consistent with the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 and State and local privacy regulations (as applicable).

(c)

Phase II

(1)

In general

Not later than the date that is 1 year after the date on which the activities described in subsection (b)(1) are completed, the Secretary (or the Secretary’s designee) shall ensure that the national data reporting forms and data collection methods developed in accordance with such subsection are pilot tested in 6 States selected by the Secretary.

(2)

Adjustments to the form and methods

The Secretary, after considering the results of the pilot testing described in paragraph (1) and consultation with the Attorney General and relevant experts, shall adjust the national data reporting forms and data collection methods as necessary.

(d)

Phase III

(1)

Distribution of national data reporting forms

After completion of the adjustment to the national data reporting forms under subsection (c)(2), the Secretary shall submit the national data reporting forms along with instructions to—

(A)

the heads of the relevant components of the Department of Health and Human Services, the Department of Justice, and the Department of the Treasury, and such other Federal entities as may be appropriate; and

(B)

the Governor’s office of each State for collection from all relevant State entities of data, including health care, social services, and law enforcement data.

(2)

Data collection grants

(A)

Authorization

The Secretary is authorized to award grants to States to improve data collection activities relating to elder abuse, neglect, and exploitation.

(B)

Application

To be eligible to receive a grant under this paragraph, a State shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.

(C)

Requirements

Each State receiving a grant under this paragraph for a fiscal year shall report data for the calendar year that begins during that fiscal year, using the national data reporting forms described in paragraph (1).

(D)

Funding

(i)

First year

For the first fiscal year for which a State receives grant funds under this subsection the Secretary shall initially distribute 50 percent of such funds. The Secretary shall distribute the remaining funds at the end of the calendar year that begins during that fiscal year, if the Secretary determines that the State has properly reported data required under this subsection for the calendar year.

(ii)

Subsequent years

Except as provided in clause (i), the Secretary shall distribute grant funds to a State under this subsection for a fiscal year if the Secretary determines that the State properly reported data required under this subsection for the calendar year that ends during that fiscal year.

(3)

Required information

Each report submitted under this subsection shall—

(A)

indicate the State and year in which each event occurred; and

(B)

identify the total number of events that occurred in each State during the year and the type of each event.

(e)

Report

Not later than 1 year after the date of enactment of the Older Americans Act Amendments of 2006 and annually thereafter, the Secretary shall prepare and submit to the appropriate committees of Congress, including to the Committee on Health Education, Labor, and Pensions and the Special Committee on Aging of the Senate, a report regarding activities conducted under this section.

(f)

Authorization of appropriations

There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2007, 2008, 2009, 2010, and 2011.

.

54.

Rule of construction

Subtitle C of title VII of the Older Americans Act of 1965 (42 U.S.C. 3058 et seq.) is amended by adding at the end the following:

765.

Rule of construction

Nothing in this title shall be construed to interfere with or abridge the right of an older individual to practice the individual’s religion through reliance on prayer alone for healing, in a case in which a decision to so practice the religion—

(1)

is contemporaneously expressed by the older individual—

(A)

either orally or in writing;

(B)

with respect to a specific illness or injury that the older individual has at the time of the decision; and

(C)

when the older individual is competent to make the decision;

(2)

is set forth prior to the occurrence of the illness or injury in a living will, health care proxy, or other advance directive document that is validly executed and applied under State law; or

(3)

may be unambiguously deduced from the older individual’s life history.

.

1.

Short title

This Act may be cited as the Older Americans Act Amendments of 2006.

2.

Definitions

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended—

(1)

in paragraph (12)(D), to read as follows:

(D)

evidence-based health promotion programs, including programs related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention, physical activity, and improved nutrition;

;

(2)

by striking paragraph (24) and inserting the following:

(24)

The term exploitation means the fraudulent or otherwise illegal, unauthorized, or improper act or process of an individual, including a caregiver or fiduciary (as such terms are defined in section 751), that uses the resources of an older individual for monetary or personal benefit, profit, or gain, or that results in depriving an older individual of rightful access to, or use of, benefits, resources, belongings, or assets.

;

(3)

in paragraph (29)(E)—

(A)

in clause (i), by striking and at the end;

(B)

in clause (ii), by striking the period at the end and inserting ; and; and

(C)

by adding at the end the following:

(iii)

older individuals at risk for institutional placement.

;

(4)

in paragraph (32)(D), by inserting , including an assisted living facility, after home;

(5)

by striking paragraph (34) and inserting the following:

(34)
(A)

The term neglect means—

(i)

the failure of a caregiver or fiduciary (as such terms are defined in section 751) to provide the goods or services that are necessary to maintain the health or safety of an older individual; or

(ii)

self-neglect.

(B)

The term self-neglect means an adult’s inability, due to physical or mental impairment or diminished capacity, to perform essential self-care tasks including—

(i)

obtaining essential food, clothing, shelter, and medical care;

(ii)

obtaining goods and services necessary to maintain physical health, mental health, or general safety; or

(iii)

managing one’s own financial affairs.

; and

(6)

by adding at the end the following:

(44)

The term Aging and Disability Resource Center means a center established by a State as part of the State system of long-term care, to provide a coordinated system for providing—

(A)

comprehensive information on available public and private long-term care programs, options, and resources;

(B)

personal counseling to assist individuals in assessing their existing or anticipated long-term care needs, and developing and implementing a plan for long-term care designed to meet their specific needs and circumstances; and

(C)

consumer access to the range of publicly-supported long-term care programs for which consumers may be eligible, by serving as a convenient point of entry for such programs.

(45)

The term at risk for institutional placement means, with respect to an older individual, that such individual is unable to perform at least 2 activities of daily living without substantial assistance (including verbal reminding, physical cuing, or supervision), including such an older individual that is determined by the State involved to be in need of placement in a long-term care facility.

(46)

The term Hispanic-serving institution has the meaning given the term in section 502 of the Higher Education Act of 1965 (20 U.S.C. 1101a).

(47)

Except as provided in section 751, the term long-term care means any services, care, or items (including assistive devices) that are—

(A)

intended to assist individuals in coping with, and to the extent practicable compensating for, functional impairments in carrying out activities of daily living;

(B)

furnished at home, in a community care setting (including a small community care setting as defined in subsection (g)(1), and a large community care setting as defined in subsection (h)(1), of section 1929 of the Social Security Act (42 U.S.C. 1396t)), or in a long-term care facility; and

(C)

not furnished to diagnose, treat, or cure a medical disease or condition.

(48)

The term self-directed care means an approach to providing services (including programs, benefits, supports, and technology) under this Act intended to assist an older individual with activities of daily living, in which—

(A)

such services (including the amount, duration, scope, provider, and location of such services) are planned, budgeted, and purchased under the direction and control of such individual;

(B)

such individual is provided with such information and assistance as is necessary and appropriate to enable such individual to make informed decisions about the individual's service options;

(C)

the needs, capabilities, and preferences of such individual with respect to such services, and such individual's ability to direct and control the individual's receipt of such services, are assessed by the area agency on aging involved or the local provider agency;

(D)

based on the assessment made under subparagraph (C), upon request, the area agency on aging assists such individual and the individual's family, caregiver, or legal representative in developing—

(i)

a plan of services for such individual that specifies which services such individual will be responsible for directing;

(ii)

a determination of the role of family members (and others whose participation is sought by such individual) in providing services under such plan; and

(iii)

a budget for such services; and

(E)

the area agency on aging or State agency involved provides for oversight of such individual's self-directed receipt of services, including steps to ensure the quality of services provided and the appropriate use of funds under this Act.

(49)

The term State system of long-term care means the Federal, State, and local programs and activities administered by a State that provide, support, or facilitate access to long-term care to individuals in such State.

.

3.

Office of Elder Abuse Prevention and Services

Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is amended by adding at the end the following:

(e)
(1)

In this subsection, the terms defined in section 751 shall have the meanings given those terms in that section.

(2)

The Secretary is authorized to establish or designate within the Administration (as defined in section 102) an Office of Elder Abuse Prevention and Services.

(3)

It shall be the duty of the Assistant Secretary, acting through the head of the Office of Elder Abuse Prevention and Services to—

(A)

develop objectives, priorities, policy, and a long-term plan for—

(i)

carrying out elder justice programs and activities relating to—

(I)

elder abuse prevention, detection, treatment, intervention, and response;

(II)

training of individuals regarding the matters described in subclause (I); and

(III)

the improvement of the elder justice system in the United States;

(ii)

annually collecting, maintaining, and disseminating data relating to the abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults), including collecting, maintaining, and disseminating such data under section 753 after consultation with the Attorney General and working with experts from the Department of Justice described in section 753(b)(1);

(iii)

disseminating information concerning best practices regarding, and providing training on, carrying out activities related to abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults);

(iv)

in conjunction with the necessary experts, conducting research related to abuse, neglect, and exploitation of elders (and, in the discretion of the Secretary, vulnerable adults);

(v)

providing technical assistance to States and other eligible entities that provide or fund the provision of the services described in subtitle B of title VII; and

(vi)

carrying out a study to determine the national incidence and prevalence of elder abuse, neglect, and exploitation in all settings;

(B)

implement the overall policy and a strategy to carry out the plan described in subparagraph (A); and

(C)

provide advice to the Secretary on elder justice issues and administer such programs relating to elder abuse, neglect, and exploitation as the Secretary determines to be appropriate.

(4)

The Secretary, acting through the Assistant Secretary, may issue such regulations as may be necessary to carry out this subsection and subtitle B of title VII.

.

4.

Functions of the Assistant Secretary

Section 202 of the Older Americans Act of 1965 (42 U.S.C. 3012) is amended—

(1)

in subsection (a)—

(A)

in paragraph (12)—

(i)

by striking carry on and inserting the following:

(B)

carry on

; and

(ii)

by striking (12) and inserting the following:

(12)
(A)

consult and coordinate activities with the Administrator of the Centers for Medicare & Medicaid Services to implement and build awareness of programs providing new benefits affecting older individuals; and

;

(B)

by striking paragraph (20) and inserting the following:

(20)
(A)

provide technical assistance and support for outreach and benefits enrollment assistance to support efforts—

(i)

to inform older individuals with greatest economic need, who may be eligible to participate, but who are not participating, in Federal and State programs for which the individuals are eligible, about the programs; and

(ii)

to enroll the individuals in the programs;

(B)

in cooperation with related Federal agency partners administering the Federal programs, make a grant to or enter into a contract with a qualified, experienced entity to establish a National Center on Senior Benefits Outreach and Enrollment, which shall—

(i)

maintain and update web-based decision support and enrollment tools, and integrated, person-centered systems, designed to inform older individuals about the full range of benefits for which the individuals may be eligible under Federal and State programs;

(ii)

utilize cost-effective strategies to find older individuals with greatest economic need and enroll the individuals in the programs;

(iii)

create and support efforts for Aging and Disability Resource Centers, and other public and private State and community-based organizations, including faith-based organizations and coalitions, to serve as benefits enrollment centers for the programs;

(iv)

develop and maintain an information clearinghouse on best practices and the most cost-effective methods for finding and enrolling older individuals with greatest economic need in the programs; and

(v)

provide, in collaboration with related Federal agency partners administering the Federal programs, training and technical assistance on the most effective outreach, screening, enrollment, and follow-up strategies for the Federal and State programs.

;

(C)

in paragraph (26)—

(i)

in subparagraph (D)—

(I)

by striking gaps in; and

(II)

by inserting (including services that would permit such individuals to receive long-term care in home and community-based settings) after individuals; and

(ii)

in subparagraph (E), by striking and at the end;

(D)

in paragraph (27), by striking the period at the end and inserting ; and; and

(E)

by adding at the end the following:

(28)

make available to States information and technical assistance to support the provision of evidence-based disease prevention and health promotion services.

