II 

109TH CONGRESS 

2D SESSION S. 3570 

To amend the Older Americans Act of 1965 to authorize appropriations 

for fiscal years 2007 through 2011, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 27, 2006 

Mr. ENZI (for himself, Mr. KENNEDY, Mr. DEWINE, and Ms. MIKULSKI) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Older Americans Act of 1965 to authorize 

appropriations for fiscal years 2007 through 2011, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Older Americans Act 

5 Amendments of 2006’’. 

6 SEC. 2. DEFINITIONS. 

7 Section 102 of the Older Americans Act of 1965 (42 

8 U.S.C. 3002) is amended— 

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


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1 ‘‘(D) evidence-based health promotion pro2 grams, including programs related to the pre3 vention and mitigation of the effects of chronic 

4 disease (including osteoporosis, hypertension, 

5 obesity, diabetes, and cardiovascular disease), 

6 alcohol and substance abuse reduction, smoking 

7 cessation, weight loss and control, stress man8 agement, falls prevention, physical activity, and 

9 improved nutrition;’’; 

10 (2) by striking paragraph (24) and inserting 

11 the following: 

12 ‘‘(24) The term ‘exploitation’ means the fraudu13 lent or otherwise illegal, unauthorized, or improper 

14 act or process of an individual, including a caregiver 

15 or fiduciary (as such terms are defined in section 

16 751), that uses the resources of an older individual 

17 for monetary or personal benefit, profit, or gain, or 

18 that results in depriving an older individual of right19 ful access to, or use of, benefits, resources, belong20 ings, or assets.’’; 

21 (3) in paragraph (29)(E)— 

22 (A) in clause (i), by striking ‘‘and’’ at the 

23 end; 

24 (B) in clause (ii), by striking the period at 

25 the end and inserting ‘‘; and’’; and 


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1 (C) by adding at the end the following: 

2 ‘‘(iii) older individuals at risk for in3 stitutional placement.’’; 

4 (4) in paragraph (32)(D), by inserting ‘‘, in5 cluding an assisted living facility,’’ after ‘‘home’’; 

6 (5) by striking paragraph (34) and inserting 

7 the following: 

8 ‘‘(5)(A) The term ‘neglect’ means— 

9 ‘‘(i) the failure of a caregiver or fiduciary 

10 (as such terms are defined in section 751) to 

11 provide the goods or services that are necessary 

12 to maintain the health or safety of an older in13 dividual; or 

14 ‘‘(ii) self-neglect. 

15 ‘‘(B) The term ‘self-neglect’ means an adult’s 

16 inability, due to physical or mental impairment or 

17 diminished capacity, to perform essential self-care 

18 tasks including— 

19 ‘‘(i) obtaining essential food, clothing, shel20 ter, and medical care; 

21 ‘‘(ii) obtaining goods and services nec22 essary to maintain physical health, mental 

23 health, or general safety; or 

24 ‘‘(iii) managing one’s own financial af25 fairs.’’; and 


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1 (6) by adding at the end the following: 

2 ‘‘(44) The term ‘Aging and Disability Resource 

3 Center’ means a center established by a State as 

4 part of the State’s system of long-term care, to pro5 vide a coordinated system for providing— 

6 ‘‘(A) comprehensive information on avail7 able public and private long-term care pro8 grams, options, and resources; 

9 ‘‘(B) personal counseling to assist individ10 uals in assessing their existing or anticipated 

11 long-term care needs, and developing and imple12 menting a plan for long-term care designed to 

13 meet their specific needs and circumstances; 

14 and 

15 ‘‘(C) consumer access to the range of pub16 licly-supported long-term care programs for 

17 which consumers may be eligible, by serving as 

18 a convenient point of entry for such programs. 

19 ‘‘(45) The term ‘at risk for institutional place20 ment’ means, with respect to an older individual, 

21 that such individual is unable to perform at least 

22 two activities of daily living without substantial as23 sistance (including verbal reminding, physical cuing, 

24 or supervision), including such an older individual 


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1 that is determined by the State involved to be in 

2 need of placement in a long-term care facility. 

3 ‘‘(46) The term ‘Hispanic-serving institution’ 

4 has the meaning given the term in section 502 of the 

5 Higher Education Act of 1965 (20 U.S.C. 1101a). 

6 ‘‘(47) The term ‘long-term care’ means any 

7 services, care, or items (including assistive devices) 

8 that are— 

9 ‘‘(A) intended to assist individuals in cop10 ing with, and to the extent practicable compen11 sating for, functional impairments in carrying 

12 out activities of daily living; 

13 ‘‘(B) furnished at home, in a community 

14 care setting (including a small community care 

15 setting as defined in subsection (g)(1), and a 

16 large community care setting as defined in sub17 section (h)(1), of section 1929 of the Social Se18 curity Act (42 U.S.C. 1396t)), or in a long19 term care facility; and 

20 ‘‘(C) not furnished to diagnose, treat, or 

21 cure a medical disease or condition. 

22 ‘‘(48) The term ‘self-directed care’ means an 

23 approach to providing services (including programs, 

24 benefits, supports, and technology) under this Act 


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1 intended to assist an older individual with activities 

2 of daily living, in which— 

3 ‘‘(A) such services (including the amount, 

4 duration, scope, provider, and location of such 

5 services) are planned, budgeted, and purchased 

6 under the direction and control of such indi7 vidual; 

8 ‘‘(B) such individual is provided with such 

9 information and assistance as is necessary and 

10 appropriate to enable such individual to make 

11 informed decisions about the individual’s service 

12 options; 

13 ‘‘(C) the needs, capabilities, and pref14 erences of such individual with respect to such 

15 services, and such individual’s ability to direct 

16 and control the individual’s receipt of such serv17 ices, are assessed by the area agency on aging 

18 involved or the local provider agency; 

19 ‘‘(D) based on the assessment made under 

20 subparagraph (C), upon request, the area agen21 cy on aging assists such individual and the indi22 vidual’s family, caregiver, or legal representa23 tive in developing— 


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1 ‘‘(i) a plan of services for such indi2 vidual that specifies which services such in3 dividual will be responsible for directing; 

4 ‘‘(ii) a determination of the role of 

5 family members (and others whose partici6 pation is sought by such individual) in pro7 viding services under such plan; and 

8 ‘‘(iii) a budget for such services; and 

9 ‘‘(E) the area agency on aging or State 

10 agency involved provides for oversight of such 

11 individual’s self-directed receipt of services, in12 cluding steps to ensure the quality of services 

13 provided and the appropriate use of funds 

14 under this Act. 

15 ‘‘(49) The term ‘State system of long-term 

16 care’ means the Federal, State, and local programs 

17 and activities administered by a State that provide, 

18 support, or facilitate access to long-term care to in19 dividuals in such State.’’. 

20 SEC. 3. OFFICE OF ELDER ABUSE PREVENTION AND SERV21 ICES. 

22 Section 201 of the Older Americans Act of 1965 (42 

23 U.S.C. 3011) is amended by adding at the end the fol24 lowing: 


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1 ‘‘(e)(1) In this subsection, the terms defined in sec2 tion 751 shall have the meanings given those terms in that 

3 section. 

4 ‘‘(2) The Secretary is authorized to establish or des5 ignate within the Administration (as defined in section 

6 102) an Office of Elder Abuse Prevention and Services. 

7 ‘‘(3) It shall be the duty of the Assistant Secretary, 

8 acting through the head of the Office of Elder Abuse Pre9 vention and Services to— 

10 ‘‘(A) develop objectives, priorities, policy, and a 

11 long-term plan for— 

12 ‘‘(i) carrying out elder justice programs 

13 and activities relating to— 

14 ‘‘(I) elder abuse prevention, detection, 

15 treatment, and intervention, and response; 

16 ‘‘(II) training of individuals regarding 

17 the matters described in subclause (I); and 

18 ‘‘(III) the improvement of the elder 

19 justice system in the United States; 

20 ‘‘(ii) annually collecting, maintaining, and 

21 disseminating data relating to the abuse, ne22 glect, and exploitation of elders (and, in the dis23 cretion of the Secretary, vulnerable adults), in24 cluding collecting, maintaining, and dissemi25 nating such data under section 753 after conVerDate Aug 31 2005 04:39 Jun 29, 2006 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3570.IS S3570

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1 sultation with the Attorney General and work2 ing with experts from the Department of Jus3 tice described in section 753(b)(1); 

4 ‘‘(iii) disseminating information concerning 

5 best practices regarding, and providing training 

6 on, carrying out activities related to abuse, ne7 glect, and exploitation of elders (and, in the dis8 cretion of the Secretary, vulnerable adults); 

9 ‘‘(iv) in conjunction with the necessary ex10 perts, conducting research related to abuse, ne11 glect, and exploitation of elders (and, in the dis12 cretion of the Secretary, vulnerable adults); 

13 ‘‘(v) providing technical assistance to 

14 States and other eligible entities that provide or 

15 fund the provision of the services described in 

16 subtitle B of title VII; and 

17 ‘‘(vi) carrying out a study to determine the 

18 national incidence and prevalence of elder 

19 abuse, neglect, and exploitation in all settings; 

20 ‘‘(B) implement the overall policy and a strat21 egy to carry out the plan described in subparagraph 

22 (A); and 

23 ‘‘(C) provide advice to the Secretary on elder 

24 justice issues and administer such programs relating 


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1 to elder abuse, neglect, and exploitation as the Sec2 retary determines to be appropriate. 

3 ‘‘(4) The Secretary, acting through the Assistant Sec4 retary, may issue such regulations as may be necessary 

5 to carry out this subsection and subtitle B of title VII.’’. 

6 SEC. 4. FUNCTIONS OF THE ASSISTANT SECRETARY. 

7 Section 202 of the Older Americans Act of 1965 (42 

8 U.S.C. 3012) is amended— 

9 (1) in subsection (a)— 

10 (A) in paragraph (12)— 

11 (i) by striking ‘‘carry on’’ and insert12 ing the following: 

13 ‘‘(B) carry on’’; and 

14 (ii) by striking ‘‘(12)’’ and inserting 

15 the following: 

16 ‘‘(12)(A) consult and coordinate activities with 

17 the Administrator of the Centers for Medicare & 

18 Medicaid Services to implement and build awareness 

19 of programs providing new benefits affecting older 

20 individuals; and’’; 

21 (B) by striking paragraph (20) and insert22 ing the following: 

23 ‘‘(20)(A) provide technical assistance and sup24 port for outreach and benefits enrollment assistance 

25 to support efforts— 


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1 ‘‘(i) to inform older individuals with great2 est economic need, who may be eligible to par3 ticipate, but who are not participating, in Fed4 eral and State programs for which the individ5 uals are eligible, about the programs; and 

6 ‘‘(ii) to enroll the individuals in the pro7 grams; 

8 ‘‘(B) in cooperation with related Federal agency 

9 partners administering the Federal programs, make 

10 a grant to or enter into a contract with a qualified, 

11 experienced entity to establish a National Center on 

12 Senior Benefits Outreach and Enrollment, which 

13 shall— 

14 ‘‘(i) maintain and update web-based deci15 sion support and enrollment tools, and inte16 grated, person-centered systems, designed to in17 form older individuals about the full range of 

18 benefits for which the individuals may be eligi19 ble under Federal and State programs; 

20 ‘‘(ii) utilize cost-effective strategies to find 

21 older individuals with greatest economic need 

22 and enroll the individuals in the programs; 

23 ‘‘(iii) create and support efforts for Aging 

24 and Disability Resource Centers, and other 

25 public and private State and community-based 


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1 organizations, including faith-based organiza2 tions and coalitions, to serve as benefits enroll3 ment centers for the programs; 

4 ‘‘(iv) develop and maintain an information 

5 clearinghouse on best practices and the most 

6 cost-effective methods for finding and enrolling 

7 older individuals with greatest economic need in 

8 the programs; and 

9 ‘‘(v) provide, in collaboration with related 

10 Federal agency partners administering the Fed11 eral programs, training and technical assistance 

12 on the most effective outreach, screening, en13 rollment, and follow-up strategies for the Fed14 eral and State programs.’’; 

15 (C) in paragraph (26)(D)— 

16 (i) by striking ‘‘gaps in’’; 

17 (ii) by inserting ‘‘(including services 

18 that would permit such individuals to re19 ceive long-term care in home and commu20 nity-based settings)’’ after ‘‘individuals’’; 

21 and 

22 (iii) by striking ‘‘and’’ at the end; 

23 (D) in paragraph (27), by striking the pe24 riod at the end and inserting ‘‘; and’’; and 

25 (E) by adding at the end the following: 


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1 ‘‘(28) make available to States information and 

2 technical assistance to support the provision of evi3 dence-based disease prevention and health promotion 

4 services.’’; and 

5 (2) by striking subsection (b) and inserting the 

6 following: 

7 ‘‘(b) To promote the development and implementa8 tion of comprehensive, coordinated systems at Federal, 

9 State, and local levels for providing long-term care in 

10 home and community-based settings, in a manner respon11 sive to the needs and preferences of older individuals and 

12 their family caregivers, the Assistant Secretary shall, con13 sistent with the applicable provisions of this title— 

14 ‘‘(1) collaborate, coordinate, and consult with 

15 other Federal agencies and departments (other than 

16 the Administration on Aging) responsible for formu17 lating and implementing programs, benefits, and 

18 services related to providing long-term care, and 

19 may make grants, contracts, and cooperative agree20 ments with funds received from those other Federal 

21 agencies and departments; 

22 ‘‘(2) conduct research and demonstration 

23 projects to identify innovative, cost-effective strate24 gies for modifying State systems of long-term care 

25 to— 


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1 ‘‘(A) respond to the needs and preferences 

2 of older individuals and family caregivers; 

3 ‘‘(B) target services to individuals at risk 

4 for institutional placement, to permit such indi5 viduals to remain in home and community6 based settings; and 

7 ‘‘(C) establish criteria for and promote the 

8 implementation (through area agencies on 

9 aging, service providers, and such other entities 

10 as the Assistant Secretary determines to be ap11 propriate) of evidence-based programs to assist 

12 older individuals and their family caregivers in 

13 learning about and making behavioral changes 

14 intended to reduce the risk of injury, disease, 

15 and disability among older individuals; 

16 ‘‘(3) facilitate, in coordination with the Admin17 istrator of the Centers for Medicare & Medicaid 

18 Services, including the provision of such care 

19 through self-directed care models that— 

20 ‘‘(A) provide for the assessment of the 

21 needs and preferences of an individual at risk 

22 for institutional placement to help such indi23 vidual avoid unnecessary institutional placement 

24 and depletion of income and assets to qualify 

25 for benefits under the Medicaid program under 


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1 title XIX of the Social Security Act (42 U.S.C. 

2 1396 et seq.); 

3 ‘‘(B) respond to the needs and preferences 

4 of such individual and provide the option— 

5 ‘‘(i) for the individual to direct and 

6 control the receipt of supportive services 

7 provided; or 

8 ‘‘(ii) as appropriate, for a person who 

9 was appointed by the individual, or is le10 gally acting on the individual’s behalf, in 

11 order to represent or advise the individual 

12 in financial or service coordination matters 

13 (referred to in this paragraph as a ‘rep14 resentative’ of the individual), to direct 

15 and control the receipt of those services; 

16 and 

17 ‘‘(C) assist an older individual (or, as ap18 propriate, a representative of the individual) to 

19 develop a plan for long-term support, including 

20 selecting, budgeting for, and purchasing home 

21 and community-based long-term care and sup22 portive services; 

23 ‘‘(4) provide for the Administration to play a 

24 lead role with respect to issues concerning home and 

25 community-based long-term care, including— 


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1 ‘‘(A) directing (as the Secretary or the 

2 President determines to be appropriate) or oth3 erwise participating in departmental and inter4 departmental activities concerning long-term 

5 care; and 

6 ‘‘(B) reviewing and commenting on depart7 mental rules, regulations, and policies related to 

8 providing long-term care; and 

9 ‘‘(C) making recommendations to the Sec10 retary with respect to home and community11 based long-term care, including recommenda12 tions based on findings made through projects 

13 conducted under paragraph (2); 

14 ‘‘(5) promote, in coordination with other appro15 priate Federal agencies— 

16 ‘‘(A) enhanced awareness by the public of 

17 the importance of planning in advance for long18 term care; and 

19 ‘‘(B) the availability of information and re20 sources to assist in such planning; 

21 ‘‘(6) establish, either directly or through grants 

22 or contracts, a national technical assistance program 

23 to assist State agencies, area agencies on aging, and 

24 community-based service providers funded under this 

25 Act in implementing home and community-based 


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1 long-term care systems, including evidence-based 

2 programs; 

3 ‘‘(7) develop, in collaboration with the Adminis4 trator of the Centers for Medicare & Medicaid Serv5 ices, performance standards and measures for use by 

6 States to determine the extent to which their sys7 tems of long-term care fulfill the objectives described 

8 in this subsection; and 

9 ‘‘(8) conduct such other activities as the Assist10 ant Secretary determines to be appropriate. 

