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S. 3562 (112th): Older Americans Act Amendments of 2012


The text of the bill below is as of Sep 19, 2012 (Introduced). The bill was not enacted into law.


II

112th CONGRESS

2d Session

S. 3562

IN THE SENATE OF THE UNITED STATES

September 19, 2012

(for himself, Mr. Blumenthal, Mr. Kerry, Ms. Mikulski, Mr. Begich, Mr. Akaka, Mr. Durbin, Mrs. Gillibrand, Ms. Klobuchar, Mr. Leahy, Mr. Wyden, Mr. Franken, Mrs. Boxer, Mr. Johnson of South Dakota, Mr. Merkley, and Mr. Menendez) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL

To reauthorize and improve the Older Americans Act of 1965, and for other purposes.

1.

Short title

This Act may be cited as the Older Americans Act Amendments of 2012.

2.

Findings

Congress finds the following:

(1)

Older adults are the fastest growing segment of the Nation’s population, in the Nation’s history.

(2)

Every day, 10,000 Baby Boomers turn 65.

(3)

One in every 5 of those individuals age 65 and older survives on an average of $7,500 a year.

(4)

Older adults haven’t seen a cost of living adjustment in Federal benefits, including assistance under the Social Security Act, in more than 2 years and will only see a very slight cost of living adjustment in those benefits for fiscal year 2012.

(5)

Federal funding to support older adults and their caregivers has not kept pace with inflation.

(6)

Only 7 percent of individuals who are food insecure are getting a home-delivered meal.

(7)

The cost of staying in a nursing home is averaging over $77,000 per year.

(8)

The Medicaid program is paying for the majority of nursing home care.

(9)

States are cutting budgets for Medicaid programs, and the cuts sometimes result in nursing homes dropping older adults off at homeless shelters.

(10)

In 2009, the Department of Justice estimated that 14.1 percent of noninstitutionalized older adults in the United States had experienced some form of elder abuse in the past year.

(11)

Only 1 in 23.5 cases of abuse of older adults is ever reported due to a lack of screening, awareness, and prevention efforts.

(12)

The mortality rate for older adults who are victims of abuse is 3 times higher than for older adults who are not victims of abuse.

(13)

The annual financial loss by older adults who are victims of financial abuse, due to that abuse, is estimated to be at least $2,900,000,000, and steadily increasing.

(14)

By making significant improvements through the Older Americans Act Amendments of 2012, it is possible to improve the lives of millions of older adults, and ensure that they receive all of the supports and services that they need to stay healthy and active in their homes and communities.

I

Declaration of objectives; definitions

101.

Declaration of objectives

Section 101 of the Older Americans Act of 1965 (42 U.S.C. 3001) is amended—

(1)

by striking paragraph (1) and inserting the following:

(1)

An adequate income and economic security in later life in accordance with the American standard of living.

;

(2)

in paragraph (4), by inserting care coordination and after including;

(3)

in paragraph (8), by inserting and supports, offered in a culturally and linguistically competent manner after community services.;

(4)

by striking paragraphs (9) and (10) and inserting the following:

(9)

Immediate benefit from proven research knowledge which can sustain and improve health, happiness, and economic security.

(10)

Freedom, independence, economic security, and the free exercise of individual initiative for older people in planning and managing their own lives, full participation in the planning and operation of community-based services and programs provided for their benefit, and protection against abuse, neglect, and exploitation.

; and

(5)

by adding at the end the following:

(11)

Acquiring high-quality services in a manner that is culturally and linguistically responsive to older individuals and family caregivers.

.

102.

Definitions

(a)

In general

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

(1)

by amending paragraph (1) to read as follows:

(1)

The term abuse means the knowing infliction of physical or psychological harm or the knowing deprivation of goods or services that are necessary to meet essential needs or to avoid physical or psychological harm.

;

(2)

by redesignating paragraphs (4) through (14) and (15) through (54) as paragraphs (5) through (15) and (17) through (56), respectively;

(3)

by inserting after paragraph (3) the following:

(4)

The term adult protective services means such services provided to adults as the Secretary may specify and includes services such as—

(A)

receiving reports of adult abuse, neglect, or exploitation;

(B)

investigating the reports described in subparagraph (A);

(C)

case planning, monitoring, evaluation, and other case work and services; and

(D)

providing, arranging for, or facilitating the provision of medical, social service, economic, legal, housing, law enforcement, or other protective, emergency, or support services.

;

(4)

by striking paragraph (5), as redesignated by paragraph (2) of this subsection, and inserting the following:

(5)

The term Aging and Disability Resource Center means an entity established by a State as part of the State system of long-term care, that provides a coordinated and integrated system that serves individuals with disabilities and older individuals, including, at a minimum providing—

(A)

comprehensive information on the full range of—

(i)

available public and private long-term care programs, options, service providers, and resources within a State, and within a community, including information on the availability of integrated long-term care; and

(ii)

Federal or State programs that provide long-term care services and supports for individuals with disabilities and older individuals through home and community-based service programs;

(B)

personal and peer counseling to assist individuals with disabilities and older individuals in—

(i)

assessing their existing or anticipated long-term care needs and goals, including needs and goals related to the availability of home and community-based services as an alternative to care in a nursing home or other institutional settings; and

(ii)

developing and implementing a plan for long-term care, consistent with the desires of an individual and designed to meet the individual’s specific priorities, goals, needs, and circumstances;

(C)

access for individuals with disabilities and older individuals to the full range of publicly-supported long-term care programs and supports for which individuals described in this subparagraph may be eligible, including home and community-based options, by serving as a convenient point of entry for such programs and supports;

(D)

if an individual with a disability or older individual wants to live or remain in the community, efforts to work in cooperation with centers for independent living (as defined in section 702 of the Rehabilitation Act of 1973 (29 U.S.C. 796a)) and other community-based entities—

(i)

to facilitate the transition of an individual described in this subparagraph from a nursing home or other institutional setting to a home or community-based residence, with the requisite supports and services; or

(ii)

to provide assistance to an individual who is at risk for placement in a nursing home or other institutional setting, or of re-entering a nursing home or other institutional setting, so that an individual described in this subparagraph may remain in the individual’s own home, or in a home or community-based residence;

(E)

initiatives that involve coordinating State and local partnerships, including those with disability advocacy organizations such as centers for independent living (as so defined) and aging networks such as area agencies on aging, to ensure that individuals with disabilities and older individuals have access to the full array of needed services and opportunities; and

(F)

initiatives that connect, to the greatest extent practicable, individuals with disabilities and older individuals with available long-term care services and supports, including home and community-based services and supports, through the development of coordinated systems of information, referral, and access, regardless of an individual's point of entry or initial inquiry, age, income, disability, or advance planning for long-term care services and supports.

;

(5)

in subparagraph (B)(i) of paragraph (12), as redesignated by paragraph (2) of this subsection, by striking comprehensive and all that follows through psychological and inserting comprehensive person-centered assessment of the older individual (including the physical, psychological, economic,;

(6)

in paragraph (15), as redesignated by paragraph (1) of this subsection—

(A)

in subparagraph (C), by inserting , their family members, before and their primary; and

(B)

by striking the last sentence;

(7)

by inserting after that paragraph (15) the following:

(16)
(A)

The term economic security means access to the assets, income, and community-based services necessary to provide for adequate and unsubsidized housing, health care, transportation, food, long-term care, and goods and services to meet other basic human needs. Such access shall be measured in a manner that shall be geographically based, and take into account an individual’s life circumstances.

(B)

The term economic security and benefits counseling

(i)

means a supportive service that provides, to an older individual, a comprehensive assessment of the Federal, State, and community benefits and services for which the individual qualifies, along with assistance in applying for and obtaining the benefits and services; and

(ii)

to the extent appropriate, includes an evaluation of the older individual's—

(I)

economic situation, including income, assets, and access to pensions or other private benefits;

(II)

health care and housing needs;

(III)

access to nutrition and nutrition services;

(IV)

ability to satisfy transportation needs; and

(V)

long-term care planning.

;

(8)

by amending paragraph (19), as redesignated by paragraph (2) of this subsection, to read as follows:

(19)

The term elder justice means—

(A)

from a societal perspective, efforts to—

(i)

prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation; and

(ii)

protect older individuals with diminished capacity while maximizing their autonomy; and

(B)

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

;

(9)

in paragraph (20), as redesignated by paragraph (2) of this subsection, by striking The term exploitation means and inserting The terms exploitation and financial exploitation mean;

(10)

in paragraph (25), as redesignated by paragraph (2) of this subsection, by striking at or below the poverty line. and inserting that is not more than 200 percent of the poverty line.;

(11)

by striking paragraph (26), as redesignated by paragraph (2) of this subsection, and inserting the following:

(26)

The term greatest social need means need caused by noneconomic factors—

(A)

that—

(i)

restrict the ability of an individual to perform normal daily tasks; or

(ii)

threaten the capacity of the individual to live independently; and

(B)

which include—

(i)

physical and mental disabilities;

(ii)

language barriers including limited English proficiency;

(iii)

cultural, social, or geographic isolation (such as residence in a rural area), including isolation caused by racial, minority, or ethnic status, or status as an LGBT individual;

(iv)

HIV-positive health status or Alzheimer's disease or a related disorder with neurological and organic brain dysfunction;

(v)

greatest health service need, particularly a need posed by multiple chronic health conditions or a condition that places an individual at risk for falls;

(vi)

abuse, neglect (including self-neglect), or financial exploitation, including factors that are the basis of a referral to adult protective services;

(vii)

status as a veteran; and

(viii)

status as a Holocaust survivor.

;

(12)

in paragraph (30), as redesignated by paragraph (2) of this subsection—

(A)

in subparagraph (C), by inserting , including opportunities for work and volunteer service in the community after available; and

(B)

in subparagraph (E), by inserting , in a culturally and linguistically competent manner, before the entire community of older individuals;

(13)

in paragraph (31), as redesignated by paragraph (2) of this subsection, by striking information and referral and inserting information and referral assistance;

(14)

in paragraph (35), as redesignated by paragraph (2) of this subsection—

(A)

by redesignating clauses (i) and (ii) of subparagraph (B) as subclauses (I) and (II), respectively, and aligning the margins of the subclauses with the margins of subclause (I) of subparagraph (A)(i) of paragraph (34), as so redesignated;

(B)

by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively, and aligning the margins of the clauses with the margins of clause (ii) of subparagraph (A) of that paragraph (34);

(C)

by inserting (A) before The term; and

(D)

by adding at the end the following:

(B)

The term integrated legal assistance delivery system means a collaboratively run, statewide network that is established to provide direct legal assistance, in the most efficient and impactful manner possible, targeted at older individuals with greatest economic need and older individuals with greatest social need (with particular attention to individuals with factors listed in paragraph (26)(B)), in coordination with the legal assistance developer for the State and all State, regional, and local service providers engaged in promoting or supporting elder rights.

;

(15)

in paragraph (36), as redesignated by paragraph (2) of this subsection—

(A)

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

(B)

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

(C)

by striking subparagraph (C);

(16)

in paragraph (37), as redesignated by paragraph (2) of this subsection, by striking sections 307(a)(12) and and inserting the activities carried out under section 307(a)(9);

(17)

in paragraph (38), as redesignated by paragraph (2) of this subsection, by inserting (including elder abuse and neglect screening) after educational services;

(18)

in paragraph (50)(B), as redesignated by paragraph (2) of this subsection, by striking subparagraphs (A) through (G) of paragraph (8) and inserting subparagraphs (A) through (I) of paragraph (14); and

(19)

by adding at the end the following:

(57)
(A)

The term care coordination means a person- and family-centered, assessment-based, and interdisciplinary approach to meet the needs and preferences of an older individual and a family caregiver while enhancing the capabilities of the older individual (including the ability to self-direct services).

(B)

The term care coordination means coordination that—

(i)

integrates health care, long-term services and supports, and social support services in a high-quality and cost-effective manner in which an individual’s needs, preferences, and capabilities are assessed, along with the needs and preferences of a family caregiver;

(ii)

includes, as a core element, the active involvement of the older individual, the family, or a representative appointed by the older individual or legally acting on the individual's behalf, community-based service professionals, and health care professionals providing care to the older individual, in the design and implementation of an individualized, individual-centered service and support plan, through which the services and supports will be provided in a manner free from conflicts of interest;

(iii)

integrates services and interventions that are implemented, monitored, and evaluated for effectiveness using an evidence-based process, which typically involves a designated lead care coordinator and involves feedback from the older individual;

(iv)

includes activities that aim simultaneously at meeting individual and family needs and preferences, building on individual capabilities, and improving outcomes and systems of care;

(v)

includes provision of some or all of the services and activities described in clauses (i) through (iv) by trained professionals employed by or under a contract with—

(I)

area agencies on aging;

(II)

Aging and Disability Resource Centers; or

(III)

other service providers, including in-home service providers; and

(vi)

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

(58)

The term cultural and linguistic competence means competence in a set of behaviors, attitudes, and policies that is—

(A)

used by an organization or among professionals; and

(B)

enables effective work in cross-cultural situations.

(59)

The term family caregiver means an adult family member, or another individual, who is an informal provider of in-home and community care to an older individual or to an individual with Alzheimer's disease or a related disorder with neurological and organic brain dysfunction.

(60)

The term Holocaust survivor means an individual who—

(A)
(i)

lived in a country between 1933 and 1945 under a Nazi regime, under Nazi occupation, or under the control of Nazi collaborators; or

(ii)

fled from a country between 1933 and 1945 under a Nazi regime, under Nazi occupation, or under the control of Nazi collaborators;

(B)

was persecuted between 1933 and 1945 on the basis of race, religion, physical or mental disability, sexual orientation, political affiliation, ethnicity, or other basis; and

(C)

was a member of a group that was persecuted by the Nazis.

(61)

The term LGBT, used with respect to an individual, means a lesbian, gay, bisexual, or transgender individual.

(62)

The term person-centered, used with respect to a service for an individual, means a service provided with an approach designed to ensure that an outcome reflects the needs, preferences, and situations of the individual.

(63)

The term veteran has the meaning given the term in section 101 of title 38, United States Code.

.

(b)

Conforming amendments

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002), as redesignated by subsection (a)(2), is amended—

(1)

in paragraph (39)(A), by striking as defined in paragraph (5) and inserting as defined in paragraph (28);

(2)

in paragraph (40), by striking (as defined in paragraph (18)(B)) and inserting (as defined in paragraph (20)(B)); and

(3)

in paragraph (48)(D), by striking (as defined in paragraph (18)(B)) and inserting (as defined in paragraph (20)(B)).

II

Administration on aging

201.

Establishment of Administration on Aging

Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is amended—

(1)

in subsection (d)(3)—

(A)

in subparagraph (C)—

(i)

in clause (i), by striking ; and and inserting a semicolon;

(ii)

by redesignating clause (ii) as clause (iii); and

(iii)

by inserting after clause (i) the following:

(ii)

resources needed by State Long-Term Care Ombudsmen to collect and report program data through the National Ombudsman Reporting System, including hardware and software that meet national standards; and

;

(B)

in subparagraph (J), by inserting before the semicolon the following: , including the effectiveness of such services in meeting the needs of LGBT older individuals; and

(C)

in subparagraph (L)—

(i)

by striking Older Americans Act Amendments of 1992 and inserting Older Americans Act Amendments of 2012; and

(ii)

by striking 712(h)(4) and inserting 712(h)(5);

(2)

in subsection (e)(2)—

(A)

in the matter preceding subparagraph (A), by inserting , and in coordination with the heads of State adult protective services programs and the State Long-Term Care Ombudsmen after and services;

(B)

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

(C)

in subparagraph (B), by striking the period and inserting a semicolon; and

(D)

by adding at the end the following:

(C)

to establish best practices for State-based enforcement of a Home Care Consumer Bill of Rights through a Plan for Enforcement, as such Bill and Plan are outlined in section 705, not later than 6 months after the date of enactment of the Older Americans Act Amendments of 2012, and to make those best practices available to States, and to the public through the National Center on Elder Abuse;

(D)

to assist States with the development of Home Care Consumer Bills of Rights and Plans for Enforcement, to support the shift from institutional care to home and community-based long-term services and supports and ensure that home care consumers, as defined in section 736, have basic protections as outlined in subsections (b) and (c) of section 705;

(E)

to develop a process for review and approval of States’ Home Care Consumer Bills of Rights and Plans for Enforcement, not later than 6 months after the date of enactment of the Older Americans Act Amendments of 2012; and

(F)

to review and approve States’ Home Care Consumer Bills of Rights and Plans for Enforcement through that process.

; and

(3)

by adding at the end the following:

(g)

The Assistant Secretary is authorized to designate within the Administration a person to have responsibility for addressing issues affecting LGBT older individuals.

(h)

The Assistant Secretary is authorized to use funds appropriated to carry out this Act to implement activities authorized under part I of subtitle B of title XX of the Social Security Act (42 U.S.C. 1397k et seq.), including the establishment of the Advisory Board on Elder Abuse, Neglect, and Exploitation, and to convene the Elder Justice Coordinating Council.

(i)
(1)

The Assistant Secretary shall, by grant or contract with a national nonprofit entity, establish a National Adult Protective Services Resource Center (referred to in this subsection as the Center). The purposes of the Center are to improve the capacity of State and local adult protective services programs to respond effectively to abuse, neglect, and exploitation of vulnerable adults, including home care consumers and residents of long-term care facilities, and to coordinate with the Long-Term Care Ombudsman Program to protect home care consumers and residents most effectively.

(2)

The nonprofit entity awarded a grant or contract under this subsection shall have expertise in, and representation from, State and local adult protective services programs.

(3)

The Center shall—

(A)

collect and disseminate information regarding, and increase public awareness of, the role of adult protective services programs in investigating the abuse, neglect (including self-neglect), and exploitation of vulnerable adults, including home care consumers and residents of long-term care facilities, and in intervening to protect the consumers and residents from abuse;

(B)

develop, distribute, and provide training and technical assistance for adult protective services program investigators and supervisors investigating the abuse, neglect (including self-neglect), and exploitation of vulnerable adults, including home care consumers and residents of long-term care facilities, and intervening to protect the consumers and residents from further abuse;

(C)

develop, distribute, and provide training to home care and long-term care professionals and others on recognizing, reporting (including regarding mandatory reporting requirements), and responding to the abuse, neglect (including self-neglect), and exploitation of vulnerable adults, including home care consumers and residents of long-term care facilities;

(D)

compile and disseminate reports on research and best practices for adult protective services programs and other programs on effective responses to the abuse, neglect (including self-neglect), and exploitation of vulnerable adults, including home care consumers and residents of long-term care facilities;

(E)

work with the National Ombudsman Resource Center and State Long-Term Care Ombudsman programs to develop and disseminate training, practice standards, and policies regarding—

(i)

the roles and responsibilities of adult protective services and ombudsman programs;

(ii)

confidentiality and abuse reporting issues and protocols; and

(iii)

effective ways to maximize the resources of adult protective services programs for the benefit of home care consumers and residents of long-term care facilities; and

(F)

establish a data system to collect information on the abuse, neglect (including self-neglect), and exploitation of home care consumers and residents of long-term care facilities and to measure the effectiveness of the activities carried out by the Center.

(4)

Not later than 18 months after the date of enactment of the Older Americans Act Amendments of 2012, the Director shall—

(A)

collect and analyze, from leading national and State experts, the best practices related to screening for elder abuse;

(B)

publish a report that describes recommendations regarding such best practices and disseminate such report to all grantees under programs established under this Act and described under this section; and

(C)

submit to Congress such report and a description of the dissemination activities under subparagraph (B).

(5)

In this subsection, the terms home care consumer and home care ombudsman program have the meanings given the terms in section 736.

.

202.