; and

(2)

by striking subsections (b) and (c) and inserting the following:

(b)

To promote the development and implementation of comprehensive, coordinated systems at Federal, State, and local levels that enable older individuals to receive long-term care in home and community-based settings, in a manner responsive to the needs and preferences of the older individuals and their family caregivers, the Assistant Secretary shall, consistent with the applicable provisions of this title—

(1)

collaborate, coordinate, and consult with other Federal agencies and departments (other than the Administration on Aging) responsible for formulating and implementing programs, benefits, and services related to providing long-term care, and may make grants, contracts, and cooperative agreements with funds received from those other Federal agencies and departments;

(2)

conduct research and demonstration projects to identify innovative, cost-effective strategies for modifying State systems of long-term care to—

(A)

respond to the needs and preferences of older individuals and family caregivers;

(B)

target services to individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings; and

(C)

establish criteria for and promote the implementation (through area agencies on aging, service providers, and such other entities as the Assistant Secretary determines to be appropriate) of evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals;

(3)

facilitate, in coordination with the Administrator of the Centers for Medicare & Medicaid Services, the provision of such care through self-directed care models that—

(A)

provide for the assessment of the needs and preferences of an individual at risk for institutional placement to help such individual avoid unnecessary institutional placement and depletion of income and assets to qualify for benefits under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.);

(B)

respond to the needs and preferences of such individual and provide the option—

(i)

for the individual to direct and control the receipt of supportive services provided; or

(ii)

as appropriate, for a person who was appointed by the individual, or is legally acting on the individual’s behalf, in order to represent or advise the individual in financial or service coordination matters (referred to in this paragraph as a representative of the individual), to direct and control the receipt of those services; and

(C)

assist an older individual (or, as appropriate, a representative of the individual) to develop a plan for long-term support, including selecting, budgeting for, and purchasing home and community-based long-term care and supportive services;

(4)

provide for the Administration to play a lead role with respect to issues concerning home and community-based long-term care, including—

(A)

directing (as the Secretary or the President determines to be appropriate) or otherwise participating in departmental and interdepartmental activities concerning long-term care; and

(B)

reviewing and commenting on departmental rules, regulations, and policies related to providing long-term care; and

(C)

making recommendations to the Secretary with respect to home and community-based long-term care, including recommendations based on findings made through projects conducted under paragraph (2);

(5)

promote, in coordination with other appropriate Federal agencies—

(A)

enhanced awareness by the public of the importance of planning in advance for long-term care; and

(B)

the availability of information and resources to assist in such planning;

(6)

implement in each State an Aging and Disability Resource Center—

(A)

to serve as a visible and trusted source of information on the full range of options for long-term care, including both institutional and home and community-based care, that are available in the State;

(B)

to provide personalized and consumer-friendly assistance to empower individuals to make informed decisions about their long-term care options;

(C)

to provide coordinated and streamlined access to all publicly funded long-term care options so that consumers can obtain the care they need through a single intake, assessment, and eligibility determination process;

(D)

to help individuals to plan ahead for their long-term care needs; and

(E)

to assist, in coordination with the entity carrying out the health insurance information, counseling, and assistance program (receiving funding under section 4360 of the Omnibus Budget Reconciliation Act of 1990 (42 U.S.C. 1395b–4)) in the State, beneficiaries, and prospective beneficiaries, under the Medicare program established under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) in understanding and accessing prescription drug and preventative health benefits under the provisions of, and amendments made by, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003;

(7)

establish, either directly or through grants or contracts, a national technical assistance program to assist State agencies, area agencies on aging, and community-based service providers funded under this Act in implementing home and community-based long-term care systems, including evidence-based programs;

(8)

develop, in collaboration with the Administrator of the Centers for Medicare & Medicaid Services, performance standards and measures for use by States to determine the extent to which their State systems of long-term care fulfill the objectives described in this subsection; and

(9)

conduct such other activities as the Assistant Secretary determines to be appropriate.

(c)

The Assistant Secretary, after consultation with the Chief Executive Officer of the Corporation for National and Community Service, shall—

(1)

encourage and permit volunteer groups (including organizations carrying out national service programs and including organizations of youth in secondary or postsecondary school) that are active in supportive services and civic engagement to participate and be involved individually or through representative groups in supportive service and civic engagement programs or activities to the maximum extent feasible;

(2)

develop a comprehensive strategy for utilizing older individuals to address critical local needs of national concern; and

(3)

encourage other community capacity-building initiatives involving older individuals.

.

5.

Federal agency consultation

Section 203 of the Older Americans Act of 1965 (42 U.S.C. 3013) is amended—

(1)

in subsection (a)(3)(A)—

(A)

by striking (with particular attention to low-income minority older individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(B)

by striking section 507 and inserting section 516;

(2)

in subsection (b)—

(A)

in paragraph (17), by striking and at the end;

(B)

in paragraph (18), by striking the period and inserting , and; and

(C)

by adding at the end the following:

(19)

sections 4 and 5 of the Assistive Technology Act of 1998 (29 U.S.C. 3003, 3004).

; and

(3)

by adding at the end the following:

(c)
(1)

The Secretary, in collaboration with the Secretary of Housing and Urban Development and with the other Federal officials specified in paragraph (2), shall establish an interagency coordinating committee (referred to in this subsection as the Committee) focusing on the coordination of agencies with respect to aging issues, particularly issues related to demographic changes and housing needs among older individuals.

(2)

The officials referred to in paragraph (1) are the Secretary of Labor, the Secretary of Housing and Urban Development, the Attorney General, the Secretary of Transportation, the Secretary of the Treasury, the Secretary of Agriculture, the Commissioner of Social Security, the Surgeon General, the Administrator of the Centers for Medicare & Medicaid Services, the Director of the Centers for Disease Control and Prevention, the Director of the National Institutes of Health, the Assistant Secretary for Children and Families, the Administrator of the National Highway Traffic Safety Administration, and such other Federal officials as the Secretary of Health and Human Services determines to be appropriate.

(3)

The Secretary of Health and Human Services shall serve as the first chairperson of the Committee, for an initial period of 2 years. After that initial period, the Secretary of Housing and Urban Development and the Secretary of Health and Human Services shall alternate as chairpersons of the Committee, each serving as chairperson for a period of 2 years.

(4)

The Committee shall—

(A)

review all Federal programs and services that assist older individuals in finding and affording housing, health care, and other services, including those Federal programs and services that assist older individuals in accessing health care, transportation, supportive services, and assistance with daily activities, at the place or close to the place where the older individuals live;

(B)

monitor, evaluate, and recommend improvements in programs and services administered, funded, or financed by Federal, State, and local agencies to assist older individuals in meeting their housing, health care, and other service needs and make any recommendations about how the agencies can better carry out and provide the programs and services to house and serve older individuals;

(C)

recommend ways to—

(i)

facilitate aging in place of older individuals, by identifying and making available the programs and services necessary to enable older individuals to remain in their homes as the individuals age;

(ii)

reduce duplication by Federal agencies of programs and services to assist older individuals in meeting their housing, health care, and other service needs;

(iii)

ensure collaboration among and within agencies in providing and making available the programs and services so that older individuals are able to easily access needed programs and services;

(iv)

work with States to better provide housing, health care, and other services to older individuals by—

(I)

holding individual meetings with State representatives;

(II)

providing ongoing technical assistance to States about better meeting the needs of older individuals; and

(III)

working with States to designate State liaisons for the Committee;

(v)

identify model programs and services to assist older individuals in meeting their housing, health care, and other service needs, including model—

(I)

programs linking housing, health care, and other services;

(II)

financing products offered by government, quasi-government, and private sector entities; and

(III)

innovations in technology applications that give older individuals access to information on available services or that help in providing services to older individuals;

(vi)

collect and disseminate information about older individuals and the programs and services available to the individuals to ensure that the individuals can access comprehensive information; and

(vii)

work with the Federal Interagency Forum on Aging-Related Statistics, the Bureau of the Census, and member agencies—

(I)

to collect and maintain data relating to the housing, health care, and other service needs of older individuals so that all such data can be accessed in 1 place on a designated website; and

(II)

to identify and address unmet data needs;

(D)

make recommendations to guide policy and program development across Federal agencies with respect to demographic changes among older individuals; and

(E)

actively seek input from and consult with all appropriate and interested parties, including public health interest and research groups and foundations about the activities described in subparagraphs (A) through (D).

(5)

Each year, the Committee shall prepare and submit to the President, the Committee on Financial Services of the House of Representatives, the Committee on Education and the Workforce of the House of Representatives, the Committee on Banking, Housing, and Urban Affairs of the Senate, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Special Committee on Aging of the Senate, a report that—

(A)

describes the activities and accomplishments of the Committee in working with Federal, State, and local governments, and private organizations, in coordinating programs and services to meet the requirements of paragraph (4);

(B)

assesses the level of Federal assistance required to meet the needs described in paragraph (4);

(C)

incorporates an analysis from the head of each agency that is a member of the interagency coordinating committee established under paragraph (1) that describes the barriers and impediments, including barriers and impediments in statutory and regulatory law, to the access and use by older individuals of programs and services administered by such agency; and

(D)

makes recommendations for appropriate legislative and administrative actions to meet the needs described in paragraph (4) and for coordinating programs and services designed to meet those needs.

(6)
(A)

The Secretary of Health and Human Services, after consultation with the Secretary of Housing and Urban Development, shall appoint an executive director of the Committee.

(B)

On the request of the Committee, any Federal Government employee may be detailed to the Committee without reimbursement, and such detail shall be without interruption or loss of civil service status or privilege.

.

6.

Administration

Section 205(a) of the Older Americans Act of 1965 (42 U.S.C. 3016(a)) is amended—

(1)

in paragraph (1)—

(A)

in subparagraph (C), by adding and at the end;

(B)

in subparagraph (D), by striking ; and at the end and inserting a period; and

(C)

by striking subparagraph (E); and

(2)

in paragraph (2)—

(A)

in subparagraph (A)—

(i)

by amending clause (i) to read as follows:

(i)

designing, implementing, and evaluating evidence-based programs to support improved nutrition and regular physical activity for older individuals;

;

(ii)

by amending clause (iii) to read as follows:

(iii)

conducting outreach and disseminating evidence-based information to nutrition service providers about the benefits of healthful diets and regular physical activity, including information about the most current Dietary Guidelines for Americans published under section 301 of the National Nutrition Monitoring and Related Research Act of 1990 (7 U.S.C. 5341), the Food Guide Pyramid published by the Secretary of Agriculture, and advances in nutrition science;

;

(iii)

in clause (vii) by striking and at the end; and

(iv)

by striking clause (viii) and inserting the following:

(viii)

disseminating guidance that describes strategies for improving the nutritional quality of meals provided under title III; and

(ix)

providing technical assistance to the regional offices of the Administration with respect to each duty described in clauses (i) through (viii).

; and

(B)

by amending subparagraph (C)(i) to read as follows:

(i)

have expertise in nutrition and meal planning; and

.

7.

Evaluation

Section 206(g) of the Older Americans Act of 1965 (42 U.S.C. 3017(g)) is amended by striking the first sentence and inserting the following: From the total amount appropriated for each fiscal year to carry out title III, the Secretary may use such sums as may be necessary, but not more than 1/2 of 1 percent of such amount, for purposes of conducting evaluations under this section, either directly or by grant or contract..

8.

Reports

Section 207(b)(2) of the Older Americans Act of 1965 (42 U.S.C. 3018(b)(2)) is amended—

(1)

in subparagraph (B), by striking Labor and inserting the Workforce; and

(2)

in subparagraph (C), by striking Labor and Human Resources and inserting Health, Education, Labor, and Pensions.

9.

Contractual, commercial, and private pay relationships; appropriate use of Act funds

(a)

Private pay relationships; appropriate use of act funds

Section 212 of the Older Americans Act (42 U.S.C. 3020c) is amended to read as follows:

212.

Contracting and grant authority; private pay relationships; appropriate use of funds

(a)

In general

Subject to subsection (b), this Act shall not be construed to prevent a recipient of a grant or a contract under this Act from entering into an agreement—

(1)

with a profitmaking organization;

(2)

under which funds provided under such grant or contract are used to pay part or all of a cost (including an administrative cost) incurred by such recipient to carry out a contract or commercial relationship for the benefit of older individuals or their family caregivers, whether such contract or relationship is carried out to implement a provision of this Act or to conduct activities inherently associated with implementing such provision; or

(3)

under which any individual, regardless of age or income (including the family caregiver of such individual), who seeks to receive 1 or more services may voluntarily pay, such individual's own private expense, to receive such services based on the fair market value of such services.

(b)

Ensuring appropriate use of funds

An agreement described in subsection (a) may not—

(1)

be made without the prior approval of the State agency (or, in the case of a grantee under title VI, without the prior recommendation of the Director of the Office for American Indian, Alaska Native, and Native Hawaiian Aging and the prior approval of the Assistant Secretary);

(2)

directly or indirectly provide for, or have the effect of, paying, reimbursing, or otherwise compensating an entity under such agreement in an amount that exceeds the fair market value of the goods or services furnished by such entity under such agreement;

(3)

result in the displacement of services otherwise available to an older individual with greatest social need, an older individual with greatest economic need, or an older individual who is at risk for institutional placement; or

(4)

in any other way compromise, undermine, or be inconsistent with the objective of serving the needs of older individuals, as determined by the Assistant Secretary.

.

10.

Nutrition education

Section 214 of the Older Americans Act of 1965 (42 U.S.C. 3020e) is amended to read as follows:

214.