11 ‘‘(c) The Assistant Secretary, after consultation with 

12 the Chief Executive Officer of the Corporation for Na13 tional and Community Service, shall— 

14 ‘‘(1) encourage and permit volunteer groups 

15 (including organizations carrying out national serv16 ice programs and including organizations of youth in 

17 secondary or postsecondary school) that are active in 

18 supportive services and civic engagement to partici19 pate and be involved individually or through rep20 resentative groups in supportive service and civic en21 gagement programs or activities to the maximum ex22 tent feasible; 

23 ‘‘(2) develop a comprehensive strategy for uti24 lizing older individuals to address critical local needs 

25 of national concern; and 


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1 ‘‘(3) encourage other community capacity-build2 ing initiatives involving older individuals.’’. 

3 SEC. 5. FEDERAL AGENCY CONSULTATION. 

4 Section 203 of the Older Americans Act of 1965 (42 

5 U.S.C. 3013) is amended— 

6 (1) in subsection (a)(3)(A)— 

7 (A) by striking ‘‘(with particular attention 

8 to low-income minority older individuals and 

9 older individuals residing in rural areas)’’ and 

10 inserting ‘‘(with particular attention to low-in11 come older individuals, including low-income 

12 minority older individuals, older individuals 

13 with limited English proficiency, and older indi14 viduals residing in rural areas)’’; and 

15 (B) by striking ‘‘section 507’’ and insert16 ing ‘‘section 516’’; 

17 (2) in subsection (b), by adding at the end the 

18 following: 

19 ‘‘(19) Sections 4 and 5 of the Assistive Tech20 nology Act of 1998 (29 U.S.C. 3003, 3004).’’; and 

21 (3) by adding at the end the following: 

22 ‘‘(c)(1) The Secretary, in collaboration with the Sec23 retary of Housing and Urban Development and with the 

24 other Federal officials specified in paragraph (2), shall es25 tablish an interagency coordinating committee (referred to 


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1 in this subsection as the ‘Committee’) focusing on the co2 ordination of agencies with respect to aging issues, par3 ticularly issues related to demographic changes and hous4 ing needs among older individuals. 

5 ‘‘(2) The officials referred to in paragraph (1) are 

6 the Secretary of Labor, the Secretary of Housing and 

7 Urban Development, the Attorney General, the Secretary 

8 of Transportation, the Secretary of the Treasury, the Sec9 retary of Agriculture, the Commissioner of Social Secu10 rity, the Surgeon General, the Administrator of the Cen11 ters for Medicare & Medicaid Services, the Director of the 

12 Centers for Disease Control and Prevention, the Director 

13 of the National Institutes of Health, the Assistant Sec14 retary for Children and Families, the Administrator of the 

15 National Highway Traffic Safety Administration, and 

16 such other Federal officials as the Secretary of Health and 

17 Human Services determines to be appropriate. 

18 ‘‘(3) The Secretary of Health and Human Services 

19 shall serve as the first chairperson of the Committee, for 

20 an initial period of 2 years. After that initial period, the 

21 Secretary of Housing and Urban Development and the 

22 Secretary of Health and Human Services shall alternate 

23 as chairpersons of the Committee, each serving as chair24 person for a period of 2 years. 

25 ‘‘(4) The Committee shall— 


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1 ‘‘(A) review all Federal programs and services 

2 that assist older individuals in finding and affording 

3 housing, health care, and other services, including 

4 those Federal programs and services that assist 

5 older individuals in accessing health care, transpor6 tation, supportive services, and assistance with daily 

7 activities, at the place or close to the place where the 

8 older individuals live; 

9 ‘‘(B) monitor, evaluate, and recommend im10 provements in programs and services administered, 

11 funded, or financed by Federal, State, and local 

12 agencies to assist older individuals in meeting their 

13 housing, health care, and other service needs and 

14 make any recommendations about how the agencies 

15 can better carry out and provide the programs and 

16 services to house and serve older individuals; 

17 ‘‘(C) recommend ways to— 

18 ‘‘(i) facilitate aging in place of older indi19 viduals, by identifying and making available the 

20 programs and services necessary to enable older 

21 individuals to remain in their homes as the in22 dividuals age; 

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1 dividuals in meeting their housing, health care, 

2 and other service needs; 

3 ‘‘(iii) ensure collaboration among and with4 in agencies in providing and making available 

5 the programs and services so that older individ6 uals are able to easily access needed programs 

7 and services; 

8 ‘‘(iv) work with States to better provide 

9 housing, health care, and other services to older 

10 individuals by— 

11 ‘‘(I) holding individual meetings with 

12 State representatives; 

13 ‘‘(II) providing ongoing technical as14 sistance to States about better meeting the 

15 needs of older individuals; and 

16 ‘‘(III) working with States to des17 ignate State liaisons for the Committee; 

18 ‘‘(v) identify model programs and services 

19 to assist older individuals in meeting their hous20 ing, health care, and other service needs, in21 cluding model— 

22 ‘‘(I) programs linking housing, health 

23 care, and other services; 


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1 ‘‘(II) financing products offered by 

2 government, quasi-government, and private 

3 sector entities; and 

4 ‘‘(III) innovations in technology appli5 cations that give older individuals access to 

6 information on available services or that 

7 help in providing services to older individ8 uals; 

9 ‘‘(vi) collect and disseminate information 

10 about older individuals and the programs and 

11 services available to the individuals to ensure 

12 that the individuals can access comprehensive 

13 information; and 

14 ‘‘(vii) work with the Federal Interagency 

15 Forum on Aging-Related Statistics, the Bureau 

16 of the Census, and member agencies— 

17 ‘‘(I) to collect and maintain data re18 lating to the housing, health care, and 

19 other service needs of older individuals so 

20 that all such data can be accessed in one 

21 place on a designated website; and 

22 ‘‘(II) to identify and address unmet 

23 data needs; 

24 ‘‘(D) make recommendations to guide policy 

25 and program development across Federal agencies 


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1 with respect to demographic changes among older 

2 individuals; and 

3 ‘‘(E) actively seek input from and consult with 

4 all appropriate and interested parties, including pub5 lic health interest and research groups and founda6 tions about the activities described in subparagraphs 

7 (A) through (D). 

8 ‘‘(5) Each year, the Committee shall prepare and 

9 submit to the President, the Committee on Financial Serv10 ices of the House of Representatives, the Committee on 

11 Education and the Workforce of the House of Representa12 tives, the Committee on Banking, Housing, and Urban Af13 fairs of the Senate, the Committee on Health, Education, 

14 Labor, and Pensions of the Senate, and the Special Com15 mittee on Aging of the Senate, a report that— 

16 ‘‘(A) describes the activities and accomplish17 ments of the Committee in working with Federal, 

18 State, and local governments, and private organiza19 tions, in coordinating programs and services to meet 

20 the requirements of paragraph (4); 

21 ‘‘(B) assesses the level of Federal assistance re22 quired to meet the needs described in paragraph (4); 

23 ‘‘(C) incorporates an analysis from the head of 

24 each agency that is a member of the interagency co25 ordinating committee established under paragraph 


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1 (1) that describes the barriers and impediments, in2 cluding barriers and impediments in statutory and 

3 regulatory law, to the access and use by older indi4 viduals of programs and services administered by 

5 such agency; and 

6 ‘‘(D) makes recommendations for appropriate 

7 legislative and administrative actions to meet the 

8 needs described in paragraph (4) and for coordi9 nating programs and services designed to meet those 

10 needs. 

11 ‘‘(6)(A) The Secretary of Health and Human Serv12 ices, after consultation with the Secretary of Housing and 

13 Urban Development, shall appoint an executive director 

14 of the Committee. 

15 ‘‘(B) On the request of the Committee, any Federal 

16 Government employee may be detailed to the Committee 

17 without reimbursement, and such detail shall be without 

18 interruption or loss of civil service status or privilege.’’. 

19 SEC. 6. ADMINISTRATION. 

20 Section 205 of the Older Americans Act of 1965 (42 

21 U.S.C. 3016) is amended— 

22 (1) in subsection (a)— 

23 (A) in paragraph (1)— 

24 (i) in subparagraph (C), by adding 

25 ‘‘and’’ at the end; 


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1 (ii) in subparagraph (D), by striking 

2 ‘‘; and’’ at the end and inserting a period; 

3 and 

4 (iii) by striking subparagraph (E); 

5 and 

6 (B) in paragraph (2)— 

7 (i) in subparagraph (A)— 

8 (I) by amending clause (i) to 

9 read as follows: 

10 ‘‘(i) designing, implementing, and evaluating 

11 evidence-based programs to support improved nutri12 tion and regular physical activity for older individ13 uals;’’; 

14 (II) by amending clause (iii) to 

15 read as follows: 

16 ‘‘(iii) conducting outreach and disseminating 

17 evidence-based information to nutrition service pro18 viders about the benefits of healthful diets and reg19 ular physical activity, including information about 

20 the most current Dietary Guidelines for Americans 

21 published under section 301 of the National Nutri22 tion Monitoring and Related Research Act of 1990 

23 (7 U.S.C. 5341), the Food Guide Pyramid published 

24 by the Secretary of Agriculture, and advances in nu25 trition science;’’; 


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1 (III) in clause (vii) by striking 

2 ‘‘and’’ at the end; and 

3 (IV) by striking clause (viii) and 

4 inserting the following: 

5 ‘‘(viii) disseminating guidance that describes 

6 strategies for improving the nutritional quality of 

7 meals provided under title III; and 

8 ‘‘(ix) providing technical assistance to the re9 gional offices of the Administration with respect to 

10 each duty described in clauses (i) through (viii).’’; 

11 and 

12 (ii) by amending subparagraph (C)(i) 

13 to read as follows: 

14 ‘‘(i) have expertise in nutrition and meal plan15 ning; and’’. 

16 SEC. 7. EVALUATION. 

17 Section 206(g) of the Older Americans Act of 1965 

18 (42 U.S.C. 3017(g)) is amended by striking the first sen19 tence and inserting the following: ‘‘From the total amount 

20 appropriated for each fiscal year to carry out title III, the 

21 Secretary may use such sums as may be necessary, but 

not more than 1 22 ⁄2 of 1 percent of such amount, for pur23 poses of conducting evaluations under this section, either 

24 directly or by grant or contract.’’. 


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1 SEC. 8. REPORTS. 

2 Section 207(b)(2) of the Older Americans Act of 

3 1965 (42 U.S.C. 3018(b)(2)) is amended— 

4 (1) in subparagraph (B), by striking ‘‘Labor’’ 

5 and inserting ‘‘the Workforce’’; and 

6 (2) in subparagraph (C), by striking ‘‘Labor 

7 and Human Resources’’ and inserting ‘‘Health, Edu8 cation, Labor, and Pensions’’. 

9 SEC. 9. CONTRACTUAL, COMMERCIAL AND PRIVATE PAY 

10 RELATIONSHIPS; APPROPRIATE USE OF ACT 

11 FUNDS. 

12 (a) PRIVATE PAY RELATIONSHIPS; APPROPRIATE

13 USE OF ACT FUNDS.—Section 212 of the Older Ameri14 cans Act (42 U.S.C. 3020c) is amended to read as follows: 

15 ‘‘SEC. 212. CONTRACTING AND GRANT AUTHORITY; PRI16 VATE PAY RELATIONSHIPS; APPROPRIATE 

17 USE OF FUNDS. 

18 ‘‘(a) IN GENERAL.—Subject to subsection (b), this 

19 Act shall not be construed to prevent a recipient of a grant 

20 or a contract under this Act from entering into an agree21 ment— 

22 ‘‘(1) with a profitmaking organization; 

23 ‘‘(2) under which funds provided under such 

24 grant or contract are used to pay part or all of a 

25 cost (including an administrative cost) incurred by 

26 such recipient to carry out a contract or commercial 


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•S 3570 IS

1 relationship for the benefit of older individuals or 

2 their family caregivers, whether such contract or re3 lationship is carried out to implement a provision of 

4 this Act or to conduct activities inherently associated 

5 with implementing such provision; or 

6 ‘‘(3) under which any individual, regardless of 

7 age or income (including the family caregiver of such 

8 individual), who seeks to receive 1 or more services 

9 may voluntarily pay, at their own private expense, to 

10 receive such services based on the fair market value 

11 of such services. 

12 ‘‘(b) ENSURING APPROPRIATE USE OF FUNDS.—An 

13 agreement described in subsection (a) may not— 

14 ‘‘(1) be made without the prior approval of the 

15 State agency (or, in the case of a grantee under title 

16 VI, without the prior recommendation of the Direc17 tor of the Office for American Indian, Alaska Na18 tive, and Native Hawaiian Aging and the prior ap19 proval of the Assistant Secretary); 

20 ‘‘(2) directly or indirectly provide for, or have 

21 the effect of, paying, reimbursing, or otherwise com22 pensating an entity under such agreement in an 

23 amount that exceeds the fair market value of the 

24 goods or services furnished by such entity under 

25 such agreement; 


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•S 3570 IS

1 ‘‘(3) result in the displacement of services oth2 erwise available to an older individual with greatest 

3 social need, an older individual with greatest eco4 nomic need, or an older individual who is at risk for 

5 institutional placement; or 

6 ‘‘(4) in any other way compromise, undermine, 

7 or be inconsistent with the objective of serving the 

8 needs of older individuals, as determined by the As9 sistant Secretary.’’. 

10 SEC. 10. NUTRITION EDUCATION. 

11 Section 214 of the Older Americans Act of 1965 (42 

12 U.S.C. 3020e) is amended to read as follows: 

13 ‘‘SEC. 214. NUTRITION EDUCATION. 

14 ‘‘The Assistant Secretary, in consultation with the 

15 Secretary of Agriculture, shall conduct outreach and pro16 vide technical assistance to agencies and organizations 

17 that serve older individuals to assist such agencies and or18 ganizations to carry out integrated health promotion and 

19 disease prevention programs that— 

20 ‘‘(1) are designed for older individuals; and 

21 ‘‘(2) include— 

22 ‘‘(A) nutrition education; 

23 ‘‘(B) physical activity; and 

24 ‘‘(C) other activities to modify behavior 

25 and to improve health literacy, including proVerDate Aug 31 2005 04:39 Jun 29, 2006 Jkt 049200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\S3570.IS S3570

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•S 3570 IS

1 viding information on optimal nutrient intake, 

2 through education and counseling in accordance 

3 with section 339(2)(J).’’. 

4 SEC. 11. PENSION COUNSELING AND INFORMATION PRO5 GRAMS. 

6 Section 215 of the Older Americans Act of 1965 (42 

7 U.S.C. 3020e–1) is amended— 

8 (1) in subsection (e)(1)(J), by striking ‘‘and low 

9 income retirees’’ and inserting ‘‘, low-income retir10 ees, and older individuals with limited English pro11 ficiency’’; 

12 (2) in subsection (f), by amending paragraph 

13 (2) to read as follows: 

14 ‘‘(2) The ability of the entity to perform effec15 tive outreach to affected populations, particularly 

16 populations with limited English proficiency and 

17 other populations that are identified as in need of 

18 special outreach.’’; and 

19 (3) in subsection (h)(2), by inserting ‘‘(includ20 ing individuals with limited English proficiency)’’ 

21 after ‘‘individuals’’. 

22 SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 

23 Section 216 of the Older Americans Act of 1965 (42 

24 U.S.C. 3020f) is amended— 


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•S 3570 IS

1 (1) in subsection (a) by striking ‘‘2001, 2002, 

2 2003, 2004, and 2005’’ and inserting ‘‘2007, 2008, 

3 2009, 2010, and 2011.’’; and 

4 (2) in subsections (b) and (c) by striking 

5 ‘‘year’’ and all that follows through ‘‘years’’, and in6 serting ‘‘years 2007, 2008, 2009, 2010, and 2011’’. 