Functions of Assistant Secretary

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

(1)

in subsection (a)—

(A)

in paragraph (5), by inserting economic security, after nutrition,;

(B)

in paragraph (7), by inserting , including economic security trends among such individuals after older individuals;

(C)

in paragraph (8), by striking older individuals and inserting the health and economic security of older individuals;

(D)

in paragraph (14), by inserting for working with the Administrator of the Health Resources and Services Administration and the Secretary of Labor to identify and address workforce shortages involving such personnel, after field of aging,;

(E)

by striking paragraph (15) and inserting the following:

(15)
(A)

as needed, provide technical assistance, training through training packages, and other forms of instruction to entities consisting of State agencies, area agencies on aging, service providers, and community-based organizations, to ensure that the entities develop and implement, in a culturally and linguistically competent manner, programming, services, and outreach for older individuals with greatest economic need and older individuals with greatest social need (with particular attention to providing services to individuals with factors listed in section 102(26)(B) and providing services in areas identified by the Administrator of the Health Resources and Services Administration as having a shortage of professionals trained to care for older individuals and with a focus on strategies that enable older adults to proceed on a path to economic security); and

(B)

consult with national and community-based organizations representing minority individuals to develop the capacity of the Administration to provide such technical assistance, training, and instruction.

;

(F)

in paragraph (16)—

(i)

in subparagraph (A)(ii), by inserting , and separately specifying the number of such individuals who are LGBT individuals before the semicolon; and

(ii)

in subparagraph (C), by striking paragraphs (2) and (5)(A) and inserting paragraphs (2) and (4)(A);

(G)

in paragraph (18), by amending subparagraph (B) to read as follows:

(B)

reserve and provide, for the funding of the Center (which may include enabling the Center to collaborate and participate with the Centers for Medicare & Medicaid Services in providing training for State survey agencies with an agreement in effect under section 1864 of the Social Security Act (42 U.S.C. 1395aa) or, in the case of States without such an agency, work with the Administrator for the Centers for Medicare & Medicaid Services to improve the investigative processes used by the Center to address complaints by residents of long-term care facilities)—

(i)

for fiscal year 2013, not less than $2,000,000; and

(ii)

for each subsequent fiscal year, not less than the sum of—

(I)

$100,000; and

(II)

the amount made available under this subparagraph for the fiscal year preceding the year for which the sum is determined;

;

(H)

by striking paragraph (21) and inserting the following:

(21)
(A)

establish information and assistance services as priority services for older individuals, and ensure that quality information and assistance services are consistently provided to older individuals;

(B)

ensure that there is full collaboration between all governmental information and assistance systems that serve older individuals, whether specialized, crisis intervention, disaster assistance, or other; and

(C)

develop and operate, either directly or through contracts, grants, or cooperative agreements, a National Eldercare Locator Service, providing information and assistance services through a nationwide toll free number to identify community resources, including certified, nonprofit financial services for older individuals;

;

(I)

by striking paragraph (22) and inserting the following:

(22)

develop guidelines for area agencies on aging to follow in—

(A)

choosing and evaluating providers of legal assistance with the capacity to work within an integrated legal assistance delivery system; and

(B)

collecting data and reporting to the State agency;

;

(J)

in paragraph (23), by striking all text following developers and inserting referred to in section 307(a)(13) and section 731;;

(K)

by redesignating paragraphs (25) through (28) as paragraphs (26) through (29), respectively;

(L)

by inserting after paragraph (24) the following:

(25)
(A)

conduct a planning and feasibility study—

(i)

with the intent of establishing a national database of local service organizations or local senior community service employment programs authorized under title V that offer volunteer placements; and

(ii)

on the capacity, as of the date of the study, of the aging network to manage such a database; and

(B)

not later than 2 years after the date of enactment of the Older Americans Act Amendments of 2012, submit to Congress the results of the study conducted under subparagraph (A);

;

(M)

in paragraph (28), as redesignated by subparagraph (K), by striking and at the end;

(N)

in paragraph (29), as redesignated by subparagraph (K), by striking the period and inserting a semicolon; and

(O)

by adding at the end the following:

(30)

conduct studies and collect data to determine the services that are needed by LGBT older individuals;

(31)

collaborate and consult with the heads of Federal entities, including the Director of the Centers for Disease Control and Prevention and the Assistant Secretary for Preparedness and Response of the Department of the Health and Human Services, and the Secretary of Homeland Security, as appropriate, to provide technical assistance, training, and other assistance to States and area agencies on aging for the development and revision of emergency preparedness plans; and

(32)
(A)

encourage, provide technical assistance to and share best practices with, States, area agencies on aging, Aging and Disability Resource Centers, and service providers to carry out outreach and coordinate activities with health care entities in order to assure better care coordination for individuals with multiple chronic illnesses; and

(B)

coordinate activities with other Federal agencies that are working to improve care coordination and developing new models and best practices for that coordination.

;

(2)

in subsection (b)—

(A)

in paragraph (8)—

(i)

in subparagraph (D)—

(I)

by inserting , and with future planning for eligible care recipients (as defined in section 372(a)) who are individuals with disabilities described in section 372(a)(2)(B) and who are living with older relative caregivers (as so defined) after needs; and

(II)

by striking and at the end; and

(ii)

by adding at the end the following:

(F)

to provide quality assurance information, relating to the standards identified under paragraph (11)(A), using the methods described in paragraph (11)(B), about home and community-based long-term care programs, service providers, and resources, when referring consumers to those programs, providers, or resources; and

(G)

that may carry out the informal caregiver assessment program described in subsection (i);

;

(B)

in paragraph (9)—

(i)

in the matter preceding subparagraph (A), by striking and community-based service providers and inserting community-based service providers, and, for purposes of subparagraph (C), Aging and Disability Resource Centers,;

(ii)

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

(iii)

subparagraph (B), by adding and at the end; and

(iv)

by adding at the end the following:

(C)

methods, consistent with the methods described in paragraph (11)(B), to communicate to consumers quality assurance information, relating to the standards identified under paragraph (11)(A), about home and community-based long-term care programs, service providers, and resources;

;

(C)

in paragraph (10), by striking and at the end;

(D)

by redesignating paragraph (11) as paragraph (12); and

(E)

by inserting after paragraph (10) the following:

(11)
(A)

identify, in consultation with States (either directly or by entering into a contract under this subparagraph and considering the recommendation of the contract recipient) quality assurance standards for home and community-based long-term care programs, service providers, and resources that—

(i)

shall be designed to ensure the health, safety, and welfare of consumers who are referred to such programs, service providers, and resources by area agencies on aging, Aging and Disability Resource Centers, and such other entities as the Assistant Secretary determines to be appropriate; and

(ii)

shall be identified after the Assistant Secretary takes into account, at a minimum, standards for—

(I)

background checks of service providers;

(II)

licensure of agencies and certification and training of service providers;

(III)

consumer satisfaction regarding programs, service providers, and resources, in cases in which consumer satisfaction information is available; and

(IV)

such additional matters as the Assistant Secretary determines to be appropriate; and

(B)

taking into account the variation in communication infrastructure development among Aging and Disability Resource Centers, establish consumer-friendly methods for communicating to consumers, consistently throughout a State—

(i)

quality assurance information relating to the standards identified under subparagraph (A) about home and community-based long-term care programs, service providers, and resources to which such consumers are referred to by area agencies on aging, Aging and Disability Resource Centers, and such other entities as the Assistant Secretary determines to be appropriate; and

(ii)
(I)

the content of the State certification or licensure requirements applicable to such home and community-based long-term care programs, service providers, or resources; or

(II)

an explanation that the State does not have certification or licensure requirements applicable to such home and community-based long-term care programs, service providers, or resources; and

;

(3)

in subsection (e)(2)(B)—

(A)

in clause (viii), by striking and;

(B)

by redesignating clause (ix) as clause (x); and

(C)

by inserting after clause (viii) the following:

(ix)

organizations with expertise on economic security, asset accumulation, and retirement planning; and

; and

(4)

by adding at the end the following:

(g)

The Assistant Secretary shall—

(1)

ensure, where appropriate, that all programs funded under this Act include appropriate training in the prevention of abuse, neglect, and exploitation and provision of services that address elder justice and exploitation; and

(2)

periodically update determinations about the need for and benefit of such training related to prevention of abuse, neglect, and exploitation of older adults.

(h)
(1)

The Assistant Secretary shall establish and operate the National Resource Center for Women and Retirement (in this subsection referred to as the Center).

(2)

In operating the Center, the Assistant Secretary shall—

(A)

annually compile, publish, and disseminate a summary of recently conducted research on women and retirement security;

(B)

develop and maintain an information clearinghouse on all programs (including private programs) showing promise of success for providing retirement and financial information to women;

(C)

develop, maintain, and disseminate consumer information and public education materials regarding retirement and financial security for women;

(D)

compile, publish, and disseminate training materials for personnel who are engaged or intend to engage in outreach to women, particularly to populations that are traditionally hard to reach with retirement and financial information, such as caregivers, ethnic minorities, and low-income women;

(E)

provide technical assistance to State agencies and to other public and nonprofit private agencies and organizations to assist the agencies and organizations described in this subparagraph in planning, improving, developing, and carrying out programs and activities relating to providing women with the necessary financial management tools for secure retirement;

(F)

work in collaboration with other national and local organizations serving older individuals to make efficient use of resources related to women and retirement; and

(G)

conduct research and demonstration projects regarding the most effective methods and tools to assist women in preparing for secure retirement.

(3)
(A)

The Assistant Secretary shall carry out paragraph (2) through grants or contracts.

(B)

The Assistant Secretary shall issue criteria applicable to the recipients of funds under this subsection, which shall include experience carrying out the activities described in paragraph (2). To be eligible to receive a grant or enter into a contract under subparagraph (A), 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.

(C)

The Assistant Secretary shall make available to the Center such resources as are necessary for the Center to carry out effectively the functions of the Center under this Act, which shall be an amount not less than $750,000 for fiscal year 2013. In subsequent fiscal years, the Assistant Secretary shall make available to the Center not less than the amount of resources made available to the Center under this subparagraph for fiscal year 2013.

(i)
(1)

Aging and Disability Resource Centers implemented under subsection (b)(8) may carry out an assessment program with respect to informal caregivers and care recipients. Such assessment program shall be modeled on the family caregiver assessment program established under section 373(b).

(2)

For purposes of an informal caregiver assessment carried out in accordance with paragraph (1), the following definitions shall apply:

(A)

The term care recipient means—

(i)

an older individual;

(ii)

an individual with a disability; or

(iii)

an individual with a special need.

(B)

The term individual with a special need means an individual who requires care or supervision to—

(i)

meet the individual's basic needs;

(ii)

prevent physical self-injury or injury to others; or

(iii)

avoid placement in an institutional facility.

(C)
(i)

Subject to clause (ii), the term informal caregiver means an adult family member, or another individual, who is an informal provider of in-home and community care to a care recipient.

(ii)

A State that has a State law with an alternate definition of the term informal caregiver for purposes of a program described in paragraph (1) may use that definition (with respect to caregivers for care recipients) for purposes of provisions of this Act that relate to that program, if such alternative definition is broader than the definition in clause (i), and subject to approval by the Assistant Secretary.

(j)
(1)

The Assistant Secretary shall, directly or by grant or contract, establish and operate the National Resource Center on Lesbian, Gay, Bisexual, and Transgender Aging (in this subsection referred to as the Center).

(2)

To address the unique challenges faced by LGBT older adults, the Center shall provide national, State, and local organizations, including those with a primary mission of serving LGBT individuals, and those with a primary mission of serving older adults, with the information and technical assistance the organizations need to effectively serve LGBT older adults.

(3)

The Center shall have 3 primary objectives, consisting of—

(A)

educating aging services organizations about the existence and special needs of LGBT older adults;

(B)

sensitizing LGBT organizations about the existence and special needs of older adults; and

(C)

providing educational resources to LGBT older adults and their caregivers.

(4)
(A)

To be eligible to receive funds under this subsection, an entity—

(i)

shall have demonstrated expertise in working with organizations or individuals on issues affecting LGBT individuals;

(ii)

shall have documented experience in providing training and technical assistance on a national basis or a formal relationship with an organization that has that experience; and

(iii)

shall meet such other criteria as the Assistant Secretary shall issue.

(B)

To be eligible to receive funds under this subsection, 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.

(5)

The Assistant Secretary shall make available to the Center on an annual basis such resources as are necessary for the Center to carry out effectively the functions of the Center under this Act and not less than the amount of resources made available to the National Resource Center on Lesbian, Gay, Bisexual, and Transgender Aging for fiscal year 2012.

(6)

The Assistant Secretary shall develop and issue operating standards and reporting requirements for the Center.

.

203.

Federal agency consultation

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

(1)

in subsection (b)—

(A)

in paragraph (18), by striking , and and inserting a comma;

(B)

in paragraph (19), by striking the period at the end and inserting a comma; and

(C)

by adding at the end the following:

(20)

the Patient Protection and Affordable Care Act, including the amendments made by that Act (Public Law 111–148), including programs that increase integration with community health centers, as practicable, and

(21)

title XXIX of the Public Health Service Act (42 U.S.C. 300ii et seq.).

; and

(2)

in subsection (c)(6)—

(A)

in subparagraph (A)—

(i)

in clause (iii)—

(I)

by inserting and economic after demographic; and

(II)

by striking and at the end;

(ii)

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

(iii)

by adding at the end the following:

(v)

identifying and addressing workforce shortages related to services and supports for older individuals, and leveraging the resources of Federal programs that are related to the programs carried out under this Act, to address the shortages;

; and

(B)

in subparagraph (B)—

(i)

in the matter preceding clause (i), by inserting economic security, after housing,; and

(ii)

in clause (i), by inserting economic security, after housing,;

(C)

in subparagraph (D), by inserting economic security, after housing,;

(D)

in subparagraph (E), by inserting and economic security after public health;

(E)

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

(F)

in subparagraph (G)—

(i)

in the matter preceding clause (i), by inserting economic security, after health care,; and

(ii)

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

(G)

by adding at the end the following:

(H)
(i)

identify model Federal programs to assist older individuals with achieving economic security; and

(ii)

propose greater coordination of efforts to provide such assistance, including by creating an inventory of all Federal programs aimed at reducing poverty and increasing the economic security of older adults.

.

204.

Evaluation

Section 206 of the Older Americans Act of 1965 (42 U.S.C. 3017) is amended—

(1)

in subsection (d), by striking including, as appropriate, health and nutrition education demonstration projects conducted under section 307(f) the full contents of which shall be and inserting and the full contents of those summaries and analyses shall be;

(2)

by redesignating subsections (e) through (g) as subsections (f) through (h), respectively;

(3)

by inserting after paragraph (d) the following:

(e)

The Secretary shall prepare and submit to Congress an annual report evaluating the impact of area agencies on aging on the economic security of older individuals.

; and

(4)

in subsection (h), as redesignated by paragraph (2), by striking 1/2 of.

205.

Reports

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

(1)

in subsection (a)—

(A)

in paragraph (2), by striking section 202(a)(19) and inserting section 202(a)(16);

(B)

in paragraph (3), by striking , with particular attention and all that follows through the semicolon and inserting (with particular attention to individuals with factors listed in section 102(26)(B));; and

(C)

in paragraph (4), by striking section 202(a)(17) and inserting section 202(a)(14);

(2)

in subsection (b)—

(A)

in paragraph (1)(C), by inserting and the adult protection services programs of the States after of the States; and

(B)

in paragraph (3)(A), by striking Health Care Finance Administration and inserting Centers for Medicare & Medicaid Services;

(3)

in subsection (c)—

(A)

in paragraph (1), by inserting , and separately specify the number of such individuals who are LGBT individuals before the semicolon;

(B)

by redesignating paragraphs (4) and (5) as paragraphs (5) and (6), respectively; and

(C)

by inserting after paragraph (3) the following:

(4)

the effectiveness of such activities in assisting LGBT individuals;

; and

(4)

by adding at the end the following:

(d)

The Assistant Secretary shall ensure that—

(1)

no individual will be required to provide information regarding the sexual orientation or gender identity of the individual as a condition of participating in activities or receiving services under this Act; and

(2)

no agency or other entity providing activities or services under this Act, that receives, for the purposes of this Act, information regarding the sexual orientation or gender identity of an individual will disclose the information in any form that would permit such individual to be identified.

(e)

The Assistant Secretary shall develop appropriate protocols, demonstrations, tools, or guidance for use by State agencies and area agencies on aging, to ensure successful implementation of data collection requirements under section 201(d)(3)(J), paragraphs (16)(A)(ii) and (30) of section 202(a), subsections (a)(3), (c)(1), and (c)(4), and section 307(a)(6), relating to LGBT individuals.

(f)

The Assistant Secretary shall determine when such data collection requirements shall apply, taking into consideration the complexity and importance of each requirement, but each requirement shall apply not later than September 30, 2014.

.

206.

Conforming amendment

Section 215(j) of the Older Americans Act of 1965 (42 U.S.C. 3020e–1(j)) is amended by striking section 216 and inserting section 217.

207.

Authorization of appropriations

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

(1)

in subsection (a), by striking 2007, 2008, 2009, 2010, and 2011 and inserting 2013, 2014, 2015, 2016, and 2017;

(2)

in subsection (b)—

(A)

by striking section 202(a)(24) and inserting section 202(a)(21); and

(B)

by striking 2007, 2008, 2009, 2010, and 2011 and inserting 2013, 2014, 2015, 2016, and 2017;

(3)

in subsection (c), by striking 2007, 2008, 2009, 2010, and 2011 and inserting 2013, 2014, 2015, 2016, and 2017; and

(4)

by adding at the end the following:

(d)

National Adult Protective Services Resource Center

There are authorized to be appropriated to carry out section 201(i) (relating to the National Adult Protective Services Resource Center), such sums as may be necessary for fiscal years 2013, 2014, 2015, 2016, and 2017.

(e)

Advisory Committee To Assess, Coordinate, and Improve Legal Assistance Activities

There is authorized to be appropriated to carry out section 216, $300,000 for fiscal year 2013.

.

208.

Advisory Committee to Assess, Coordinate, and Improve Legal Assistance Activities

(a)

In general

Title II of the Older Americans Act of 1965 is amended—

(1)

by redesignating section 216 (42 U.S.C. 3020f) as section 217; and

(2)

by inserting after section 215 (42 U.S.C. 3020e–1) the following:

216.

Advisory Committee to Assess, Coordinate, and Improve Legal Assistance Activities

(a)

Establishment

There is established an Advisory Committee to Assess, Coordinate, and Improve Legal Assistance Activities (referred to in this section as the Committee).

(b)

Membership

(1)

Composition

The Committee shall be composed of 9 members—

(A)

with expertise with existing State legal assistance development programs carried out under section 731 and providers of State legal assistance under subtitle B of title III and title IV; and

(B)

who shall be individuals appointed by the Assistant Secretary—

(i)

1 of whom shall be a consumer advocate;

(ii)

1 of whom shall be a professional advocate from a State agency or State legal assistance developer;

(iii)

4 of whom shall be representatives from collaborating organizations under the National Legal Resource Center of the Administration;

(iv)

1 of whom shall be from a program providing legal assistance under part B of title III; and

(v)

1 of whom shall be from an area agency on aging.

(2)

Date

The appointments of the members of the Committee shall be made not later than 9 months after the date of enactment of the Older Americans Act Amendments of 2012.

(3)

Period of appointment; vacancies

Members shall be appointed for the life of the Committee. Any vacancy in the Committee shall not affect its powers, but shall be filled in the same manner as the original appointment.

(4)

Chairperson and vice chairperson

The Committee shall select a Chairperson and Vice Chairperson from among its members.

(c)

Initial meeting

The Committee shall hold its first meeting not later than 9 months after the date of enactment of the Older Americans Act Amendments of 2012.

(d)

Duties of the Committee

(1)

Definition

In this subsection, the term legal assistance activities includes—

(A)

legal assistance made available to older individuals with greatest economic need or with greatest social need;

(B)

activities of the National Legal Resource Center carried out under section 420(a);

(C)

State legal assistance developer activities carried out under section 731; and

(D)

any other directly related activity or program as determined appropriate by the Assistant Secretary.