Nutrition education

The Assistant Secretary, in consultation with the Secretary of Agriculture, shall conduct outreach and provide technical assistance to agencies and organizations that serve older individuals to assist such agencies and organizations to carry out integrated health promotion and disease prevention programs that—

(1)

are designed for older individuals; and

(2)

include—

(A)

nutrition education;

(B)

physical activity; and

(C)

other activities to modify behavior and to improve health literacy, including providing information on optimal nutrient intake, through education and counseling in accordance with section 339(2)(J).

.

11.

Pension counseling and information programs

Section 215 of the Older Americans Act of 1965 (42 U.S.C. 3020e–1) is amended—

(1)

in subsection (e)(1)(J), by striking and low income retirees and inserting , low-income retirees, and older individuals with limited English proficiency;

(2)

in subsection (f), by amending paragraph (2) to read as follows:

(2)

The ability of the entity to perform effective outreach to affected populations, particularly populations with limited English proficiency and other populations that are identified as in need of special outreach.

; and

(3)

in subsection (h)(2), by inserting (including individuals with limited English proficiency) after individuals.

12.

Authorization of appropriations

Section 216 of the Older Americans Act of 1965 (42 U.S.C. 3020f) is amended—

(1)

in subsection (a) by striking 2001, 2002, 2003, 2004, and 2005 and inserting 2007, 2008, 2009, 2010, and 2011.; and

(2)

in subsections (b) and (c) by striking year and all that follows through years, and inserting years 2007, 2008, 2009, 2010, and 2011.

13.

Purpose; administration

Section 301(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 3021(a)(2)) is amended—

(1)

in subparagraph (D), by striking and at the end;

(2)

in subparagraph (E), by striking the period at the end and inserting ; and; and

(3)

by adding at the end the following:

(F)

organizations with experience in providing senior volunteer services, such as Federal volunteer programs administered by the Corporation for National and Community Service and designed to provide training, placement, and stipends for volunteers in community service settings.

.

14.

Authorization of appropriations; uses of funds

Section 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) is amended—

(1)

in subsections (a)(1), (b), and (d), by striking year 2001 and all that follows through years each place it appears, and inserting years 2007, 2008, 2009, 2010, and 2011; and

(2)

in subsection (e)—

(A)

in paragraph (1) by striking $125,000,000 and all that follows and inserting $160,000,000 for fiscal year 2007.; and

(B)

in paragraph (2), by striking such sums and all that follows and inserting $170,000,000 for fiscal year 2008, $180,000,000 for fiscal year 2009, $190,000,000 for fiscal year 2010, and $200,000,000 for fiscal year 2011..

15.

Allotments

Section 304(d)(1)(A) of the Older Americans Act of 1965 (42 U.S.C. 3024(d)(1)(A)) is amended to read as follows:

(A)
(i)

such amount as the State agency determines, but not more than 10 percent thereof, shall be available for paying such percentage as the agency determines, but not more than 75 percent, of the cost of administration of area plans; and

(ii)

in addition to that amount, for any fiscal year among fiscal years 2007 through 2011 for which the amount appropriated under subsections (a) through (d) of section 303 is not less than 110 percent of that appropriated amount for fiscal year 2006, an amount equal to 1 percent of the State's allotment shall be used by the area agencies on aging in the State to carry out the assessment described in section 306(b);

.

16.

Organization

Section 305 of the Older Americans Act of 1965 (42 U.S.C. 3025) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)(E)—

(i)

by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(ii)

by striking and at the end;

(B)

in paragraph (2)—

(i)

in subparagraph (E), by striking , with particular attention to low-income minority individuals and older individuals residing in rural areas and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(ii)

in subparagraph (G), by striking the period and inserting ; and; and

(C)

by adding at the end the following:

(3)

the State agency shall, consistent with this section, promote the development and implementation of a State system of long-term care that is a comprehensive, coordinated system that enables older individuals to receive long-term care in home and community-based settings, in a manner responsive to the needs and preferences of the older individuals and their family caregivers, by—

(A)

collaborating, coordinating, and consulting with other agencies in such State responsible for formulating, implementing, and administering programs, benefits, and services related to providing long-term care;

(B)

participating in any State government activities concerning long-term care, including reviewing and commenting on any State rules, regulations, and policies related to long-term care;

(C)

conducting analyses and making recommendations with respect to strategies for modifying the State system of long-term care to better—

(i)

respond to the needs and preferences of older individuals and family caregivers;

(ii)

facilitate the provision, by service providers, of long-term care in home and community-based settings;

(iii)

target services to older individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings; and

(iv)

implement (through area agencies on aging, service providers, and such other entities as the State determines to be appropriate) programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; and

(D)

providing for the availability and distribution (through public education campaigns, Aging and Disability Resource Centers, area agencies on aging, and other appropriate means) of information relating to—

(i)

the need to plan in advance for long-term care; and

(ii)

the range of available public and private long-term care programs, options, and resources.

; and

(2)

in subsection (b), by adding at the end the following:

(6)

Nothing in this section shall prevent the Commonwealth of Puerto Rico from designating, with the approval of the Assistant Secretary, a single planning and service area to cover all the older individuals in the Commonwealth.

.

17.

Area plans

Section 306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)—

(i)

by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas);

(ii)

by striking (with particular attention to low-income minority individuals) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(iii)

by inserting the number of older individuals at risk for institutional placement residing in such area, after individuals) residing in such area,;

(B)

in paragraph (2)(A)—

(i)

by inserting after transportation, the following: health services (including mental health services),; and

(ii)

by inserting after information and assistance the following: (which may include information and assistance to consumers on availability of services under part B and how to receive benefits under and participate in publicly supported programs for which the consumer may be eligible);

(C)

in paragraph (4)—

(i)

in subparagraph (A)—

(I)

by amending clause (i) to read as follows:

(i)

provide assurances that the area agency on aging will—

(I)

set specific objectives, consistent with State policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement;

(II)

include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas; and

(III)

include in the area plan proposed methods to achieve such objectives;

; and

(II)

in clause (ii) by inserting (including older individuals with limited English proficiency) after low-income minority individuals each place it appears; and

(ii)

in subparagraph (B)—

(I)

by moving the left margin of each of subparagraph (B), clauses (i) and (ii), and subclauses (I) through (VI) of clause (i), 2 ems to the left; and

(II)

in clause (i)—

(aa)

in subclause (V) by striking with limited English-speaking ability; and and inserting with limited English proficiency;; and

(bb)

by adding at the end the following:

(VII)

older individuals at risk for institutional placement; and

;

(D)

in paragraph (5), by inserting and individuals at risk for institutional placement after severe disabilities;

(E)

in paragraph (6)—

(i)

in subparagraph (C)—

(I)

in clause (i), by striking and at the end;

(II)

in clause (ii), by adding and at the end; and

(III)

by inserting after clause (ii) the following:

(iii)

make use of trained volunteers in providing direct services delivered to older individuals and individuals with disabilities needing such services and, if possible, work in coordination with entities carrying out volunteer programs (including programs administered by the Corporation for National and Community Services) designed to provide training, placement, and stipends for volunteers in community service settings;

;

(ii)

in subparagraph (D)—

(I)

by inserting family caregivers of such individuals, after Act,; and

(II)

by inserting service providers, representatives of the business community, after individuals,; and

(iii)

in subparagraph (F), by inserting (including mental health screening) before provided each place it appears;

(F)

in paragraph (7), to read as follows:

(7)

provide that the area agency on aging shall, consistent with this section, facilitate the area-wide development and implementation of a comprehensive, coordinated system that enables older individuals to receive long-term care in home and community-based settings, in a manner responsive to the needs and preferences of the older individuals and their family caregivers, by—

(A)

collaborating, coordinating, and consulting with other local public and private agencies and organizations responsible for administering programs, benefits, and services related to providing long-term care;

(B)

conducting analyses and making recommendations with respect to strategies for modifying the local system of long-term care to better—

(i)

respond to the needs and preferences of older individuals and family caregivers;

(ii)

facilitate the provision, by service providers, of long-term care in home and community-based settings;

(iii)

target services to older individuals at risk for institutional placement, to permit such individuals to remain in home and community-based settings; and

(iv)

implement (through the agency or service providers), evidence-based programs to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals; and

(C)

providing for the availability and distribution (through public education campaigns, Aging and Disability Resource Centers, and other appropriate means) of information relating to—

(i)

the need to plan in advance for long-term care; and

(ii)

the range of available public and private long-term care programs, options, and resources.

;

(G)

by striking the 2 paragraphs (15);

(H)

by redesignating paragraph (16) as paragraph (15); and

(I)

by adding at the end the following:

(16)

provide assurances that funds received under this title will be used—

(A)

to provide benefits and services to older individuals giving priority to older individuals identified in paragraph (4)(A)(i); and

(B)

in compliance with the assurances specified in paragraph (13) and the limitations specified in section 212(b);

(17)

provide, to the extent feasible, for the furnishing of services under this Act, consistent with self-directed care; and

(18)

include information detailing how the area agency on aging will coordinate activities, and develop long-range emergency plans, with local and State emergency response agencies, relief organizations, local and State governments, and any other institutions that have responsibility for disaster relief service delivery.

;

(2)

by redesignating subsections (b), (c), (d), and (e) as subsections (c), (d), (e), and (f); and

(3)

by inserting after subsection (a) the following:

(b)
(1)

In any fiscal year, an area agency on aging may include in the area plan an assessment of how prepared the area agency on aging and service providers in the planning and service area are for a change in the number of older individuals during the 10-year period following the fiscal year for which the plan is submitted. In a fiscal year described in section 304(d)(1)(A)(ii), an area agency on aging shall include the assessment in the area plan.

(2)

Such assessment may include—

(A)

the projected change in the number of older individuals in the planning and service area;

(B)

an analysis of how such change may affect such individuals, including individuals with low incomes, individuals with greatest economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency;

(C)

an analysis of how the programs, policies, and services provided by such area agency can be improved, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the planning and service area; and

(D)

an analysis of how the change in the number of individuals age 85 and older in the planning and service area is expected to affect the need for supportive services.

(3)

An area agency on aging, in cooperation with government officials, State agencies, tribal organizations, or local entities, may make recommendations to government officials in the planning and service area and the State, on actions determined by the area agency to build the capacity in the planning and service area to meet the needs of older individuals for—

(A)

health and human services;

(B)

land use;

(C)

housing;

(D)

transportation;

(E)

public safety;

(F)

workforce and economic development;

(G)

recreation;

(H)

education;

(I)

civic engagement;

(J)

emergency preparedness; and

(K)

any other service as determined by such agency.

.

18.

State plans

Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 3027(a)) is amended—

(1)

in paragraph (2)(C), by striking section 306(b) and inserting section 306(c);

(2)

in paragraph (4), by striking , with particular attention to low-income minority individuals and older individuals residing in rural areas and inserting (with particular attention to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas);

(3)

by striking paragraph (15);

(4)

by redesignating paragraph (14) as paragraph (15);

(5)

by inserting after paragraph (13) the following:

(14)

The plan shall, with respect to the fiscal year preceding the fiscal year for which such plan is prepared—

(A)

identify the number of low-income minority older individuals in the State, including the number of low-income minority older individuals with limited English proficiency; and

(B)

describe the methods used to satisfy the service needs of the low-income minority older individuals described in subparagraph (A), including the plan to meet the needs of low-income minority older individuals with limited English proficiency.

;

(6)

in clauses (ii) and (iii) of paragraph (16)(A) by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) each place it appears and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(7)

by adding at the end the following:

(27)

The plan shall provide assurances that area agencies on aging will provide, to the extent feasible, for the furnishing of services under this Act, consistent with self-directed care.

(28)
(A)

The plan shall include, at the election of the State, an assessment of how prepared the State is, under the State's statewide service delivery model, for a change in the number of older individuals during the 10-year period following the fiscal year for which the plan is submitted.

(B)

Such assessment may include—

(i)

the projected change in the number of older individuals in the State;

(ii)

an analysis of how such change may affect such individuals, including individuals with low incomes, individuals with great economic need, minority older individuals, older individuals residing in rural areas, and older individuals with limited English proficiency;

(iii)

an analysis of how the programs, policies, and services provided by the State can be improved, including coordinating with area agencies on aging, and how resource levels can be adjusted to meet the needs of the changing population of older individuals in the State; and

(iv)

an analysis of how the change in the number of individuals age 85 and older in the State is expected to affect the need for supportive services.

(29)

The plan shall include information detailing how the State will coordinate activities, and develop long-range emergency preparedness plans, with area agencies on aging, local emergency response agencies, relief organizations, local governments, State agencies responsible for emergency preparedness, and any other institutions that have responsibility for disaster relief service delivery.

(30)

The plan shall include information describing the involvement of the head of the State agency in the development, revision, and implementation of emergency preparedness plans, including the State Public Health Emergency Preparedness and Response Plan.