7 SEC. 13. PURPOSE; ADMINISTRATION. 

8 Section 301(a)(2) of the Older Americans Act of 

9 1965 (42 U.S.C. 3021(a)(2)) is amended— 

10 (1) in subparagraph (D), by striking ‘‘and’’ at 

11 the end; 

12 (2) in subparagraph (E), by striking the period 

13 at the end and inserting ‘‘; and’’; and 

14 (3) by adding at the end the following: 

15 ‘‘(F) organizations with experience in providing 

16 senior volunteer services, such as Federal volunteer 

17 programs administered by the Corporation for Na18 tional and Community Service and designed to pro19 vide training, placement, and stipends for volunteers 

20 in community service settings.’’. 

21 SEC. 14. AUTHORIZATION OF APPROPRIATIONS; USES OF 

22 FUNDS. 

23 Section 303 of the Older Americans Act of 1965 (42 

24 U.S.C. 3023) is amended— 


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•S 3570 IS

1 (1) in subsections (a)(1), (b), and (d), by strik2 ing ‘‘year 2001’’ and all that follows through 

3 ‘‘years’’ each place it appears, and inserting ‘‘years 

4 2007, 2008, 2009, 2010, and 2011’’; and 

5 (2) in subsection (e)— 

6 (A) in paragraph (1) by striking 

7 ‘‘$125,000,000’’ and all that follows and insert8 ing ‘‘$160,000,000 for fiscal year 2007.’’; and 

9 (B) in paragraph (2), by striking ‘‘such 

10 sums’’ and all that follows and inserting 

11 ‘‘$170,000,000 for fiscal year 2008, 

12 $180,000,000 for fiscal year 2009, 

13 $190,000,000 for fiscal year 2010, and 

14 $200,000,000 for fiscal year 2011.’’. 

15 SEC. 15. ALLOTMENTS. 

16 Section 304(d)(1)(A) of the Older Americans Act of 

17 1965 (42 U.S.C. 3024(d)(1)(A)) is amended to read as 

18 follows: 

19 ‘‘(A)(i) such amount as the State agency 

20 determines, but not more than 10 percent 

21 thereof, shall be available for paying such per22 centage as the agency determines, but not more 

23 than 75 percent, of the cost of administration 

24 of area plans; and 


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•S 3570 IS

1 ‘‘(ii) in addition to that amount, for any 

2 fiscal year among fiscal years 2007 through 

3 2011 for which the amount appropriated under 

4 subsections (a) through (d) of section 303 is 

5 not less than 110 percent of that appropriated 

6 amount for fiscal year 2006, an amount equal 

7 to 1 percent of the State’s allotment shall be 

8 used by the area agencies on aging in the State 

9 to carry out the assessment described in section 

10 306(b);’’. 

11 SEC. 16. ORGANIZATION. 

12 Section 305 of the Older Americans Act of 1965 (42 

13 U.S.C. 3025) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (1)(E)— 

16 (i) by striking ‘‘(with particular atten17 tion to low-income minority individuals and 

18 older individuals residing in rural areas)’’ 

19 each place it appears and inserting ‘‘(with 

20 particular attention to low-income older in21 dividuals, including low-income minority 

22 older individuals, older individuals with 

23 limited English proficiency, and older indi24 viduals residing in rural areas)’’; and 

25 (ii) by striking ‘‘and’’ at the end; 


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•S 3570 IS

1 (B) in paragraph (2)— 

2 (i) in subparagraph (E), by striking ‘‘, 

3 with particular attention to low-income mi4 nority individuals and older individuals re5 siding in rural areas’’ and inserting ‘‘(with 

6 particular attention to low-income older in7 dividuals, including low-income minority 

8 older individuals, older individuals with 

9 limited English proficiency, and older indi10 viduals residing in rural areas)’’; and 

11 (ii) in subparagraph (G), by striking 

12 the period and inserting ‘‘; and’’; and 

13 (C) by adding at the end the following: 

14 ‘‘(3) the State agency shall, consistent with this 

15 section, promote the development and implementa16 tion of a comprehensive, coordinated system in such 

17 State for providing long-term care in home and com18 munity-based settings, in a manner responsive to the 

19 needs and preferences of older individuals and their 

20 family caregivers, by— 

21 ‘‘(A) collaborating, coordinating, and con22 sulting with other agencies in such State re23 sponsible for formulating, implementing, and 

24 administering programs, benefits, and services 

25 related to providing long-term care; 


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•S 3570 IS

1 ‘‘(B) participating in any State govern2 ment activities concerning long-term care, in3 cluding reviewing and commenting on any State 

4 rules, regulations, and policies related to long5 term care; 

6 ‘‘(C) conducting analyses and making rec7 ommendations with respect to strategies for 

8 modifying the State’s system of long-term care 

9 to better— 

10 ‘‘(i) respond to the needs and pref11 erences of older individuals and family 

12 caregivers; 

13 ‘‘(ii) facilitate the provision, by service 

14 providers, of long-term care in home and 

15 community-based settings; 

16 ‘‘(iii) target services to older individ17 uals at risk for institutional placement, to 

18 permit such individuals to remain in home 

19 and community-based settings; and 

20 ‘‘(iv) implement (through area agen21 cies on aging, service providers, and such 

22 other entities as the State determines to be 

23 appropriate) programs to assist older indi24 viduals and their family caregivers in 

25 learning about and making behavioral 


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•S 3570 IS

1 changes intended to reduce the risk of in2 jury, disease, and disability among older 

3 individuals; and 

4 ‘‘(D) providing for the availability and dis5 tribution (through public education campaigns, 

6 Aging and Disability Resource Centers, area 

7 agencies on aging, and other appropriate 

8 means) of information relating to— 

9 ‘‘(i) the need to plan in advance for 

10 long-term care; and 

11 ‘‘(ii) the range of available public and 

12 private long-term care programs, options, 

13 and resources.’’; and 

14 (2) in subsection (b), by adding at the end the 

15 following: 

16 ‘‘(6) Nothing in this section shall prevent the Com17 monwealth of Puerto Rico from designating, with the ap18 proval of the Assistant Secretary, a single planning and 

19 service area to cover all the older individuals in the Com20 monwealth.’’. 

21 SEC. 17. AREA PLANS. 

22 Section 306 of the Older Americans Act of 1965 (42 

23 U.S.C. 3026) is amended— 

24 (1) in subsection (a)— 

25 (A) in paragraph (1)— 


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•S 3570 IS

1 (i) by striking ‘‘(with particular atten2 tion to low-income minority individuals and 

3 older individuals residing in rural areas)’’ 

4 and inserting ‘‘(with particular attention to 

5 low-income older individuals, including low6 income minority older individuals, older in7 dividuals with limited English proficiency, 

8 and older individuals residing in rural 

9 areas)’’; 

10 (ii) by striking ‘‘(with particular at11 tention to low-income minority individ12 uals)’’ and inserting ‘‘(with particular at13 tention to low-income older individuals, in14 cluding low-income minority older individ15 uals, older individuals with limited English 

16 proficiency, and older individuals residing 

17 in rural areas)’’; and 

18 (iii) by inserting ‘‘the number of older 

19 individuals at risk for institutional place20 ment residing in such area,’’ after ‘‘indi21 viduals) residing in such area,’’; 

22 (B) in paragraph (2)(A)— 

23 (i) by inserting after ‘‘transpor24 tation,’’ the following: ‘‘health services (in25 cluding mental health services),’’; and 


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•S 3570 IS

1 (ii) by inserting after ‘‘information 

2 and assistance’’ the following: ‘‘(which may 

3 include information and assistance to con4 sumers on availability of services under 

5 part B and how to receive benefits under 

6 and participate in publicly supported pro7 grams for which the consumer may be eli8 gible)’’; 

9 (C) in paragraph (4)— 

10 (i) in subparagraph (A)— 

11 (I) by amending clause (i) to 

12 read as follows: 

13 ‘‘(i) provide assurances that the area agency on 

14 aging will— 

15 ‘‘(I) set specific objectives, consistent with 

16 State policy, for providing services to older indi17 viduals with greatest economic need, older indi18 viduals with greatest social need, and older in19 dividuals at risk for institutional placement; 

20 ‘‘(II) include specific objectives for pro21 viding services to low-income minority older in22 dividuals, older individuals with limited English 

23 proficiency, and older individuals residing in 

24 rural areas; and 


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•S 3570 IS

1 ‘‘(III) include in the area plan proposed 

2 methods to achieve such objectives;’’; and 

3 (II) in clause (ii) by inserting 

4 ‘‘(including older individuals with lim5 ited English proficiency)’’ after ‘‘low 

6 income minority individuals’’ each 

7 place it appears; and 

8 (ii) in subparagraph (B)— 

9 (I) by moving the left margin of 

10 each of subparagraph (B), clauses (i) 

11 and (ii), and subclauses (I) through 

12 (VI) of clause (i), 2 ems to the left; 

13 and 

14 (II) in clause (i)— 

15 (aa) in subclause (V) by 

16 striking ‘‘with limited English17 speaking ability; and’’ and insert18 ing ‘‘with limited English pro19 ficiency;’’; and 

20 (bb) by adding at the end 

21 the following: 

22 ‘‘(VII) older individuals at risk for in23 stitutional placement; and’’; 


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1 (D) in paragraph (5), by inserting ‘‘and in2 dividuals at risk for institutional placement’’ 

3 after ‘‘severe disabilities’’; 

4 (E) in paragraph (6)— 

5 (i) in subparagraph (C)— 

6 (I) in clause (i), by striking 

7 ‘‘and’’ at the end; 

8 (II) in clause (ii), by adding 

9 ‘‘and’’ at the end; and 

10 (III) by inserting after clause (ii) 

11 the following: 

12 ‘‘(iii) make use of trained volunteers in 

13 providing direct services delivered to older indi14 viduals and individuals with disabilities needing 

15 such services and, if possible, work in coordina16 tion with entities carrying out volunteer pro17 grams (including programs administered by the 

18 Corporation for National and Community Serv19 ices) designed to provide training, placement, 

20 and stipends for volunteers in community serv21 ice settings.’’; 

22 (ii) in subparagraph (D)— 

23 (I) by inserting ‘‘family care24 givers of such individuals,’’ after 

25 ‘‘Act,’’; and 


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•S 3570 IS

1 (II) by inserting ‘‘service pro2 viders, representatives of the business 

3 community,’’ after ‘‘individuals,’’; and 

4 (iii) in subparagraph (F), by inserting 

5 ‘‘(including mental health screening)’’ be6 fore ‘‘provided’’ each place it appears; 

7 (F) in paragraph (7), to read as follows: 

8 ‘‘(7) provide that the area agency on aging 

9 shall, consistent with this section, facilitate the area10 wide development and implementation of a com11 prehensive, coordinated system for providing long12 term care in home and community-based settings, in 

13 a manner responsive to the needs and preferences of 

14 older individuals and their family caregivers, by— 

15 ‘‘(A) collaborating, coordinating, and con16 sulting with other local public and private agen17 cies and organizations responsible for admin18 istering programs, benefits, and services related 

19 to providing long-term care; 

20 ‘‘(B) conducting analyses and making rec21 ommendations with respect to strategies for 

22 modifying the local system of long-term care to 

23 better— 


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•S 3570 IS

1 ‘‘(i) respond to the needs and pref2 erences of older individuals and family 

3 caregivers; 

4 ‘‘(ii) facilitate the provision, by service 

5 providers, of long-term care in home and 

6 community-based settings; 

7 ‘‘(iii) target services to older individ8 uals at risk for institutional placement, to 

9 permit such individuals to remain in home 

10 and community-based settings; and 

11 ‘‘(iv) implement (through the agency 

12 or service providers), evidence-based pro13 grams to assist older individuals and their 

14 family caregivers in learning about and 

15 making behavioral changes intended to re16 duce the risk of injury, disease, and dis17 ability among older individuals; and 

18 ‘‘(C) providing for the availability and dis19 tribution (through public education campaigns, 

20 Aging and Disability Resource Centers, and 

21 other appropriate means) of information relat22 ing to— 

23 ‘‘(i) the need to plan in advance for 

24 long-term care; and 


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•S 3570 IS

1 ‘‘(ii) the range of available public and 

2 private long-term care programs, options, 

3 and resources.’’; 

4 (G) by striking the 2 paragraphs (15); 

5 (H) by redesignating paragraph (16) as 

6 paragraph (15); and 

7 (I) by adding at the end the following: 

8 ‘‘(16) provide assurances that funds received 

9 under this title will be used— 

10 ‘‘(A) to provide benefits and services to 

11 older individuals giving priority to older individ12 uals identified in paragraph (4)(A)(i); and 

13 ‘‘(B) in compliance with the assurances 

14 specified in paragraph (13) and the limitations 

15 specified in section 212(b); and 

16 ‘‘(17) provide, to the extent feasible, for the 

17 furnishing of services under this Act, consistent with 

18 self-directed care. 

19 ‘‘(18) include information detailing how the 

20 area agency on aging will coordinate activities, and 

21 develop long-range emergency plans, with local and 

22 State emergency response agencies, relief organiza23 tions, local and State governments, and any other 

24 institutions that have responsibility for disaster re25 lief service delivery.’’; 


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1 (2) by redesignating subsections (b), (c), (d), 

2 and (e) as subsections (c), (d), (e), and (f); and 

3 (3) by inserting after subsection (a) the fol4 lowing: 

5 ‘‘(b)(1) In any fiscal year, an area agency on aging 

6 may include in the area plan an assessment of how pre7 pared the area agency on aging and service providers in 

8 the planning and service area are for a change in the num9 ber of older individuals during the 10-year period following 

10 the fiscal year for which the plan is submitted. In a fiscal 

11 year described in section 304(d)(1)(A)(ii), an area agency 

12 or aging shall include the assessment in the area plan. 

13 ‘‘(2) Such assessment may include— 

14 ‘‘(A) the projected change in the number of 

15 older individuals in the planning and service area; 

16 ‘‘(B) an analysis of how such change may affect 

17 such individuals, including individuals with low in18 comes, individuals with greatest economic need, mi19 nority older individuals, older individuals residing in 

20 rural areas, and older individuals with limited 

21 English proficiency; 

22 ‘‘(C) an analysis of how the programs, policies, 

23 and services provided by such area agency can be 

24 improved, and how resource levels can be adjusted to 


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•S 3570 IS

1 meet the needs of the changing population of older 

2 individuals in the planning and service area; and 

3 ‘‘(D) an analysis of how the change in the num4 ber of individuals age 85 and older in the planning 

5 and service area is expected to affect the need for 

6 supportive services. 

7 ‘‘(3) An area agency on aging, in cooperation with 

8 government officials, State agencies, tribal organizations, 

9 or local entities, may make recommendations to govern10 ment officials in the planning and service area and the 

11 State, on actions determined by the area agency to build 

12 the capacity in the planning and service area to meet the 

13 needs of older individuals for— 

14 ‘‘(A) health and human services; 

15 ‘‘(B) land use; 

16 ‘‘(C) housing; 

17 ‘‘(D) transportation; 

18 ‘‘(E) public safety; 

19 ‘‘(F) workforce and economic development; 

20 ‘‘(G) recreation; 

21 ‘‘(H) education; 

22 ‘‘(I) civic engagement; 

23 ‘‘(J) emergency preparedness; and 

24 ‘‘(K) any other service as determined by such 

25 agency.’’. 


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•S 3570 IS

1 SEC. 18. STATE PLANS. 

2 Section 307(a) of the Older Americans Act of 1965 

3 (42 U.S.C. 3027(a)) is amended— 

4 (1) in paragraph (2)(C), by striking ‘‘section 

5 306(b)’’ and inserting ‘‘section 306(c)’’; 

6 (2) in paragraph (4), by striking ‘‘, with par7 ticular attention to low-income minority individuals 

8 and older individuals residing in rural areas’’ and in9 serting ‘‘(with particular attention to low-income mi10 nority older individuals, older individuals with lim11 ited English proficiency, and older individuals resid12 ing in rural areas)’’; 

13 (3) by striking paragraph (15); 

14 (4) by redesignating paragraph (14) as para15 graph (15); 

16 (5) by inserting after paragraph (13) the fol17 lowing: 

18 ‘‘(14) The plan shall, with respect to the fiscal 

19 year preceding the fiscal year for which such plan is 

20 prepared— 

21 ‘‘(A) identify the number of low-income 

22 minority older individuals in the State, includ23 ing the number of low-income minority older in24 dividuals with limited English proficiency; and 

25 ‘‘(B) describe the methods used to satisfy 

26 the service needs of the low-income minority 


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•S 3570 IS

1 older individuals described in subparagraph (A), 

2 including the plan to meet the needs of low-in3 come minority older individuals with limited 

4 English proficiency.’’; 

5 (6) in clauses (ii) and (iii) of paragraph (16)(A) 

6 by striking ‘‘(with particular attention to low-income 

7 minority individuals and older individuals residing in 

8 rural areas)’’ each place it appears and inserting 

9 ‘‘(with particular attention to low-income older indi10 viduals, including low-income minority older individ11 uals, older individuals with limited English pro12 ficiency, and older individuals residing in rural 

13 areas)’’; and 

14 (7) by adding at the end the following: 

15 ‘‘(27) The plan shall provide assurances that 

16 area agencies on aging will provide, to the extent 

17 feasible, for the furnishing of services under this 

18 Act, consistent with self-directed care. 

19 ‘‘(28)(A) The plan shall include, at the election 

20 of the State, an assessment of how prepared the 

21 State is, under the State’s statewide service delivery 

22 model, for a change in the number of older individ23 uals during the 10-year period following the fiscal 

24 year for which the plan is submitted. 