(2)

Study

(A)

In general

The Committee shall design, implement, and analyze results of a study of—

(i)

the extent to which State leadership is provided through the State legal assistance developer in States to enhance the coordination and effectiveness of legal assistance activities across the State;

(ii)

the extent to which—

(I)

there is data collection and reporting of information by legal assistance providers in States;

(II)

there is uniform statewide reporting among States; and

(III)

the value and impact of services provided by the providers is being measured at the State or local level; and

(iii)

the mechanisms to organize and promote legal assistance activities and development to best meet the needs of older individuals with greatest economic need and greatest social need, with particular attention to individuals with factors listed in section 102(26)(B).

(B)

Considerations

In carrying out subparagraph (A)(i), particular attention shall be given to—

(i)

State leadership on targeting limited legal resources to older individuals with greatest economic need and greatest social need, with particular attention to individuals with factors listed in section 102(26)(B); and

(ii)

State leadership on establishing priority legal issue areas in accordance with section 307(a)(11)(E).

(3)

Recommendations

After completion of the study and analysis of study results under paragraph (2), the Committee shall develop recommendations for the establishment of regulations or guidance for—

(A)

enhancing the leadership capacity of the State legal assistance developers to carry out statewide coordinated legal assistance activities, with particular focus on enhancing leadership capacity to—

(i)

target limited legal resources to older individuals with greatest economic need and greatest social need, with particular attention to individuals with factors listed in section 102(26)(B); and

(ii)

establish priority legal issue areas in accordance with section 307(a)(11)(E);

(B)

developing a uniform national data collection system to be implemented in all States on legal assistance activities and development;

(C)

State agencies in conducting an assessment of the adequacy of the current funding (as of the date of the assessment) provided through the minimum proportion of the funds received by each area agency on aging in the State to carry out part B that must be expended on legal services (as specified in section 306(a)(2)(C) and section 307(a)(2)(C)); and

(D)

identifying mechanisms for organizing and promoting legal assistance activities to provide the highest quality, impact, and effectiveness to older individuals with greatest economic need and greatest social need, with particular attention to individuals with factors listed in section 102(26)(B).

(4)

Report

Not later than 1 year after the date of the establishment of the Committee, the Committee shall submit to the President, Congress, and the Assistant Secretary a report that contains a detailed statement of the findings and conclusions of the Committee, together with the recommendations described in paragraph (3).

(e)

Duties of the Assistant Secretary

Not later than 180 days after receiving the report described in subsection (d)(4), the Assistant Secretary shall issue regulations or guidance on the topics described in subsection (d)(3), taking into consideration the recommendations described in subsection (d)(3).

(f)

Powers

(1)

Information from Federal agencies

The Committee may secure directly from any Federal department or agency such information as the Committee considers necessary to carry out the provisions of this section. Upon request of the Committee, the head of such department or agency shall furnish such information to the Committee.

(2)

Postal services

The Committee may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government.

(g)

Personnel and administration

(1)

Travel expenses

The members of the Committee shall not receive compensation for the performance of services for the Committee, but shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of chapter 57 of title 5, United States Code, while away from their homes or regular places of business in the performance of services for the Committee. Notwithstanding section 1342 of title 31, United States Code, the Secretary may accept the voluntary and uncompensated services of members of the Committee.

(2)

Detail of government employees

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.

(3)

Administrative and support services

The Assistant Secretary shall provide administrative and support services to the Committee.

(4)

Procurement of temporary and intermittent services

The Chairman of the Committee may procure temporary and intermittent services under section 3109(b) of title 5, United States Code, at rates for individuals that do not exceed the daily equivalent of the annual rate of basic pay prescribed for level V of the Executive Schedule under section 5316 of such title.

(h)

Exemption from termination requirements

Section 14 of the Federal Advisory Committee Act shall not apply to the Committee.

.

209.

Consumer Price Index

(a)

In general

The Secretary of Labor, through the Bureau of Labor Statistics and in consultation with the Assistant Secretary for Aging, shall revise and improve the Experimental Price Index for the Elderly published by the Bureau of Labor Statistics (commonly referred to as the CPI–E) in order for the CPI–E to be considered a reliable measure in determining future cost of living adjustments that impact Americans who are 62 years of age or older.

(b)

Revision requirements

In carrying out subsection (a), the Secretary of Labor shall—

(1)

increase the number of individuals in the United States who are 62 years of age and older (referred to in this section as older adults) sampled in the consumer expenditure survey used to establish the CPI–E;

(2)

establish samples of market-based items, stores, and prices to represent the purchasing patterns of older adults; and

(3)

examine the medical care component, including the cost and usage of prescription drugs, of the CPI–E taking into account that older adults have different illnesses and medical expenses, including oral health medical expenses, than individuals in the United States who are under 62 years of age.

(c)

Report to Congress

Not later than 2 years after the date of enactment of this Act, the Secretary of Labor shall submit to Congress a report that describes the revised CPI–E and the activities carried out by the Secretary under this section.

210.

Functions within the Administration on Aging to assist Holocaust survivors

(a)

Designation of individual within the Administration

The Assistant Secretary on Aging is authorized to designate within the Administration on Aging a person who has specialized training, background, or experience with Holocaust survivor issues to have responsibility for implementing services for older individuals who are Holocaust survivors.

(b)

Annual report to Congress

The Assistant Secretary on Aging, with assistance from the individual designated under subsection (a), shall prepare and submit to Congress an annual report on the status and needs, including the priority areas of concern, of older individuals who are Holocaust survivors.

(c)

Definitions

In this section, the terms older individual and Holocaust survivor have the meanings given the terms in section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002).

III

Grants for State and community programs on aging

301.

Purpose; administration

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

(1)

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

(2)

in subparagraph (F), by striking the period and inserting a semicolon; and

(3)

by adding at the end the following:

(G)

Federally qualified health centers, as defined in sections 1861(aa)(4) and 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(4), 1396d(l)(2)(B)); and

(H)

organizations that serve LGBT individuals.

.

302.

Definition

Section 302 of the Older Americans Act of 1965 (42 U.S.C. 3022) is amended—

(1)

by striking paragraph (3); and

(2)

by redesignating paragraph (4) as paragraph (3).

303.

Authorization of appropriations

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

(1)

in subsection (a), by striking paragraph (1) and inserting the following:

(1)

There are authorized to be appropriated to carry out part B (relating to supportive services) such sums as may be necessary for each of fiscal years 2013, 2014, 2015, 2016, and 2017.

;

(2)

by striking subsection (b) and inserting the following:

(b)
(1)

There are authorized to be appropriated to carry out subpart 1 of part C (relating to congregate nutrition services) such sums as may be necessary for each of fiscal years 2013, 2014, 2015, 2016, and 2017.

(2)

There are authorized to be appropriated to carry out subpart 2 of part C (relating to home delivered nutrition services) such sums as may be necessary for fiscal years 2013, 2014, 2015, 2016, and 2017.

;

(3)

by striking subsection (d) and inserting the following:

(d)

There are authorized to be appropriated to carry out part D (relating to disease prevention and health promotion services) such sums as may be necessary for each of fiscal years 2013, 2014, 2015, 2016, and 2017.

;

(4)

by striking subsection (e) and inserting the following:

(e)
(1)

There are authorized to be appropriated to carry out part E (relating to family caregiver support) $250,000,000 for each of fiscal years 2013 through 2017.

(2)

Of the funds appropriated under paragraph (1), not more than 1 percent of such funds may be reserved to carry out activities described in section 411(a)(11).

; and

(5)

by adding at the end the following:

(f)

It is the sense of Congress that—

(1)

in order to carry out part B (relating to supportive services), the amount appropriated under subsection (a)(1) should be not less than $551,000,000 for fiscal year 2013;

(2)

in order to carry out subparts 1 and 2 of part C (relating to nutrition services), the amount appropriated under subsection (b) should be not less than $1,200,000,000 for fiscal year 2013; and

(3)

in order to carry out part D (relating to disease prevention and health promotion services), the amount appropriated under subsection (d) should be not less than $32,000,000 for fiscal year 2013.

.

304.

Allotments

Section 304(b) of such Act (42 U.S.C. 3024(b)) is amended, in the first sentence, by striking part B and all that follows through part E, and inserting part B, C, or E.

305.

Organization

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

(1)

in subsection (a)—

(A)

in paragraph (2)—

(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 adding at the end the following:

(iii)

the distribution among planning and service areas of service providers who specialize in serving populations of older individuals with greatest social need;

; and

(ii)

in subparagraph (G)—

(I)

by striking clause (ii) and inserting the following:

(ii)

provide an assurance that the State agency will undertake specific program development, advocacy, and outreach efforts focused on the needs of older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)) and older individuals with greatest economic need; and

; and

(II)

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

(B)

in paragraph (3)(E)—

(i)

in the matter before clause (i), by striking information relating to;

(ii)

in clause (i)—

(I)

by inserting information relating to after (i); and

(II)

by striking and at the end;

(iii)

in clause (ii)—

(I)

by inserting information relating to after (ii); and

(II)

by striking the period and inserting ; and; and

(iv)

by adding at the end the following:

(iii)

quality assurance information, relating to the standards identified under section 202(b)(11)(A), about home and community-based long-term care programs, service providers, and resources, provided through methods described in section 202(b)(11)(B), when the Aging and Disability Resource Centers, area agencies on aging, and such other entities as the Assistant Secretary determines to be appropriate, refer consumers to those programs, providers, and resources in the State; and

; and

(C)

by adding at the end the following:

(4)

the State agency shall promote the development and implementation of a State system to address the care coordination needs of older individuals with multiple chronic illnesses, and shall work with acute care providers, area agencies on aging, service providers, and Federal agencies to ensure that the system uses best practices and is evaluated on its provision of care coordination.

; and

(2)

in subsection (b)(5)(C)(i)(III), by striking planning and services areas and inserting planning and service areas.

306.

Area plans

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

(1)

in subsection (a)—

(A)

in paragraph (1), by striking maintenance, or construction of multipurpose senior centers and inserting maintenance, modernization, or construction of multipurpose senior centers (which system includes a plan to use the skills and services of older individuals in paid and unpaid work, including multigenerational work and older individual-to-older individual service activities, relating to such maintenance, modernization, or construction, or activities at the centers);

(B)

in paragraph (2)(A)—

(i)

by striking mental health services and inserting evidence-based mental health services, evidence-based chronic condition self-care management programs, and evidence-based falls prevention programs; and

(ii)

by striking eligible) and inserting eligible and shall include information on paid and unpaid work opportunities for older individuals);

(C)

in paragraph (4)(B)(i)(VII) by inserting with multiple chronic illnesses or after older individuals;

(D)

in paragraph (6)—

(i)

in subparagraph (D), by inserting (including acute care providers) after service providers;

(ii)

in subparagraph (E)(ii), by inserting and Federally qualified health centers, as defined in sections 1861(aa)(4) and 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(4), 1396d(l)(2)(B)) after 203(b); and

(iii)

by adding at the end the following:

(H)
(i)

in coordination with the State agency and with the State agency responsible for elder abuse prevention services, increase public awareness of elder abuse and exploitation, and remove barriers to elder abuse education, prevention, investigation, and treatment;

(ii)

coordinate elder justice activities (including screenings) provided by the area agency on aging, community health centers, other public agencies, and nonprofit private organizations;

(iii)

develop standardized, coordinated, and reporting protocols with respect to elder abuse; and

(iv)

report any instances elder abuse in accordance with State law; and

(I)

serve as an advocate in the corresponding planning and service area for evidence-based falls prevention programs and policies for older individuals, and, if possible, enter into partnerships with State government agencies (such as the State health agency and State transportation agency), local agencies, and community-based organizations that implement evidence-based falls prevention programs and policies, in order to increase public awareness of and access to in-home and community-based evidence-based falls prevention strategies, services, and programs that aim to improve the health of older individuals and reduce health care costs;

;

(E)

in paragraph (7)—

(i)

in subparagraph (B)(iii), by striking placement, to permit such individuals and inserting placement, with particular attention to individuals with factors listed in section 102(26)(B), to permit such at-risk individuals;

(ii)

in subparagraph (C)—

(I)

by inserting (including falls) after injury; and

(II)

by striking and at the end;

(iii)

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

(iv)

by adding at the end the following:

(E)

implementing, through the agency or service providers, evidence-based health promotion, chronic condition self-care management, and falls prevention programs, to assist older individuals and their family caregivers in learning about and making behavioral changes intended to improve health outcomes, reduce the impact of living with multiple chronic health conditions, and reduce health care spending;

;

(F)

by striking paragraph (9) and inserting the following:

(9)

provide assurances that the area agency on aging, in carrying out the State Long-Term Care Ombudsman program described in section 307(a)(9), will—

(A)

provide adequate funding to conduct an effective Ombudsman program in compliance with this Act; and

(B)

expend not less than the total amount of funds appropriated under this Act or made available through other resources, and expended by the agency in fiscal year 2010, in carrying out such a program under this Act;

;

(G)

in paragraph (16), by striking and at the end;

(H)

in paragraph (17)—

(i)

by inserting and revise after develop;

(ii)

by inserting and health after State emergency response; and

(iii)

by striking the period and inserting a semicolon; and

(I)

by adding at the end the following:

(18)

include information describing—

(A)

how the area agency on aging will engage in outreach to veterans who are eligible for services under this Act; and

(B)

effective and efficient procedures for the coordination of services provided under this Act with services provided to veterans by the Department of Veterans Affairs and other providers;

(19)

describe how the area agency on aging will leverage its position as the primary community-based provider of senior support services to—

(A)

champion the cause of economic security for older individuals among community members, political leaders, businesses, and families;

(B)

concentrate resources of the area agency on aging toward promoting economic security for older individuals at both the individual and community level; and

(C)

serve as a community resource for older individuals who lack the economic, social, or familial supports necessary to age with dignity;

(20)

provide assurances that the area agency on aging will—

(A)

identify existing (as of the date of submission of the plan) care coordination programs and systems;

(B)

identify unmet community need for care coordination;

(C)

facilitate the development and implementation of an area-wide system to address the care coordination needs of older individuals with multiple chronic illnesses; and

(D)

work with acute care providers, service providers, and Federal and State agencies to ensure that the system uses best practices in its provision of care coordination;

(21)

provide assurances that programming, services, and outreach will be developed and implemented in a culturally and linguistically competent manner, for older individuals with greatest social need;

(22)

provide assurances that staff training includes instruction on cultural and linguistic competence in the provision of services to older individuals with greatest social need;

(23)

provide assurances that the services of providers who are contractors will be provided in a culturally and linguistically competent manner; and

(24)

provide assurances that, to the extent feasible, services provided in response to elder abuse will be provided in a culturally and linguistically competent manner.

; and

(2)

in subsection (b)(3)—

(A)

in subparagraph (J), by striking and;

(B)

by redesignating subparagraph (K) as subparagraph (L); and

(C)

by inserting after subparagraph (J) the following:

(K)

protection from elder abuse, neglect, and exploitation; and

.

307.

State plans

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

(1)

in paragraph (2), by striking subparagraph (A) and inserting the following:

(A)

evaluate, using uniform procedures described in section 202(a)(27), the need for supportive services (including legal assistance pursuant to paragraph (11), information and assistance, care coordination, and transportation services), nutrition services, economic security and benefits counseling, and multipurpose senior centers within the State;

;

(2)

by striking paragraph (9) and inserting the following:

(9)

The plan shall provide assurances that the State agency will carry out, through the Office of the State Long-Term Care Ombudsman, a State Long-Term Care Ombudsman program in accordance with section 712 and this title, and, in carrying out the program, will—

(A)

provide adequate funding to conduct an effective Ombudsman program in compliance with this Act; and

(B)

expend not less than the total amount of funds appropriated under this Act or made available through other resources, and expended by the agency in fiscal year 2010, in carrying out such a program under this Act.

;

(3)

in paragraph (11), in the matter preceding subparagraph (A), by striking legal assistance— and inserting legal assistance, which shall be provided through an integrated legal assistance delivery system—;

(4)

in paragraph (12)—

(A)

by redesignating subparagraphs (B) and (C) as subparagraphs (C) and (D); and

(B)

by inserting after subparagraph (A) the following:

(B)

that the State will develop and implement standardized protocols for screening and reporting with respect to elder abuse;

;

(5)

by striking paragraph (15) and inserting the following:

(15)
(A)

The plan shall provide assurances that programming and services will be provided in a culturally and linguistically competent manner to older individuals with greatest social need, and that the State will require the area agency on aging for each planning and service area in which a significant number of older individuals are limited English proficient—

(i)

to utilize in the provision of such programming and services, workers who are fluent in the language spoken by a predominant number of such older individuals who are limited English proficient; and

(ii)

to designate an individual employed by the area agency on aging, or available to such area agency on aging on a full-time basis, whose responsibilities will include—

(I)

taking such action as may be appropriate to assure that programming, services, and outreach are developed and implemented in a culturally and linguistically competent manner for older individuals with greatest social need; and

(II)

providing guidance to individuals engaged in the delivery of services under the area plan involved to enable such individuals to deliver the services in a culturally and linguistically competent manner.

(B)

The plan shall provide assurances that, if a substantial number of the older individuals residing in any planning and service area in the State are limited English proficient, then the State will require the area agency on aging for each such planning and service area to utilize, in the delivery of outreach services under section 306(a)(2)(A) in a culturally and linguistically competent manner, the services of workers who are fluent in the language spoken by a predominant number of such older individuals who are limited English proficient.

;

(6)

in paragraph (16)—

(A)

in subparagraph (A), by striking clauses (i) through (vi) and inserting the following:

(i)

older individuals with greatest economic need;

(ii)

older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)); and

(iii)

caregivers of individuals described in clause (i) or (ii); and

; and

(B)

in subparagraph (B)—

(i)

by striking through (vi) and inserting and (ii); and

(ii)

by striking caretakers and inserting caregivers;

(7)

in paragraph (17), by striking and develop collaborative programs, where appropriate, and inserting , ensure care coordination, and (where appropriate) develop collaborative programs,;

(8)

in paragraph (18), in the matter preceding subparagraph (A), by inserting and ensure care coordination that integrates long-term care services and other care services, before for older;

(9)

by striking paragraph (20) and inserting the following:

(20)

The plan shall provide assurances that special efforts will be made to provide technical assistance to minority providers of services and to providers who specialize in serving populations of older individuals with greatest social need.

;

(10)

in paragraph (23)(A), by striking with other State services and inserting with other Federal and State health care programs and services;

(11)

in paragraph (28)(B)—

(A)

by striking clause (i) and inserting the following:

(i)

the projected change in the number of older individuals in the State, and the dispersal and growth in the number of older individuals with greatest social need in each planning and service area in the State;

; and

(B)

by striking clause (iii) and inserting the following:

(iii)

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

;

(12)

in paragraph (29)—

(A)

by inserting and revise after develop; and

(B)

by inserting and health after local emergency response; and

(13)

by adding at the end the following:

(31)

The plan shall provide assurances that the State agency will, if possible, enter into partnerships with other relevant State government agencies when collaborating with area agencies on aging, local agencies, or community-based organizations described in section 306(a)(6)(I) in order to increase public awareness of and access to in-home and community-based evidence-based falls prevention strategies, services, and programs that aim to improve the health of older individuals and reduce health care costs.

(32)

The plan shall include information describing—

(A)

how the State agency will engage in outreach to veterans who are eligible for services under this Act; and

(B)

effective and efficient procedures for the coordination of services provided under this Act with services provided to veterans by the Department of Veterans Affairs and other providers.

(33)

The plan shall provide assurances that the area agencies on aging in the State will facilitate the area-wide development and implementation of an area-wide system to address the care coordination needs of older individuals with multiple chronic illnesses, and work with acute care providers, service providers, and other Federal and State agencies to ensure that the system uses best practices and is evaluated on its provision of care coordination.

.

308.