.

19.

Payments

Section 309(b)(2) of the Older Americans Act of 1965 (42 U.S.C. 3029(b)(2)) is amended by striking the non-Federal share required prior to fiscal year 1981 and inserting 10 percent of the cost of the services specified in section 304(d)(1)(D).

20.

Nutrition services incentive program

Section 311 of the Older Americans Act of 1965 (42 U.S.C. 3030a) is amended—

(1)

in subsection (b), by adding at the end the following:

(3)

Each State agency and grantee under title VI shall promptly and equitably disburse amounts received under this subsection to recipients of grants and contracts.

;

(2)

in subsection (c)—

(A)

in paragraph (1), by inserting , including bonus commodities, after agricultural commodities;

(B)

in paragraph (2), by inserting , including bonus commodities, after food commodities; and

(C)

in paragraph (3), by inserting , including bonus commodities, after Dairy products;

(3)

in subsection (d)(4), by inserting and grantee under title VI after State agency; and

(4)

in subsection (e), by striking 2001 and inserting 2007.

21.

Consumer contributions

Section 315 of the Older Americans Act of 1965 (42 U.S.C. 3030c–2) is amended—

(1)

in subsection (b)—

(A)

in paragraph (1)—

(i)

by striking provided that and inserting if; and

(ii)

by adding at the end the following: Such contributions shall be encouraged for individuals whose self-declared income is at or above 200 percent of the poverty line, at contribution levels based on the actual cost of services.; and

(B)

in paragraph (4)(E), by inserting and to supplement (not supplant) funds received under this Act after given;

(2)

in subsection (c)(2), by striking (with particular attention to low-income minority individuals and older individuals residing in rural areas) and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas); and

(3)

in subsection (d), by striking with particular attention to low-income and minority older individuals and older individuals residing in rural areas and inserting (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas).

22.

Supportive services and senior centers

Section 321(a) of the Older Americans Act of 1965 (42 U.S.C. 3030d(a)) is amended—

(1)

in paragraph (8), by inserting (including mental health screening) after screening;

(2)

in paragraph (11) by striking services and inserting provision of devices and services (including provision of assistive technology devices and assistive technology services);

(3)

in paragraph (14)(B) by inserting (including mental health) after health;

(4)

in paragraph (22) by striking the period at the end and inserting a semicolon;

(5)

by redesignating paragraph (23) as paragraph (24); and

(6)

by inserting after paragraph (22) the following:

(23)

services designed to support States, area agencies on aging, and local service providers in carrying out and coordinating activities for older individuals with respect to mental health services, including outreach for, education concerning, and screening for such services, and referral to such services for treatment; and

.

23.

Nutrition services

After the part heading of part C of title III of the Older Americans Act of 1965 (42 U.S.C. 3030e et seq.), insert the following:

330.

Purpose

It is the purpose of this part to promote socialization and the health and well-being of older individuals by assisting such individuals to gain access to nutrition services to delay the onset of adverse health conditions.

.

24.

Congregate nutrition program

Section 331 of the Older Americans Act of 1965 (42 U.S.C. 3030e) is amended—

(1)

by striking projects— and inserting projects that—;

(2)

in paragraph (1) by striking which the first place it appears;

(3)

in paragraph (2), by striking which; and

(4)

by striking paragraph (3) and inserting the following:

(3)

provide nutrition education, nutrition counseling, and other nutrition services, as appropriate, based on the needs of meal participants.

.

25.

Home delivered nutrition services

Section 336 of the Older Americans Act of 1965 (42 U.S.C. 3030f) is amended to read as follows:

336.

Program authorized

The Assistant Secretary shall establish and carry out a program to make grants to States under State plans approved under section 307 for the establishment and operation of nutrition projects for older individuals that provide—

(1)

on 5 or more days a week (except in a rural area where such frequency is not feasible (as defined by the Assistant Secretary by rule) and a lesser frequency is approved by the State agency) at least 1 home delivered meal per day, which may consist of hot, cold, frozen, dried, canned, fresh, or supplemental foods and any additional meals that the recipient of a grant or contract under this subpart elects to provide; and

(2)

nutrition education, nutrition counseling, and other nutrition services as appropriate, based on the needs of meal recipients.

.

26.

Criteria

Section 337 of the Older Americans Act of 1965 (42 U.S.C. 3030g) is amended to read as follows:

337.

Criteria

The Assistant Secretary, in consultation with recognized experts in the fields of nutrition science, dietetics, meal planning and food service management, and aging, shall develop minimum criteria of efficiency and quality for the furnishing of home delivered meal services for projects described in section 336.

.

27.

Nutrition

Section 339 of the Older Americans Act of 1965 (42 U.S.C. 3030g–21) is amended—

(1)

in paragraph (1), to read as follows:

(1)

solicit the advice and expertise of a dietitian or other individual with education and training in nutrition science or, if such an individual is not available, an individual with comparable expertise in the planning of nutritional services, and

; and

(2)

in paragraph (2)—

(A)

in subparagraph (A)(i), to read as follows:

(i)

comply with the most recent Dietary Guidelines for Americans, published by the Secretary and the Secretary of Agriculture, and

;

(B)

in subparagraph (D), by inserting joint after encourages;

(C)

in subparagraph (G), to read as follows:

(G)

ensures that meal providers solicit the advice and expertise of—

(i)

a dietitian or other individual described in paragraph (1),

(ii)

meal participants, and

(iii)

other individuals knowledgeable with regard to the needs of older individuals,

;

(D)

in subparagraph (I), by striking and at the end; and

(E)

in subparagraph (J), to read as follows:

(J)

provides for nutrition screening and nutrition education, and nutrition assessment and counseling if appropriate; and

(K)

encourages individuals who distribute nutrition services under subpart 2 to provide, to homebound older individuals, available medical information approved by health care professionals, such as informational brochures and information on how to get vaccines, including vaccines for influenza, pneumonia, and shingles, in the individuals’ communities.

.

28.

Study of nutrition projects

(a)

Study

(1)

In general

The Assistant Secretary for Aging shall use funds allocated in section 206(g) of the Older Americans Act of 1965 (42 U.S.C. 3017(g)) to enter into a contract with the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences, for the purpose of establishing an independent panel of experts that will conduct an evidence-based study of the nutrition projects authorized under such Act.

(2)

Study

Such study shall, to the extent data are available, include—

(A)

an evaluation of the effect of the nutrition projects authorized by such Act on—

(i)

improvement of the health status, including nutritional status, of participants in the projects;

(ii)

prevention of hunger and food insecurity of the participants; and

(iii)

continuation of the ability of the participants to live independently;

(B)

a cost-benefit analysis of nutrition projects authorized by such Act, including the potential to affect costs of the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and

(C)

an analysis of how nutrition projects authorized by such Act may be modified to improve the outcomes described in subparagraph (A), including by improving the nutritional quality of the meals provided through the projects and undertaking other potential strategies to improve the nutritional status of the participants.

(b)

Reports

(1)

Report to the assistant secretary

The panel described in subsection (a) shall submit to the Assistant Secretary a report containing the results of the evidence-based study described in subsection (a), including any recommendations resulting from the analysis described in subsection (a)(2)(C).

(2)

Report to congress

The Assistant Secretary shall submit a report containing the results described in paragraph (1) to the Committee on Education and the Workforce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate.

(c)

Timing

The Food and Nutrition Board shall establish the independent panel of experts described in subsection (a) not later than 90 days after the date of the enactment of this Act. The panel shall submit the report described in subsection (b)(1) to the Assistant Secretary not later than 24 months after the date of the enactment of this Act.

29.

Improving indoor air quality in buildings where older individuals congregate

Section 361 of the Older Americans Act of 1965 (42 U.S.C. 3030m) is amended by adding at the end the following:

(c)

The Assistant Secretary shall work in consultation with qualified experts to provide information on methods of improving indoor air quality in buildings where older individuals congregate.

.

30.

Caregiver support program definitions

Section 372 of the Older Americans Act of 1965 (42 U.S.C. 3030s) is amended—

(1)

in paragraph (1), by inserting or an adult child with mental retardation or a related developmental disability after age;

(2)

in paragraph (2), by inserting before the period the following: or an individual with Alzheimer's disease or a related disorder with neurological and organic brain dysfunction who is 50 years of age or older;

(3)

in paragraph (3)—

(A)

by striking child the first place it appears and inserting child (including an adult child with mental retardation or a related developmental disability);

(B)

by striking a child by blood or marriage and inserting such a child by blood, marriage, or adoption; and

(C)

by striking 60 and inserting 55;

(4)

by redesignating paragraphs (2) and (3) as paragraphs (3) and (4), respectively; and

(5)

by inserting after paragraph (1) the following:

(2)

Developmental disability

The term developmental disability has the meaning given the term in section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15002).

.

31.

Caregiver support program

Section 373 of the National Family Support Caregiver Act (42 U.S.C. 3030s–1) is amended—

(1)

in subsection (b)(3), by striking caregivers to assist and all that follows through the end and inserting the following: assist the caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles;;

(2)

in subsection (c)(2)—

(A)

by striking (as defined and all that follows and inserting a period; and

(B)

by adding at the end the following: In providing services for family caregivers under this subpart, the State shall give priority for services to family caregivers who provide care for older individuals.;

(3)

in subsection (d), to read as follows:

(d)

Use of volunteers

In carrying out this subpart, each area agency on aging shall make use of trained volunteers to expand the provision of the available services described in subsection (b) and shall, if possible, work in coordination with entities carrying out volunteer programs (including programs administered by the Corporation for National and Community Service) designed to provide training, placement, and stipends for volunteers in community service settings.

;

(4)

in subsection (e)(3), by adding at the end the following: The reports shall describe any mechanisms used in the State to provide to persons who are family caregivers, or grandparents or older individuals who are relative caregivers, information about and access to various services so that the persons can better carry out their care responsibilities.; and

(5)

in subsection (f)(1), by striking 2001 through 2005 and inserting 2007, 2008, 2009, 2010, and 2011.

32.

Activities and programs of national significance

Section 376(a) of the National Family Support Caregiver Act (42 U.S.C. 3030s–12(a)) is amended—

(1)

by striking the title heading and inserting the following:

376.

Activities and programs of national significance

;

(2)

by striking (a) In general.—;

(3)

by striking shall and inserting may;

(4)

by striking program and inserting activities that include;

(5)

by striking research. and inserting “research, and programs that include—

(1)

multigenerational programs, including programs that provide supports for grandparents and other older individuals who are relative caregivers (as defined in section 372) raising children (such as kinship navigator programs), and programs that sustain and replicate innovative multigenerational family support programs involving volunteers who are older individuals;

(2)

programs providing support and information to families who have a child with a disability or chronic illness, and to other families in need of family support programs;

(3)

programs addressing unique issues faced by rural caregivers;

(4)

programs focusing on the needs of older individuals with Alzheimer’s disease and related dementia and their caregivers; and

(5)

programs supporting caregivers in the roles the caregivers carry out in health promotion and disease prevention.

; and

(6)

by striking subsection (b).

33.

Grant programs

Section 411 of the Older Americans Act of 1965 (42 U.S.C. 3032) is amended—

(1)

in subsection (a)—

(A)

in paragraph (8), by striking and at the end;

(B)

by redesignating paragraph (9) as paragraph (11); and

(C)

by inserting after paragraph (8) the following:

(9)

planning activities to prepare communities for the aging of the population, which activities may include—

(A)

efforts to assess the aging population;

(B)

activities to coordinate the activities of State and local agencies in order to meet the needs of older individuals; and

(C)

training and technical assistance to support States, area agencies on aging, and tribal organizations receiving grants under part A of title VI, in engaging in community planning activities;

(10)

the development, implementation, and assessment of technology-based service models and best practices, to support the use of health monitoring and assessment technologies, communication devices, assistive technologies, and other technologies that may remotely connect family and professional caregivers to frail older individuals residing in home and community-based settings or rural areas; and

.

34.

Career preparation for the field of aging

Section 412(a) of the Older Americans Act of 1965 (42 U.S.C. 3032a(a)) is amended to read as follows:

(a)

Grants

The Assistant Secretary shall make grants to institutions of higher education, including historically Black colleges or universities, Hispanic-serving institutions, Hispanic Centers of Excellence in Applied Gerontology, and other educational institutions that serve the needs of minority students, to provide education and training that prepare students for careers in the field of aging.

.

35.

Health care service demonstration projects in rural areas

Section 414 of the Older Americans Act of 1965 (42 U.S.C. 3032c) is amended—

(1)

in subsection (a), by inserting mental health care, after adult day health care,; and

(2)

in subsection (b)(1)(B)(i), by inserting mental health, after public health,.

36.