25 ‘‘(B) Such assessment may include— 


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•S 3570 IS

1 ‘‘(i) the projected change in the number of 

2 older individuals in the State; 

3 ‘‘(ii) an analysis of how such change may 

4 affect such individuals, including individuals 

5 with low incomes, individuals with great eco6 nomic need, minority older individuals, older in7 dividuals residing in rural areas, and older indi8 viduals with limited English proficiency; 

9 ‘‘(iii) an analysis of how the programs, 

10 policies, and services provided by the State can 

11 be improved, including coordinating with area 

12 agencies on aging, and how resource levels can 

13 be adjusted to meet the needs of the changing 

14 population of older individuals in the State; and 

15 ‘‘(iv) an analysis of how the change in the 

16 number of individuals age 85 and older in the 

17 State is expected to affect the need for sup18 portive services. 

19 ‘‘(29) The plan shall include information detail20 ing how the State will coordinate activities, and de21 velop long-range emergency preparedness plans, with 

22 area agencies on aging, local emergency response 

23 agencies, relief organizations, local governments, and 

24 any other institutions that have responsibility for 

25 disaster relief service delivery. 


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•S 3570 IS

1 ‘‘(30) The plan shall include information de2 scribing the involvement of the head of the State 

3 agency in the development, revision, and implemen4 tation of emergency preparedness plans, including 

5 the State Public Health Emergency Preparedness 

6 and Response Plan. 

7 ‘‘(31) The plan shall provide that the State 

8 shall implement an Aging and Disability Resource 

9 Center— 

10 ‘‘(A) to serve as a visible and trusted 

11 source of information on the full range of op12 tions for long-term care, including both institu13 tional and home and community-based care, 

14 that are available in the State; 

15 ‘‘(B) to provide personalized and con16 sumer-friendly assistance to empower individ17 uals to make informed decisions about their 

18 long-term care options; 

19 ‘‘(C) to provide coordinated and stream20 lined access to all publicly funded long-term 

21 care options so that consumers can obtain the 

22 care they need through a single intake, assess23 ment, and eligibility determination process; 

24 ‘‘(D) to help individuals to plan ahead for 

25 their long-term care needs; and 


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•S 3570 IS

1 ‘‘(E) to assist, in coordination with the en2 tity carrying out the health insurance informa3 tion, counseling, and assistance program (re4 ceiving funding under section 4360 of the Om5 nibus Budget Reconciliation Act of 1990 (42 

6 U.S.C. 1395b–4)) in the State, beneficiaries, 

7 and prospective beneficiaries, under the Medi8 care program established under title XVIII of 

9 the Social Security Act (42 U.S.C. 1395 et 

10 seq.) in understanding and accessing prescrip11 tion drug and preventative health benefits 

12 under the provisions of, and amendments made 

13 by, the Medicare Prescription Drug, Improve14 ment, and Modernization Act of 2003.’’. 

15 SEC. 19. PAYMENTS. 

16 Section 309(b)(2) of the Older Americans Act of 

17 1965 (42 U.S.C. 3029(b)(2)) is amended by striking ‘‘the 

18 non-Federal share required prior to fiscal year 1981’’ and 

19 inserting ‘‘10 percent of the cost of the services specified 

20 in section 304(d)(1)(D)’’. 

21 SEC. 20. NUTRITION SERVICES INCENTIVE PROGRAM. 

22 Section 311 of the Older Americans Act of 1965 (42 

23 U.S.C. 3030a) is amended— 

24 (1) in subsection (b), by adding at the end the 

25 following: 


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1 ‘‘(3) Each State agency and grantee under title VI 

2 shall promptly and equitably disburse amounts received 

3 under this subsection to recipients of grants and con4 tracts.’’; 

5 (2) in subsection (c)— 

6 (A) in paragraph (1), by inserting ‘‘, in7 cluding bonus commodities,’’ after ‘‘agricultural 

8 commodities’’; 

9 (B) in paragraph (2), by inserting ‘‘, in10 cluding bonus commodities,’’ after ‘‘food com11 modities’’; and 

12 (C) in paragraph (3), by inserting ‘‘, in13 cluding bonus commodities,’’ after ‘‘Dairy prod14 ucts’’; 

15 (3) in subsection (d)(4), by inserting ‘‘and 

16 grantee under title VI’’ after ‘‘State agency’’; and 

17 (4) in subsection (e), by striking ‘‘2001’’ and 

18 inserting ‘‘2007’’. 

19 SEC. 21. CONSUMER CONTRIBUTIONS. 

20 Section 315 of the Older Americans Act of 1965 (42 

21 U.S.C. 3030c–2) is amended— 

22 (1) in subsection (b)— 

23 (A) in paragraph (1)— 

24 (i) by striking ‘‘provided that’’ and in25 serting ‘‘if’’; and 


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1 (ii) by adding at the end the fol2 lowing: ‘‘Such contributions shall be en3 couraged for individuals whose self-de4 clared income is at or above 200 percent of 

5 the poverty line, at contribution levels 

6 based on the actual cost of services.’’; and 

7 (B) in paragraph (4)(E), by inserting ‘‘and 

8 to supplement (not supplant) funds received 

9 under this Act’’ after ‘‘given’’; 

10 (2) in subsection (c)(2), by striking ‘‘(with par11 ticular attention to low-income minority individuals 

12 and older individuals residing in rural areas)’’ and 

13 inserting ‘‘(with particular attention to low-income 

14 older individuals, including low-income minority 

15 older individuals, older individuals with limited 

16 English proficiency, and older individuals residing in 

17 rural areas)’’; and 

18 (3) in subsection (d), by striking ‘‘with par19 ticular attention to low-income and minority older 

20 individuals and older individuals residing in rural 

21 areas’’ and inserting ‘‘(with particular attention to 

22 low-income older individuals, including low-income 

23 minority older individuals, older individuals with lim24 ited English proficiency, and older individuals resid25 ing in rural areas)’’. 


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1 SEC. 22. SUPPORTIVE SERVICES AND SENIOR CENTERS. 

2 Section 321(a) of the Older Americans Act of 1965 

3 (42 U.S.C. 3030d(a)) is amended— 

4 (1) in paragraph (8), by inserting ‘‘(including 

5 mental health screening)’’ after ‘‘screening’’; 

6 (2) in paragraph (11) by striking ‘‘services’’ 

7 and inserting ‘‘provision of devices and services (in8 cluding provision of assistive technology devices and 

9 assistive technology services)’’; 

10 (3) in paragraph (14)(B) by inserting ‘‘(includ11 ing mental health)’’ after ‘‘health’’; 

12 (4) in paragraph (22) by striking the period at 

13 the end and inserting a semicolon; 

14 (5) by redesignating paragraph (23) as para15 graph (24); and 

16 (6) by inserting after paragraph (22) the fol17 lowing: 

18 ‘‘(23) services designed to support States, area 

19 agencies on aging, and local service providers in car20 rying out and coordinating activities for older indi21 viduals with respect to mental health services, in22 cluding outreach for, education concerning, and 

23 screening for such services, and referral to such 

24 services for treatment; and’’. 


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1 SEC. 23. NUTRITION SERVICES. 

2 After the part heading of part C of title III of the 

3 Older Americans Act of 1965 (42 U.S.C. 3030e et seq.), 

4 insert the following: 

5 ‘‘SEC. 330. PURPOSE. 

6 ‘‘It is the purpose of this part to promote socializa7 tion and the health and well-being of older individuals by 

8 assisting such individuals to gain access to nutrition serv9 ices to delay the onset of adverse health conditions.’’. 

10 SEC. 24. CONGREGATE NUTRITION PROGRAM. 

11 Section 331 of the Older Americans Act of 1965 (42 

12 U.S.C. 3030e) is amended— 

13 (1) by striking ‘‘projects—’’ and inserting 

14 ‘‘projects that—’’; 

15 (2) in paragraph (1) by striking ‘‘which’’ the 

16 first place it appears; 

17 (3) in paragraph (2), by striking ‘‘which’’; and 

18 (4) by striking paragraph (3) and inserting the 

19 following: 

20 ‘‘(3) provide nutrition education, nutrition 

21 counseling, and other nutrition services, as appro22 priate, based on the needs of meal participants.’’. 

23 SEC. 25. HOME DELIVERED NUTRITION SERVICES. 

24 Section 336 of the Older Americans Act of 1965 (42 

25 U.S.C. 3030f) is amended to read as follows: 


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1 ‘‘SEC. 336. PROGRAM AUTHORIZED. 

2 ‘‘The Assistant Secretary shall establish and carry 

3 out a program to make grants to States under State plans 

4 approved under section 307 for the establishment and op5 eration of nutrition projects for older individuals that pro6 vide— 

7 ‘‘(1) on 5 or more days a week (except in a 

8 rural area where such frequency is not feasible (as 

9 defined by the Assistant Secretary by rule) and a 

10 lesser frequency is approved by the State agency) at 

11 least 1 home delivered meal per day, which may con12 sist of hot, cold, frozen, dried, canned, fresh, or sup13 plemental foods and any additional meals that the 

14 recipient of a grant or contract under this subpart 

15 elects to provide; and 

16 ‘‘(2) nutrition education, nutrition counseling, 

17 and other nutrition services as appropriate, based on 

18 the needs of meal recipients.’’. 

19 SEC. 26. CRITERIA. 

20 Section 337 of the Older Americans Act of 1965 (42 

21 U.S.C. 3030g) is amended to read as follows: 

22 ‘‘SEC. 337. CRITERIA. 

23 ‘‘The Assistant Secretary, in consultation with recog24 nized experts in the fields of nutrition science, dietetics, 

25 meal planning and food service management, and aging, 

26 shall develop minimum criteria of efficiency and quality 


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1 for the furnishing of home delivered meal services for 

2 projects described in section 336.’’. 

3 SEC. 27. NUTRITION. 

4 Section 339 of the Older Americans Act of 1965 (42 

5 U.S.C. 3030g–21) is amended— 

6 (1) in paragraph (1), to read as follows: 

7 ‘‘(1) solicit the advice and expertise of a dieti8 tian or other individual with education and training 

9 in nutrition science or, if such an individual is not 

10 available, an individual with comparable expertise in 

11 the planning of nutritional services, and’’; and 

12 (2) in paragraph (2)— 

13 (A) in subparagraph (A)(i), to read as fol14 lows: 

15 ‘‘(i) comply with the most recent Die16 tary Guidelines for Americans, published 

17 by the Secretary and the Secretary of Ag18 riculture, and’’; and 

19 (B) in subparagraph (D), by inserting 

20 ‘‘joint’’ after ‘‘encourages’’; and 

21 (C) in subparagraph (G), to read as fol22 lows: 

23 ‘‘(G) ensures that meal providers solicit 

24 the advice and expertise of— 


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1 ‘‘(i) a dietitian or other individual de2 scribed in paragraph (1), 

3 ‘‘(ii) meal participants, and 

4 ‘‘(iii) other individuals knowledgeable 

5 with regard to the needs of older individ6 uals,’’; and 

7 (D) in subparagraph (I), by striking ‘‘and’’ 

8 at the end; and 

9 (E) in subparagraph (J), to read as fol10 lows: 

11 ‘‘(J) provides for nutrition screening and 

12 nutrition education, and nutrition assessment 

13 and counseling if appropriate; and 

14 ‘‘(K) encourages individuals who distribute 

15 nutrition services under subpart 2 to provide, to 

16 homebound older individuals, available medical 

17 information approved by health care profes18 sionals, such as informational brochures and in19 formation on how to get vaccines, including vac20 cines for influenza, pneumonia, and shingles, in 

21 the individuals’ communities.’’. 

22 SEC. 28. STUDY OF NUTRITION PROJECTS. 

23 (a) STUDY.— 

24 (1) IN GENERAL.—The Assistant Secretary for 

25 Aging shall use funds allocated in section 206(g) of 


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1 the Older Americans Act of 1965 (42 U.S.C. 

2 3017(g)) to enter into a contract with the Food and 

3 Nutrition Board of the Institute of Medicine of the 

4 National Academy of Sciences, for the purpose of es5 tablishing an independent panel of experts that will 

6 conduct an evidence-based study of the nutrition 

7 projects authorized under such Act. 

8 (2) STUDY.—Such study shall, to the extent 

9 data are available, include— 

10 (A) an evaluation of the effect of the nutri11 tion projects authorized by such Act on— 

12 (i) improvement of the health status, 

13 including nutritional status, of participants 

14 in the projects; 

15 (ii) prevention of hunger and food in16 security of the participants; and 

17 (iii) continuation of the ability of the 

18 participants to live independently; 

19 (B) a cost-benefit analysis of nutrition 

20 projects authorized by such Act, including the 

21 potential to affect costs of the Medicaid pro22 gram under title XIX of the Social Security Act 

23 (42 U.S.C. 1396 et seq.); and 

24 (C) an analysis of how nutrition projects 

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1 prove the outcomes described in subparagraph 

2 (A), including by improving the nutritional 

3 quality of the meals provided through the 

4 projects and undertaking other potential strate5 gies to improve the nutritional status of the 

6 participants. 

7 (b) REPORTS.— 

8 (1) REPORT TO THE ASSISTANT SECRETARY.— 

9 The panel described in subsection (a) shall submit to 

10 the Assistant Secretary a report containing the re11 sults of the evidence-based study described in sub12 section (a), including any recommendations resulting 

13 from the analysis described in subsection (a)(2)(C). 

14 (2) REPORT TO CONGRESS.—The Assistant 

15 Secretary shall submit a report containing the re16 sults described in paragraph (1) to the Committee 

17 on Education and the Workforce of the House of 

18 Representatives and the Committee on Health, Edu19 cation, Labor, and Pensions of the Senate. 

20 (c) TIMING.—The Food and Nutrition Board shall 

21 establish the independent panel of experts described in 

22 subsection (a) not later than 90 days after the date of 

23 the enactment of this Act. The panel shall submit the re24 port described in subsection (b)(1) to the Assistant SecVerDate Aug 31 2005 04:39 Jun 29, 2006 Jkt 049200 PO 00000 Frm 00059 Fmt 6652 Sfmt 6201 E:\BILLS\S3570.IS S3570

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1 retary not later than 24 months after the date of the en2 actment of this Act. 

3 SEC. 29. IMPROVING INDOOR AIR QUALITY IN BUILDINGS 

4 WHERE OLDER INDIVIDUALS CONGREGATE. 

5 Section 361 of the Older Americans Act of 1965 (42 

6 U.S.C. 3030m) is amended by adding at the end the fol7 lowing: 

8 ‘‘(c) The Assistant Secretary shall work in consulta9 tion with qualified experts to provide information on meth10 ods of improving indoor air quality in buildings where 

11 older individuals congregate.’’. 