Planning, coordination, evaluation, and administration of State plans

Section 308(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 3028(a)(1)) is amended—

(1)

by striking , and the carrying out and inserting , the carrying out; and

(2)

by inserting before the period the following: , and the modernization of such senior centers.

309.

Disaster Relief Reimbursements

Section 310 of the Older Americans Act of 1965 (42 U.S.C. 3030) is amended—

(1)

in the section heading, by inserting and planning after reimbursements; and

(2)

in subsection (b)(2), by inserting section 202(a)(29), emergency planning under this section, or after carry out.

310.

Consumer contributions

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

(1)

in subsection (b)—

(A)

in paragraph (1), by striking 185 percent and inserting 200 percent; and

(B)

in paragraph (3), by adding at the end the following: Contributions under this section shall be used to supplement, and not to supplant, any other funds expended for activities described in this Act.; and

(2)

in subsection (d)—

(A)

by striking Not later and all that follows through shall conduct and inserting Not later than January 1, 2014, and annually thereafter, the Assistant Secretary shall conduct, and submit to the appropriate committees of Congress a report containing the results of,; and

(B)

by adding at the end the following: The Assistant Secretary shall include in the report an evaluation of the methods used, by the area agencies on aging and service providers under this Act, to ensure that the consumer contributions are used to supplement the services for which the contributions were collected..

311.

Study of nutrition projects

Section 317(a)(2) of the Older Americans Act Amendments of 2006 (Public Law 109–365) is amended—

(1)

in subparagraph (B), by striking ; and and inserting a semicolon;

(2)

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

(3)

by adding at the end the following:

(D)

an analysis of the ability of service providers to obtain viable contracts for special foods necessary to meet a religious requirement, required dietary need, or ethnic consideration.

.

312.

Supportive services and senior centers program

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

(1)

in subsection (a)—

(A)

in paragraph (5)(C), by striking and letter writing services and inserting evidence-based chronic condition self-care management, and letter writing services, and evidence-based falls prevention programs;

(B)

in paragraph (7)—

(i)

by inserting evidence-based after through; and

(ii)

by striking and dance-movement therapy and inserting dance-movement therapy, chronic condition self-care management, and falls prevention;

(C)

in paragraph (8)—

(i)

by inserting , screening for elder abuse and neglect, and falls prevention screening after mental health screening; and

(ii)

by striking illness, or both, and inserting illnesses and injuries;

(D)

in paragraph (15), by inserting before the semicolon the following: and elder abuse and neglect screening, chronic condition self-care management, and falls prevention services; and

(E)

in paragraph (23), by striking mental health services and inserting evidence-based mental health, chronic condition self-care management, elder abuse, neglect, and exploitation prevention, and falls prevention services; and

(2)

in subsection (b)(1), by inserting or modernization after construction.

313.

Nutrition services

(a)

In general

Section 339(2) of the Older Americans Act of 1965 (42 U.S.C. 3030g–21(2)) is amended—

(1)

in subparagraph (A), by amending clause (iii) to read as follows:

(iii)

to the maximum extent practicable, are adjusted and appropriately funded to meet any special health-related or other dietary needs of program participants, including needs based on religious, cultural, or ethnic requirements,

;

(2)

in subparagraph (J), by striking , and and inserting a comma;

(3)

in subparagraph (K), by striking the period and inserting a comma; and

(4)

by adding at the end the following:

(L)

encourages individuals who distribute nutrition services under subpart 2 to engage in conversation with homebound older individuals and to be aware of the warning signs of medical emergencies, injury, or abuse in order to reduce isolation and promote well-being,

(M)

encourages individuals who distribute nutrition services under subpart 2 to distribute information on diabetes, elder abuse, neglect, exploitation, and the annual Medicare wellness exam, and

(N)

where feasible, encourages the use of locally grown foods in meal programs and identifies potential partnerships and contracts with local producers and providers of locally grown foods.

.

(b)

Special Rule

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

(1)

by inserting before A State the following:

(a)

In general

; and

(2)

by adding at the end the following:

(b)

Transportation

Funds appropriated to carry out this part may be used for transportation costs that can be demonstrated to be directly related to the provision of services specified in this part.

.

314.

Disease prevention and health promotion services

(a)

Program

Section 361 of the Older Americans Act of 1965 (42 U.S.C. 3030m) is amended—

(1)

in subsection (a), in the first sentence—

(A)

by inserting evidence-based after to provide;

(B)

by inserting (through programs such as the programs coordinated through the Sickness Prevention Achieved Through Regional Collaboration program) after promotion services; and

(C)

by inserting before or at the following: at Federally qualified health centers (as defined in sections 1861(aa)(4) and 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1395x(aa)(4), 1396d(l)(2)(B))),;

(2)

by striking subsection (b); and

(3)

by redesignating subsection (c) as subsection (b).

(b)

Clinical preventive services

Part D of title III of the Older Americans Act of 1965 (42 U.S.C. 3030m et seq.) is amended by adding at the end the following:

363.

Clinical preventive services

(a)

Finding

Congress finds that the clinical preventive services described in subsection (c) are covered under the Medicare program carried out under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).

(b)

Purposes

The purpose of this section is to increase the number of older individuals receiving, at a minimum, the clinical preventive services.

(c)

Definition

In this part, the term disease prevention and health promotion services includes diabetes screening and the clinical preventive services consisting of—

(1)

provision of influenza vaccines;

(2)

provision of pneumococcal vaccines;

(3)

breast cancer screening;

(4)

cervical cancer screening;

(5)

colorectal cancer screening;

(6)

hypertension screening; and

(7)

cholesterol screening.

.

315.

National family caregiver support program

(a)

Older relative caregiver

Section 372 of such Act (42 U.S.C. 3030s) is amended—

(1)

in subsection (a)—

(A)

by striking paragraphs (1) and (2) and inserting the following:

(1)

Child

The term child means an individual who is not more than 18 years of age.

(2)

Eligible care recipient

The term eligible care recipient means a relative, of a caregiver, who is—

(A)

a child; or

(B)

an individual with a disability who is not less than 19 and not more than 59 years of age.

(3)

Older relative caregiver

(A)

In general

The term older relative caregiver means a caregiver, as defined in subparagraph (B) or (C), who—

(i)

is 55 years of age or older;

(ii)

lives with, is the informal provider of in-home and community care to, and is the primary caregiver for, an eligible care recipient who is described in subparagraph (B) or (C), respectively; and

(iii)

is not a family caregiver.

(B)

Caregiver for child

For purposes of subparagraph (A), the term caregiver, used with respect to an eligible care recipient who is a child, means an individual who—

(i)

is the grandparent, step­grand­parent, or other relative (other than the parent) by blood, marriage, or adoption, of the eligible care recipient;

(ii)

is the primary caregiver of the eligible care recipient because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the eligible care recipient; and

(iii)

has a legal relationship to the eligible care recipient, such as legal custody or guardianship, or is raising the eligible care recipient informally.

(C)

Caregiver of individual with a disability

For purposes of subparagraph (A), the term caregiver, used with respect to an eligible care recipient who is an individual with a disability described in paragraph (2)(B) means an individual who is the parent, grandparent, or other relative by blood, marriage, or adoption, of the eligible care recipient.

;

(2)

by striking subsection (b);

(3)

by striking (a) In general.—; and

(4)

by striking this subpart: and inserting this part:.

(b)

Program

Section 373 of the Older Americans Act of 1965 (42 U.S.C. 3030s–1) is amended—

(1)

in subsection (a)(2), by striking grandparents or older individuals who are relative caregivers. and inserting older relative caregivers.;

(2)

by redesignating subsections (b) through (g) as subsections (c) through (h), respectively;

(3)

by inserting after subsection (a) the following:

(b)

Assessment program of needs of family caregivers

(1)

In general

The Assistant Secretary may make grants to States to establish a program, in accordance with the program requirements described in paragraph (5), to assess the needs of family caregivers for targeted support services described in paragraph (5)(C).

(2)

Application by States

Each State seeking a grant under this subsection shall submit an application to the Assistant Secretary at such time, in such manner, and containing such information and assurances as the Assistant Secretary determines appropriate.

(3)

Grant amount

The amount of a grant to a State under this subsection shall be determined according to such methodology as the Assistant Secretary determines appropriate.

(4)

Program administration

A State receiving a grant under this subsection may enter into an agreement with area agencies on aging in the State, or an Aging and Disability Resource Center in the State, to administer the program, using such grant funds.

(5)

Program Requirements

(A)

Standardized assessment

Assessments under a program established under paragraph (1)—

(i)

shall be conducted by social workers, care managers, nurses, or other appropriate professionals; and

(ii)
(I)

shall be conducted with a standardized instrument to identify family caregiver needs; and

(II)

in a State in which an area agency on aging or an Aging and Disability Resource Center is using such an instrument on the date of enactment of the Older Americans Act Amendments of 2012, may continue to be conducted with that instrument.

(B)

Questionnaire

(i)

In general

Subject to clause (ii), assessments under a program established as described in paragraph (1) shall include asking the family caregiver relevant questions in order to determine whether the family caregiver would benefit from any targeted support services described in subparagraph (C).

(ii)

Completion on a voluntary basis

The answering of questions under clause (i) by a family caregiver shall be on a voluntary basis.

(iii)

Addressing diverse caregiver needs and preferences

The questionnaire administered under this subparagraph shall be designed in a manner that accounts for, and aims to ascertain, the varying needs and preferences of family caregivers, based on the range of their capabilities, caregiving experience, and other relevant personal characteristics and circumstances.

(C)

Targeted support services described

The following targeted support services are described in this subparagraph:

(i)

Information and assistance (including brochures and online resources for researching a disease or disability or for learning and managing a regular caregiving role, new technologies that can assist family caregivers, and practical assistance for locating services).

(ii)

Individual counseling (including advice and consultation sessions to bolster emotional support for the family caregiver to make well-informed decisions about how to cope with caregiver strain).

(iii)

Support groups, including groups that provide help for family caregivers to—

(I)

locate a support group either locally or online to share experiences and reduce isolation;

(II)

make well-informed caregiving decisions; and

(III)

reduce isolation.

(iv)

Education and training (including workshops and other resources available with information about stress management, self-care to maintain good physical and mental health, understanding and communicating with individuals with dementia, medication management, normal aging processes, change in disease and disability, the role of assistive technologies, and other relevant topics).

(v)

Respite care and emergency back-up services (including, on a short-term basis, in-home care services that give the family caregiver a break from providing such care).

(vi)

Chore services (such as house cleaning) to assist the individual receiving care.

(vii)

Personal care (including outside help) to assist the individual receiving care.

(viii)

Legal and financial planning and consultation (including advice and counseling regarding long-term care planning, estate planning, powers of attorney, community property laws, tax advice, employment leave advice, advance directives, and end-of-life care).

(ix)

Transportation (including transportation to medical appointments) to assist the individual receiving care.

(x)

Other targeted support services, as determined appropriate by the State agency and approved by the Assistant Secretary.

(D)

Referrals

In the case where a questionnaire completed by a family caregiver under subparagraph (B) indicates that the family caregiver would benefit from 1 or more of the targeted support services described in subparagraph (C), the agency administering the program established under paragraph (1) shall provide referrals to the family caregiver for State, local, and private-sector caregiver programs and other resources that provide such targeted support services to such caregivers.

(E)

Targeting and timing of assessments

Assessments under the program established under paragraph (1) may be conducted—

(i)

when an individual who is being assisted by a family caregiver transitions from one care setting to another;

(ii)

upon referral from a social worker, care manager, nurse, physician, or other appropriate professional; or

(iii)

according to circumstances determined by the State and approved by the Assistant Secretary.

(F)

Coordination with other assessment

Assessments under the program established under paragraph (1) may be conducted separately or as part of, or in conjunction with, eligibility or other routine assessments of an individual who is being (or is going to be) assisted by a family caregiver.

(G)

Followup services

As the Assistant Secretary determines appropriate, a State with a program described in paragraph (1) shall conduct followup activities with caregivers who have participated in an assessment under the program to determine the status of the caregivers and whether services were provided.

(H)

Reporting requirement

Each State with a program described in paragraph (1) shall periodically submit to the Assistant Secretary a report containing information on the number of caregivers assessed under the program, information on the number of referrals made for targeted support services under the program (disaggregated by type of service), demographic information on caregivers assessed under the program, and other information required by the Assistant Secretary.

;

(4)

in subsection (c), as redesignated by paragraph (2)—

(A)

in paragraph (4), by striking and at the end;

(B)

in paragraph (5), by striking the period and inserting ; and; and

(C)

by adding at the end the following:

(6)

the efforts of the Ombudsman to facilitate the activities of, and support, the State Long-Term Care Ombudsman program under title VII and this title, and the efforts of the Ombudsman to facilitate the activities of, and support, family and caregiver councils in long-term care facilities.

;

(5)

in subsection (d), as redesignated by paragraph (2)—

(A)

in paragraph (1)—

(i)

in the matter preceding subparagraph (A), by striking and grandparents and older individuals who are relative caregivers, and inserting and older relative caregivers,;

(ii)

in subparagraph (A), by striking paragraph (1) or (2) of ; and

(iii)

in subparagraph (B)—

(I)

by striking subsection (b), in the case of a caregiver described in paragraph (1) and inserting subsection (c), in the case of a caregiver described in subsection (a)(1); and

(II)

by striking section 102(22). and inserting section 102(24).; and

(B)

by striking paragraph (2) and inserting the following:

(2)

Priority

In providing services under this part, the State shall give—

(A)

with respect to family caregivers who provide care for individuals with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction, priority to caregivers who provide care for older individuals with such disease or disorder;

(B)

with respect to older relative caregivers, priority to caregivers—

(i)

who provide care for eligible care recipients described in section 372(a)(2)(B) who have severe disabilities; but

(ii)

who are not the parents of the recipients; and

(C)

priority to caregivers who are older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)), or are older individuals with greatest economic need.

;

(6)

in subsection (e), as redesignated by paragraph (2), by striking subsection (b) and inserting subsection (c);

(7)

in subsection (f)(3), as redesignated by paragraph (2), in the second sentence, by striking or grandparents or older individuals who are relative caregivers, and inserting older relative caregivers,;

(8)

in subsection (g)(1), as redesignated by paragraph (2)—

(A)

in subparagraph (A), by striking for fiscal years 2007, 2008, 2009, 2010, and 2011 and inserting for each of fiscal years 2013 through 2017 and remaining after the reservation described in section 303(e)(2) (if elected) is made; and

(B)

in subparagraph (B), by striking sums appropriated under section 303 and inserting remaining sums described in subparagraph (A); and

(9)

in subsection (h), as redesignated by paragraph (2)—

(A)

in paragraph (2), by striking subparagraph (C) and inserting the following:

(C)

Limitation

A State may use not more than 10 percent of the total Federal and non-Federal share available to the State under this part to provide support services to—

(i)

older relative caregivers who provide care for children; and

(ii)

older relative caregivers—

(I)

who provide care for individuals described in section 372(a)(2)(B); and

(II)

who are the parents of the individuals.

; and

(B)

by adding at the end the following:

(3)

Use of funds for ombudsman program

Amounts made available to a State to carry out the State program under this part may be used to support the Office of the State Long-Term Care Ombudsman, including supporting the development of resident and family councils.

.

(c)

Elimination of superfluous subpart designation

(1)

Heading

Part E of title III of such Act (42 U.S.C. 3021 et seq.) is amended by striking the subpart heading for subpart 1.

(2)

Conforming amendments

Sections 373 (as amended by subsection (b)) and 374 of such Act (42 U.S.C. 3030s–1, 3030s–2) are further amended by striking this subpart in each place it appears and inserting this part.

IV

Activities for health, independence, and longevity

401.

Grant programs

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

(1)

in subsection (a)—

(A)

in the matter preceding paragraph (1), by inserting (including the highest court of each State) after with States;

(B)

in paragraph (9)(C), by adding at the end the following: , and technical assistance and training to States and area agencies on aging for preparedness for and response to all hazards and emergencies;;

(C)

by striking paragraph (11) and inserting the following:

(11)

conducting activities of national significance to promote quality and continuous improvement in the support and services provided to individuals with the greatest social need, through activities that include needs assessment, program development and evaluation, training, technical assistance, and research, concerning—

(A)

addressing physical and mental health, disabilities, and health disparities;

(B)

providing long-term care, including in-home and community-based care;

(C)

providing informal care, and formal care in a facility setting;

(D)

providing access to culturally responsive health and human services; and

(E)

addressing other gaps in assistance and issues that the Assistant Secretary determines are of particular importance to older individuals with the greatest social need;

;

(D)

in paragraph (12), by striking ; and and inserting a semicolon;

(E)

by redesignating paragraph (13) as paragraph (14); and

(F)

by inserting after paragraph (12) the following:

(13)

in accordance with subsection (c), assessing the fairness, effectiveness, timeliness, safety, integrity, and accessibility of adult guardianship and conservatorship proceedings, including the appointment and the monitoring of the performance of guardians and conservators, and implementing changes deemed necessary as a result of the assessments; and

;

(2)

in subsection (b), by striking 2007 and all that follows through 2011 and inserting 2013, 2014, 2015, 2016, and 2017; and

(3)

by inserting at the end the following:

(c)

Adult guardianships and conservatorships

(1)

Grants

(A)

In general

In awarding grants or contracts under subsection (a)(13), the Assistant Secretary shall obtain feedback from the State Justice Institute in accordance with subparagraph (B) and may consult with the Attorney General, and such grants or contracts shall otherwise comply with this subsection.

(B)

State Justice Institute

The Assistant Secretary shall submit to the State Justice Institute recommendations for the awarding of grants or contracts under subsection (a)(13). The Institute shall have 60 days in which to submit to the Assistant Secretary the response of the Institute to such recommendations. The Assistant Secretary shall consider such response prior to awarding such grants or contracts.

(2)

Grantees and activities

Grants may be awarded under subsection (a)(13) to the highest court of each State for the purpose of enabling such court, in collaboration with the State agency and State adult protective services program—

(A)

to conduct assessments of the practices and procedures used to—

(i)

determine whether to impose a full, limited, or temporary adult guardianship or conservatorship;

(ii)

select a guardian of a person or conservator of an estate;

(iii)

review the continued need for a full, limited, or temporary guardianship or conservatorship of an adult; and

(iv)

review the performance of guardians or conservators;

(B)

to implement changes deemed necessary as a result of the assessments; and

(C)

to collect data regarding those practices and procedures and the impact of the necessary changes.

(3)

Allotments

The amount of a grant under subsection (a)(13) shall be determined by the Assistant Secretary, in consultation with the State Justice Institute and the Attorney General (if the Assistant Secretary determines appropriate).

(4)

Background checks

The Assistant Secretary shall set aside 25 percent of amounts made available for grants under this subsection for each fiscal year to enable courts to implement or improve systems to conduct background checks on prospective guardians and conservators. Such systems shall comply with the following requirements:

(A)

At minimum, the background checks shall include national and State criminal background checks, a search of child abuse and adult abuse registries, and a search as to whether the individual has been suspended or disbarred from law, accounting, or other professional licensing for misconduct.

(B)

The court shall consider all of the information obtained from the background check to determine whether such an individual is sufficiently trustworthy to be a guardian or conservator and that the appointment of such individual is in the best interest of the protected person.

(C)

The information obtained from the background check shall only be used for the purpose of determining the suitability of the prospective guardian or conservator for appointment.

(5)

Electronic filing

Funds received pursuant to subsection (a)(13) may be used to implement systems enabling the annual accountings and other required conservatorship and guardianship filings to be completed, filed, and reviewed electronically in order to simplify the filing process for conservators and guardians, and better enable the courts to identify discrepancies and detect fraud and the exploitation of protected persons.