Technical assistance and innovation to improve transportation for older individuals

Section 416 of the Older Americans Act of 1965 (42 U.S.C. 3032e) is amended to read as follows:

416.

Technical assistance and innovation to improve transportation for older individuals

(a)

In general

The Secretary may award grants or contracts to nonprofit organizations to improve transportation services for older individuals.

(b)

Use of funds

(1)

In general

A nonprofit organization receiving a grant or contract under subsection (a) shall use the funds received through such grant or contract to carry out a demonstration project, or to provide technical assistance to assist local transit providers, area agencies on aging, senior centers, and local senior support groups, to encourage and facilitate coordination of Federal, State, and local transportation services and resources for older individuals. The organization may use the funds to develop and carry out an innovative transportation demonstration project to create transportation services for older individuals.

(2)

Specific activities

In carrying out a demonstration project or providing technical assistance under paragraph (1) the organization may carry out activities that include—

(A)

developing innovative approaches for improving access by older individuals to transportation services, including volunteer driver programs, economically sustainable transportation programs, and programs that allow older individuals to transfer their automobiles to a provider of transportation services in exchange for the services;

(B)

preparing information on transportation options and resources for older individuals and organizations serving such individuals, and disseminating the information by establishing and operating a toll-free telephone number;

(C)

developing models and best practices for providing comprehensive integrated transportation services for older individuals, including services administered by the Secretary of Transportation, by providing ongoing technical assistance to agencies providing services under title III and by assisting in coordination of public and community transportation services; and

(D)

providing special services to link seniors to transportation services not provided under title III.

(c)

Economically sustainable transportation

In this section, the term economically sustainable transportation means demand responsive transportation for older individuals—

(1)

that may be provided through volunteers; and

(2)

that the provider will provide without receiving Federal or other public financial assistance, after a period of not more than 5 years of providing the services under this section.

.

37.

Community planning

Title IV of the Older Americans Act of 1965 is amended by inserting after section 416 (42 U.S.C. 3032e) the following:

416A.

Community planning for the aging population

The Secretary may establish, either directly or through grants or contracts, a national technical assistance program to assist States and area agencies on aging funded under this Act in planning efforts to prepare communities for the aging of the population.

.

38.

Demonstration, support, and research projects for multigenerational activities and civic engagement activities

Section 417 of the Older Americans Act of 1965 (42 U.S.C. 3032f) is amended to read as follows:

417.

Demonstration, support, and research projects for multigenerational activities and civic engagement activities

(a)

Grants and contracts

The Assistant Secretary shall award grants and enter into contracts with eligible organizations to—

(1)

conduct productivity and cost-benefit research to determine the effectiveness of engaging older individuals in paid and unpaid positions with public and nonprofit organizations;

(2)

develop a national agenda and blueprint for creating paid and unpaid positions for older individuals with public and nonprofit organizations to increase the capacity of the organizations to provide needed services to communities;

(3)

carry out demonstration and support projects to provide older individuals with multigenerational activities, and civic engagement activities, designed to meet critical community needs; and

(4)

carry out demonstration projects to coordinate multigenerational activities and civic engagement activities, and facilitate development of and participation in multigenerational activities.

(b)

Use of funds

An eligible organization shall use funds made available under a grant awarded, or a contract entered into, under subsection (a)—

(1)
(A)

to conduct the research described in subsection (a)(1);

(B)

to develop the national agenda and blueprint described in subsection (a)(2);

(C)

to carry out a demonstration or support project described in subsection (a)(3); or

(D)

to carry out a demonstration project described in subsection (a)(4); and

(2)

to evaluate the project involved in accordance with subsection (f).

(c)

Preference

In awarding grants and entering into contracts under subsection (a) to carry out a demonstration or support project described in subsection (a)(3), the Assistant Secretary shall give preference to—

(1)

eligible organizations with a demonstrated record of carrying out multigenerational activities or civic engagement activities;

(2)

eligible organizations proposing multigenerational activity service projects that will serve older individuals and communities with the greatest need (with particular attention to low-income minority older individuals, older individuals with limited English proficiency, older individuals residing in rural areas, and low-income minority communities);

(3)

eligible organizations proposing civic engagement activity service projects that will serve communities with the greatest need; and

(4)

eligible organizations with the capacity to develop meaningful roles and assignments that use the time, skills, and experience of older individuals to serve public and nonprofit organizations.

(d)

Application

To be eligible to receive a grant or a contract under subsection (a), an organization shall submit an application to the Assistant Secretary at such time, in such manner, and accompanied by such information as the Assistant Secretary may reasonably require.

(e)

Eligible organizations

Organizations eligible to receive a grant or enter into a contract under subsection (a)—

(1)

to carry out activities described in subsection (a)(1), shall be research or academic organizations with the capacity to conduct productivity and cost-benefit research described in subsection (a)(1);

(2)

to carry out activities described in subsection (a)(2), shall be organizations with the capacity to develop the national agenda and blueprint described in subsection (a)(2);

(3)

to carry out activities described in subsection (a)(3), shall be organizations that provide paid or unpaid positions for older individuals to serve in multigenerational activities, or civic engagement activities, designed to meet critical community needs and use the full range of time, skills, and experience of older individuals; and

(4)

to carry out activities described in subsection (a)(4), shall be organizations with the capacity to facilitate and coordinate activities as described in subsection (a)(4), through the use of multigenerational coordinators.

(f)

Local evaluation and report

(1)

Evaluation

Each organization receiving a grant or a contract under subsection (a) to carry out a demonstration or support project under subsection (a)(3) shall evaluate the multigenerational activities or civic engagement activities assisted under the project to determine the effectiveness of the activities involved, the impact of such activities on the community being served and the organization providing the activities, and the impact of such activities on older individuals involved in such project.

(2)

Report

The organization shall submit a report to the Assistant Secretary containing the evaluation not later than 6 months after the expiration of the period for which the grant or contract is in effect.

(g)

Report to congress

Not later than 6 months after the Assistant Secretary receives the reports described in subsection (f)(2), the Assistant Secretary shall prepare and submit to the Speaker of the House of Representatives and the President pro tempore of the Senate a report that assesses the evaluations and includes, at a minimum—

(1)

the names or descriptive titles of the demonstration, support, and research projects funded under subsection (a);

(2)

a description of the nature and operation of the projects;

(3)

the names and addresses of organizations that conducted the projects;

(4)

in the case of demonstration and support projects carried out under subsection (a)(3), a description of the methods and success of the projects in recruiting older individuals as employees and volunteers to participate in the projects;

(5)

in the case of demonstration and support projects carried out under subsection (a)(3), a description of the success of the projects in retaining older individuals involved in the projects as employees and as volunteers;

(6)

in the case of demonstration and support projects carried out under subsection (a)(3), the rate of turnover of older individual employees and volunteers in the projects;

(7)

a strategy for disseminating the findings resulting from the projects described in paragraph (1); and

(8)

any policy change recommendations relating to the projects.

(h)

Definitions

As used in this section:

(1)

Civic engagement activity

The term civic engagement activity includes an opportunity that uses the time, skills, and experience of older individuals, in paid or unpaid positions with a public or nonprofit organization, to help address the unmet human, educational, health care, environmental, and public safety needs, and nurture and sustain active participation in community affairs.

(2)

Multigenerational activity

The term multigenerational activity includes an opportunity that uses the time, skills, and experience of older individuals, in paid or unpaid positions with a public or nonprofit organization, to serve as a mentor or adviser in a child care program, a youth day care program, an educational assistance program, an at-risk youth intervention program, a juvenile delinquency treatment program, a before- or after-school program, or a family support program.

(3)

Multigenerational coordinator

The term multigenerational coordinator means a person who—

(A)

builds the capacity of public and nonprofit organizations to develop meaningful roles and assignments, that use the time, skill, and experience of older individuals to serve those organizations; and

(B)

nurtures productive, sustainable working relationships between—

(i)

individuals from the generations with older individuals; and

(ii)

individuals in younger generations.

.

39.

Native American Programs

Section 418(a)(2)(B)(i) of the Older Americans Act of 1965 (42 U.S.C. 3032g)(a)(2)(B)(i)) is amended by inserting (including mental health) after health.

40.

Multidisciplinary centers and multidisciplinary systems

Section 419 of the Older Americans Act of 1965 (42 U.S.C. 3032h) is amended—

(1)

by striking the title and inserting the following:

419.

Multidisciplinary centers and multidisciplinary systems

;

(2)
(A)

in subsection (b)(2), by redesignating subparagraphs (A) through (G) as clauses (i) through (vii), respectively;

(B)

in subsection (c)(2), by redesignating subparagraphs (A) through (D) as clauses (i) through (iv), respectively; and

(C)

by aligning the margins of the clauses described in subparagraphs (A) and (B) with the margins of clause (iv) of section 418(a)(2)(A) of such Act;

(3)
(A)

in subsection (b), by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively;

(B)

in subsection (c), by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively; and

(C)

by aligning the margins of the subparagraphs described in subparagraphs (A) and (B) with the margins of subparagraph (D) of section 420(a)(1) of such Act;

(4)

in subsection (a), by striking (a) and all that follows through The and inserting the following:

(a)

Multidisciplinary centers

(1)

Program authorized

The

;

(5)

in subsection (b)—

(A)

by striking the following:

(b)

Use of Funds

and inserting the following:

(2)

Use of funds

; and

(B)

by striking subsection (a) each place it appears and inserting paragraph (1);

(6)

in subsection (c)—

(A)

by striking the following:

(c)

Data

and inserting the following:

(3)

Data

;

(B)

by striking subsection (a) and inserting paragraph (1);

(C)

by striking such subsection and inserting such paragraph;

(D)

by striking paragraph (1) and inserting subparagraph (A); and

(E)

by striking this section and inserting this subsection; and

(7)

by adding at the end the following:

(b)

Multidisciplinary health services in communities

(1)

Program authorized

The Assistant Secretary shall make grants to States, on a competitive basis, for the development and operation of—

(A)

systems for the delivery of mental health screening and treatment services for older individuals who lack access to such services; and

(B)

programs to—

(i)

increase public awareness regarding the benefits of prevention and treatment of mental disorders in older individuals;

(ii)

reduce the stigma associated with mental disorders in older individuals and other barriers to the diagnosis and treatment of the disorders; and

(iii)

reduce age-related prejudice and discrimination regarding mental disorders in older individuals.

(2)

Application

To be eligible to receive a grant under this subsection for a State, a State agency shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

(3)

State allocation and priorities

A State agency that receives funds through a grant made under this subsection shall allocate the funds to area agencies on aging to carry out this subsection in planning and service areas in the State. In allocating the funds, the State agency shall give priority to planning and service areas in the State—

(A)

that are medically underserved; and

(B)

in which there are large numbers of older individuals.

(4)

Area coordination of services with other providers

In carrying out this part, to more efficiently and effectively deliver services to older individuals, each area agency on aging shall—

(A)

coordinate services described in paragraph (1) with other community agencies, and voluntary organizations, providing similar or related services; and

(B)

to the greatest extent practicable, integrate outreach and educational activities with existing (as of the date of the integration) health care and social service providers serving older individuals in the planning and service area involved.

(5)

Relationship to other funding sources

Funds made available under this part shall supplement, and not supplant, any Federal, State, and local funds expended by a State or unit of general purpose local government (including an area agency on aging) to provide the services described in paragraph (1).

(6)

Definition

In this subsection, the term mental health screening and treatment services means patient screening, diagnostic services, care planning and oversight, therapeutic interventions, and referrals, that are—

(A)

provided pursuant to evidence-based intervention and treatment protocols (to the extent such protocols are available) for mental disorders prevalent in older individuals; and

(B)

coordinated and integrated with the services of social service, mental health, and health care providers in an area in order to—

(i)

improve patient outcomes; and

(ii)

ensure, to the maximum extent feasible, the continuing independence of older individuals who are residing in the area.

.

41.

Community innovations for aging in place

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3031 et seq.) is amended by adding at the end the following:

422.

Community innovations for aging in place

(a)

Definitions

In this section:

(1)

Eligible entity

The term eligible entity

(A)

means a nonprofit health or social service organization, a community-based nonprofit organization, an area agency on aging or other local government agency, a tribal organization, or another entity that—

(i)

the Assistant Secretary determines to be appropriate to carry out a project under this part; and

(ii)

demonstrates a record of, and experience in, providing or administering group and individual health and social services for older individuals; and

(B)

does not include an entity providing housing under the congregate housing services program carried out under section 802 of the Cranston-Gonzalez National Affordable Housing Act (42 U.S.C. 8011) or the multifamily service coordinator program carried out under section 202(g) of the Housing Act of 1959 (12 U.S.C. 1701q(g)).