12 SEC. 30. CAREGIVER SUPPORT PROGRAM DEFINITIONS. 

13 Section 372 of the Older Americans Act of 1965 (42 

14 U.S.C. 3030s) is amended— 

15 (1) in paragraph (1), by inserting ‘‘or an adult 

16 child with mental retardation or a related develop17 mental disability’’ after ‘‘age’’; 

18 (2) in paragraph (2), by inserting before the pe19 riod the following: ‘‘or an individual with Alz20 heimer’s disease or a related disorder with neuro21 logical and organic brain dysfunction who is 50 

22 years of age or older’’; 

23 (3) in paragraph (3)— 

24 (A) by striking ‘‘child’’ the first place it 

25 appears and inserting ‘‘child (including an adult 


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1 child with mental retardation or a related devel2 opmental disability)’’; 

3 (B) by striking ‘‘a child by blood or mar4 riage’’ and inserting ‘‘such a child by blood, 

5 marriage, or adoption’’; and 

6 (C) by striking ‘‘60’’ and inserting ‘‘55’’; 

7 (4) by redesignating paragraphs (2) and (3) as 

8 paragraphs (3) and (4), respectively; and 

9 (5) by inserting after paragraph (1) the fol10 lowing: 

11 ‘‘(2) DEVELOPMENTAL DISABILITY.—The term 

12 ‘developmental disability’ has the meaning given the 

13 term in section 102 of the Developmental Disabil14 ities Assistance and Bill of Rights Act of 2000 (42 

15 U.S.C. 15002).’’. 

16 SEC. 31. CAREGIVER SUPPORT PROGRAM. 

17 Section 373 of the National Family Support Care18 giver Act (42 U.S.C. 3030s–1) is amended— 

19 (1) in subsection (b)(3), by striking ‘‘caregivers 

20 to assist’’ and all that follows through the end and 

21 inserting the following: ‘‘assist the caregivers in the 

22 areas of health, nutrition, and financial literacy, and 

23 in making decisions and solving problems relating to 

24 their caregiving roles;’’; 

25 (2) in subsection (c)(2)— 


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1 (A) by striking ‘‘(as defined’’ and all that 

2 follows and inserting a period; and 

3 (B) by adding at the end the following: ‘‘In 

4 providing services for family caregivers under 

5 this subpart, the State shall give priority for 

6 services to family caregivers who provide care 

7 for older individuals.’’; and 

8 (3) in subsection (d), to read as follows: 

9 ‘‘(d) USE OF VOLUNTEERS.—In carrying out this 

10 subpart, each area agency on aging shall make use of 

11 trained volunteers to expand the provision of the available 

12 services described in subsection (b) and shall, if possible, 

13 work in coordination with entities carrying out volunteer 

14 programs (including programs administered by the Cor15 poration for National and Community Service) designed 

16 to provide training, placement, and stipends for volunteers 

17 in community service settings.’’; and 

18 (4) in subsection (e)(3), by adding at the end 

19 the following: ‘‘The reports shall describe any mech20 anisms used in the State to provide to persons who 

21 are family caregivers, or grandparents or older indi22 viduals who are relative caregivers, information 

23 about and access to various services so that the per24 sons can better carry out their care responsibil25 ities.’’; and 


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1 (5) in subsection (f)(1), by striking ‘‘2001 

2 through 2005’’ and inserting ‘‘2007, 2008, 2009, 

3 2010, and 2011’’. 

4 SEC. 32. ACTIVITIES AND PROGRAMS OF NATIONAL SIG5 NIFICANCE. 

6 Section 376(a) of the National Family Support Care7 giver Act (42 U.S.C. 3030s–12(a)) is amended— 

8 (1) by striking the title heading and inserting 

9 the following: 

10 ‘‘SEC. 376. ACTIVITIES AND PROGRAMS OF NATIONAL SIG11 NIFICANCE.’’; 

12 (2) by striking ‘‘(a) IN GENERAL.—’’; 

13 (3) by striking ‘‘shall’’ and inserting ‘‘may’’; 

14 (4) by striking ‘‘program’’ and inserting ‘‘ac15 tivities that include’’; 

16 (5) by striking ‘‘research.’’ and inserting ‘‘re17 search, and programs that include— 

18 ‘‘(1) multigenerational programs, including pro19 grams that provide supports for grandparents and 

20 other older individuals who are relative caregivers 

21 (as defined in section 372) raising children (such as 

22 kinship navigator programs), and programs that 

23 sustain and replicate innovative multigenerational 

24 family support programs involving volunteers who 

25 are older individuals; 


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1 ‘‘(2) programs providing support and informa2 tion to families who have a child with a disability or 

3 chronic illness, and to other families in need of fam4 ily support programs; 

5 ‘‘(3) programs addressing unique issues faced 

6 by rural caregivers; 

7 ‘‘(4) programs focusing on the needs of older 

8 individuals with Alzheimer’s disease and related de9 mentia and their caregivers; and 

10 ‘‘(5) programs supporting caregivers in the 

11 roles the caregivers carry out in health promotion 

12 and disease prevention.’’; and 

13 (6) by striking subsection (b). 

14 SEC. 33. GRANT PROGRAMS. 

15 Section 411 of the Older Americans Act of 1965 (42 

16 U.S.C. 3032) is amended— 

17 (1) in subsection (a)— 

18 (A) in paragraph (8), by striking ‘‘and’’ at 

19 the end; 

20 (B) by redesignating paragraph (9) as 

21 paragraph (11); and 

22 (C) by inserting after paragraph (8) the 

23 following: 


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1 ‘‘(9) planning activities to prepare communities 

2 for the aging of the population, which activities may 

3 include— 

4 ‘‘(A) efforts to assess the aging population; 

5 ‘‘(B) activities to coordinate the activities 

6 of State and local agencies in order to meet the 

7 needs of older individuals; and 

8 ‘‘(C) training and technical assistance to 

9 support States, area agencies on aging, and 

10 tribal organizations receiving grants under part 

11 A of title VI, in engaging in community plan12 ning activities; and 

13 ‘‘(10) the development, implementation, and as14 sessment of technology-based service models and 

15 best practices, to support the use of health moni16 toring and assessment technologies, communication 

17 devices, assistive technologies, and other technologies 

18 that may remotely connect family and professional 

19 caregivers to frail older individuals residing in home 

20 and community-based settings or rural areas.’’. 

21 SEC. 34. CAREER PREPARATION FOR THE FIELD OF AGING. 

22 Section 412(a) of the Older Americans Act of 1965 

23 (42 U.S.C. 3032a(a)) is amended to read as follows: 

24 ‘‘(a) GRANTS.—The Assistant Secretary shall make 

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1 torically Black colleges or universities, Hispanic-serving 

2 institutions, Hispanic Centers of Excellence in Applied 

3 Gerontology, and other educational institutions that serve 

4 the needs of minority students, to provide education and 

5 training that prepare students for careers in the field of 

6 aging.’’. 

7 SEC. 35. HEALTH CARE SERVICE DEMONSTRATION 

8 PROJECTS IN RURAL AREAS. 

9 Section 414 of the Older Americans Act of 1965 (42 

10 U.S.C. 3032c) is amended— 

11 (1) in subsection (a), by inserting ‘‘mental 

12 health care,’’ after ‘‘adult day health care,’’; and 

13 (2) in subsection (b)(1)(B)(i), by inserting 

14 ‘‘mental health,’’ after ‘‘public health,’’. 

15 SEC. 36. TECHNICAL ASSISTANCE AND INNOVATION TO IM16 PROVE TRANSPORTATION FOR OLDER INDI17 VIDUALS. 

18 Section 416 of the Older Americans Act of 1965 (42 

19 U.S.C. 3032e) is amended to read as follows: 

20 ‘‘SEC. 416. TECHNICAL ASSISTANCE AND INNOVATION TO 

21 IMPROVE TRANSPORTATION FOR OLDER IN22 DIVIDUALS. 

23 ‘‘(a) IN GENERAL.—The Secretary may award grants 

24 or contracts to nonprofit organizations to improve trans25 portation services for older individuals. 


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1 ‘‘(b) USE OF FUNDS.— 

2 ‘‘(1) IN GENERAL.—A nonprofit organization 

3 receiving a grant or contract under subsection (a) 

4 shall use the funds received through such grant or 

5 contract to carry out a demonstration project, or to 

6 provide technical assistance to assist local transit 

7 providers, area agencies on aging, senior centers, 

8 and local senior support groups, to encourage and 

9 facilitate coordination of Federal, State, and local 

10 transportation services and resources for older indi11 viduals. The organization may use the funds to de12 velop and carry out an innovative transportation 

13 demonstration project to create transportation serv14 ices for older individuals. 

15 ‘‘(2) SPECIFIC ACTIVITIES.—In carrying out a 

16 demonstration project or providing technical assist17 ance under paragraph (1) the organization may 

18 carry out activities that include— 

19 ‘‘(A) developing innovative approaches for 

20 improving access by older individuals to trans21 portation services, including volunteer driver 

22 programs, economically sustainable transpor23 tation programs, and programs that allow older 

24 individuals to transfer their automobiles to a 


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1 provider of transportation services in exchange 

2 for the services; 

3 ‘‘(B) preparing information on transpor4 tation options and resources for older individ5 uals and organizations serving such individuals, 

6 and disseminating the information by estab7 lishing and operating a toll-free telephone num8 ber; 

9 ‘‘(C) developing models and best practices 

10 for providing comprehensive integrated trans11 portation services for older individuals, includ12 ing services administered by the Secretary of 

13 Transportation, by providing ongoing technical 

14 assistance to agencies providing services under 

15 title III and by assisting in coordination of pub16 lic and community transportation services; and 

17 ‘‘(D) providing special services to link sen18 iors to transportation services not provided 

19 under title III. 

20 ‘‘(c) ECONOMICALLY SUSTAINABLE TRANSPOR21 TATION.—In this section, the term ‘economically sustain22 able transportation’ means demand responsive transpor23 tation for older individuals— 

24 ‘‘(1) that may be provided through volunteers; 

25 and 


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1 ‘‘(2) that the provider will provide without re2 ceiving Federal or other public financial assistance, 

3 after a period of not more than 5 years of providing 

4 the services under this section.’’. 

5 SEC. 37. COMMUNITY PLANNING. 

6 Title IV of the Older Americans Act of 1965 is 

7 amended by inserting after section 416 (42 U.S.C. 3032e) 

8 the following: 

9 ‘‘SEC. 416A. COMMUNITY PLANNING FOR THE AGING POPU10 LATION. 

11 ‘‘The Secretary may establish, either directly or 

12 through grants or contracts, a national technical assist13 ance program to assist States and area agencies on aging 

14 funded under this Act in planning efforts to prepare com15 munities for the aging of the population.’’. 

16 SEC. 38. DEMONSTRATION, SUPPORT, AND RESEARCH 

17 PROJECTS FOR MULTIGENERATIONAL AC18 TIVITIES AND CIVIC ENGAGEMENT ACTIVI19 TIES. 

20 Section 417 of the Older Americans Act of 1965 (42 

21 U.S.C. 3032f) is amended to read as follows: 


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1 ‘‘SEC. 417. DEMONSTRATION, SUPPORT, AND RESEARCH 

2 PROJECTS FOR MULTIGENERATIONAL AC3 TIVITIES AND CIVIC ENGAGEMENT ACTIVI4 TIES. 

5 ‘‘(a) GRANTS AND CONTRACTS.—The Assistant Sec6 retary shall award grants and enter into contracts with 

7 eligible organizations to— 

8 ‘‘(1) conduct productivity and cost-benefit re9 search to determine the effectiveness of engaging 

10 older individuals in paid and unpaid positions with 

11 public and nonprofit organizations; 

12 ‘‘(2) develop a national agenda and blueprint 

13 for creating paid and unpaid positions for older indi14 viduals with public and nonprofit organizations to 

15 increase the capacity of the organizations to provide 

16 needed services to communities; 

17 ‘‘(3) carry out demonstration and support 

18 projects to provide older individuals with 

19 multigenerational activities, and civic engagement 

20 activities, designed to meet critical community 

21 needs; and 

22 ‘‘(4) carry out demonstration projects to coordi23 nate multigenerational activities and civic engage24 ment activities, and facilitate development of and 

25 participation in multigenerational activities. 


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1 ‘‘(b) USE OF FUNDS.—An eligible organization shall 

2 use funds made available under a grant awarded, or a con3 tract entered into, under subsection (a)— 

4 ‘‘(1)(A) to conduct the research described in 

5 subsection (a)(1); 

6 ‘‘(B) to develop the national agenda and blue7 print described in subsection (a)(2); or 

8 ‘‘(C) to carry out a demonstration or support 

9 project described in subsection (a)(3); 

10 ‘‘(D) to carry out a demonstration project de11 scribed in subsection (a)(4); and 

12 ‘‘(2) to evaluate the project involved in accord13 ance with subsection (f). 

14 ‘‘(c) PREFERENCE.—In awarding grants and enter15 ing into contracts under subsection (a) to carry out a dem16 onstration or support project described in subsection 

17 (a)(3), the Assistant Secretary shall give preference to— 

18 ‘‘(1) eligible organizations with a demonstrated 

19 record of carrying out multigenerational activities or 

20 civic engagement activities; 

21 ‘‘(2) eligible organizations proposing 

22 multigenerational activity service projects that will 

23 serve older individuals and communities with the 

24 greatest need (with particular attention to low-in25 come minority older individuals, older individuals 


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1 with limited English proficiency, older individuals re2 siding in rural areas, and low-income minority com3 munities); 

4 ‘‘(3) eligible organizations proposing civic en5 gagement activity service projects that will serve 

6 communities with the greatest need; and 

7 ‘‘(4) eligible organizations with the capacity to 

8 develop meaningful roles and assignments that use 

9 the time, skills, and experience of older individuals 

10 to serve public and nonprofit organizations. 

11 ‘‘(d) APPLICATION.—To be eligible to receive a grant 

12 or a contract under subsection (a), an organization shall 

13 submit an application to the Assistant Secretary at such 

14 time, in such manner, and accompanied by such informa15 tion as the Assistant Secretary may reasonably require. 

16 ‘‘(e) ELIGIBLE ORGANIZATIONS.—Organizations eli17 gible to receive a grant or enter into a contract under sub18 section (a)— 

19 ‘‘(1) to carry out activities described in sub20 section (a)(1) shall be research or academic organi21 zations with the capacity to conduct productivity and 

22 cost-benefit research described in subsection (a)(1); 

23 ‘‘(2) to carry out activities described in sub24 section (a)(2) shall be organizations with the capacVerDate Aug 31 2005 04:39 Jun 29, 2006 Jkt 049200 PO 00000 Frm 00072 Fmt 6652 Sfmt 6201 E:\BILLS\S3570.IS S3570

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1 ity to develop the national agenda and blueprint de2 scribed in subsection (a)(2); 

3 ‘‘(3) to carry out activities described in sub4 section (a)(3) shall be organizations that provide 

5 paid or unpaid positions for older individuals to 

6 serve in multigenerational activities, or civic engage7 ment activities, designed to meet critical community 

8 needs and use the full range of time, skills, and ex9 perience of older individuals; and 

10 ‘‘(4) to carry out activities described in sub11 section (a)(4) shall be organizations with the capac12 ity to facilitate and coordinate activities as described 

13 in subsection (a)(4), through the use of 

14 multigenerational coordinators. 

15 ‘‘(f) LOCAL EVALUATION AND REPORT.— 

16 ‘‘(1) EVALUATION.—Each organization receiv17 ing a grant or a contract under subsection (a) to 

18 carry out a demonstration or support project under 

19 subsection (a)(3) shall evaluate the 

20 multigenerational activities or civic engagement ac21 tivities assisted under the project to determine the 

22 effectiveness of the activities involved, the impact of 

23 such activities on the community being served and 

24 the organization providing the activities, and the imVerDate Aug 31 2005 04:39 Jun 29, 2006 Jkt 049200 PO 00000 Frm 00073 Fmt 6652 Sfmt 6201 E:\BILLS\S3570.IS S3570

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1 pact of such activities on older individuals involved 

2 in such project. 

3 ‘‘(2) REPORT.—The organization shall submit a 

4 report to the Assistant Secretary containing the 

5 evaluation not later than 6 months after the expira6 tion of the period for which the grant or contract is 

7 in effect. 

8 ‘‘(g) REPORT TO CONGRESS.—Not later than 6 

9 months after the Assistant Secretary receives the reports 

10 described in subsection (f)(2), the Assistant Secretary 

11 shall prepare and submit to the Speaker of the House of 

12 Representatives and the President pro tempore of the Sen13 ate a report that assesses the evaluations and includes, 

14 at a minimum— 

15 ‘‘(1) the names or descriptive titles of the dem16 onstration, support, and research projects funded 

17 under subsection (a); 

18 ‘‘(2) a description of the nature and operation 

19 of the projects; 

20 ‘‘(3) the names and addresses of organizations 

21 that conducted the projects; 

22 ‘‘(4) in the case of demonstration and support 

23 projects carried out under subsection (a)(3), a de24 scription of the methods and success of the projects 


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1 in recruiting older individuals as employees and vol2 unteers to participate in the projects; 

3 ‘‘(5) in the case of demonstration and support 

4 projects carried out under subsection (a)(3), a de5 scription of the success of the projects in retaining 

6 older individuals involved in the projects as employ7 ees and as volunteers; 

8 ‘‘(6) in the case of demonstration and support 

9 projects carried out under subsection (a)(3), the rate 

10 of turnover of older individual employees and volun11 teers in the projects; 

12 ‘‘(7) a strategy for disseminating the findings 

13 resulting from the projects described in paragraph 

14 (1); and 

15 ‘‘(8) any policy change recommendations relat16 ing to the projects. 