(6)

Evaluation and report

The Assistant Secretary, in consultation with the Attorney General and the State Justice Institute, shall conduct an evaluation of the improvements made by courts to which this subsection applies, and prepare and submit a report concerning such evaluation to Congress within 18 months of the date on which the first grant is awarded under subsection (a)(13), and a second report 18 months later, and shall use and distribute the reports and evaluations as the Assistant Secretary, in consultation with the Attorney General and the State Justice Institute, determines appropriate in order to improve guardianships and conservatorships nationwide.

.

402.

Protection form violence projects

Section 413(b) of the Older Americans Act of 1965 (42 U.S.C. 3032b(b)) is amended—

(1)

in paragraph (3), by striking or after the semicolon at the end;

(2)

in paragraph (4), by striking the period at the end and inserting ; or; and

(3)

by adding at the end the following:

(5)

research and replicate successful models of elder abuse, neglect, and exploitation prevention and training.

.

403.

Demonstration, support, and research projects

Section 417(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 3032(a)(1)) is amended—

(1)

in subparagraph (A)—

(A)

by striking grandparents and other older individuals who are relative caregivers and inserting older relative caregivers who are; and

(B)

by striking or after the semicolon;

(2)

in subparagraph (B), by striking and after the semicolon and inserting or; and

(3)

by adding at the end the following:

(C)

engage volunteers in providing support and information to older individuals (and their families or caretakers) who have experienced or are at risk of elder abuse, including physical or emotional abuse, neglect, or exploitation; and

.

404.

Community innovations for aging in place

Section 422 of the Older Americans Act of 1965 (42 U.S.C. 3032k) is amended by adding at the end the following:

(g)

Authorization of appropriations

There is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2013 through 2017.

.

405.

Multipurpose senior center modernization, training, and support

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3032 et seq.) is amended by adding at the end the following:

423.

Multipurpose senior center modernization, training, and support

(a)

Program authorized

The Assistant Secretary shall award grants and enter into contracts with eligible entities to carry out projects to—

(1)

support and promote modern multipurpose senior center models which yield vibrant, multiservice, multigenerational centers for older individuals, families of older individuals, and others in the community to gain skills, resources, and connections needed to meet the challenges that occur with continuum of care and quality of life;

(2)

build an evidence base of modern, replicable practices that allow senior centers to serve a diverse array of older individuals, as well as their families and other caregivers, leveraging innovative partnerships and public and private resources to develop and expand programs; and

(3)

mobilize services and leverage resources to support the role of multipurpose senior centers as community focal points, as provided in section 306(a)(3), and for the establishment, construction, maintenance, and operation of centers, as described in sections 303(c)(2) and 306(a)(1), including development of intergenerational shared site models, consistent with the purposes of this Act.

(b)

Use of funds

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

(1)

carry out a project described in subsection (a); and

(2)

evaluate the project in accordance with subsection (f).

(c)

Application

To be eligible to receive a grant or enter into a contract under subsection (a), an eligible entity 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.

(d)

Eligible entity

For purposes of this section, the term eligible entity means—

(1)

a multipurpose senior center that has met national accreditation and fiduciary standards; and

(2)

a regional partnership or collaboration of multipurpose senior centers or State association of senior centers in which not less than 2 centers are accredited.

(e)

Competitive grants for technical assistance

(1)

Grants

The Assistant Secretary shall make a grant, on a competitive basis, to an eligible nonprofit organization described in paragraph (2), to enable the organization to—

(A)

provide training and technical assistance to recipients of grants under this section and other multipurpose senior centers to adopt and tailor evidence-based modernization strategies and practices to respond to the economic and health needs of the diverse and growing aging populations in their own communities; and

(B)

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

(2)

Eligible nonprofit organization

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

(A)

has experience and expertise in providing technical assistance to a range of multipurpose senior centers and experience evaluating and reporting on programs; and

(B)

has demonstrated knowledge of and expertise in multipurpose senior center accreditation or other standards of excellence.

(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)

Local evaluation and report

(1)

Evaluation

Each entity receiving a grant or a contract under subsection (a) to carry out a project described in subsection (a) shall evaluate the project, leadership, and resources for the modernization of multipurpose senior centers to determine—

(A)

the effectiveness of the project in producing innovations and mobilizing resources;

(B)

the impact on older individuals, families of older individuals, and the community being served; and

(C)

the potential for the project to be replicated by other multipurpose senior centers, noting the necessary resources and partnerships and the types of populations and communities best suited for the model.

(2)

Report

The entity described in paragraph (1) shall submit a report to the Assistant Secretary containing the evaluation not later than 6 months after the expiration of the period for which the grant or contract is in effect.

(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 Congress a report that assesses the evaluations and includes, at a minimum—

(1)

a description of the nature and operation of the projects funded under this section and other activities conducted in support of such projects;

(2)

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

(3)

a description of recommended best practices of modern multipurpose senior centers;

(4)

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

(5)

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

.

406.

Demonstration program on care coordination and service delivery

(a)

Findings

Congress finds the following:

(1)

As of 2011, more than 35,000,000 Americans are aged 65 or older. Sixty-two percent of them suffer from multiple chronic conditions which require person-centered, coordinated care that helps them to live in a home- or community-based setting. In 2007, 42 percent of Americans age 65 or older reported needing assistance performing instrumental activities of daily living or activities of daily living.

(2)

Direct-care workers (referred to in this subsection as DCWs) provide an estimated 70 to 80 percent of the paid hands-on long-term care and personal assistance received by elders and people with disabilities or other chronic conditions in the United States. These workers help their clients bathe, dress, and negotiate a host of other daily tasks. DCWs are a lifeline for those they serve, as well as for families and friends struggling to provide quality care.

(3)

Eldercare and disability services positions account for nearly one-third of the 15,000,000 health care jobs in the United States. The direct-care workforce alone accounts for more than 3,000,000 jobs, expected to grow to more than 4,000,000 by 2018.

(4)

The majority of DCWs are now employed in home and community-based settings, and not in institutional settings such as nursing care facilities or hospitals. By 2018, home and community-based DCWs are likely to outnumber facility workers by nearly 2 to 1.

(5)

A 2008 Institute of Medicine report, entitled Re-tooling for an Aging America: Building the Health Care Workforce, called for new models of care delivery and coordination, and dedicated a chapter to the central importance of the direct-care workforce in a re-tooled eldercare delivery system.

(6)

An Institute of Medicine report on the future of nursing, released in October of 2010, recommended nurses should practice to the full extent of their education and training. The report also states that all health care professionals should work collaboratively in team-based models, and that the goal should be to encourage care models that use every member of the team to the full capacity of his or her training and skills.

(7)

The Patient Protection and Affordable Care Act (Public Law 111–148) emphasizes the need for improving care and lowering costs by better coordination of care and integration of services, particularly for consumers with multiple chronic conditions. This will require developing new models of care for those receiving long-term services and supports.

(8)

A November 2010 focus group of DCWs examined the concept of an advanced role for this workforce. About half of the participants shared that they care for consumers who do not have any family or other unpaid caregivers present, which often requires them to assume an additional role as an advocate, with those consumers often turning to them as a source of trusted information and emotional support. All participants agreed that consumers and family members frequently ask them to undertake tasks that they would like to provide, but for which they have not received proper training.

(b)

Program

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3032 et seq.), as amended by section 405, is further amended by adding at the end the following:

424.

Demonstration program on care coordination and service delivery

(a)

Establishment of demonstration program

(1)

In general

The Assistant Secretary shall carry out a demonstration program in accordance with this section. Under such program, the Assistant Secretary shall award grants to eligible entities to carry out demonstration projects that focus on care coordination and service delivery redesign for older individuals with chronic illness or at risk of institutional placement by—

(A)

designing and testing new models of care coordination and service delivery that thoughtfully and effectively deploy advanced aides to improve efficiency and quality of care for frail older individuals; and

(B)

giving direct-care workers opportunities for career advancement through additional training, an expanded role, and increased compensation.

(2)

Direct-care worker

In this section, the term direct-care worker has the meaning given that term in the 2010 Standard Occupational Classifications of the Department of Labor for Home Health Aides [31–1011], Psychiatric Aides [31–1013], Nursing Assistants [31–1014], and Personal Care Aides [39–9021].

(b)

Demonstration projects

The demonstration program shall be composed of 6 demonstration projects, as follows:

(1)

Two demonstration projects shall focus on using the abilities of direct-care workers to promote smooth transitions in care and help to prevent unnecessary hospital readmissions. Under these projects, direct-care workers shall be incorporated as essential members of interdisciplinary care coordination teams.

(2)

Two demonstration projects shall focus on maintaining the health and improving the health status of those with multiple chronic conditions and long-term care needs. Under these projects, direct-care workers shall assist in monitoring health status, ensuring compliance with prescribed care, and educating and coaching the older individual involved and any family caregivers.

(3)

Two demonstration projects shall focus on training direct-care workers to take on deeper clinical responsibilities related to specific diseases, including Alzheimer’s and dementia, congestive heart failure, and diabetes.

(c)

Eligible entity

In this section, the term eligible entity means a consortium that consists of—

(1)

not less than 1—

(A)

home personal care service provider; or

(B)

area agency on aging; and

(2)

not less than 1—

(A)

hospital or health system;

(B)

long-term care and rehabilitation facility;

(C)

labor organization or labor-management partnership;

(D)

community-based aging service provider;

(E)

patient-centered medical home;

(F)

Federally qualified health center;

(G)

managed care entity, including a managed health and long-term care program;

(H)

entity that provides health services training;

(I)

State-based public entity engaged in building new roles and related curricula for direct-care workers; or

(J)

any other entity that the Assistant Secretary deems eligible based on integrated care criteria.

(d)

Application

To be eligible to receive a grant under this section, an eligible entity shall submit to the Assistant Secretary an application at such time, in such manner, and containing such information as the Secretary may require, which shall include—

(1)

a description of the care coordination and service delivery models of the entity, detailed on a general, organizational, and staff level;

(2)

a description of how the demonstration project carried out by the entity will improve care quality, including specific objectives and anticipated outcomes that will be used to measure success; and

(3)

a description of how the coordinated care team approach with an enhanced role for the direct-care worker under the demonstration project will increase efficiency and cost effectiveness compared to past practice.

(e)

Planning awards under demonstration program

(1)

In general

Each eligible entity that receives a grant under this section shall receive a grant for planning activities related to the demonstration project to be carried out by the entity, including—

(A)

designing the implementation of the project;

(B)

identifying competencies and developing curricula for the training of participating direct-care workers;

(C)

developing training materials and processes for other members of the interdisciplinary care team;

(D)

articulating a plan for identifying and tracking cost savings gained from implementation of the project and for achieving long-term financial sustainability; and

(E)

articulating a plan for evaluating the project.

(2)

Amount and term

(A)

Total amount

The amount awarded under paragraph (1) for all grants shall not exceed $600,000.

(B)

Term

Activities carried out under a grant awarded under paragraph (1) shall be completed not later than 1 year after the grant is awarded.

(f)

Implementation awards under demonstration program

(1)

In general

Each eligible entity may receive a grant for implementation activities related to the demonstration project to be carried out by the entity, if the Assistant Secretary determines the entity—

(A)

has successfully carried out the activities under the grant awarded under subsection (e);

(B)

offers a feasible plan for long-term financial sustainability;

(C)

has constructed a meaningful model of advancement for direct-care workers; and

(D)

aims to provide training to a sizeable number of direct-care workers and to serve a sizeable number of older individuals.

(2)

Use of funds

The implementation activities described under paragraph (1) shall include—

(A)

training of all care team members in accordance with the design of the demonstration project; and

(B)

evaluating the competency of all staff based on project design.

(3)

Evaluation and report

(A)

Evaluation

Each recipient of a grant under paragraph (1), in consultation with an independent evaluation contractor, shall—

(i)

evaluate the impact of training and deployment of direct-care workers in advanced roles, as described in this section, within each participating entity on outcomes, such as direct-care worker job satisfaction and turnover, beneficiary and family caregiver satisfaction with services, rate of hospitalization of beneficiaries, and additional measures determined by the Secretary;

(ii)

evaluate the impact of such training and deployment on the long-term services and supports delivery system and resources;

(iii)

issue a statement of the potential of the use of direct-care workers in advanced roles to lower cost and improve quality of care in the Medicaid program; and

(iv)

evaluate the long-term financial sustainability of the model used under the grant and the impact of such model on quality of care.

(B)

Reports

Not later than 180 days after completion of the demonstration program under this section, each recipient of a grant under paragraph (1) shall submit to the Secretary a report on the implementation of activities conducted under the demonstration project, including—

(i)

the outcomes, performance benchmarks, and lessons learned from the project;

(ii)

a statement of cost savings gained from implementation of the project and how the cost savings have been reinvested to improve direct-care job quality and quality of care; and

(iii)

results of the evaluation conducted under subparagraph (A), and the statement of potential issued under subparagraph (A)(iii), with respect to such activities, together with such recommendations for legislation or administrative action for expansion of the demonstration program on a broader scale as the Secretary determines appropriate.

(4)

Amount and term

(A)

Total amount

The amount awarded under paragraph (1) for all grants shall not exceed $2,900,000.

(B)

Term

Activities carried out under a grant awarded under paragraph (1) shall be completed not later than 2 years after the grant is awarded.

.

407.

Livable communities grant program

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3032 et seq.), as amended by section 406, is further amended by adding at the end the following:

425.

Livable communities grant program

(a)

Definitions

In this section:

(1)

Eligible entity

The term eligible entity means—

(A)

a State;

(B)

an area agency on aging; or

(C)

a tribal or Native Hawaiian organization.

(2)

Livable community

The term livable community means a metropolitan, urban, suburban, or rural community in which—

(A)

safe, reliable, and accessible transportation choices exist;

(B)

long-term, affordable, accessible, energy-efficient, and conveniently located housing choices exist for people of all ages, incomes, races, and ethnicities;

(C)

the growth of neighborhoods is supported, revitalized, and encouraged, and the cost-effectiveness of infrastructure is maximized;

(D)

economic development and economic competitiveness are promoted;

(E)

the environment and natural resources are preserved;

(F)

agricultural land, rural land, and green space are protected; and

(G)

public health is supported, improving the quality of life for residents of, and workers in, the community.

(3)

Tribal or native hawaiian organization

The term tribal or Native Hawaiian organization means an organization that is eligible to receive a grant under title VI.

(b)

In general

The Assistant Secretary shall award grants, from allotments made under subsection (c)(1) and as described in subsection (c)(2), to eligible entities to pay for the Federal share of the cost of assisting communities in preparing for the aging of the population, through activities described in subsection (e).

(c)

Availability of funds

(1)

States and area agencies on aging

Subject to paragraph (4), from the sums appropriated under subsection (h) for each of fiscal years 2013, 2014, 2015, 2016, and 2017, the Assistant Secretary shall allot funds under this section in the amount of—

(A)

$30,000 to each State; and

(B)

$30,000 to each area agency on aging.

(2)

Tribal or native hawaiian organizations

Subject to paragraph (4), from the sums appropriated under subsection (h) for each of fiscal years 2013, 2014, 2015, 2016, and 2017, the Assistant Secretary shall reserve $1,500,000, and use the reserved funds for grants to tribal or Native Hawaiian organizations.

(3)

National Resource Center

Subject to paragraph (4), from the sums appropriated under subsection (h) for each of fiscal years 2013, 2014, 2015, 2016, and 2017, the Assistant Secretary shall reserve $3,000,000, and use the reserved funds for a grant to the national organization selected under subsection (f)(1).

(4)

Insufficient appropriations

Notwithstanding paragraphs (1), (2), and (3), if the amount appropriated under subsection (h) for a fiscal year is insufficient for the Assistant Secretary to provide all the allotments described in paragraph (1), and to reserve the amounts described in paragraphs (2) and (3), for that fiscal year, the Secretary shall proportionately reduce the number of allotments made under paragraph (1), and the amount of each reservation described in paragraph (2) or (3) for that fiscal year.

(d)

Application

An eligible entity desiring a grant under this section shall submit an application to the Assistant Secretary at such time, in such manner, and accompanied by such information as the Assistant Secretary may require.

(e)

Use of grant funds

An eligible entity may use the funds made available through a grant—

(1)

to hire a professional planner to help State agencies, local elected officials, local government agencies, tribal or Native Hawaiian organizations, and private and nonprofit organizations to develop policies, programs, and services to foster livable communities for people of all ages;

(2)

to assess the aging population; and

(3)

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

(f)

National Resource Center

(1)

In general

The Assistant Secretary shall make a grant to a national organization, as described in subsection (c)(3), to establish a National Resource Center on Livable Communities for All Ages to provide technical assistance to eligible entities awarded grants under subsection (b).

(2)

Criteria for selection

The national organization selected under paragraph (1) shall have a proven capacity to provide training and technical assistance to support States, area agencies on aging, and tribal or Native Hawaiian organizations, in engaging in community planning activities.

(3)

Application

A national organization desiring the grant under this subsection shall submit an application to the Assistant Secretary at such time, in such manner, and accompanied by such information as the Assistant Secretary may require.

(g)

Federal share

(1)

In general

Except as provided in paragraph (2), the Federal share of the cost described in subsection (b) shall be 75 percent.

(2)

Exceptions

(A)

Small and rural communities

In the case of an eligible entity that is an area agency on aging that serves an area with less than 200,000 in population, the Federal share of the cost described in subsection (b) may be 80 percent.

(B)

Tribal or native hawaiian organizations

In the case of an eligible entity that is a tribal or Native Hawaiian organization, the Federal share of the cost described in subsection (b) shall be 100 percent.

(3)

Non-Federal share

(A)

In-kind contributions

For the purpose of this section, the non-Federal share of the cost may be provided in cash or in-kind, fairly evaluated.

(B)

Other Federal funding

An eligible entity may use Federal funds appropriated under this Act and available to carry out section 306, 307, 614, or 624, as the case may be, towards providing the non-Federal share of the cost.

(h)

Authorization of appropriations

(1)

In general

There are authorized to be appropriated to carry out this section such sums as may be necessary for fiscal years 2013, 2014, 2015, 2016, and 2017.

(2)

Sense of the Senate

It is the sense of the Senate that the amount appropriated under paragraph (1) should be not less than $25,000,000 for fiscal year 2013.

.

408.

Innovation to improve transportation for older individuals who are Holocaust survivors

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3032 et seq.), as amended by section 407, is further amended by adding at the end the following:

426.

Innovation to improve transportation for older individuals who are Holocaust survivors

(a)

In general

The Assistant Secretary shall award grants or contracts to eligible entities to increase and improve transportation services, including affordable non-emergency transportation to medical appointments and shopping for food and other essential items, to enable older individuals to remain in the community, with a preference for those older individuals who are Holocaust survivors. The Assistant Secretary shall make grants or enter into such contracts for a period of not less than 5 years.

(b)

Use of funds

(1)

In general

An eligible entity receiving a grant or contract under subsection (a)—

(A)

shall use 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 who are Holocaust survivors; and

(B)

may use funds received through such grant or contract to provide such technical assistance on behalf of, or carry out such a demonstration project for, older individuals.

(2)

Specific activities

In carrying out a demonstration project or providing technical assistance under paragraph (1) the eligible entity 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 older individuals to transportation services not provided under title III.

(c)

Preference

In awarding grants and entering into contracts under subsection (a), the Assistant Secretary shall give preference to eligible entities that have previous extensive experience working with and conducting assessments of the needs of Holocaust survivors who are older individuals.

(d)

Consultation

In selecting grantees under this section, the Assistant Secretary shall consult with the individual designated under section 210(a) of the Older Americans Act Amendments of 2012 and with national organizations with special expertise in serving Holocaust survivors who are older individuals.

(e)

Eligible entity

In this section, the term eligible entity means an entity that has previous extensive experience working with and conducting assessments of the needs of older individuals.

.

409.

Grants or contracts to facilitate low-income access to dental care

Part A of title IV of the Older Americans Act of 1965, as amended by section 408, is further amended by adding at the end the following:

427.

Grants or contracts to facilitate low-income access to dental care

(a)

Definition

In this section, the term medically recommended dental care means treatment of an oral disease or other oral condition, on the referral of a physician or other health care professional, to sustain or improve overall health, prevent exacerbation of a co-morbid condition, or as a prerequisite to a required medical therapy.