(2)

Naturally Occurring Retirement Community

The term Naturally Occurring Retirement Community means a residential building, a housing complex, an area (including a rural area) of single family residences, or a neighborhood composed of age-integrated housing—

(A)

where—

(i)

40 percent of the heads of households are older individuals; or

(ii)

a critical mass of older individuals exists, based on local factors which, taken in total, allow an organization to achieve efficiencies in the provision of health and social services to older individuals living in the community; and

(B)

that is not an institutional care or assisted living setting.

(b)

Grants

(1)

In general

The Assistant Secretary shall make grants to eligible entities to enable the entities to pay for developing or carrying out model aging in place projects. The projects shall permit aging in place for older individuals, including such individuals who reside in Naturally Occurring Retirement Communities, which help to sustain the independence of older individuals in communities where the individuals have established personal, family, and professional supportive networks. The entities shall provide comprehensive and coordinated health and social services through the projects.

(2)

Grant periods

The Assistant Secretary shall make the grants for periods of 3 years.

(c)

Applications

(1)

In general

To be eligible to receive a grant under subsection (b) for a project, an entity shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

(2)

Contents

The application shall include—

(A)

a detailed description of the entity's experience in providing services to older individuals in age-integrated settings;

(B)

a definition of the contiguous service area and a description of the project boundaries in which the older individuals reside or carry out activities to sustain their well-being;

(C)

a description of how the entity will cooperate and coordinate planning and services, with agencies and organizations that provide publicly supported services for older individuals within the project boundaries, including the State agency and area agencies on aging with planning and service areas within the project boundaries;

(D)

an assurance that the entity will seek to establish cooperative relationships with interested local entities, including private agencies and businesses that provide health and social services, housing entities, community development organizations, philanthropic organizations, foundations, and other non-Federal entities;

(E)

a description of the entity’s protocol for referral of residents who may require long-term care services, including coordination with local information and referral agencies and Aging and Disability Resource Centers who serve as single points of entry to public services;

(F)

a description of how the entity will offer opportunities for older individuals to be involved in the governance, oversight, and operation of the project;

(G)

an assurance that the entity will submit to the Assistant Secretary such evaluations and reports as the Assistant Secretary may require; and

(H)

a plan for long-term sustainability of the project.

(d)

Use of funds

(1)

In general

An eligible entity that receives a grant under subsection (b) shall use the funds made available through the grant to provide and coordinate, through aging in place projects described in subsection (b), services that include a comprehensive and coordinated array of community-based health and social services, which may include mental health services, for eligible older individuals.

(2)

Services

The services described in paragraph (1) shall include—

(A)

providing—

(i)

case management, case assistance, and social work services;

(ii)

health care management and health care assistance, including disease prevention and health promotion services;

(iii)

education, socialization, and recreational activities; and

(iv)

volunteer opportunities for project participants; and

(B)

coordinating the services provided under title III for eligible older individuals served by the project.

(3)

Preference

In carrying out an aging in place project, an eligible entity shall, to the extent practicable, serve communities of low-income individuals and operate or locate projects and services in or in close proximity to locations where large concentrations of older individuals have aged in place and resided, such as Naturally Occurring Retirement Communities.

(4)

Supplement not supplant

Funds made available to an eligible entity under this section shall be used to supplement, not supplant, any Federal, State, or other funds otherwise available to the entity to provide health and social services to eligible older individuals.

(e)

Competitive grants for technical assistance

(1)

Grants

The Assistant Secretary shall (or shall make a grant, on a competitive basis, to an eligible nonprofit organization, to enable the organization to)—

(A)

provide technical assistance to recipients of grants under subsection (b); and

(B)

carry out other duties, as determined by the Assistant Secretary.

(2)

Eligible organization

To be eligible to receive a grant under this subsection, an organization shall be a nonprofit organization (including a partnership of nonprofit organizations), that—

(A)

has experience and expertise in providing technical assistance to a range of entities serving older individuals and experience evaluating and reporting on programs; and

(B)

has demonstrated knowledge of and expertise in community-based health and social services.

(3)

Application

To be eligible to receive a grant under this subsection, an organization (including a partnership of nonprofit organizations) shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require, including an assurance that the organization will submit to the Assistant Secretary such evaluations and reports as the Assistant Secretary may require.

(f)

Report

The Assistant Secretary shall annually prepare and submit a report to Congress that shall include—

(1)

the findings resulting from the evaluations of the model projects conducted under this section;

(2)

a description of recommended best practices regarding carrying out health and social service projects for older individuals aging in place; and

(3)

recommendations for legislative or administrative action, as the Assistant Secretary determines appropriate.

.

42.

Choices for independence demonstration projects

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3031 et seq.), as amended by section 41, is further amended by adding at the end the following:

423.

Choices for independence demonstration projects

(a)

Definitions

In this section:

(1)

Consumer

The term consumer means an older individual, a family member of such individual, and any other person seeking information or assistance with respect to long-term care.

(2)

High-risk individual

The term high-risk individual means an older individual who—

(A)

has a functional impairment affecting the individual’s activities of daily living;

(B)

is ineligible for the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.); and

(C)

meets such income and functional status criteria as are determined to be appropriate by the State involved and approved by the Assistant Secretary.

(3)

Qualified expenditures

The term qualified expenditures means reported expenditures of a State under this section that have been reviewed and approved by the Assistant Secretary.

(4)

Service coordination

The term service coordination means a coordinated approach taken on behalf of high-risk older individuals to facilitate the development and implementation of a long-term care plan and the choice and independence of the individuals in securing long-term care.

(b)

Authority

The Assistant Secretary shall make grants on a competitive basis, in accordance with this section, to States to enable the States to pay for the Federal share of the cost of modifying their State systems of long-term care in order to promote and facilitate—

(1)

the choice and control of older individuals and their families in securing long-term care;

(2)

the coordination and cost-effectiveness of State systems of long-term care;

(3)

the provision of long-term care in home and community-based settings; and

(4)

the ability of individuals receiving long-term care to remain as independent and self-sufficient as possible.

(c)

Applications by States

For a State to be eligible to receive a grant under this section, the Governor of such State shall submit an application to the Assistant Secretary, at such time, in such manner, and containing such information as the Assistant Secretary may specify, containing a plan for implementation of the component strategies described in subsection (d) and such other information and assurances as the Secretary determines to be appropriate.

(d)

Use of funds by States

(1)

Component strategies

A State that receives funds through a grant made under subsection (b) shall use the funds to carry out a demonstration project under this section (directly or by grant or contract) by integrating into the State system of long-term care the component strategies described in paragraphs (2) through (5).

(2)

Public education

In carrying out the demonstration project, the State shall conduct activities that shall include media campaigns, targeted mailings, and related activities, to help ensure that consumers are aware of—

(A)

the need to plan in advance for long-term care;

(B)

available public and private long-term care options, including private long-term care insurance; and

(C)

sources of information and resources related to long-term care, including the resource centers described in paragraph (3).

(3)

Aging and disability resource centers

(A)

In general

The State shall provide for community-level Aging and Disability Resource Centers, which, consistent with section 102(47) and subsection (f), shall provide—

(i)

comprehensive information on available public and private long-term care programs, options, and resources;

(ii)

personal counseling and service coordination to assist consumers in assessing their existing or anticipated long-term care needs and circumstances, and developing and implementing a plan for long-term care designed to meet their specific needs and circumstances;

(iii)

a convenient point of entry to the range of publicly-supported long-term care programs for which an individual may be eligible, including the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), and to such other public benefit programs as the State determines to be appropriate;

(iv)

a single process for consumer intake, assessment, and application for benefits under the programs described in clause (iii), including, where appropriate and feasible, facilitating the determination of an individual’s eligibility (including facilitating that determination in compliance with the requirements of title XIX of the Social Security Act) under such programs by collaborating with the appropriate programmatic office; and

(v)

the ability—

(I)

to respond immediately to a request for assistance from an individual or a family member of the individual, in the event of a crisis situation that could result in placement of such individual in an institutional care setting; and

(II)

to provide (or coordinate the provision of), such available short-term assistance as would be necessary and appropriate to temporarily preclude the need for such institutional placement, until a plan for home and community-based long-term care can be developed and implemented.

(B)

Training

In providing for the Centers, the State shall ensure that the staff of the Centers is appropriately trained to understand the interactions between private long-term care insurance (especially insurance through long-term care partnership policies) and eligibility for benefits under the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.).

(4)

Healthy lifestyle choices

The State shall, in accordance with standards established by the Assistant Secretary, provide for low-cost, community-level, evidence-based prevention programs and related tools to assist older individuals and their family caregivers in learning about and making behavioral changes intended to reduce the risk of injury, disease, and disability among older individuals.

(5)

Community living incentives

(A)

In general

The State shall provide funding toward and otherwise assist with the provision of home and community-based long-term care to individuals at high risk for placement in institutional care (referred to in this paragraph as high-risk individuals). The State shall ensure that individuals at greatest risk for becoming eligible for benefits under the Medicaid program receive priority for the home and community-based long-term care.

(B)

Long-term care plan

The State shall provide for assessments of the needs and preferences of high-risk individuals with respect to long-term care, and based on such assessments, shall develop with such individuals and their family members, caregivers, or legal representatives a plan for long-term care for such individuals, specifying the types of support, providers, budget, and, if the State elects, cost-sharing contributions involved.

(C)

Allocation of funds based on individual budgets

The State shall ensure that the funding described in subparagraph (A) will be allocated among, and disbursed for, the budgets of high-risk individuals under long-term care plans developed for such individuals.

(D)

Option to provide consumer-directed care

The State shall provide high-risk individuals with the option to receive home and community-based long-term care under this paragraph in a manner that permits such individuals to direct and control, in conjunction with a service coordinator, the selection, planning, budgeting, and purchasing of such care (including the amount, duration, scope, providers, and location of such care), to the extent determined appropriate and feasible under the long-term care plan developed under subparagraph (B). The service coordinator shall assist the high-risk individuals in purchasing a range of long-term care services or supplies, not otherwise available or eligible for payment through an entity carrying out a Federal or State program or a similar third party, from a qualified provider that are delivered in home and community-based settings and in a manner that best meets the individuals' needs and respects the individuals' preferences to remain in the least restrictive setting possible.

(e)

Federal share

The Federal share of the cost of modifying systems of long-term systems care as described in subsection (b) shall be not more than 75 percent of such cost (calculated on an annual basis as the State’s qualified expenditures for such modifications for such year).

(f)

Special provisions relating to aging and disability resource centers

A State shall ensure that any Aging and Disability Resource Center shall—

(1)

fully coordinate its activities with any health insurance information, counseling, and assistance (receiving funding under section 4360 of the Omnibus Budget Reconciliation Act of 1990 (42 U.S.C. 1395b–4)) in the State;

(2)

be subject to such controls as the Assistant Secretary determines to be appropriate to ensure there is no conflict of interest with respect to any referrals, for information or otherwise, made by the Center for individuals receiving services through the Center; and

(3)

provide no long-term care services or supplies, with the exception of case management services provided through area agencies on aging as described in section 306(a)(8).

(g)

Special provisions relating to option to provide consumer-directed care

Payments made for a high-risk individual under subsection (d)(5)(D) shall not be included in the gross income of the high-risk individual for purposes of the Internal Revenue Code of 1986 or be treated as income, be treated as assets or benefits, or otherwise be taken into account, for purposes of determining the individual's eligibility for, the amount of benefits for the individual under, or the amount of cost-sharing required of the individual by, any other Federal or State program, other than the program carried out under this section.

(h)

Technical assistance to States

The Assistant Secretary, directly or by grant or contract, shall provide for technical assistance to and oversight of States carrying out demonstration projects under this section, for purposes of administration, quality assurance, and quality improvement.

(i)

Evaluation and report

The Assistant Secretary, directly or by grant or contract, shall provide for an evaluation of the demonstration projects carried out under this section. The Assistant Secretary shall submit to the President a report containing the findings resulting from such evaluation not later than 6 months after the termination of the demonstration projects.

.

43.

Responsibilities of Assistant Secretary

Section 432(c)(2)(B) of the Older Americans Act of 1965 (42 U.S.C. 3033a(c)(2)(B)) is amended by inserting before the period the following: , including preparing an analysis of such services, projects, and programs, and of how the evaluation relates to improvements in such services, projects, and programs and in the strategic plan of the Administration.

44.