17 ‘‘(h) DEFINITIONS.—As used in this section: 

18 ‘‘(1) CIVIC ENGAGEMENT ACTIVITY.—The term 

19 ‘civic engagement activity’ includes an opportunity 

20 that uses the time, skills, and experience of older in21 dividuals, in paid or unpaid positions with a public 

22 or nonprofit organization, to help address the unmet 

23 human, educational, health care, environmental, and 

24 public safety needs and nurture and sustain active 

25 participation in community affairs. 


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1 ‘‘(2) MULTIGENERATIONAL ACTIVITY.—The 

2 term ‘multigenerational activity’ includes an oppor3 tunity that uses the time, skills, and experience of 

4 older individuals, in paid or unpaid positions with a 

5 public or nonprofit organization, to serve as a men6 tor or adviser in a child care program, a youth day 

7 care program, an educational assistance program, an 

8 at-risk youth intervention program, a juvenile delin9 quency treatment program, a before- or after-school 

10 program, or a family support program. 

11 ‘‘(3) MULTIGENERATIONAL COORDINATOR.— 

12 The term ‘multigenerational coordinator’ means a 

13 person who— 

14 ‘‘(A) builds the capacity of public and non15 profit organizations to develop meaningful roles 

16 and assignments, that use the time, skill, and 

17 experience of older individuals to serve those or18 ganizations; and 

19 ‘‘(B) nurtures productive, sustainable 

20 working relationships between— 

21 ‘‘(i) individuals from the generations 

22 with older individuals; and 

23 ‘‘(ii) individuals in younger genera24 tions.’’. 


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1 SEC. 39. NATIVE AMERICAN PROGRAMS. 

2 Section 418(a)(2)(B)(i) of the Older Americans Act 

3 of 1965 (42 U.S.C. 3032g)(a)(2)(B)(i)) is amended by in4 serting ‘‘(including mental health)’’ after ‘‘health’’. 

5 SEC. 40. MULTIDISCIPLINARY CENTERS AND MULTIDISCI6 PLINARY SYSTEMS. 

7 Section 419 of the Older Americans Act of 1965 (42 

8 U.S.C. 3032h) is amended— 

9 (1) by striking the title and inserting the fol10 lowing: 

11 ‘‘SEC. 419. MULTIDISCIPLINARY CENTERS AND MULTIDISCI12 PLINARY SYSTEMS.’’; 

13 (2)(A) in subsection (b)(2), by redesignating 

14 subparagraphs (A) through (G) as clauses (i) 

15 through (vii), respectively; 

16 (B) in subsection (c)(2), by redesignating sub17 paragraphs (A) through (D) as clauses (i) through 

18 (iv), respectively; and 

19 (C) by aligning the margins of the clauses de20 scribed in subparagraphs (A) and (B) with the mar21 gins of clause (iv) of section 418(a)(2)(A) of such 

22 Act; 

23 (3)(A) in subsection (b), by redesignating para24 graphs (1) and (2) as subparagraphs (A) and (B), 

25 respectively; 


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1 (B) in subsection (c), by redesignating para2 graphs (1) and (2) as subparagraphs (A) and (B), 

3 respectively; and 

4 (C) by aligning the margins of the subpara5 graphs described in subparagraphs (A) and (B) with 

6 the margins of subparagraph (D) of section 

7 420(a)(1) of such Act; 

8 (4) in subsection (a), by striking ‘‘(a)’’ and all 

9 that follows through ‘‘The’’ and inserting the fol10 lowing: 

11 ‘‘(a) MULTIDISCIPLINARY CENTERS.— 

12 ‘‘(1) PROGRAM AUTHORIZED.—The’’; 

13 (5) in subsection (b)— 

14 (A) by striking the following: 

15 ‘‘(b) USE OF FUNDS.—’’ and inserting the following: 

16 ‘‘(2) USE OF FUNDS.—’’; and 

17 (B) by striking ‘‘subsection (a)’’ each place 

18 it appears and inserting ‘‘paragraph (1)’’; 

19 (6) in subsection (c)— 

20 (A) by striking the following: 

21 ‘‘(c) DATA.—’’ and inserting the following: 

22 ‘‘(3) DATA.—’’; 

23 (B) by striking ‘‘subsection (a)’’ and in24 serting ‘‘paragraph (1)’’; 


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1 (C) by striking ‘‘such subsection’’ and in2 serting ‘‘such paragraph’’; and 

3 (D) by striking ‘‘paragraph (1)’’ and in4 serting ‘‘subparagraph (A)’’; and 

5 (7) by adding at the end the following: 

6 ‘‘(b) MULTIDISCIPLINARY HEALTH SERVICES IN

7 COMMUNITIES.— 

8 ‘‘(1) PROGRAM AUTHORIZED.—The Assistant 

9 Secretary shall make grants to States, on a competi10 tive basis, for the development and operation of— 

11 ‘‘(A) systems for the delivery of mental 

12 health screening and treatment services for 

13 older individuals who lack access to such serv14 ices; and 

15 ‘‘(B) programs to— 

16 ‘‘(i) increase public awareness regard17 ing the benefits of prevention and treat18 ment of mental disorders in older individ19 uals; 

20 ‘‘(ii) reduce the stigma associated 

21 with mental disorders in older individuals 

22 and other barriers to the diagnosis and 

23 treatment of the disorders; and 


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1 ‘‘(iii) reduce age-related prejudice and 

2 discrimination regarding mental disorders 

3 in older individuals. 

4 ‘‘(2) APPLICATION.—To be eligible to receive a 

5 grant under this subsection for a State, a State 

6 agency shall submit an application to the Assistant 

7 Secretary at such time, in such manner, and con8 taining such information as the Assistant Secretary 

9 may require. 

10 ‘‘(3) STATE ALLOCATION AND PRIORITIES.—A 

11 State agency that receives funds through a grant 

12 made under this subsection shall allocate the funds 

13 to area agencies on aging to carry out this sub14 section in planning and service areas in the State. 

15 In allocating the funds, the State agency shall give 

16 priority to planning and service areas in the State— 

17 ‘‘(A) that are medically underserved; and 

18 ‘‘(B) in which there are a large number of 

19 older individuals. 

20 ‘‘(4) AREA COORDINATION OF SERVICES WITH

21 OTHER PROVIDERS.—In carrying out this part, to 

22 more efficiently and effectively deliver services to 

23 older individuals, each area agency on aging shall— 

24 ‘‘(A) coordinate services described in para25 graph (1) with other community agencies, and 


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1 voluntary organizations, providing similar or re2 lated services; and 

3 ‘‘(B) to the greatest extent practicable, in4 tegrate outreach and educational activities with 

5 existing (as of the date of the integration) 

6 health care and social service providers serving 

7 older individuals in the planning and service 

8 area involved. 

9 ‘‘(5) RELATIONSHIP TO OTHER FUNDING

10 SOURCES.—Funds made available under this part 

11 shall supplement, and not supplant, any Federal, 

12 State, and local funds expended by a State or unit 

13 of general purpose local government (including an 

14 area agency on aging) to provide the services de15 scribed in paragraph (1). 

16 ‘‘(6) DEFINITION.—In this subsection, the term 

17 ‘mental health screening and treatment services’ 

18 means patient screening, diagnostic services, care 

19 planning and oversight, therapeutic interventions, 

20 and referrals, that are— 

21 ‘‘(A) provided pursuant to evidence-based 

22 intervention and treatment protocols (to the ex23 tent such protocols are available) for mental 

24 disorders prevalent in older individuals; and 


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1 ‘‘(B) coordinated and integrated with the 

2 services of social service, mental health, and 

3 health care providers in an area in order to— 

4 ‘‘(i) improve patient outcomes; and 

5 ‘‘(ii) ensure, to the maximum extent 

6 feasible, the continuing independence of 

7 older individuals who are residing in the 

8 area.’’. 

9 SEC. 41. COMMUNITY INNOVATIONS FOR AGING IN PLACE. 

10 Part A of title IV of the Older Americans Act of 1965 

11 (42 U.S.C. 3031 et seq.) is amended by adding at the end 

12 the following: 

13 ‘‘SEC. 422. COMMUNITY INNOVATIONS FOR AGING IN 

14 PLACE. 

15 ‘‘(a) DEFINITIONS.—In this section: 

16 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en17 tity’— 

18 ‘‘(A) means a nonprofit health or social 

19 service organization, a community-based non20 profit organization, an area agency on aging or 

21 other local government agency, a tribal organi22 zation, or another entity that— 

23 ‘‘(i) the Assistant Secretary deter24 mines to be appropriate to carry out a 

25 project under this part; and 


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1 ‘‘(ii) demonstrates a record of, and ex2 perience in, providing or administering 

3 group and individual health and social 

4 services for older individuals; and 

5 ‘‘(B) does not include an entity providing 

6 housing under the congregate housing services 

7 program carried out under section 802 of the 

8 Cranston-Gonzalez National Affordable Hous9 ing Act (42 U.S.C. 8011) or the multifamily 

10 service coordinator program carried out under 

11 section 202(g) of the Housing Act of 1959 (12 

12 U.S.C. 1701q(g)). 

13 ‘‘(2) NATURALLY OCCURRING RETIREMENT

14 COMMUNITY.—The term ‘Naturally Occurring Re15 tirement Community’ means a residential building, a 

16 housing complex, an area (including a rural area) of 

17 single family residences, or a neighborhood com18 posed of age-integrated housing— 

19 ‘‘(A) where— 

20 ‘‘(i) 40 percent of the heads of house21 holds are older individuals; or 

22 ‘‘(ii) a critical mass of older individ23 uals exists, based on local factors which, 

24 taken in total, allow an organization to 

25 achieve efficiencies in the provision of 


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1 health and social services to older individ2 uals living in the community; and 

3 ‘‘(B) that is not an institutional care or as4 sisted living setting. 

5 ‘‘(b) GRANTS.— 

6 ‘‘(1) IN GENERAL.—The Assistant Secretary 

7 shall make grants to eligible entities to enable the 

8 entities to pay for developing or carrying out model 

9 aging in place projects. The projects shall permit 

10 aging in place for older individuals, including such 

11 individuals who reside in Naturally Occurring Re12 tirement Communities, which help to sustain the 

13 independence of older individuals in communities 

14 where the individuals have established personal, fam15 ily, and professional supportive networks. The enti16 ties shall provide comprehensive and coordinated 

17 health and social services through the projects. 

18 ‘‘(2) GRANT PERIODS.—The Assistant Sec19 retary shall make the grants for periods of 3 years. 

20 ‘‘(c) APPLICATIONS.— 

21 ‘‘(1) IN GENERAL.—To be eligible to receive a 

22 grant under subsection (b) for a project, an entity 

23 shall submit an application to the Assistant Sec24 retary at such time, in such manner, and containing 


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1 such information as the Assistant Secretary may re2 quire. 

3 ‘‘(2) CONTENTS.—The application shall in4 clude— 

5 ‘‘(A) a detailed description of the entity’s 

6 experience in providing services to older individ7 uals in age-integrated settings; 

8 ‘‘(B) a definition of the contiguous service 

9 area and a description of the project boundaries 

10 in which the older individuals reside or carry 

11 out activities to sustain their well-being; 

12 ‘‘(C) a description of how the entity will 

13 cooperate and coordinate planning and services, 

14 with agencies and organizations that provide 

15 publicly supported services for older individuals 

16 within the project boundaries, including the 

17 State agency and area agencies on aging with 

18 planning and service areas within the project 

19 boundaries; 

20 ‘‘(D) an assurance that the entity will seek 

21 to establish cooperative relationships with inter22 ested local entities, including private agencies 

23 and businesses that provide health and social 

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1 ment organizations, philanthropic organizations, 

2 foundations, and other non-Federal entities; 

3 ‘‘(E) a description of the entity’s protocol 

4 for referral of residents who may require long5 term care services, including coordination with 

6 local information and referral agencies and 

7 Aging and Disability Resource Centers who 

8 serve as single points of entry to public services; 

9 ‘‘(F) a description of how the entity will 

10 offer opportunities for older individuals to be 

11 involved in the governance, oversight, and oper12 ation of the project; 

13 ‘‘(G) an assurance that the entity will sub14 mit to the Assistant Secretary such evaluations 

15 and reports as the Assistant Secretary may re16 quire; and 

17 ‘‘(H) a plan for long-term sustainability of 

18 the project. 

19 ‘‘(d) USE OF FUNDS.— 

20 ‘‘(1) IN GENERAL.—An eligible entity that re21 ceives a grant under subsection (b) shall use the 

22 funds made available through the grant to provide 

23 and coordinate, through aging in place projects de24 scribed in subsection (b), services that include a 

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1 based health and social services, which may include 

2 mental health services, for eligible older individuals. 

3 ‘‘(2) SERVICES.—The services described in 

4 paragraph (1) shall include— 

5 ‘‘(A) providing— 

6 ‘‘(i) case management, case assist7 ance, and social work services; 

8 ‘‘(ii) health care management and 

9 health care assistance, including disease 

10 prevention and health promotion services; 

11 ‘‘(iii) education, socialization, and rec12 reational activities; and 

13 ‘‘(iv) volunteer opportunities for 

14 project participants; and 

15 ‘‘(B) coordinating the services provided 

16 under title III for eligible older individuals 

17 served by the project. 

18 ‘‘(3) PREFERENCE.—In carrying out an aging 

19 in place project, an eligible entity shall, to the extent 

20 practicable, serve communities of low-income individ21 uals and operate or locate projects and services in or 

22 in close proximity to locations where large con23 centrations of older individuals have aged in place 

24 and resided, such as Naturally Occurring Retirement 

25 Communities. 


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1 ‘‘(4) SUPPLEMENT NOT SUPPLANT.—Funds 

2 made available to an eligible entity under this sec3 tion shall be used to supplement, not supplant, any 

4 Federal, State, or other funds otherwise available to 

5 the entity to provide health and social services to eli6 gible older individuals. 

7 ‘‘(e) COMPETITIVE GRANTS FOR TECHNICAL ASSIST8 ANCE.— 

9 ‘‘(1) GRANTS.—The Assistant Secretary shall 

10 (or shall make a grant, on a competitive basis, to an 

11 eligible nonprofit organization, to enable the organi12 zation to)— 

13 ‘‘(A) provide technical assistance to recipi14 ents of grants under subsection (b); and 

15 ‘‘(B) carry out other duties, as determined 

16 by the Assistant Secretary. 

17 ‘‘(2) ELIGIBLE ORGANIZATION.—To be eligible 

18 to receive a grant under this subsection, an organi19 zation shall be a nonprofit organization (including a 

20 partnership of nonprofit organizations), that— 

21 ‘‘(A) has experience and expertise in pro22 viding technical assistance to a range of entities 

23 serving older individuals and experience evalu24 ating and reporting on programs; and 


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1 ‘‘(B) has demonstrated knowledge of and 

2 expertise in community-based health and social 

3 services. 

4 ‘‘(3) APPLICATION.—To be eligible to receive a 

5 grant under this subsection, an organization (includ6 ing a partnership of nonprofit organizations) shall 

7 submit an application to the Assistant Secretary at 

8 such time, in such manner, and containing such in9 formation as the Assistant Secretary may require, 

10 including an assurance that the organization will 

11 submit to the Assistant Secretary such evaluations 

12 and reports as the Assistant Secretary may require. 

13 ‘‘(f) REPORT.—The Assistant Secretary shall annu14 ally prepare and submit a report to Congress that shall 

15 include— 

16 ‘‘(1) the findings resulting from the evaluations 

17 of the model projects conducted under this section; 

18 ‘‘(2) a description of recommended best prac19 tices regarding carrying out health and social service 

20 projects for older individuals aging in place; and 

21 ‘‘(3) recommendations for legislative or admin22 istrative action, as the Assistant Secretary deter23 mines appropriate.’’. 