(b)

Grants

The Secretary shall award competitive grants to, or enter into contracts with, eligible entities to fund the employment costs of professionals who will use grant or contract funds to—

(1)

coordinate the provision of medically recommended dental care to eligible individuals by volunteer dentists in a manner consistent with State licensing laws; and

(2)

verify the medical, dental, and financial needs of eligible individuals who may be eligible for free medically recommended dental care.

(c)

Eligibility

(1)

Eligible entity

To be eligible to receive a grant or contract under subsection (b), an entity shall—

(A)

be an entity that is exempt from tax under section 501(c) of the Internal Revenue Code of 1986;

(B)

provide for the participation of eligible individuals in a free dental services program on a national basis; and

(C)

submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require.

(2)

Eligible individual

To be eligible to participate in a program described in paragraph (1)(B), an individual shall be—

(A)

an older individual with greatest economic need;

(B)

an older individual or adult individual entitled to benefits under part A, or an individual enrolled in part B, of title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.); or

(C)

an individual enrolled in a State plan under title XIX, or a health plan under title XXI, of such Act (42 U.S.C. 1396 et seq., 1397aa et seq.), or under an approved waiver of either such plan.

(d)

Use of funds

An entity shall use amounts received under a grant or contract under this section to establish, expand, or operate a program to coordinate the provision of free medically recommended dental care through volunteer dentists to eligible individuals.

(e)

Evaluation and report

(1)

Evaluation

Each entity that receives a grant or contract under this section shall evaluate the number of patients served under the grant or contract, and the effectiveness of the program described in subsection (d) in reducing medical expenses associated with the disease or condition for which care described in subsection (d) was provided.

(2)

Report

The entity shall submit a report containing the results of the evaluation to the Assistant Secretary, not later than 6 months after the end of the period of the grant or contract.

(f)

Authorization of appropriations

There is authorized to be appropriated to carry out this section, $2,000,000 for each of fiscal years 2013 through 2017.

.

410.

National Resource Center on Family Caregiving

(a)

In general

Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 3032 et seq.), as amended by section 409, is further amended by adding at the end the following:

428.

National resource center on family caregiving

(a)

Definitions

In this section:

(1)

Public or private nonprofit entity

The term public or private nonprofit entity means—

(A)

a State, a political subdivision of a State, or an agency or instrumentality of such a State or political subdivision; or

(B)

a nonprofit entity that is described in section 501(c)(3) of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code.

(2)

State

The term State means 1 of the 50 States.

(b)

Establishment

The Secretary of Health and Human Services shall award a grant to or enter into a cooperative agreement with a public or private nonprofit entity to establish a National Resource Center on Family Caregiving (referred to in this section as the Center).

(c)

Purposes of National Resource Center

The Center shall—

(1)

identify, develop, and disseminate information on best practices for and evidence-based models of family caregiver support programs;

(2)

provide timely information on policy and program updates relating to family caregivers;

(3)

partner with related organizations to disseminate practical strategies and tools to support families in their caregiving roles;

(4)

convene educational programs and web-based seminars on family caregiver issues and program development; and

(5)

provide a comprehensive Internet website with a national searchable database on family caregiver programs and resources in the States.

(d)

Authorization

There is authorized to be appropriated to carry out this section $12,000,000 for the period of fiscal years 2013 through 2017.

.

(b)

Technical amendments

(1)

Section 431(a) of such Act (42 U.S.C. 3033(a)) is amended by striking or contract the first place it appears and inserting or contract (including a cooperative agreement).

(2)

Section 432(a) of such Act (42 U.S.C. 3033a(a)) is amended by striking and contracts and inserting and contracts (including cooperative agreements).

V

Community service senior opportunities

501.

Older american community service employment program

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

(1)

in subsection (a)(1)—

(A)

by striking To foster individual economic self-sufficiency and and inserting To further the goal of economic security, foster individual economic self-sufficiency, grow local economies, improve the quality of life in local communities, and; and

(B)

by striking persons who are age 55 and inserting persons who are not economically secure and who are age 55;

(2)

in subsection (b)—

(A)

in paragraph (1)—

(i)

in the matter preceding subparagraph (A), in the first sentence, by inserting after nonprofit private agencies and organizations the following: (which nonprofit organizations may include eligible technology organizations);

(ii)

in subparagraph (E)—

(I)

by striking support for children, and inserting support for adults, children,; and

(II)

by inserting , and which may include support for the health and safety of older adults and the prevention and detection of elder abuse after families;

(iii)

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

(iv)

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

(v)

by adding at the end the following:

(S)

will, to the maximum extent practicable, achieve the goal described in paragraph (4).

; and

(B)

by adding at the end the following:

(4)

Placement goal

(A)

Goal

In order to maximize the number of older individuals being served, each grantee under this title shall, to the maximum extent practicable, achieve a goal, referred to paragraph (1)(S), of placing not less than 50 percent of the participants in the grantee's project in positions with organizations that assist older adults or in positions with duties that positively impact the lives of older adults.

(B)

Contracts with service providers

In order to achieve the goal described in subparagraph (A), each such grantee shall enter into a contract or memorandum of understanding with—

(i)

entities from 2 or more categories of entities, which categories shall consist of—

(I)

the State Long-Term Care Ombudsman selected in accordance in section 712;

(II)

an area agency on aging;

(III)

a multipurpose senior center;

(IV)

a contractor providing support services under part B, C, D, or E of title III; and

(V)

a transportation service provider; or

(ii)

an entity approved by the Assistant Secretary, and the Secretary of Labor.

; and

(3)

in subsection (e)(2)—

(A)

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

(B)

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

(C)

by adding at the end the following:

(G)

a project carried, out by an eligible technology organization, that will focus on the provision to eligible individuals of—

(i)

basic and intermediate computer skills;

(ii)

Internet skills;

(iii)

e-mail skills;

(iv)

word processing and spreadsheet skills;

(v)

presentation software skills; and

(vi)

any other key skills appropriate for assisting eligible individuals in entering or re-entering the workforce.

.

502.

State plan

Section 503(a)(4)(C) of the Older Americans Act of 1965 (42 U.S.C. 3056a(a)(4)(C)) is amended by striking clauses (i) through (iv) and inserting the following:

(i)

minority and Indian eligible individuals;

(ii)

eligible individuals with limited English proficiency;

(iii)

eligible individuals with disabilities;

(iv)

eligible individuals with greatest economic need; and

(v)

eligible individuals with greatest social need;

.

503.

Authorization of appropriations

Section 517(a) of the Older Americans Act of 1965 (42 U.S.C. 3056o(a)) is amended to read as follows:

(a)

Authorization

(1)

In general

There are authorized to be appropriated to carry out this title such sums as may be necessary for fiscal years 2013, 2014, 2015, 2016, and 2017.

(2)

Sense of Congress

It is the sense of Congress that the amount appropriated under paragraph (1) should not be less than $660,000,000 for fiscal year 2013.

.

504.

Definitions

Section 518(a) of the Older Americans Act of 1965 (42 U.S.C. 3056p(a)) is amended—

(1)

by redesignating paragraphs (4) through (8) as paragraphs (5) through (9), respectively; and

(2)

by inserting after paragraph (3) the following:

(4)

Eligible technology organization

The term eligible technology organization includes a nonprofit organization that—

(A)

has developed a research-based curriculum specifically designated to help older adults improve their technology skills, such as a curriculum developed through a Broadband Technology Opportunities Program or a Technology Opportunities Program of the Department of Commerce; or

(B)

is an eligible provider of training services identified under section 122 of the Workforce Investment Act of 1998 (29 U.S.C. 2842).

.

505.

Study on feasibility of transfer of program

(a)

Study

The Assistant Secretary for Aging of the Department of Health and Human Services, and the Secretary of Labor, shall study the feasibility of transferring the program carried out under title V of the Older Americans Act of 1965 (42 U.S.C. 3056 et seq.) to the Administration on Aging.

(b)

Report

Not later than 2 years after the date of enactment of this Act, the Assistant Secretary and the Secretary shall submit a report containing the results of the study to the appropriate committees of Congress.

VI

Grants for native americans

601.

Technical amendment

Section 611 of such Act (42 U.S.C. 3057b) is amended by striking (a) in the matter preceding paragraph (1).

602.

Conforming amendment

Section 631(b) of the Older Americans Act of 1965 (42 U.S.C. 3057k–11(b)) is amended by striking subsections (c), (d), and (e) and inserting subsections (d), (e), and (f).

603.

Reauthorization of funding for grants for Native Americans

Section 643(2) of the Older Americans Act of 1965 (42 U.S.C. 3057n(2)) is amended by striking part C, and all that follows and inserting part C, $11,000,000 for each of fiscal years 2013 through 2017..

VII

Vulnerable elder rights protection activities

701.

Establishment

Section 701 of the Older Americans Act of 1965 (42 U.S.C. 3058) is amended—

(1)

by inserting and grants after allotments; and

(2)

by adding at the end the following: The Assistant Secretary, to the maximum extent practicable, shall ensure that education and public awareness activities under this title are fully integrated with all service programs under title III (with special emphasis on the nutrition programs, legal services, and information and referral assistance activities), the work of Aging and Disability Resource Centers, and the long-term care ombudsman programs, including programs carried out under title VI..

702.

Authorization of Appropriations for Ombudsman Program

(a)

State long-Term care ombudsman program

Section 702 of the Older Americans Act of 1965 (42 U.S.C. 3058a) is amended—

(1)

in subsection (a), by striking , such sums and all that follows and inserting , such sums as may be necessary for fiscal years 2013, 2014, 2015, 2016, and 2017.; and

(2)

by adding at the end the following:

(d)

Sense of Congress

It is the sense of Congress that, in order to carry out chapter 2 (relating to State Long-Term Care Ombudsman programs), the amount appropriated under subsection (a) should be not less than $25,500,000 for fiscal year 2013.

.

(b)

State home care ombudsman programs

Chapter 1 of subtitle A of title VII of the Older Americans Act of 1965 is amended by inserting after section 702 (42 U.S.C. 3058a) the following:

702A.

Authorization of appropriations for State home care ombudsman program

There are authorized to be appropriated to carry out chapter 5 such sums as may be necessary for fiscal year 2013 and each subsequent fiscal year.

.

703.

Grants

Section 703 of the Older Americans Act of 1965 (42 U.S.C. 3058b) is amended by adding at the end the following:

(d)

Grants for State home care ombudsman programs

(1)

In general

The Assistant Secretary shall use funds made available under section 702A to award grants, on a competitive basis, to States for State Home Care Ombudsman Programs.

(2)

Considerations

In selecting States to receive the grants, the Assistant Secretary shall consider—

(A)

a State’s current financial support (as of the date of consideration) for home care ombudsman services;

(B)

a State’s commitment to preventing conflict of interest between providers of home care services and providers of home care ombudsman services; and

(C)

other criteria determined by the Assistant Secretary.

(3)

Priorities

In selecting States to receive the grants, the Assistant Secretary may give first priority to States that are providing home care ombudsman services to home care consumers on the date of enactment of section 737, and seek to enhance the home care ombudsman programs through which the States provide those services.

.

704.

Eligibility

Section 704 of the Older Americans Act of 1965 (42 U.S.C. 3058c) is amended, in the matter preceding paragraph (1), by inserting or grants after allotments.

705.

Additional State plan requirements

(a)

In general

Section 705 of the Older Americans Act of 1965 (42 U.S.C. 3058d) is amended—

(1)

in subsection (a)—

(A)

in the matter preceding paragraph (1), by inserting or grant after allotment;

(B)

in paragraph (1), by striking requirements of the chapter and this chapter and inserting requirements of this chapter and this subtitle;

(C)

in paragraph (2), by inserting family caregivers, after title VI,;

(D)

in paragraph (4), by striking enactment of this subtitle and inserting enactment of the chapter;

(E)

in paragraph (6), by striking and at the end;

(F)

in paragraph (7), by striking the period and inserting ; and; and

(G)

by adding at the end the following:

(8)

subject to section 705(b) of the Older Americans Act Amendments of 2012, an assurance—

(A)

that the State has a Home Care Consumer Bill of Rights and a Plan for Enforcement of such a Bill, developed in accordance with the procedures described under paragraph (2) and as approved by the Assistant Secretary, and the State shall include a copy of the Bill and Plan; or

(B)

at the discretion of the Assistant Secretary, in the event the State does not have an approved Home Care Consumer Bill of Rights and Plan for Enforcement, that the State has an alternative such as a proposal for developing and submitting for approval a Home Care Consumer Bill of Rights and Plan for Enforcement.

;

(2)

by redesignating subsection (b) as subsection (d);

(3)

by inserting after subsection (a) the following:

(b)

Home Care Consumer Bill of Rights

The Home Care Consumer Bill of Rights referred to in subsection (a)(8) shall, at a minimum—

(1)

address a home care consumer’s right to basic safety by—

(A)

affirming that home care consumers are protected from physical, sexual, mental, and verbal abuse, neglect, and exploitation;

(B)

affirming that home care consumers are served by providers who are properly trained and are providing home care services within their scope of practice and the scope of their certification or licensure (if such a certification or licensure is required by the applicable State);

(C)

affirming that such providers maintain the confidentiality of all personal, financial, and medical information of home care consumers; and

(D)

affirming that providers respect the personal property of home care consumers, and in the event of consumer reports of theft or loss, that providers will investigate and report back to the consumer the results of the investigation;

(2)

address a home care consumer’s right to access information by—

(A)

affirming that home care consumers are informed of their rights under this subsection and subsection (c) within 2 weeks after the start of home care services, and about the entities the consumers may contact if their rights are violated, including the name and contact information for State and local agencies responsible for enforcing the Home Care Consumer Bill of Rights;

(B)

affirming that home care consumers—

(i)

are informed of the cost of home care services prior to receiving those services, whether the cost of those services are covered under health insurance, long-term care insurance, or other private and public programs, and any charges the consumer will be expected to pay; and

(ii)

are given advance notice of any changes to those costs or services; and

(C)

affirming that home care consumers have access to information about the availability of the home care services provided in the community involved and have the ability to choose among home care services and providers of home care services available in the community;

(3)

address a home care consumer’s right to choice, participation, and self-determination by—

(A)

affirming that home care consumers can participate in the planning of their home care services, including making choices about aspects of their care and services that are important to them, choosing providers and schedules to the extent practicable, receiving reasonable accommodation of their needs and preferences, and involving anyone they chose to participate with them in that planning;

(B)

affirming that home care consumers are provided with sufficient information to make informed decisions, are fully informed in advance about any proposed changes in care and services, and are involved in the decisionmaking process regarding those changes; and

(C)

affirming that home care consumers can refuse services and receive an explanation of the consequences of doing so;

(4)

address a home care consumer’s right to receive care and services provided in a way that promotes each consumer’s dignity and individuality;

(5)

address a home care consumer’s right to redress grievances by—

(A)

affirming that home care consumers are able to voice grievances about the quality of their home care services, the number of hours of service, and violations of their rights, receive prompt responses to those concerns, and are informed about the entities the consumers may contact to state those grievances in order to have the grievances addressed in an appropriate and timely manner, and without retaliation; and

(B)

affirming that home care consumers are able to assert their rights under this subsection and subsection (c) without retaliation;

(6)

address the role and responsibilities that fiduciaries may have in securing the rights of home care consumers affirmed under the Home Care Consumer Bill of Rights; and

(7)

meet any other guidelines determined to be appropriate by the Assistant Secretary.

(c)

Plan for enforcement

In developing the Plan for Enforcement referred to in subsection (a)(8), the State shall take into account the best practices established under section 201(e)(2)(C). The Plan shall include a description of how State entities with a role in protecting older individuals, such as home care services licensing agencies, adult protective services agencies, the Office of the State Long-Term Care Ombudsman (if the office has jurisdiction over home and community-based long-term care), local law enforcement agencies, and other entities determined to be appropriate by the Assistant Secretary, will coordinate activities to enforce the Home Care Consumer Bill of Rights.

; and

(4)

by adding at the end the following:

(e)

Definition

In this section, the term home care consumer and home care services have the meanings given the terms in section 736.

.

(b)

Application of requirement To submit State home care consumer bill of rights and plan for enforcement

(1)

In general

The requirement for a State to provide an assurance, and either a Home Care Consumer Bill of Rights and a Plan for Enforcement of such Bill or an alternative, under paragraph (8) of section 705(a) of the Older Americans Act of 1965 (as added by subsection (a)) shall apply to States beginning on the date (referred to in this subsection as the application date) that is 1 year after the date of the establishment of best practices under section 201(e)(2)(C) of such Act (as added by section 201).

(2)

First submission after application date

A State shall comply with paragraph (8) of section 705(a) of the Older Americans Act of 1965 (as added by subsection (a)) in whichever of the following 2 submissions occurs first with respect to such State after the application date described under paragraph (1):

(A)

The submission of a new State plan under section 307 of the Older Americans Act of 1965 (42 U.S.C. 3027).

(B)

The submission of an annual revision to a State plan submitted under such section 307.

(3)

Ongoing submissions

After complying with paragraph (8) of section 705(a) of the Older Americans Act of 1965 (as added by subsection (a)) in a submission in accordance with paragraph (2) of this subsection, a State shall comply with such paragraph (8) in each new State plan submitted under section 307 of the Older Americans Act of 1965 (42 U.S.C. 3027).

706.

Definitions

Section 711(6) of the Older Americans Act of 1965 (42 U.S.C. 3058f(6)) is amended by striking older individual and inserting individual.

707.

State Long-Term Care Ombudsman program

Section 712 of the Older Americans Act of 1965 (42 U.S.C. 3058g) is amended—

(1)

in subsection (a)—

(A)

in paragraph (2), by adding at the end the following: The Ombudsman shall be responsible for the management, including the fiscal management, of the Office.;

(B)

in paragraph (3)—

(i)

in subparagraph (A), by striking clause (i) and inserting the following:

(i)

are made by or on behalf of residents, including residents with limited or no decisionmaking capacity and who have no known legal representative, and if such a resident is unable to provide or refuses consent for an Ombudsman to work on a complaint directly involving the resident, the Ombudsman shall seek evidence to indicate what outcome the resident would have desired and, in a case in which such evidence is reliable, shall assume that the resident wishes to have the resident's health, safety, welfare, and rights protected and shall work to accomplish the desired outcome;

;

(ii)

in subparagraph (D), by striking regular and timely and inserting regular, timely, private, and unimpeded;

(iii)

by redesignating subparagraphs (F) through (I) as subparagraphs (G) through (J);

(iv)

by inserting after subparagraph (E) the following:

(F)

collect and analyze data, relating to discrimination against LGBT older individuals on the basis of actual or perceived sexual orientation or gender identity in the admission to, transfer or discharge from, or lack of adequate care provided in long term care settings, and shall include the analyses in the reports;

; and

(v)

in subparagraph (I), as redesignated by clause (iii) of this subparagraph—

(I)

in clauses (ii) and (iii), by striking and at the end;

(II)

in clause (iii), by striking provide technical support for and inserting actively encourage and assist in; and

(III)

by adding at the end the following:

(iv)

identify interventions or devices that affect the rights and safety of residents, including the use of chemical and physical restraints; and

(v)

educate providers, residents, and families about the danger of those interventions and devices; and

;

(C)

in paragraph (4)—

(i)

in the paragraph header, by striking Contracts and arrangements and inserting Organizational placement; and

(ii)

by striking subparagraph (B) and inserting the following:

(B)

Identifying, removing, and remedying organizational conflict

(i)

In general

The State agency may not operate the Office or carry out the program, directly, or by contract or other arrangement with any public agency or nonprofit private organization, in a case in which there is an organizational conflict of interest unless such conflict has been—

(I)

identified by the State agency;

(II)

disclosed by the State agency to the Assistant Secretary in writing; and

(III)

remedied in accordance with this subparagraph.