Older American community service employment program

(a)

In general

Section 502 of the Older Americans Act of 1965 (42 U.S.C. 3056) is amended—

(1)

in subsection (a)(1), by adding at the end the following: For purposes of this paragraph, an underemployed person shall be considered to be an unemployed person.;

(2)

in subsection (b)(1)(M), by striking minority, limited English-speaking, and Indian eligible individuals, and eligible individuals who have the greatest economic need, and inserting minority and Indian eligible individuals, eligible individuals with limited English proficiency, and eligible individuals with greatest economic need,; and

(3)

by adding at the end the following:

(g)
(1)

Except as provided in paragraphs (2) and (3), an eligible individual may participate in projects carried out under this title for a period of not more than 36 months (whether or not consecutive) in the aggregate.

(2)

A grantee for a project may extend the period of participation for not more than 20 percent of the project participants. In selecting participants for the extended period of participation, the grantee shall give priority to—

(A)

participants who are 65 years old or older or frail older individuals; and

(B)

individuals who have more than 1 of the following barriers to employment:

(i)

A disability.

(ii)

Limited English proficiency or low literacy skills.

(iii)

A residence in a rural area.

(iv)

A residence in an area of high unemployment.

(v)

Homelessness or a situation that puts the individual at risk for homelessness.

(vi)

A failure to find employment after utilizing services under title I of the Workforce Investment Act of 1998 (29 U.S.C. 2801 et seq.).

(3)

A grantee may petition for a waiver of the 36-month limit described in paragraph (1) if the grantee serves a high concentration of individuals who are hard-to-serve individuals because they have more than 1 barrier to employment as described in paragraph (2)(B), including a grantee who operates a project in an area in which at least 60 percent of the counties are rural counties, as defined by the Economic Research Service of the Department of Agriculture.

(h)

It is the sense of the Senate that—

(1)

the older American community service employment program was created with the intent of placing older individuals in community service positions to provide job training placements; and

(2)

placing older individuals in community service positions strengthens the ability of the individuals to become self-sufficient, provides much-needed volunteer support to organizations who benefit significantly from increased civic engagement, and strengthens the communities that are served by such organizations.

.

(b)

Definition

Section 506(g)(2) of the Older Americans Act of 1965 (42 U.S.C. 3056d(g)(2)) is amended—

(1)

in subparagraph (A), by striking , or the amount remaining after the application of section 514(e); and

(2)

in subparagraph (B), by striking , or the amount remaining after the application of section 514(f).

45.

Performance

Section 513 of the Older Americans Act of 1965 (42 U.S.C. 3056k) is amended—

(1)

in subsection (a)—

(A)

in paragraph (1)—

(i)

by striking the paragraph designation and all that follows through grantees and inserting the following:

(1)

Establishment and implementation of measures

The Secretary shall establish and implement, after consultation with the Assistant Secretary, grantees

; and

(ii)

by adding at the end the following: The Assistant Secretary shall provide recommendations to the Secretary on the establishment and implementation of the performance measures.;

(B)

in paragraph (2)(B), by adding at the end the following:

(iv)

Not less than 60 percent of the counties, in the areas served by the grantee, being rural counties as defined by the Economic Research Service of the Department of Agriculture.

(v)

The areas served by the grantee comprising a difficult to serve territory due to limited economies of scale.

; and

(C)

by adding at the end the following:

(6)

Special rules

(A)

Establishment and implementation

The Secretary shall establish and implement the performance measures described in this section, including all required indicators described in subsection (b), not later than 1 year after the date of enactment of the Older Americans Act Amendments of 2006.

(B)

Impact on grant competition

The Secretary may not publish a notice announcing a grant competition under this title, and soliciting proposals for grants, until the day that is the later of—

(i)

the date on which the Secretary implements all required indicators described in subsection (b); and

(ii)

January 1, 2010.

; and

(2)

by adding at the end the following:

(e)

Effect of Exemption

In implementing a performance measure under this section, the Secretary shall not reduce a score on the performance measure of—

(1)

a grantee that receives a waiver under section 502(g)(3) on the basis that the grantee is extending the period of participation for project participants under that section; and

(2)

a grantee on the basis that the grantee is extending the period of participation for project participants under section 502(g)(2).

.

46.

Competitive requirements

Section 514 of the Older Americans Act of 1965 (42 U.S.C. 3056l) is amended—

(1)

by striking subsection (a) and inserting the following:

(a)

Program authorized

In accordance with section 502(b), the Secretary shall award grants to eligible applicants, through a competitive process that emphasizes meeting performance measures, to carry out projects under this title for a 4-year period. The Secretary may not conduct a grant competition under this title until the day described in section 513(a)(6)(B).

;

(2)

by striking subsection (b) and inserting the following:

(b)

Eligible applicants

An applicant shall be eligible to receive a grant as described in subsection (a) if the applicant meets the requirements and criteria described in section 502(b)(1), subsections (c) and (d), and paragraphs (2) and (3) of subsection (e).

;

(3)

in subsection (c)—

(A)

by redesignating paragraphs (2) through (7) as paragraphs (4) through (9), respectively;

(B)

by inserting after paragraph (1) the following:

(2)

The applicant’s performance on the required indicators described in section 513(b), in the case of an applicant that has previously received a grant under this title, and the applicant’s ability to meet the required indicators, in the case of any other applicant.

(3)

The applicant's ability to administer a program that provides community service.

; and

(C)

by striking paragraph (9) and inserting the following:

(9)

The applicant’s ability to minimize disruption in services for project participants and the entities employing the participants.

(10)

Any additional criteria that the Secretary may determine to be appropriate.

;

(4)

in subsection (e)—

(A)

in paragraph (2), by striking subparagraphs (C) and (D);

(B)

in paragraph (3)—

(i)

by striking (3) and all that follows through In and inserting the following:

(3)

Competition requirements for public and private nonprofit agencies and organizations in a State

In

;

(ii)

by striking subparagraphs (B) through (D); and

(iii)

by striking take corrective action and inserting provide technical assistance; and

(C)

in paragraph (4)—

(i)

in the first sentence, by striking paragraph (3)(A) and inserting paragraph (3); and

(ii)

by striking the second sentence;

(5)

in subsection (f), by striking paragraph (4); and

(6)

by adding at the end the following:

(g)

Grantees serving individuals with barriers to employment

(1)

Definition

In this subsection, the term individuals with barriers to employment means minority and Indian individuals, individuals with limited English proficiency, and individuals with greatest economic need.

(2)

Special consideration

In areas where a substantial population of individuals with barriers to employment exists, a grantee that receives a national grant under this section shall, in selecting subgrantees, give special consideration to organizations (including former recipients of such national grants) with demonstrated expertise in serving individuals with barriers to employment.

(h)

Minority-serving grantees

The Secretary may not promulgate rules or regulations, affecting grantees in areas where a substantial population of minority individuals exists, that would significantly compromise the ability of the grantees to serve their targeted population of minority older individuals.

.

47.

Definitions

Section 516(2) of the Older Americans Act of 1965 (42 U.S.C. 3056n(2)) is amended—

(1)

in the header, by striking individuals and inserting individual;

(2)

by inserting before The term the following:

(A)

In general

;

(3)

by striking individuals and inserting individual; and

(4)

by adding at the end the following:

(B)

Determination of low income

For purposes of determining income eligibility under subparagraph (A), the Secretary shall not include as income—

(i)

unemployment compensation;

(ii)

benefits received under title XVI of the Social Security Act (42 U.S.C. 1381 et seq.);

(iii)

payments made to or on behalf of veterans or former members of the Armed Forces under the laws administered by the Secretary of Veterans Affairs; or

(iv)

25 percent of the old-age and survivors insurance benefits received under title II of the Social Security Act (42 U.S.C. 401 et seq.).

.

48.

Clarification of maintenance requirement

(a)

In general

Section 614A of the Older Americans Act of 1965 (42 U.S.C. 3057e–1) is amended by adding at the end the following:

(c)

Clarification

(1)

Definition

In this subsection, the term covered year means fiscal year 2006 or a subsequent fiscal year.

(2)

Consortia of tribal organizations

If a tribal organization received a grant under this part for fiscal year 1991 as part of a consortium, the Assistant Secretary shall consider the tribal organization to have received a grant under this part for fiscal year 1991 for purposes of subsections (a) and (b), and shall apply the provisions of subsections (a) and (b)(1) (under the conditions described in subsection (b)) to the tribal organization for each covered year for which the tribal organization submits an application under this part, even if the tribal organization submits—

(A)

a separate application from the remaining members of the consortium; or

(B)

an application as 1 of the remaining members of the consortium.

.

(b)

Effective date

Subsection (a) takes effect on October 1, 2005.

49.

Native Americans caregiver support program

Section 643 of the Older Americans Act of 1965 (42 U.S.C. 3057n) is amended—

(1)

in paragraph (1), by striking 2001 and inserting 2007; and

(2)

in paragraph (2), by striking $5,000,000 and all that follows and inserting $6,500,000 for fiscal year 2007, $7,000,000 for fiscal year 2008, $7,500,000 for fiscal year 2009, $8,000,000 for fiscal year 2010, and $8,500,000 for fiscal year 2011..

50.

Vulnerable elder rights protection activities

Section 702 of the Older Americans Act of 1965 (42 U.S.C. 3058a) is amended by striking 2001 each place it appears and inserting 2007.

51.

Elder abuse, neglect, and exploitation prevention amendment

Section 721 of the Older Americans Act of 1965 (42 U.S.C. 3058i) is amended—

(1)

in subsection (b)—

(A)

by redesignating paragraphs (2) through (8) as paragraphs (3) through (9), respectively; and

(B)

by inserting after paragraph (1) the following new paragraph:

(2)

providing for public education and outreach to promote financial literacy and prevent identity theft and financial exploitation of older individuals;

; and

(2)

in subsection (e)(2)—

(A)

by striking subsection (b)(8)(B)(i) and inserting subsection (b)(9)(B)(i); and

(B)

by striking subsection (b)(8)(B)(ii) and inserting subsection (b)(9)(B)(ii).

52.

Native American organization provisions

Section 751(d) of the Older Americans Act of 1965 (42 U.S.C. 3058aa(d)) is amended by striking 2001 and inserting 2007.

53.

Elder justice programs

(a)

Purposes

The purposes of this section are as follows:

(1)

To assist States and Indian tribes in developing a comprehensive multi-disciplinary approach to elder justice.

(2)

To promote research and data collection that will fill gaps in knowledge about elder abuse, neglect, and exploitation.

(3)

To support innovative and effective activities of service providers and programs that are designed to address issues relating to elder abuse, neglect, and exploitation.

(4)

To assist States, Indian tribes, and local service providers in the development of short- and long-term strategic plans for the development and coordination of elder justice research, programs, studies, training, and other efforts.

(5)

To promote collaborative efforts and diminish overlap and gaps in efforts in developing the important field of elder justice.

(b)

Elder justice

Title VII of the Older Americans Act of 1965 (42 U.S.C. 3058 et seq.) is amended—

(1)

by redesignating subtitles B and C as subtitles C and D, respectively;

(2)

by redesignating sections 751, and 761 through 764, as sections 761, and 771 through 774, respectively; and

(3)

by inserting after subtitle A the following:

B

Elder Justice Programs

751.

Definitions

In this subtitle:

(1)

Caregiver

The term caregiver means an individual who has the responsibility for the care of an elder, either voluntarily, by contract, by receipt of payment for care, or as a result of the operation of law and means a family member or other individual who provides (on behalf of such individual or of a public or private agency, organization, or institution) compensated or uncompensated care to an elder.

(2)

Direct care

The term direct care means care by an employee or contractor who provides assistance or long-term care services to a recipient.

(3)

Elder

The term elder means an older individual, as defined in section 102.

(4)

Elder justice

The term elder justice means—

(A)

efforts to prevent, detect, treat, intervene in, and respond to elder abuse, neglect, and exploitation and to protect elders with diminished capacity while maximizing their autonomy; and

(B)

from an individual perspective, the recognition of an elder’s rights, including the right to be free of abuse, neglect, and exploitation.

(5)

Eligible entity

The term eligible entity means a State or local government agency, Indian tribe, or any other public or private entity, that is engaged in and has expertise in issues relating to elder justice.

(6)

Fiduciary

The term fiduciary

(A)

means a person or entity with the legal responsibility—

(i)

to make decisions on behalf of and for the benefit of another person; and

(ii)

to act in good faith and with fairness; and

(B)

includes a trustee, a guardian, a conservator, an executor, an agent under a financial power of attorney or health care power of attorney, or a representative payee.

(7)

Grant

The term grant includes a contract, cooperative agreement, or other mechanism for providing financial assistance.

(8)

Law enforcement

The term law enforcement means the full range of potential responders to elder abuse, neglect, and exploitation including—

(A)

police, sheriffs, detectives, public safety officers, and corrections personnel;

(B)

prosecutors;

(C)

medical examiners;

(D)

investigators; and

(E)

coroners.

(9)

Long-term care

(A)

In general

The term long-term care means supportive and health services specified by the Secretary for individuals who need assistance because the individuals have a loss of capacity for self-care due to illness, disability, or vulnerability.