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1 SEC. 42. CHOICES FOR INDEPENDENCE DEMONSTRATION 

2 PROJECTS. 

3 Part A of title IV of the Older Americans Act of 1965 

4 (42 U.S.C. 3031 et seq.), as amended by section 41, is 

5 further amended by adding at the end the following: 

6 ‘‘SEC. 423. CHOICES FOR INDEPENDENCE DEMONSTRATION 

7 PROJECTS. 

8 ‘‘(a) DEFINITIONS.—In this section: 

9 ‘‘(1) CONSUMER.—The term ‘consumer’ means 

10 an older individual, a family member of such indi11 vidual, and any other person seeking information or 

12 assistance with respect to long-term care. 

13 ‘‘(2) HIGH-RISK INDIVIDUAL.—The term ‘high14 risk individual’ means an older individual who— 

15 ‘‘(A) has a functional impairment affecting 

16 the individual’s activities of daily living; 

17 ‘‘(B) is ineligible for the Medicaid program 

18 under title XIX of the Social Security Act (42 

19 U.S.C. 1396 et seq.); and 

20 ‘‘(C) meets such income and functional 

21 status criteria as are determined to be appro22 priate by the State involved and approved by 

23 the Assistant Secretary. 

24 ‘‘(3) QUALIFIED EXPENDITURES.—The term 

25 ‘qualified expenditures’ means reported expenditures 


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1 of a State under this section that have been reviewed 

2 and approved by the Assistant Secretary. 

3 ‘‘(4) SERVICE COORDINATION.—The term ‘serv4 ice coordination’ means a coordinated approach 

5 taken on behalf of high-risk older individuals to fa6 cilitate the development and implementation of a 

7 long-term care plan and the choice and independence 

8 of the individuals in securing long-term care. 

9 ‘‘(b) AUTHORITY.—The Assistant Secretary shall 

10 make grants on a competitive basis, in accordance with 

11 this section, to States to enable the States to pay for the 

12 Federal share of the cost of modifying their systems of 

13 long-term care in order to promote and facilitate— 

14 ‘‘(1) the choice and control of older individuals 

15 and their families in securing long-term care; 

16 ‘‘(2) the coordination and cost-effectiveness of 

17 State systems of long-term care; 

18 ‘‘(3) the provision of long-term care in home 

19 and community-based settings; and 

20 ‘‘(4) the ability of individuals receiving long21 term care to remain as independent and self-suffi22 cient as possible. 

23 ‘‘(c) APPLICATIONS BY STATES.—For a State to be 

24 eligible to receive a grant under this section, the Governor 

25 of such State shall submit an application to the Assistant 


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1 Secretary, at such time, in such manner, and containing 

2 such information as the Assistant Secretary may specify, 

3 containing a plan for implementation of the component 

4 strategies described in subsection (d) and such other infor5 mation and assurances as the Secretary determines to be 

6 appropriate. 

7 ‘‘(d) USE OF FUNDS BY STATES.— 

8 ‘‘(1) COMPONENT STRATEGIES.—A State that 

9 receives funds through a grant made under sub10 section (b) shall use the funds to carry out a dem11 onstration project under this section (directly or by 

12 grant or contract) by integrating into the State’s 

13 system of long-term care the component strategies 

14 described in paragraphs (2) through (5). 

15 ‘‘(2) PUBLIC EDUCATION.—In carrying out the 

16 demonstration project, the State shall conduct activi17 ties that shall include media campaigns, targeted 

18 mailings, and related activities, to help ensure that 

19 consumers are aware of— 

20 ‘‘(A) the need to plan in advance for long21 term care; 

22 ‘‘(B) available public and private long-term 

23 care options, including private long-term care 

24 insurance; and 


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1 ‘‘(C) sources of information and resources 

2 related to long-term care, including the resource 

3 centers described in paragraph (3). 

4 ‘‘(3) AGING AND DISABILITY RESOURCE CEN5 TERS.— 

6 ‘‘(A) IN GENERAL.—The State shall pro7 vide for community-level Aging and Disability 

8 Resource Centers, which, consistent with sec9 tion 102(47) and subsection (f), shall provide— 

10 ‘‘(i) comprehensive information on 

11 available public and private long-term care 

12 programs, options, and resources; 

13 ‘‘(ii) personal counseling and service 

14 coordination to assist consumers in assess15 ing their existing or anticipated long-term 

16 care needs and circumstances, and devel17 oping and implementing a plan for long18 term care designed to meet their specific 

19 needs and circumstances; 

20 ‘‘(iii) a convenient point of entry to 

21 the range of publicly-supported long-term 

22 care programs for which an individual may 

23 be eligible, including the Medicaid program 

24 under title XIX of the Social Security Act 

25 (42 U.S.C. 1396 et seq.), and to such 


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1 other public benefit programs as the State 

2 determines to be appropriate; 

3 ‘‘(iv) a single process for consumer in4 take, assessment, and application for bene5 fits under the programs described in sub6 paragraph (C), including, where appro7 priate and feasible, facilitating the deter8 mination of an individual’s eligibility (in9 cluding facilitating that determination in 

10 compliance with the requirements of title 

11 XIX of the Social Security Act) under such 

12 programs by collaborating with the appro13 priate programmatic office; and 

14 ‘‘(v) the ability— 

15 ‘‘(I) to respond immediately to a 

16 request for assistance from an indi17 vidual or a family member of the indi18 vidual, in the event of a crisis situa19 tion that could result in placement of 

20 such individual in an institutional care 

21 setting; and 

22 ‘‘(II) to provide (or coordinate 

23 the provision of), such available short24 term assistance as would be necessary 

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1 clude the need for such institutional 

2 placement, until a plan for home and 

3 community-based long-term care can 

4 be developed and implemented. 

5 ‘‘(B) TRAINING.—In providing for the 

6 Centers, the State shall ensure that the staff of 

7 the Centers is appropriately trained to under8 stand the interactions between private long9 term care insurance (especially insurance 

10 through long-term care partnership policies) 

11 and eligibility for benefits under the Medicaid 

12 program under title XIX of the Social Security 

13 Act (42 U.S.C. 1396 et seq.). 

14 ‘‘(4) HEALTHY LIFESTYLE CHOICES.—The 

15 State shall, in accordance with standards established 

16 by the Assistant Secretary, provide for low-cost, 

17 community-level, evidence-based prevention pro18 grams and related tools to assist older individuals 

19 and their family caregivers in learning about and 

20 making behavioral changes intended to reduce the 

21 risk of injury, disease, and disability among older in22 dividuals. 

23 ‘‘(5) COMMUNITY LIVING INCENTIVES.— 

24 ‘‘(A) IN GENERAL.—The State shall pro25 vide funding toward and otherwise assist with 


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1 the provision of home and community-based 

2 long-term care to individuals at high risk for 

3 placement in institutional care (referred to in 

4 this paragraph as ‘high-risk individuals’). The 

5 State shall ensure that individuals at greatest 

6 risk for becoming eligible for benefits under the 

7 Medicaid program receive priority for the home 

8 and community-based long-term care. 

9 ‘‘(B) LONG-TERM CARE PLAN.—The State 

10 shall provide for assessments of the needs and 

11 preferences of high-risk individuals with respect 

12 to long-term care, and based on such assess13 ments, shall develop with such individuals and 

14 their family members, caregivers, or legal rep15 resentatives a plan for long-term care for such 

16 individuals, specifying the types of support, pro17 viders, budget, and, if the State elects, cost18 sharing contributions involved. 

19 ‘‘(C) ALLOCATION OF FUNDS BASED ON

20 INDIVIDUAL BUDGETS.—The State shall ensure 

21 that the funding described in subparagraph (A) 

22 will be allocated among, and disbursed for, the 

23 budgets of high-risk individuals under long-term 

24 care plans developed for such individuals. 


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1 ‘‘(D) OPTION TO PROVIDE CONSUMER-DI2 RECTED CARE.—The State shall provide high3 risk individuals with the option to receive home 

4 and community-based long-term care under this 

5 paragraph in a manner that permits such indi6 viduals to direct and control, in conjunction 

7 with a service coordinator, the selection, plan8 ning, budgeting, and purchasing of such care 

9 (including the amount, duration, scope, pro10 viders, and location of such care), to the extent 

11 determined appropriate and feasible under the 

12 long-term care plan developed under subpara13 graph (B). The service coordinator shall assist 

14 the high-risk individuals in purchasing a range 

15 of long-term care services or supplies, not oth16 erwise available or eligible for payment through 

17 an entity carrying out a Federal or State pro18 gram or a similar third party, from a qualified 

19 provider that are delivered in home and commu20 nity-based settings and in a manner that best 

21 meets the individuals’ needs and respects the 

22 individuals’ preferences to remain in the least 

23 restrictive setting possible. 

24 ‘‘(e) FEDERAL SHARE.—The Federal share of the 

25 cost of modifying systems of long-term systems care as 


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1 described in subsection (b) shall be not more than 75 per2 cent of such cost (calculated on an annual basis as the 

3 State’s qualified expenditures for such modifications for 

4 such year). 

5 ‘‘(f) SPECIAL PROVISIONS RELATING TO AGING AND

6 DISABILITY RESOURCE CENTERS.—A State shall ensure 

7 that any Aging and Disability Resource Center shall— 

8 ‘‘(1) fully coordinate its activities with any 

9 health insurance information, counseling, and assist10 ance (receiving funding under section 4360 of the 

11 Omnibus Budget Reconciliation Act of 1990 (42 

12 U.S.C. 1395b-4)) in the State; 

13 ‘‘(2) be subject to such controls as the Assist14 ant Secretary determines to be appropriate to ensure 

15 there is no conflict of interest with respect to any re16 ferrals, for information or otherwise, made by the 

17 Center for individuals receiving services through the 

18 Center; and 

19 ‘‘(3) provide no long-term care services or sup20 plies, with the exception of case management serv21 ices provided through area agencies on aging as de22 scribed in section 306(a)(8). 

23 ‘‘(g) SPECIAL PROVISIONS RELATING TO OPTION TO

24 PROVIDE CONSUMER-DIRECTED CARE.—Payments made 

25 for a high-risk individual under subsection (d)(5)(D) shall 


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1 not be included in the gross income of the high-risk indi2 vidual for purposes of the Internal Revenue Code of 1986 

3 or be treated as income, be treated as assets or benefits, 

4 or otherwise be taken into account, for purposes of deter5 mining the individual’s eligibility for, the amount of bene6 fits for the individual under, or the amount of cost-sharing 

7 required of the individual by, any other Federal or State 

8 program, other than the program carried out under this 

9 section. 

10 ‘‘(h) TECHNICAL ASSISTANCE TO STATES.—The As11 sistant Secretary, directly or by grant or contract, shall 

12 provide for technical assistance to and oversight of States 

13 carrying out demonstration projects under this section, for 

14 purposes of administration, quality assurance, and quality 

15 improvement. 

16 ‘‘(i) EVALUATION AND REPORT.—The Assistant Sec17 retary, directly or by grant or contract, shall provide for 

18 an evaluation of the demonstration projects carried out 

19 under this section. The Assistant Secretary shall submit 

20 to the President a report containing the findings resulting 

21 from such evaluation not later than 6 months after the 

22 termination of the demonstration projects.’’. 

23 SEC. 43. RESPONSIBILITIES OF ASSISTANT SECRETARY. 

24 Section 432(c)(2)(B) of the Older Americans Act of 

25 1965 (42 U.S.C. 3033a(c)(2)(B)) is amended by inserting 


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1 before the period the following: ‘‘, including preparing an 

2 analysis of such services, projects, and programs, and of 

3 how the evaluation relates to improvements in such serv4 ices, projects, and programs and in the strategic plan of 

5 the Administration’’. 

6 SEC. 44. OLDER AMERICAN COMMUNITY SERVICE EMPLOY7 MENT PROGRAM. 

8 Section 502 of the Older Americans Act of 1965 (42 

9 U.S.C. 3056) is amended— 

10 (1) in subsection (a)(1), by adding at the end 

11 the following: ‘‘For purposes of this paragraph, an 

12 underemployed person shall be considered to be an 

13 unemployed person.’’; 

14 (2) in subsection (b)(1)(M), by striking ‘‘minor15 ity, limited English-speaking, and Indian eligible in16 dividuals, and eligible individuals who have the 

17 greatest economic need,’’ and inserting ‘‘minority 

18 and Indian eligible individuals, eligible individuals 

19 with limited English proficiency, and eligible individ20 uals with greatest economic need,’’; and 

21 (3) by adding at the end the following: 

22 ‘‘(g)(1) Except as provided in paragraphs (2) and 

23 (3), an eligible individual may participate in projects car24 ried out under this title for a period of not more than 

25 36 months (whether or not consecutive) in the aggregate. 


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1 ‘‘(2) A grantee for a project may extend the period 

2 of participation for not more than 20 percent of the 

3 project participants. In selecting participants for the ex4 tended period of participation, the grantee shall give pri5 ority to— 

6 ‘‘(A) participants who are 65 years old or older 

7 or frail older individuals; and 

8 ‘‘(B) individuals who have more than 1 of the 

9 following barriers to employment: 

10 ‘‘(i) A disability. 

11 ‘‘(ii) Limited English proficiency or low lit12 eracy skills. 

13 ‘‘(iii) A residence in a rural area. 

14 ‘‘(iv) A residence in an area of high unem15 ployment. 

16 ‘‘(v) Homelessness or a situation that puts 

17 the individual at risk for homelessness. 

18 ‘‘(vi) A failure to find employment after 

19 utilizing services under title I of the Workforce 

20 Investment Act of 1998 (29 U.S.C. 2801 et 

21 seq.). 

22 ‘‘(3) A grantee may petition for a waiver of the 36- 

23 month limit described in paragraph (1) if the grantee 

24 serves a high concentration of individuals who are hard25 to-serve individuals because they have more than 1 barrier 


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1 to employment as described in paragraph (2)(B), includ2 ing a grantee who operates a project in an area in which 

3 at least 60 percent of the counties are rural counties, as 

4 defined by the Economic Research Service of the Depart5 ment of Agriculture. 

6 ‘‘(h) It is the sense of the Senate that— 

7 ‘‘(1) the older American community service em8 ployment program was created with the intent of 

9 placing older individuals in community service posi10 tions to provide job training placements; and 

11 ‘‘(2) placing older individuals in community 

12 service positions strengthens the ability of the indi13 viduals to become self-sufficient, provides much14 needed volunteer support to organizations who ben15 efit significantly from increased civic engagement, 

16 and strengthens the communities that are served by 

17 such organizations.’’. 

18 SEC. 45. PERFORMANCE. 

19 Section 513 of the Older Americans Act of 1965 (42 

20 U.S.C. 3056k) is amended— 

21 (1) in subsection (a)— 

22 (A) in paragraph (1)— 

23 (i) by striking the paragraph designa24 tion and all that follows through ‘‘grant25 ees’’ and inserting the following: 


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1 ‘‘(1) ESTABLISHMENT AND IMPLEMENTATION

2 OF MEASURES.—The Secretary shall establish and 

3 implement, after consultation with the Assistant 

4 Secretary, grantees’’; and 

5 (ii) by adding at the end the fol6 lowing: ‘‘The Assistant Secretary shall pro7 vide recommendations to the Secretary on 

8 the establishment and implementation of 

9 the performance measures.’’; 

10 (B) in paragraph (2)(B), by adding at the 

11 end the following: 

12 ‘‘(iv) Not less than 60 percent of the 

13 counties, in the areas served by the grant14 ee, being rural counties as defined by the 

15 Economic Research Service of the Depart16 ment of Agriculture. 

17 ‘‘(v) The areas served by the grantee 

18 comprising a difficult to serve territory due 

19 to limited economies of scale.’’; and 

20 (C) by adding at the end the following: 

21 ‘‘(6) SPECIAL RULES.— 

22 ‘‘(A) ESTABLISHMENT AND IMPLEMENTA23 TION.—The Secretary shall establish and imple24 ment the performance measures described in 

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1 scribed in subsection (b), not later than 1 year 

2 after the date of enactment of the Older Ameri3 cans Act Amendments of 2006. 

4 ‘‘(B) IMPACT ON GRANT COMPETITION.— 

5 The Secretary may not publish a notice an6 nouncing a grant competition under this title, 

7 and soliciting proposals for grants, until the 

8 day that is the later of— 

9 ‘‘(i) the date on which the Secretary 

10 implements all required indicators de11 scribed in subsection (b); and 

12 ‘‘(ii) January 1, 2010.’’; and 

13 (2) by adding at the end the following: 

14 ‘‘(e) EFFECT OF EXEMPTION.—In implementing a 

15 performance measure under this section, the Secretary 

16 shall not reduce a score on the performance measure of— 

17 ‘‘(1) a grantee that receives a waiver under sec18 tion 502(g)(3) on the basis that the grantee is ex19 tending the period of participation for project par20 ticipants under that section; and 

21 ‘‘(2) a grantee on the basis that the grantee is 

22 extending the period of participation for project par23 ticipants under section 502(g)(2).’’. 