(ii)

Reporting by any person or entity

Any person or entity may identify any potential or actual organizational conflict of interest involving the Office and report the conflict to the Assistant Secretary for review and action under clause (iii).

(iii)

Action by administration

In a case in which a potential or actual organizational conflict of interest involving the Office is disclosed or reported to the Assistant Secretary, the Assistant Secretary shall require that the State agency—

(I)

remove the conflict; or

(II)

submit, and obtain the approval of the Assistant Secretary for, an adequate remedial plan that indicates how the Ombudsman will be unencumbered in fulfilling all of the functions specified in paragraph (3).

(C)

Organizational conflict of interest

In this paragraph, the term organizational conflict of interest includes a situation in which the Office is placed in an organization that—

(i)

is responsible for licensing or certifying long-term care services in the State;

(ii)

is an association (or an affiliate of such an association) of long-term care facilities, or of any other residential facilities for older individuals;

(iii)

provides long-term care services, including programs carried out under a Medicaid waiver approved under section 1115 of the Social Security Act (42 U.S.C. 1315) or under subsection (c) or (b) of 1915 of the Social Security Act (42 U.S.C. 1396n), or under a Medicaid State plan amendment under subsection (i) of section 1915 of the Social Security Act (42 U.S.C. 1396n(i));

(iv)

provides long-term care case management;

(v)

sets rates for long-term care services;

(vi)

provides adult protective services;

(vii)

is responsible for eligibility determinations for the Medicare program carried out under title XVIII, or the Medicaid program carried out under title XIX, of the Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.);

(viii)

conducts preadmission screening for placements in facilities described in clause (ii); or

(ix)

makes decisions regarding admission of individuals to such facilities.

; and

(D)

in paragraph (5)—

(i)

in subparagraph (A)—

(I)

by striking In carrying and inserting the following:

(i)

In general

In carrying

; and

(II)

by adding at the end the following:

(ii)

Relationship with the office

The program shall be a unified program under the Office. Local Ombudsman entities and representatives shall report to the Ombudsman on all functions, duties, and programmatic issues related to the program that are carried out or addressed by the entities or representatives. Case and other programmatic records maintained by representatives, employees, or volunteers of the local Ombudsman entity shall be considered to be the property of the Ombudsman.

; and

(ii)

in subparagraph (B)(vi), by striking support and inserting actively encourage and assist in;

(2)

in subsection (b)—

(A)

in paragraph (1)—

(i)

in subparagraph (A), by striking access and inserting private and unimpeded access;

(ii)

in subparagraph (B)(i), by striking the medical and social records of a and inserting all records concerning a;

(iii)

by redesignating subparagraphs (C) and (D) as subparagraphs (E) and (F), respectively; and

(iv)

by inserting after subparagraph (B) the following:

(C)

such access as is necessary to advocate for a resident’s desired outcome to the extent that the resident can express the outcome desired, even if the resident has limited decisionmaking capacity;

(D)

access to the records of a resident with limited decisionmaking capacity in a case in which—

(i)

the access is necessary to investigate and resolve a complaint described in subsection (a)(3);

(ii)

a legal guardian of the resident refuses to give permission for the access;

(iii)

such a representative of the Office has reasonable cause to believe that the guardian is not acting in the best interests of the resident by refusing;

(iv)

the resident has no other known legal representative; and

(v)

the representative of the Office obtains the approval of the Ombudsman;

; and

(B)

by adding at the end the following:

(3)

Health oversight agency

For purposes of section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (including regulations issued under that section) (42 U.S.C. 1320d–2 note), the Ombudsman and a representative of the Office shall be considered a health oversight agency, so that release of residents' individually identifiable health information to the Ombudsman or representative is not precluded in cases in which the requirements of clause (i) or (ii) of paragraph (1)(B) are otherwise met.

;

(3)

in subsection (c)(2)(D), by striking section 202(a)(21) and inserting section 202(a)(18);

(4)

in subsection (d)—

(A)

in paragraph (1), by striking files and inserting information; and

(B)

in paragraph (2)—

(i)

in the paragraph heading, by striking Identity of complainant or resident and inserting Procedures;

(ii)

in subparagraph (A)—

(I)

by striking files and records the first place it appears and inserting information (including files or records);

(II)

by striking disclose and all that follows and inserting disclose such information);; and

(III)

by striking and at the end;

(iii)

in subparagraph (B)—

(I)

in the matter preceding clause (i), by striking files or records and inserting information;

(II)

in clause (ii), by striking or at the end;

(III)

by redesignating clause (iii) as clause (iv);

(IV)

by inserting after clause (ii) the following:

(iii)

in a case in which a resident has limited decisionmaking capacity—

(I)

disclosure of the identity of the resident is necessary to investigate and resolve a complaint described in subsection (a)(3);

(II)

a legal guardian of the resident refuses to give permission for the disclosure;

(III)

a representative of the Office has reasonable cause to believe that the guardian is not acting in the best interests of the resident by refusing;

(IV)

the resident has no other known legal representative; and

(V)

the representative of the Office obtains the approval of the Ombudsman; or

; and

(V)

in clause (iv), as redesignated by subclause (III), by striking the period and inserting ; and; and

(iv)

by adding at the end the following:

(C)

require that the Ombudsman and representatives of the Office hold all communications with a complainant or resident who is seeking assistance in strict confidence and take all reasonable steps to safeguard the confidentiality of information provided by the complainant or resident.

;

(5)

in subsection (f)(3)—

(A)

in subparagraph (C), by striking facility; and and inserting facility or a related organization, and has not been employed by such a facility or organization within 2 years before the date of the determination involved;;

(B)

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

(C)

by adding at the end the following:

(E)

does not have management responsibility for, nor operate under the supervision of, an agency with responsibility for adult protective services; and

(F)

does not serve as a guardian or in another fiduciary capacity for residents of long-term care facilities in an official capacity (as opposed to serving as a guardian or fiduciary, for a family member, in a personal capacity); and

;

(6)

in subsection (h)—

(A)

in paragraph (4), by striking all that precedes procedures and inserting the following:

(4)

strengthen and update

;

(B)

by redesignating paragraphs (4) through (9) as paragraphs (5) through (10), respectively;

(C)

by inserting after paragraph (3) the following:

(4)

ensure that the Ombudsman attends training provided by the Administration through the National Ombudsman Resource Center established in section 202(a)(18);

;

(D)

in paragraph (7)(A), as redesignated by subparagraph (B) of this paragraph, by striking subtitle C of the and inserting subtitle C of title I of the; and

(E)

in paragraph (10), as redesignated by subparagraph (B) of this paragraph, by striking (6), or (7) and inserting (7), or (8); and

(7)

by adding at the end the following:

(k)

Ensuring effective programs and residents' rights

The State agency shall ensure the Office—

(1)

provides facility residents with private and unimpeded access to the Office, including access to all records concerning the resident; and

(2)

allows all facility residents to receive services from the Office.

.

708.

Prevention of elder abuse, neglect, and exploitation

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

(1)

in subsection (b)—

(A)

in paragraph (2), by striking the semicolon and inserting the following: , including education and outreach to professionals including postal carriers, employees of financial institutions, firefighters, meter readers, and other community professionals who are in a position to observe an older individual on a daily or regular basis;;

(B)

in paragraph (4), by inserting before the semicolon the following: and submit data on the prevalence of elder abuse, neglect, and exploitation for the appropriate database of the Administration or another database specified by the Assistant Secretary;

(C)

by redesignating paragraphs (7), (8), (9), (10), (11), and (12), as paragraphs (8), (10), (11), (12), (13), and (14), respectively;

(D)

by striking paragraph (6) and inserting the following:

(6)

conducting specialized abuse sensitivity training for caregivers described in part E of title III;

(7)

conducting training for professionals and paraprofessionals, including trainers, in relevant fields on the identification, prevention, and treatment of elder abuse, neglect, and exploitation, with particular focus on prevention and enhancement of self-determination and autonomy;

;

(E)

in paragraph (8), as redesignated by subparagraph (C) of this paragraph, by inserting before the semicolon the following: , including providing intake workers or hotlines that are able to take information or calls directly from older individuals, their family members, and community professionals in the planning and service areas of the older individuals, about elder abuse, neglect, and exploitation;

(F)

by inserting after paragraph (8), as redesignated by subparagraph (C) of this paragraph, the following:

(9)

conducting appropriate training to ensure cultural sensitivity in the provision of elder rights services, including training in cultural issues associated with abuse;

;

(G)

in subparagraph (C) of paragraph (11), as redesignated by subparagraph (C) of this paragraph—

(i)

in clause (ii), by inserting , such as forensic accountants, after such personnel; and

(ii)

in clause (v), by striking the comma at the end and inserting , including programs and arrangements that will safeguard victims' or potential victims' finances, such as daily money management programs and conservatorships,;

(H)

in paragraph (13), as redesignated by subparagraph (C) of this paragraph—

(i)

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

(ii)

by adding at the end the following:

(F)

supporting and studying innovative practices in local communities, to develop partnerships across disciplines for the prevention, investigation, and prosecution of exploitation;

;

(I)

in paragraph (14), as redesignated by subparagraph (C) of this paragraph—

(i)

in subparagraph (B), by striking or at the end;

(ii)

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

(iii)

by adding at the end the following:

(D)

older individuals who are Holocaust survivors; and

; and

(J)

by adding at the end the following:

(15)

developing a State Home Care Consumer Bill of Rights and Plan for Enforcement (as described in section 705) to protect home care consumers (as defined in section 736) from abuse, neglect, and exploitation.

.

709.

State legal assistance development

Section 731 of the Older Americans Act of 1965 (42 U.S.C. 3058j) is amended by striking A State agency and all that follows through to ensure— and inserting the following:

(a)

State legal services developer

A State agency shall provide the services of an individual who shall be known as a State legal services developer, who shall promote, and may facilitate, the development and operation of an integrated legal assistance delivery system for the State. To the maximum extent practicable, the individual selected to serve as the developer shall—

(1)

agree to serve as the developer on a full-time basis;

(2)

have a law degree from an accredited law school or have been admitted to practice law in any jurisdiction in the United States; and

(3)

possess other knowledge, skills, training, and education that reflect a comprehensive understanding of legal services for older individuals.

(b)

Other personnel

In addition to the State legal services developer, the State agency shall provide the services of other personnel, sufficient to ensure—

.

710.

State Home Care Ombudsman Programs

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

5

State Home Care Ombudsman Programs

736.

Definitions

In this chapter:

(1)

Home care consumer

The term home care consumer means a person who receives services in the person’s home or community to promote independence and reduce the necessity for residence in a long-term care facility, which may include—

(A)

home care services provided through this Act, the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.), the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), or another public or private funding source; or

(B)

home care services determined to be appropriate by a State operating a State Home Care Ombudsman Program.

(2)

Home care ombudsman program

The term home care ombudsman program means a State Home Care Ombudsman Program described in section 737(a)(1).

(3)

Home care ombudsman representative

The term home care ombudsman representative includes an employee or volunteer who represents an entity designated under section 737(a)(5)(A) and who is individually designated by the Ombudsman.

(4)

Home care services

The term home care services means home and community-based services to promote independence and reduce the necessity for residence in a long-term care facility, including personal care services designed to assist an individual in the activities of daily living such as bathing, exercising, personal grooming, and getting in and out of bed.

(5)

Local home care Ombudsman entity

The term local home care Ombudsman entity means an entity designated under section 737(a)(5)(A) to carry out the duties described in section 737(a)(5)(B) with respect to a planning and service area or other substate area.

(6)

Office; Ombudsman

The terms Office and Ombudsman, used without further modification, have the meanings given the terms in section 711.

737.

Program

(a)

Establishment

(1)

In general

In order to be eligible to receive a grant under section 703(d) from funds appropriated under section 702A and made available to carry out this chapter, a State agency shall, in accordance with this section, agree to carry out a State Home Care Ombudsman Program within the Office of the State Long-Term Care Ombudsman.

(2)

Home care ombudsman program

The home care ombudsman program shall be carried out by the Ombudsman.

(3)

Functions

In carrying out the home care ombudsman program, the Ombudsman, personally or through representatives of the home care ombudsman program—

(A)

shall identify, investigate, and resolve complaints that—

(i)

are made by, or on behalf of, home care consumers;

(ii)

relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of home care consumers (including the welfare and rights of home care consumers with respect to the appointment and activities of guardians and representative payees), of—

(I)

entities responsible for determining eligibility for home care services, such as State and local governments; and

(II)

entities responsible for determining availability of home care services, such as managed care organizations; or

(iii)

relate to action, inaction, or decisions, regarding informing home care consumers about their eligibility for, or the availability of, home care services, of—

(I)

providers, or representatives of providers, of home care services;

(II)

public agencies;

(III)

health and social service agencies; and

(IV)

entities providing consumer-directed services under a consumer-directed program;

(B)

shall provide services to protect the health, safety, welfare, and rights of home care consumers;

(C)

shall inform home care consumers about means of obtaining services provided by providers or agencies described in subparagraph (A)(ii) or services described in subparagraph (B);

(D)

shall, in conjunction with other entities, such as area agencies on aging, conduct public education about the home care ombudsman program and its services, including the rights of home care workers to report concerns to the Ombudsman in order to protect the health, safety, welfare, and rights of home care consumers;

(E)

shall ensure that home care consumers and complainants receive timely responses from representatives of the home care ombudsman program to complaints;

(F)

shall represent the interests of home care consumers before governmental agencies and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of the home care consumers, including issues related to the sufficiency of the home care workforce and its availability to meet the needs of home care consumers;

(G)

shall provide administrative and technical assistance to entities designated under paragraph (5) to assist the entities in participating in the home care ombudsman program;

(H)

shall provide for training representatives of the home care ombudsman program;

(I)

shall—

(i)

promote the development of citizen organizations, to participate in the home care ombudsman program;

(ii)

analyze, comment on, and monitor the development and implementation of Federal, State, and local laws, regulations, and other governmental policies and actions, that pertain to the health, safety, welfare, and rights of home care consumers, with respect to the adequacy of home care services in the State, including issues related to the sufficiency of the home care workforce and its availability to meet the needs of home care consumers;

(iii)

recommend any changes in such laws, regulations, policies, and actions as the Ombudsman determines to be appropriate; and

(iv)

facilitate public comment on the laws, regulations, policies, and actions; and

(J)

shall carry out other activities as the Assistant Secretary determines to be appropriate.

(4)

Contracts and arrangements

(A)

In general

(i)

Agencies and organizations

Except as provided in subparagraph (B), the State agency shall carry out the home care ombudsman program, directly, or by contract or other arrangement with any public agency or nonprofit private organization.

(ii)

Area agencies on aging

The State agency shall determine whether to enter into contracts or arrangements with area agencies on aging to carry out the home care ombudsman program, based on the structure of the State's existing (as of the date of the determination) long-term care ombudsman program and the potential for conflicts of interest in the home and community-based services system in the State. A State agency may carry out a home care ombudsman program through area agencies on aging in the State, if the area agencies on aging—

(I)

have existing (as of the date of the determination) consumer protection systems in place to prevent such conflicts of interest; or

(II)

establish adequate procedures to prevent conflicts of interest under the program.

(B)

Licensing and certification organizations; associations

The State agency may not enter into the contract or other arrangement described in subparagraph (A) with—

(i)

an agency or organization that is responsible for licensing or certifying home care services in the State; or

(ii)

an association (or an affiliate of such an association) of providers of home care services.

(5)

Designation of local home care ombudsman entities and home care ombudsman representatives

(A)

Designation

In carrying out the duties of the Office, the Ombudsman may designate an entity as a local home care Ombudsman entity (and, in doing so, the Ombudsman shall, if a local Ombudsman entity has already been designated, designate such local Ombudsman entity as the local home care Ombudsman entity), and may designate an employee or volunteer to represent the entity.

(B)

Duties

An individual so designated, in accordance with the policies and procedures established by the Ombudsman and the State agency—

(i)

shall provide services to protect the health, safety, welfare, and rights of home care consumers;

(ii)

shall ensure that home care consumers in the service area of the entity have timely responses to complaints and requests for assistance;

(iii)

shall identify, investigate, and resolve complaints made by or on behalf of home care consumers that relate to action, inaction, or decisions, that may adversely affect the health, safety, welfare, or rights of home care consumers;

(iv)

shall represent the interests of home care consumers before government agencies and seek administrative, legal, and other remedies to protect the health, safety, welfare, and rights of home care consumers;

(v)

shall—

(I)

review, and if necessary, comment on any existing and proposed laws, regulations, and other government policies and actions, that pertain to the rights and well-being of home care consumers; and

(II)

facilitate the ability of the public to comment on the laws, regulations, policies, and actions;

(vi)

shall make referrals for services to protect and provide for the health, safety, educational needs, welfare, and rights of family or household members (including children) of home care consumers; and

(vii)

shall carry out other activities that the Ombudsman determines to be appropriate.

(C)

Eligibility for designation

Entities eligible to be designated as local home care Ombudsman entities, and individuals eligible to be designated as home care ombudsman representatives of such entities, shall—

(i)

have demonstrated capability to carry out the duties established in section 712(a)(5)(B);

(ii)

be free of conflicts of interest and not stand to gain financially through an action or potential action brought on behalf of individuals the Ombudsman serves; and

(iii)

meet such additional requirements as the Ombudsman may specify.

(D)

Policies and procedures

(i)

In general

The State agency shall establish, in accordance with the Ombudsman, policies and procedures for monitoring local home care Ombudsman entities designated to carry out the duties established in section 712(a)(5)(B).

(ii)

Policies

In a case in which the entities are grantees or the home care ombudsman representatives are employees, of area agencies on aging, the State agency shall develop the policies in consultation with the area agencies on aging. The policies shall provide for participation and comment by the agencies and for resolution of concerns with respect to case activity.

(iii)

Confidentiality and disclosure

The State agency shall develop the policies and procedures in accordance with all provisions of this subtitle regarding confidentiality and conflict of interest for providers of home care services.

(b)

Procedures for access

(1)

In general

The State shall ensure that representatives of the home care ombudsman program shall have—

(A)

access to home care consumers and their homes with permission of the home care consumer involved or a legal representative;

(B)
(i)

appropriate access to review all records of a home care consumer, if—

(I)

the representative of the home care ombudsman program has the permission of the home care consumer, or the legal representative of the home care consumer; or

(II)

the home care consumer is unable to consent to the review and has no legal representative; or

(ii)

such access to the records as is necessary to investigate a complaint if—

(I)

a legal guardian of the home care consumer refuses to give the permission;

(II)

a representative of the home care ombudsman program has reasonable cause to believe that the guardian is not acting in the best interests of the home care consumer; and

(III)

the representative obtains the approval of the Ombudsman;

(C)

access to the administrative records, policies, and documents, to which home care consumers have, or the general public has access, of the provider of home care services; and

(D)

access to and, on request, copies of all licensing and certification records maintained by the State with respect to the provider of home care services.

(2)

Procedures

The State agency shall establish procedures to ensure the access described in paragraph (1).

(c)

Reporting system

The State agency shall ensure that the reporting system established in section 712(c) is equipped to—

(1)

collect and analyze data relating to complaints and conditions concerning home care services and to home care consumers for the purpose of identifying and resolving significant problems, including complaints concerning—

(A)

quality of services;

(B)

quantity of services;

(C)

availability of services; and

(D)

denial, reduction, and termination of services; and

(2)

submit the data, on a regular basis, to—

(A)

the agency of the State responsible for licensing or certifying providers of home care services in the State;

(B)

other State and Federal entities that the Ombudsman determines to be appropriate;

(C)

the Assistant Secretary; and

(D)

the National Ombudsman Resource Center established in section 202(a)(18)(A).

(d)

Disclosure

(1)

In general

The State agency shall establish procedures for the disclosure by the Ombudsman or local home care Ombudsman entities of information maintained by the home care ombudsman program, including records described in subsection (b)(1) or (c).