(B)

Loss of capacity for self-care

For purposes of subparagraph (A), the term loss of capacity for self-care means an inability to engage effectively in activities of daily living, including eating, dressing, bathing, and management of one’s financial affairs.

(10)

Long-term care facility

The term long-term care facility means a residential care provider that arranges for, or directly provides, long-term care.

(11)

Nursing facility

The term nursing facility has the meaning given such term under section 1919(a) of the Social Security Act (42 U.S.C. 1396r(a)).

(12)

State legal assistance developer

The term State legal assistance developer means an individual described in section 731.

(13)

State long-term care ombudsman

The term State Long-Term Care Ombudsman means the State Long-Term Care Ombudsman described in section 712(a)(2).

752.

State and tribal grants to strengthen long-term care and provide assistance for elder justice programs

(a)

Grants

The Assistant Secretary may award grants to States and Indian tribes to enable the States and tribes to strengthen long-term care and provide assistance for elder justice programs.

(b)

Application

To be eligible to receive a grant under this subtitle, a State or Indian tribe shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information as the Assistant Secretary may require.

(c)

Use of funds

A State or Indian tribe that receives a grant under this subtitle may use the funds made available through the grant to award grants—

(1)

to eligible entities for the prevention, detection, assessment, and treatment of, intervention in, investigation of, and response to elder abuse, neglect, and exploitation;

(2)

to eligible entities to examine various types of elder shelters (in this paragraph referred to as safe havens), and to test various safe haven models for establishing safe havens (at home or elsewhere), that—

(A)

recognize autonomy and self-determination, and fully protect the due process rights of elders; and

(B)
(i)

provide a comprehensive, culturally sensitive, and multidisciplinary team response to allegations of elder abuse, neglect, or exploitation;

(ii)

provide a dedicated, elder-friendly setting;

(iii)

have the capacity to meet the needs of elders for care; and

(iv)

provide various services including—

(I)

nursing and forensic evaluation;

(II)

therapeutic intervention;

(III)

victim support and advocacy; and

(IV)

case review and assistance to make the elders safer at home or to find appropriate placement in safer environments, including shelters, and, in some circumstances long-term care facilities, other residential care facilities, and hospitals;

(3)

to eligible entities to establish or continue volunteer programs that focus on the issues of elder abuse, neglect, and exploitation, or to provide related services;

(4)

to eligible entities to support multidisciplinary elder justice activities, such as—

(A)

supporting and studying team approaches for bringing a coordinated multidisciplinary or interdisciplinary response to elder abuse, neglect, and exploitation, including a response from individuals in social service, health care, public safety, and legal disciplines;

(B)

establishing a State or tribal coordinating council, which shall identify the individual State’s or Indian tribe’s needs and provide the Secretary with information and recommendations relating to efforts by the State or Indian tribe to combat elder abuse, neglect, and exploitation;

(C)

providing training, technical assistance, and other methods of support to groups carrying out multidisciplinary efforts at the State or Indian tribe level (referred to in some States as State Working Groups);

(D)

broadening and studying various models for elder fatality and serious injury review teams, to make recommendations about their composition, protocols, functions, timing, roles, and responsibilities, with a goal of producing models and information that will allow for replication based on the needs of other States, Indian tribes, and communities; or

(E)

carrying out such other interdisciplinary or multidisciplinary efforts as the Assistant Secretary determines to be appropriate;

(5)

to eligible entities to provide training for individuals with respect to issues of elder abuse, neglect, and exploitation, consisting of—

(A)

training within a discipline; or

(B)

cross-training activities that permit individuals in multiple disciplines to train together, fostering communication, coordinating efforts, and ensuring collaboration;

(6)

to eligible entities to address underserved populations of elders, such as—

(A)

elders living in rural locations;

(B)

elders in minority populations; or

(C)

low-income elders;

(7)

to eligible entities to provide incentives for individuals to train for, seek, and maintain employment providing direct care in a long-term care facility, such as—

(A)

to eligible entities to provide incentives to participants in programs carried out under part A of title IV, and section 403(a)(5), of the Social Security Act (42 U.S.C. 601 et seq., 603(a)(5)) to train for and seek employment providing direct care in a long-term care facility;

(B)

to long-term care facilities to carry out programs through which the facilities—

(i)

offer, to employees who provide direct care to residents of a long-term care facility, continuing training and varying levels of professional certification, based on observed clinical care practices and the amount of time the employees spend providing direct care; and

(ii)

provide, or make arrangements with employers to provide, bonuses or other increased compensation or benefits to employees who achieve professional certification under such a program; or

(C)

to long-term care facilities to enable the facilities to provide training and technical assistance to eligible employees regarding management practices using methods that are demonstrated to promote retention of employees of the facilities, such as—

(i)

the establishment of basic human resource policies that reward high performance, including policies that provide for improved wages and benefits on the basis of job reviews; or

(ii)

the establishment of other programs that promote the provision of high quality care, such as a continuing education program that provides additional hours of training, including on-the-job training, for employees who are certified nurse aides;

(8)

to encourage the establishment of eligible partnerships to develop collaborative and innovative approaches to improve the quality of, including preventing abuse, neglect, and exploitation in, long-term care; or

(9)

to eligible entities to establish multidisciplinary panels to address and develop best practices concerning methods of—

(A)

improving the quality of long-term care; and

(B)

addressing abuse, including resident-to-resident abuse, in long-term care.

(d)

Administrative expenses

A State or Indian tribe that receives a grant under this section shall not use more than 5 percent of the funds made available through the grant to pay for administrative expenses.

(e)

Supplement not supplant

Funds made available pursuant to this section shall be used to supplement and not supplant other Federal, State, and local (including tribal) funds expended to provide activities described in subsection (c).

(f)

Maintenance of effort

The State or Indian tribe, in using the proceeds of a grant received under this section, shall maintain the expenditures of the State or tribe for activities described in subsection (c) at a level equal to not less than the level of such expenditures maintained by the State or tribe for the fiscal year preceding the fiscal year for which the grant is received.

(g)

Accountability measures

The Assistant Secretary shall develop accountability measures to ensure the effectiveness of the activities conducted using funds made available under this section, including accountability measures to ensure that the activities described in subsection (c)(7) benefit eligible employees and increase the stability of the long-term care workforce.

(h)

Evaluating programs

The Assistant Secretary shall evaluate the activities conducted using funds made available under this section and shall use the results of such evaluation to determine the activities for which funds made available under this section may be used.

(i)

Compliance with applicable laws

In order to receive funds under this section, an entity shall comply with all applicable laws, regulations, and guidelines.

(j)

Eligible partnerships

In subsection (c)(8), the term eligible partnership means a multidisciplinary community partnership consisting of eligible entities or appropriate individuals, such as a partnership consisting of representatives in a community of nursing facility providers, State legal assistance developers, advocates for residents of long-term care facilities, State Long-Term Care Ombudsmen, surveyors, the State agency with responsibility for adult protective services, the State agency with responsibility for licensing long-term care facilities, law enforcement agencies, courts, family councils, residents, certified nurse aides, registered nurses, physicians, and other eligible entities and appropriate individuals.

(k)

Authorization of appropriations

There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2005 through 2008.

753.

Collection of uniform national data on elder abuse, neglect, and exploitation

(a)

Purpose

The purpose of this section is to improve, streamline, and promote uniform collection, maintenance, and dissemination of national data relating to the various types of elder abuse, neglect, and exploitation.

(b)

Phase I

(1)

In general

Not later than the date that is 1 year after the date of enactment of the Older Americans Act Amendments of 2006, the Assistant Secretary, acting through the head of the Office of Elder Abuse Prevention and Services, after consultation with the Attorney General and working with experts in relevant disciplines from the Bureau of Justice Statistics of the Office of Justice Programs of the Department of Justice, shall—

(A)

develop a method for collecting national data regarding elder abuse, neglect, and exploitation; and

(B)

develop uniform national data reporting forms adapted to each relevant entity or discipline (such as health, public safety, social and protective services, and law enforcement) reflecting—

(i)

the distinct manner in which each entity or discipline receives and maintains information; and

(ii)

the sequence and history of reports to or involvement of different entities or disciplines, independently, or the sequence and history of reports from 1 entity or discipline to another over time.

(2)

Forms

(A)

In general

Subject to subparagraph (B), the national data reporting forms described in paragraph (1)(B) shall incorporate the definitions of section 751, for use in determining whether an event is reportable.

(B)

Protection of privacy

In pursuing activities under this paragraph, the Secretary shall ensure the protection of individual health privacy consistent with the regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 and State and local privacy regulations (as applicable).

(c)

Phase II

(1)

In general

Not later than the date that is 1 year after the date on which the activities described in subsection (b)(1) are completed, the Secretary (or the Secretary’s designee) shall ensure that the national data reporting forms and data collection methods developed in accordance with such subsection are pilot tested in 6 States selected by the Secretary.

(2)

Adjustments to the form and methods

The Secretary, after considering the results of the pilot testing described in paragraph (1) and consultation with the Attorney General and relevant experts, shall adjust the national data reporting forms and data collection methods as necessary.

(d)

Phase III

(1)

Distribution of national data reporting forms

After completion of the adjustment to the national data reporting forms under subsection (c)(2), the Secretary shall submit the national data reporting forms along with instructions to—

(A)

the heads of the relevant components of the Department of Health and Human Services, the Department of Justice, and the Department of the Treasury, and such other Federal entities as may be appropriate; and

(B)

the Governor’s office of each State for collection from all relevant State entities of data, including health care, social services, and law enforcement data.

(2)

Data collection grants

(A)

Authorization

The Secretary is authorized to award grants to States to improve data collection activities relating to elder abuse, neglect, and exploitation.

(B)

Application

To be eligible to receive a grant under this paragraph, a State shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.

(C)

Requirements

Each State receiving a grant under this paragraph for a fiscal year shall report data for the calendar year that begins during that fiscal year, using the national data reporting forms described in paragraph (1).

(D)

Funding

(i)

First year

For the first fiscal year for which a State receives grant funds under this subsection the Secretary shall initially distribute 50 percent of such funds. The Secretary shall distribute the remaining funds at the end of the calendar year that begins during that fiscal year, if the Secretary determines that the State has properly reported data required under this subsection for the calendar year.

(ii)

Subsequent years

Except as provided in clause (i), the Secretary shall distribute grant funds to a State under this subsection for a fiscal year if the Secretary determines that the State properly reported data required under this subsection for the calendar year that ends during that fiscal year.

(3)

Required information

Each report submitted under this subsection shall—

(A)

indicate the State and year in which each event occurred; and

(B)

identify the total number of events that occurred in each State during the year and the type of each event.

(e)

Report

Not later than 1 year after the date of enactment of the Older Americans Act Amendments of 2006 and annually thereafter, the Secretary shall prepare and submit to the appropriate committees of Congress, including to the Committee on Health Education, Labor, and Pensions and the Special Committee on Aging of the Senate, a report regarding activities conducted under this section.

(f)

Authorization of appropriations

There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2007, 2008, 2009, 2010, and 2011.

.

54.

Rule of construction

Subtitle D of title VII of the Older Americans Act of 1965 (42 U.S.C. 3058bb et seq.), as redesignated by section 53(b)(1), is amended by adding at the end the following:

775.

Rule of construction

Nothing in this title shall be construed to interfere with or abridge the right of an older individual to practice the individual’s religion through reliance on prayer alone for healing, in a case in which a decision to so practice the religion—

(1)

is contemporaneously expressed by the older individual—

(A)

either orally or in writing;

(B)

with respect to a specific illness or injury that the older individual has at the time of the decision; and

(C)

when the older individual is competent to make the decision;

(2)

is set forth prior to the occurrence of the illness or injury in a living will, health care proxy, or other advance directive document that is validly executed and applied under State law; or

(3)

may be unambiguously deduced from the older individual’s life history.

.

55.

Technical amendments

The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is amended—

(1)

in section 202(e)(1)(A) by striking the semicolon at the end and inserting a period; and

(2)

by inserting before section 401 the following:

IV

Activities for health, independence, and longevity

.

56.

Conforming amendments to other Acts

(a)

Older Americans Act Amendments of 1987

Section 205(1) of the Older Americans Act Amendments of 1987 (42 U.S.C. 3001 note) is amended by striking section 102(17) of the Older Americans Act of 1965 (42 U.S.C. 3002(17)) and inserting section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).

(b)

Energy Conservation and Production Act

Section 412(6) of the Energy Conservation and Production Act (42 U.S.C. 6862(6)) is amended by striking paragraphs (4), (5), and (6), respectively, of section 102 and inserting section 102.

September 19, 2006

Reported with an amendment