(2)

Identity of complainant or home care consumer

The procedures described in paragraph (1) shall—

(A)

provide that, subject to subparagraph (B), the information (including files or records) described in paragraph (1) may be disclosed only at the discretion of the Ombudsman (or the person designated by the Ombudsman to disclose such information); and

(B)

prohibit the disclosure of the identity of any complainant or home care consumer with respect to whom the Office maintains such information unless—

(i)

the complainant or home care consumer, or the legal representative of the complainant or home care consumer, consents to the disclosure and the consent is given in writing;

(ii)
(I)

the complainant or home care consumer gives consent orally; and

(II)

the consent is documented contemporaneously in a writing made by a representative of the home care ombudsman program in accordance with such requirements as the State agency shall establish; or

(iii)

the disclosure is required by court order.

(e)

Consultation

In planning and carrying out the home care ombudsman program, the State agency shall consider the views of area agencies on aging, older individuals, and providers of home care services and demonstrate how the State agency has taken their views into consideration.

(f)

Conflict of interest

The State agency shall—

(1)

ensure that no individual, or member of the immediate family of an individual, involved in the designation of the Ombudsman (whether by appointment or otherwise) or the designation of an entity designated under subsection (a)(5), is subject to a conflict of interest;

(2)

ensure that no officer or employee of the Office, home care ombudsman representative of a local home care Ombudsman entity, or member of the immediate family of the officer, employee, or home care ombudsman representative, is subject to a conflict of interest;

(3)

ensure that the Ombudsman—

(A)

does not have a direct involvement in the licensing or certification of a provider of home care services;

(B)

does not have an ownership or investment interest (represented by equity, debt, contract, or other financial relationship) in a provider of home care services;

(C)

is not employed by, or participating in the management of, a provider of home care services; and

(D)

does not receive, or have the right to receive, directly or indirectly, remuneration (in cash or in-kind) under a compensation arrangement with an owner or operator of a provider of home care services; and

(4)

establish, and specify in writing, mechanisms to identify and remove conflicts of interest referred to in paragraphs (1) and (2), and to identify and eliminate the relationships described in subparagraphs (A) through (D) of paragraph (3), including such mechanisms as—

(A)

the methods by which the State agency will examine individuals, and immediate family members, to identify the conflicts; and

(B)

the actions that the State agency will require the individuals and such family members to take to remove such conflicts.

(g)

Legal counsel

The State agency shall ensure that—

(1)
(A)

adequate legal counsel is available, and is able, without conflict of interest, to—

(i)

provide advice and consultation needed to protect the health, safety, welfare, and rights of home care consumers; and

(ii)

assist the Ombudsman and representatives of the home care ombudsman program in the performance of the official duties of the Ombudsman and representatives; and

(B)

legal representation is provided to any representative of the home care ombudsman program against whom suit or other legal action is brought or threatened to be brought in connection with the performance of the official duties of the Ombudsman or such a representative; and

(2)

the Ombudsman pursues administrative, legal, and other appropriate remedies on behalf of home care consumers.

(h)

Administration

(1)

Requirements

The State agency shall require the Office to—

(A)

include in its annual report required in section 712(h)(1)—

(i)

a description of the activities carried out by the Office as they related to the home care ombudsman program in the year for which the report is prepared;

(ii)

the data and an analysis of the data collected under subsection (c);

(iii)

an evaluation of the problems experienced by, and the complaints made by or on behalf of, home care consumers;

(iv)

recommendations for—

(I)

improving quality of the care and life of the home care consumers; and

(II)

protecting the health, safety, welfare, and rights of the home care consumers;

(v)
(I)

an analysis of the success of the home care ombudsman program including success in providing services to home care consumers in communities with high percentages of racial or ethnic minorities; and

(II)

identification of barriers that prevent the optimal operation of the home care ombudsman program; and

(vi)

policy, regulatory, and legislative recommendations to solve identified problems, to resolve the complaints, to improve the quality of care and life of home care consumers, to protect the health, safety, welfare, and rights of home care consumers, and to remove the barriers;

(B)

not later than 2 years after the date of the enactment of this chapter, establish procedures for the training of the representatives of the home care ombudsman program, including unpaid volunteers, based on best practices outlined by the Assistant Secretary in the most recent report submitted under subsection (m)(1), in consultation with representatives of citizen groups, providers of home care services, and the home care ombudsman program, that—

(i)

specify a minimum number of hours of initial training;

(ii)

specify the content of the training, including training relating to—

(I)

Federal, State, and local laws, regulations, and policies, with respect to providers of home care services in the State;

(II)

investigative techniques; and

(III)

such other matters as the State determines to be appropriate; and

(iii)

specify an annual number of hours of in-service training for all designated representatives;

(C)

prohibit any representative of the home care ombudsman program (other than the Ombudsman) from carrying out any activity described in subparagraphs (A) through (H) of subsection (a)(3) unless the representative—

(i)

has received the training required under subparagraph (B); and

(ii)

has been approved by the Ombudsman as qualified to carry out the activity on behalf of the Office;

(D)

coordinate home care ombudsman services with the protection and advocacy systems for individuals with developmental disabilities and mental illnesses established under—

(i)

subtitle C of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15041 et seq.); and

(ii)

the Protection and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10801 et seq.);

(E)

coordinate, to the greatest extent possible, home care ombudsman services with legal assistance provided under section 306(a)(2)(C), through adoption of memoranda of understanding and other means;

(F)

coordinate services with State and local law enforcement agencies and courts of competent jurisdiction; and

(G)

permit any local home care Ombudsman entity to carry out the responsibilities described in subparagraph (A), (D), or (E).

(2)

Authorities

The State agency shall require the Office to—

(A)

analyze, comment on, and monitor the development and implementation of Federal, State, and local laws, regulations, and other government policies and actions that pertain to providers of home care services and those services, and to the health, safety, welfare, and rights of home care consumers, in the State, and recommend any changes in such laws, regulations, and policies as the Ombudsman determines to be appropriate;

(B)
(i)

provide such information as the Ombudsman determines to be necessary to public and private agencies, legislators, and other persons, regarding—

(I)

the problems and concerns of older individuals receiving home care services; and

(II)

recommendations related to the problems and concerns; and

(ii)

make available to the public, and submit to the Assistant Secretary, the chief executive officer of the State, the State legislature, the State agency responsible for licensing or certifying providers of home care services, and other appropriate governmental entities, each report prepared under paragraph (1)(A); and

(C)

permit any local home care Ombudsman entity to carry out the responsibilities described in subparagraph (A) or (B).

(i)

Liability

The State shall ensure that no representative of the home care ombudsman program will be liable under State law for the good faith performance of official duties.

(j)

Noninterference

The State shall—

(1)

ensure that willful interference with representatives of the home care ombudsman program in the performance of the official duties of the representatives (as defined by the Assistant Secretary) shall be unlawful;

(2)

prohibit retaliation and reprisals by a provider of home care services or other entity with respect to any recipient of home and community-based services, employee, exclusive representative of an employee, or other person for filing a complaint with, providing information to, or otherwise cooperating with any representative of, the home care ombudsman program; and

(3)

provide for appropriate sanctions with respect to the interference, retaliation, and reprisals.

(k)

Coordination with Adult Protective Services

(1)

In general

The Ombudsman, in carrying out the State Home Care Ombudsman Program, shall coordinate activities with the National Adult Protective Services Resource Center and the head of the State’s adult protective services program in a manner that is consistent with the State’s existing (as of the date of the coordination) protocols for coordination of activities between the Ombudsman, in carrying out the State Long-Term Care Ombudsman Program.

(2)

Establishment of protocols

If the protocols described in paragraph (1) do not exist in the State, the Ombudsman, in conjunction with the head of the State’s adult protective services program, shall establish protocols to coordinate activities with the intent of better serving vulnerable adults, which protocols shall—

(A)

clarify the roles of each program;

(B)

establish procedures for maintaining a working relationship;

(C)

outline mutual expectations; and

(D)

establish procedures for coordinating activities with law enforcement.

(l)

Maintenance of effort

A State, in using the funds made available for a fiscal year through a grant received under section 703(d), shall maintain the expenditures of the State for home care ombudsman services at a level that is not less than the level of such expenditures maintained by the State for the preceding fiscal year.

(m)

Evaluation

The Assistant Secretary shall—

(1)

in conjunction with the Director of the Office of Long-Term Care Ombudsman Programs and the heads of other entities determined to be necessary by the Assistant Secretary, collect and analyze the data required to be submitted under subsection (c) by the States and within 1 year after receipt of the data, submit a report to Congress outlining best practices for carrying out a home care ombudsman program; and

(2)

make the report available to States.

.

711.

Establishment of Senior Medicare Patrol Program as Permanent Program

Title VII of the Older Americans Act of 1965 is amended—

(1)

by redesignating subtitle C as subtitle D;

(2)

by redesignating sections 761 through 765 as sections 771 through 775, respectively; and

(3)

by adding after subtitle B the following:

C

Senior Medicare Patrol Program

761.

Findings

Congress finds the following:

(1)

At least 3 percent of all health care spending is lost to fraud each year.

(2)

The Medicare Fraud Strike Forces have charged with fraud over 1,000 individuals, who collectively have falsely billed the Centers for Medicare & Medicaid Services for over $2,300,000,000 in Medicare benefits.

(3)

Approximately $1.55 is saved for every 1 dollar the government spends on fraud prevention in the Medicare program and Medicaid program.

(4)

Due to the SMP program, between the inception of the SMP program in 1996, and 2010—

(A)

25,300,000 Medicare and Medicaid beneficiaries have been reached through community education programs;

(B)

a total of 72 SMP projects have educated Medicare and Medicaid beneficiaries in 82,968 group sessions and 1,112,887 individual sessions;

(C)

1,321,222 media airings have occurred and 75,062 community outreach education events have been conducted;

(D)

savings to and costs avoided by Medicare, Medicaid, and other programs, and beneficiaries, total over $114,000,000; and

(E)

over 24,000 volunteers have been active in educating Medicare and Medicaid beneficiaries.

(5)

Many Medicare and Medicaid beneficiaries who receive help from the SMP program to avoid fraud cannot be tracked by the Office of the Inspector General of the Department of Health and Human Services, so the figures described in paragraphs (1) through (4) are most likely much higher.

762.

Definitions

In this subtitle:

(1)

Beneficiary

Except as provided in section 761, the term beneficiary means an individual entitled to, or enrolled for, benefits under part A of the Medicare program or enrolled for benefits under part B of the Medicare program, including such an individual who is also eligible for medical assistance under the Medicaid program.

(2)

Fraud

The term fraud means fraud, waste, and abuse within the meaning of section 1128J of the Social Security Act (42 U.S.C. 1320a–7k).

(3)

Medicare program; Medicaid program

The terms Medicare program and Medicaid program mean the programs carried out under titles XVIII and XIX, respectively, of the Social Security Act (42 U.S.C. 1395 et seq., 1396 et seq.).

(4)

SMP

The term SMP means Senior Medicare Patrol.

763.

Program authorized

(a)

In general

The Assistant Secretary shall carry out a program for making grants to States with State plans approved under section 307. The grants shall enable the States to establish and operate State SMP programs, in accordance with this section, to assist participants in the SMP programs in empowering and assisting beneficiaries, and their families and caregivers, through outreach, counseling, and education, to prevent, detect, and report health care fraud, errors, and abuse.

(b)

Grant amounts

(1)

In general

Except as provided in paragraph (2), each grant made under subsection (a) shall be for an amount equal to $180,000.

(2)

Territories

In the case of the Virgin Islands of the United States, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands, each such grant shall be for an amount equal to the amount the State received for fiscal year 2012 under the SMP program carried out under titles II and IV.

(3)

Study

The Assistant Secretary shall conduct a study on the benefits and drawbacks of allotting funds to States under a formula, for grants made under subsection (a). The study shall address a formula under which the Assistant Secretary would allot funds to a State based on the number of beneficiaries in the State, or based on the percentage of individuals in the State who are beneficiaries. The Assistant Secretary shall submit to the appropriate committees of Congress a report containing the results of the study.

(c)

Use of funds

(1)

In general

Each State that receives such a grant shall use the grant funds to establish and operate a State SMP program.

(2)

Activities

In establishing and operating the program, the State shall—

(A)

provide, directly or by grant or contract, for the services of a State SMP Director and staff sufficient to—

(i)

play a leadership role in State efforts to prevent, detect, and report fraud under the Medicare program and Medicaid program;

(ii)

report to the Assistant Secretary on State SMP activities described in clause (i), in such manner as the Assistant Secretary determines to be appropriate to facilitate evaluation of the effectiveness of such activities in achieving such SMP program goals and standards as the Assistant Secretary shall issue; and

(iii)

coordinate with the Secretary, the State Attorney General, State Medicaid fraud control unit, law enforcement, and consumer protection entities with respect to efforts to prevent fraud under the Medicare program and Medicaid program;

(B)

empower older individuals, through increased awareness and understanding of health care programs, to protect themselves from the economic and health-related consequences of fraud under the Medicare program and Medicaid program;

(C)

work to resolve complaints by beneficiaries of potential fraud in partnership with national and State fraud control or consumer protection entities, including Medicare program contractors, State Medicaid fraud control units, State Attorneys General, the Inspector General of the Department of Health and Human Services, and the Administrator of the Centers for Medicare & Medicaid Services;

(D)

undertake the training of older individuals and other volunteers, so that the trainees are able to conduct outreach to beneficiaries—

(i)

in their communities through conducting group presentations, exhibiting at community events, answering calls to SMP help lines, and providing one-on-one counseling; and

(ii)

in order to teach beneficiaries how to protect their personal identities, identify and report errors on their health care bills, and identify deceptive health care practices, such as illegal marketing, providing unnecessary or inappropriate services, and charging for services that were never provided; and

(E)

provide any additional activities the State wishes to provide through the State SMP program that will contribute to the overall purpose of empowering and assisting beneficiaries and their families and caregivers, to prevent, detect, and report health care fraud, errors, and abuse.

(3)

Eligible entities; priority in selection

(A)

In general

Subject to subparagraph (B), to be eligible to receive a grant or contract under paragraph (2)(A), an entity shall be a State or local government agency, an area agency on aging, a private nonprofit organization, a faith-based organization, or such other entity as the Assistant Secretary determines to be appropriate.

(B)

Priority

In selecting eligible entities to receive such grants or contracts, a State shall give priority to those entities with demonstrated experience in conducting health care fraud prevention programs.

(d)

Authorization of appropriations

There is authorized to be appropriated to carry out this subtitle, such sums as may be necessary for each of fiscal years 2013 through 2017.

.

VIII

Geriatrics and gerontology

801.

Primary health services

Section 331(a)(3)(D) of the Public Health Service Act (42 U.S.C. 254d(a)(3)(D)) is amended by inserting geriatrics, gerontology, after pediatrics,.

IX

Conforming amendments

901.

Greatest economic need; greatest social need

(a)

Definitions

Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is amended in subparagraph (E)(i) of paragraph (30), as redesignated by section 102(a)(2), by inserting after social need the following: (with particular attention to individuals with factors listed in paragraph (26)(B)).

(b)

Federal agency consultation

Section 203(a)(3)(A) of the Older Americans Act of 1965 (42 U.S.C. 3013(a)(3)(A)) is amended by striking older individuals (with particular attention to low-income older individuals, including low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas) and inserting older individuals, older individuals with greatest economic need, older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)),.

(c)

Evaluation

Section 206(a) of the Older Americans Act of 1965 (42 U.S.C. 3017(a)) is amended by striking greatest economic need and all that follows through areas), and inserting greatest economic need and unserved older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)),.

(d)

Reports

Section 207(c) of the Older Americans Act of 1965 (42 U.S.C. 3018(c)) is amended in paragraph (6), as redesignated by section 205(3)(B)—

(1)

by striking economic need (including low-income minority individuals and older individuals residing in rural areas) and inserting economic need; and

(2)

by striking social need (including low-income minority individuals and older individuals residing in rural areas) and inserting social need (with particular attention to individuals with factors listed in section 102(26)(B)).

(e)

Appropriate use of funds

Section 212(b)(3) of the Older Americans Act of 1965 (42 U.S.C. 3020c(b)(3)) is amended—

(1)

by striking social need, and inserting social need (with particular attention to individuals with factors listed in section 102(26)(B)) or; and

(2)

by striking , or an older and all that follows through placement.

(f)

Organization

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

(1)

in subsection (a)—

(A)

in paragraph (1)(E)—

(i)

by striking greatest economic need and all that follows through rural areas) the first place it appears and inserting greatest economic need; and

(ii)

by striking greatest social need and all that follows through rural areas) and inserting greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)); and

(B)

in paragraph (2)—

(i)

in subparagraph (C)(ii), as amended by section 305(1)(A)(i) of this Act, by striking areas and all that follows and inserting areas of older individuals with greatest economic need and older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)); and; and

(ii)

in subparagraph (E), by striking services to and all that follows through rural areas) and inserting services to older individuals with greatest economic need and older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B), including such individuals who are or are alleged victims of elder abuse, neglect, or exploitation); and

(2)

in subsection (d)(1), by striking greatest economic or social need and inserting greatest economic need and greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)).

(g)

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 greatest economic need and all that follows through rural areas) the first place it appears and inserting greatest economic need; and

(ii)

by striking greatest social need and all that follows through rural areas) residing in such area, and inserting greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)) residing in such area,; and

(B)

in paragraph (4)—

(i)

in subparagraph (A)—

(I)

in clause (i)(I), by striking will— and all that follows and inserting will set specific objectives, consistent with State policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)), and older individuals at risk for institutional placement; and;

(II)

in clause (i)(II), by striking items (aa) and (bb) of; and

(III)

in subclauses (I), (II), and (III) of clause (ii), by striking low-income and all that follows through rural areas and inserting individuals with greatest economic need and individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)); and

(ii)

in subparagraph (B)(i)—

(I)

in subclause (II), by striking economic need and all that follows through rural areas) and inserting economic need; and

(II)

in subclause (III), by striking social need and all that follows through rural areas) and inserting social need (with particular attention to individuals with factors listed in section 102(26)(B)); and

(2)

in subsection (b)(2)(B), by striking including individuals and all that follows and inserting including older individuals with greatest economic need and older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B));.

(h)

State plans

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

(1)

in paragraph (4), by striking provided to individuals and all that follows and inserting provided to individuals with greatest economic need and individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)).;

(2)

in paragraph (11)(B), by striking individuals with the greatest such need; and inserting individuals with greatest economic need and individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)),; and

(3)

in paragraph (28)(B)(ii), by striking including individuals and all that follows and inserting including older individuals with greatest economic need and older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B));.

(i)

Consumer contributions

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

(1)

in subsection (c)(2), by striking participation of and all that follows through rural areas) and inserting participation of older individuals with greatest economic need and older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)); and

(2)

in subsection (d), by striking (with particular and all that follows through rural areas) and inserting , including participation rates for individuals with greatest economic need and individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)).

(j)

Demonstration, support, and research projects

Section 417(c)(2) of the Older Americans Act of 1965 (42 U.S.C. 3032f(c)(2)) is amended by striking older individuals and communities and all that follows and inserting communities with greatest need, older individuals with greatest economic need, and older individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B));.

(k)

Older American community service employment program

Section 502(b)(1)(M) of the Older Americans Act of 1965 (42 U.S.C. 3056(b)(1)(M)) is amended by striking and eligible individuals with greatest economic need and inserting eligible individuals with disabilities, eligible individuals with greatest economic need, and eligible individuals with greatest social need.

(l)

Interagency cooperation

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

(1)

in subsection (c)(1), by striking individuals with greatest economic need, individuals with greatest social need, and inserting individuals with greatest economic need, individuals with greatest social need (with particular attention to individuals with factors listed in section 102(26)(B)),; and

(2)

in subsection (e)(1), by striking minority and all that follows through economic need, and inserting individuals with greatest economic need, individuals with greatest social need,.