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1 SEC. 46. COMPETITIVE REQUIREMENTS. 

2 Section 514 of the Older Americans Act of 1965 (42 

3 U.S.C. 3056l) is amended— 

4 (1) by striking subsection (a) and inserting the 

5 following: 

6 ‘‘(a) PROGRAM AUTHORIZED.—In accordance with 

7 section 502(b), the Secretary shall award grants to eligible 

8 applicants, through a competitive process that emphasizes 

9 meeting performance measures, to carry out projects 

10 under this title for a 4-year period. The Secretary may 

11 not conduct a grant competition under this title until the 

12 day described in section 513(a)(6)(B).’’; 

13 (2) by striking subsection (b) and inserting the 

14 following: 

15 ‘‘(b) ELIGIBLE APPLICANTS.—An applicant shall be 

16 eligible to receive a grant as described in subsection (a) 

17 if the applicant meets the requirements and criteria de18 scribed in section 502(b)(1), subsections (c) and (d), and 

19 paragraphs (2) and (3) of subsection (e).’’; 

20 (3) in subsection (c)— 

21 (A) by redesignating paragraphs (2) 

22 through (7) as paragraphs (4) through (9), re23 spectively; 

24 (B) by inserting after paragraph (1) the 

25 following: 


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1 ‘‘(2) The applicant’s performance on the re2 quired indicators described in section 513(b), in the 

3 case of an applicant that has previously received a 

4 grant under this title, and the applicant’s ability to 

5 meet the required indicators, in the case of any 

6 other applicant. 

7 ‘‘(3) The applicant’s ability to administer a pro8 gram that provides community service.’’; and 

9 (C) by striking paragraph (9) and insert10 ing the following: 

11 ‘‘(9) The applicant’s ability to minimize disrup12 tion in services for project participants and the enti13 ties employing the participants. 

14 ‘‘(10) Any additional criteria that the Secretary 

15 may determine to be appropriate.’’; 

16 (4) in subsection (e)— 

17 (A) in paragraph (2), by striking subpara18 graphs (C) and (D); and 

19 (B) in paragraph (3)— 

20 (i) by striking ‘‘(3)’’ and all that fol21 lows through ‘‘In’’ and inserting the fol22 lowing: 

23 ‘‘(3) COMPETITION REQUIREMENTS FOR PUBLIC

24 AND PRIVATE NONPROFIT AGENCIES AND ORGANIZA25 TIONS IN A STATE.—In’’; 


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1 (ii) by striking subparagraphs (B) 

2 through (D); and 

3 (iii) by striking ‘‘take corrective ac4 tion’’ and inserting ‘‘provide technical as5 sistance’’; 

6 (C) in paragraph (4), by striking ‘‘para7 graph (3)(A)’’ and inserting ‘‘paragraph (3)’’; 

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

9 (6) by adding at the end the following: 

10 ‘‘(g) GRANTEES SERVING INDIVIDUALS WITH BAR11 RIERS TO EMPLOYMENT.— 

12 ‘‘(1) DEFINITION.—In this subsection, the term 

13 ‘individuals with barriers to employment’ means mi14 nority and Indian individuals, individuals with lim15 ited English proficiency, and individuals with great16 est economic need. 

17 ‘‘(2) SPECIAL CONSIDERATION.—In areas where 

18 a substantial population of individuals with barriers 

19 to employment exists, a grantee that receives a na20 tional grant under this section shall, in selecting 

21 subgrantees, give special consideration to organiza22 tions (including former recipients of such national 

23 grants) with demonstrated expertise in serving indi24 viduals with barriers to employment. 


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1 ‘‘(h) MINORITY-SERVING GRANTEES.—The Secretary 

2 may not promulgate rules or regulations, affecting grant3 ees in areas where a substantial population of minority 

4 individuals exists, that would significantly compromise the 

5 ability of the grantees to serve their targeted population 

6 of minority older individuals.’’. 

7 SEC. 47. DEFINITIONS. 

8 Section 516(2) of the Older Americans Act of 1965 

9 (42 U.S.C. 3056n(2)) is amended— 

10 (1) in the header, by striking ‘‘INDIVIDUALS’’ 

11 and inserting ‘‘INDIVIDUAL’’ ; 

12 (2) by inserting before ‘‘The term’’ the fol13 lowing: 

14 ‘‘(A) IN GENERAL.—’’; 

15 (3) by striking ‘‘individuals’’ and inserting ‘‘in16 dividual’’; and 

17 (4) by adding at the end the following: 

18 ‘‘(B) DETERMINATION OF LOW INCOME.— 

19 For purposes of determining income eligibility 

20 under subparagraph (A), the Secretary shall 

21 not include as income— 

22 ‘‘(i) unemployment compensation; 

23 ‘‘(ii) benefits received under title XVI 

24 of the Social Security Act (42 U.S.C. 1381 

25 et seq.); 


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1 ‘‘(iii) payments made to or on behalf 

2 of veterans or former members of the 

3 Armed Forces under the laws administered 

4 by the Secretary of Veterans Affairs; or 

5 ‘‘(iv) 25 percent of the old-age and 

6 survivors insurance benefits received under 

7 title II of the Social Security Act (42 

8 U.S.C. 401 et seq.).’’. 

9 SEC. 48. CLARIFICATION OF MAINTENANCE REQUIREMENT. 

10 (a) IN GENERAL.—Section 614A of the Older Ameri11 cans Act of 1965 (42 U.S.C. 3057e–1) is amended by add12 ing at the end the following: 

13 ‘‘(c) CLARIFICATION.— 

14 ‘‘(1) DEFINITION.—In this subsection, the term 

15 ‘covered year’ means fiscal year 2006 or a subse16 quent fiscal year. 

17 ‘‘(2) CONSORTIA OF TRIBAL ORGANIZATIONS.— 

18 If a tribal organization received a grant under this 

19 part for fiscal year 1991 as part of a consortium, 

20 the Assistant Secretary shall consider the tribal or21 ganization to have received a grant under this part 

22 for fiscal year 1991 for purposes of subsections (a) 

23 and (b), and shall apply the provisions of subsections 

24 (a) and (b)(1) (under the conditions described in 

25 subsection (b)) to the tribal organization for each 


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1 covered year for which the tribal organization sub2 mits an application under this part, even if the tribal 

3 organization submits— 

4 ‘‘(A) a separate application from the re5 maining members of the consortium; or 

6 ‘‘(B) an application as 1 of the remaining 

7 members of the consortium.’’. 

8 (b) EFFECTIVE DATE.—Subsection (a) takes effect 

9 on October 1, 2005. 

10 SEC. 49. NATIVE AMERICANS CAREGIVER SUPPORT PRO11 GRAM. 

12 Section 643 of the Older Americans Act of 1965 (42 

13 U.S.C. 3057n) is amended— 

14 (1) in paragraph (1), by striking ‘‘2001’’ and 

15 inserting ‘‘2007’’; and 

16 (2) in paragraph (2), by striking ‘‘$5,000,000’’ 

17 and all that follows and inserting ‘‘$6,500,000 for 

18 fiscal year 2007, $7,000,000 for fiscal year 2008, 

19 $7,500,000 for fiscal year 2009, $8,000,000 for fis20 cal year 2010, and $8,500,000 for fiscal year 

21 2011.’’. 


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1 SEC. 50. VULNERABLE ELDER RIGHTS PROTECTION ACTIVI2 TIES. 

3 Section 702 of the Older Americans Act of 1965 (42 

4 U.S.C. 3058a) is amended by striking ‘‘2001’’ each place 

5 it appears and inserting ‘‘2007’’. 

6 SEC. 51. ELDER ABUSE, NEGLECT, AND EXPLOITATION PRE7 VENTION AMENDMENT. 

8 Section 721 of the Older Americans Act of 1965 (42 

9 U.S.C. 3058i) is amended— 

10 (1) in subsection (b)— 

11 (A) by redesignating paragraphs (2) 

12 through (8) as paragraphs (3) through (9), re13 spectively; and 

14 (B) by inserting after paragraph (1) the 

15 following new paragraph: 

16 ‘‘(2) providing for public education and out17 reach to promote financial literacy and prevent iden18 tity theft and financial exploitation of older individ19 uals;’’; and 

20 (2) in subsection (e)(2)— 

21 (A) by striking ‘‘subsection (b)(8)(B)(i)’’ 

22 and inserting ‘‘subsection (b)(9)(B)(i)’’; and 

23 (B) by striking ‘‘subsection (b)(8)(B)(ii)’’ 

24 and inserting ‘‘subsection (b)(9)(B)(ii)’’. 


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1 SEC. 52. NATIVE AMERICAN ORGANIZATION PROVISIONS. 

2 Section 751(d) of the Older Americans Act of 1965 

3 (42 U.S.C. 3058aa(d)) is amended by striking ‘‘2001’’ and 

4 inserting ‘‘2007’’. 

5 SEC. 53. ELDER JUSTICE PROGRAMS. 

6 (a) PURPOSES.—The purposes of this section are as 

7 follows: 

8 (1) To assist States and Indian tribes in devel9 oping a comprehensive multi-disciplinary approach 

10 to elder justice. 

11 (2) To promote research and data collection 

12 that will fill gaps in knowledge about elder abuse, 

13 neglect, and exploitation. 

14 (3) To support innovative and effective activi15 ties of service providers and programs that are de16 signed to address issues relating to elder abuse, ne17 glect, and exploitation. 

18 (4) To assist States, Indian tribes, and local 

19 service providers in the development of short- and 

20 long-term strategic plans for the development and 

21 coordination of elder justice research, programs, 

22 studies, training, and other efforts. 

23 (5) To promote collaborative efforts and dimin24 ish overlap and gaps in efforts in developing the im25 portant field of elder justice. 


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1 (b) ELDER JUSTICE.—Title VII of the Older Ameri2 cans Act of 1965 (42 U.S.C. 3058 et seq.) is amended— 

3 (1) by redesignating subtitles B and C as sub4 titles C and D, respectively; 

5 (2) by redesignating sections 751, and 761 

6 through 764, as sections 761, and 771 through 774, 

7 respectively; and 

8 (3) by inserting after subtitle A the following: 

9 ‘‘Subtitle B—Elder Justice 

10 Programs 

11 ‘‘SEC. 751. DEFINITIONS. 

12 ‘‘In this subtitle: 

13 ‘‘(1) CAREGIVER.—The term ‘caregiver’ means 

14 an individual who has the responsibility for the care 

15 of an elder, either voluntarily, by contract, by receipt 

16 of payment for care, or as a result of the operation 

17 of law and means a family member or other indi18 vidual who provides (on behalf of such individual or 

19 of a public or private agency, organization, or insti20 tution) compensated or uncompensated care to an 

21 elder. 

22 ‘‘(2) DIRECT CARE.—The term ‘direct care’ 

23 means care by an employee or contractor who pro24 vides assistance or long-term care services to a re25 cipient. 


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1 ‘‘(3) ELDER.—The term ‘elder’ means an older 

2 individual, as defined in section 102. 

3 ‘‘(4) ELDER JUSTICE.—The term ‘elder justice’ 

4 means— 

5 ‘‘(A) efforts to prevent, detect, treat, inter6 vene in, and respond to elder abuse, neglect, 

7 and exploitation and to protect elders with di8 minished capacity while maximizing their au9 tonomy; and 

10 ‘‘(B) from an individual perspective, the 

11 recognition of an elder’s rights, including the 

12 right to be free of abuse, neglect, and exploi13 tation. 

14 ‘‘(5) ELIGIBLE ENTITY.—The term ‘eligible en15 tity’ means a State or local government agency, In16 dian tribe, or any other public or private entity, that 

17 is engaged in and has expertise in issues relating to 

18 elder justice. 

19 ‘‘(6) FIDUCIARY.—The term ‘fiduciary’— 

20 ‘‘(A) means a person or entity with the 

21 legal responsibility— 

22 ‘‘(i) to make decisions on behalf of 

23 and for the benefit of another person; and 

24 ‘‘(ii) to act in good faith and with 

25 fairness; and 


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1 ‘‘(B) includes a trustee, a guardian, a con2 servator, an executor, an agent under a finan3 cial power of attorney or health care power of 

4 attorney, or a representative payee. 

5 ‘‘(7) GRANT.—The term ‘grant’ includes a con6 tract, cooperative agreement, or other mechanism 

7 for providing financial assistance. 

8 ‘‘(8) LAW ENFORCEMENT.—The term ‘law en9 forcement’ means the full range of potential re10 sponders to elder abuse, neglect, and exploitation in11 cluding— 

12 ‘‘(A) police, sheriffs, detectives, public safe13 ty officers, and corrections personnel; 

14 ‘‘(B) prosecutors; 

15 ‘‘(C) medical examiners; 

16 ‘‘(D) investigators; and 

17 ‘‘(E) coroners. 

18 ‘‘(9) LONG-TERM CARE.— 

19 ‘‘(A) IN GENERAL.—The term ‘long-term 

20 care’ means supportive and health services spec21 ified by the Secretary for individuals who need 

22 assistance because the individuals have a loss of 

23 capacity for self-care due to illness, disability, 

24 or vulnerability. 


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1 ‘‘(B) LOSS OF CAPACITY FOR SELF2 CARE.—For purposes of subparagraph (A), the 

3 term ‘loss of capacity for self-care’ means an in4 ability to engage effectively in activities of daily 

5 living, including eating, dressing, bathing, and 

6 management of one’s financial affairs. 

7 ‘‘(10) LONG-TERM CARE FACILITY.—The term 

8 ‘long-term care facility’ means a residential care pro9 vider that arranges for, or directly provides, long10 term care. 

11 ‘‘(11) NURSING FACILITY.—The term ‘nursing 

12 facility’ has the meaning given such term under sec13 tion 1919(a) of the Social Security Act (42 U.S.C. 

14 1396r(a)). 

15 ‘‘(12) STATE LEGAL ASSISTANCE DEVEL16 OPER.—The term ‘State legal assistance developer’ 

17 means an individual described in section 731. 

18 ‘‘(13) STATE LONG-TERM CARE OMBUDSMAN.— 

19 The term ‘State Long-Term Care Ombudsman’ 

20 means the State Long-Term Care Ombudsman de21 scribed in section 712(a)(2). 


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1 ‘‘SEC. 752. STATE AND TRIBAL GRANTS TO STRENGTHEN 

2 LONG-TERM CARE AND PROVIDE ASSISTANCE 

3 FOR ELDER JUSTICE PROGRAMS. 

4 ‘‘(a) GRANTS.—The Assistant Secretary may award 

5 grants to States and Indian tribes to enable the States 

6 and tribes to strengthen long-term care and provide assist7 ance for elder justice programs. 

8 ‘‘(b) APPLICATION.—To be eligible to receive a grant 

9 under this subtitle, a State or Indian tribe shall submit 

10 an application to the Assistant Secretary at such time, in 

11 such manner, and containing such information as the As12 sistant Secretary may require. 

13 ‘‘(c) USE OF FUNDS.—A State or Indian tribe that 

14 receives a grant under this subtitle may use the funds 

15 made available through the grant to award grants— 

16 ‘‘(1) to eligible entities for the prevention, de17 tection, assessment, and treatment of, intervention 

18 in, investigation of, and response to elder abuse, ne19 glect, and exploitation; 

20 ‘‘(2) to eligible entities to examine various types 

21 of elder shelters (in this paragraph referred to as 

22 ‘safe havens’), and to test various safe haven models 

23 for establishing safe havens (at home or elsewhere), 

24 that— 


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1 ‘‘(A) recognize autonomy and self-deter2 mination, and fully protect the due process 

3 rights of elders; and 

4 ‘‘(B)(i) provide a comprehensive, culturally 

5 sensitive, and multidisciplinary team response 

6 to allegations of elder abuse, neglect, or exploi7 tation; 

8 ‘‘(ii) provide a dedicated, elder-friendly set9 ting; 

10 ‘‘(iii) have the capacity to meet the needs 

11 of elders for care; and 

12 ‘‘(iv) provide various services including— 

13 ‘‘(I) nursing and forensic evaluation; 

14 ‘‘(II) therapeutic intervention; 

15 ‘‘(III) victim support and advocacy; 

16 and 

17 ‘‘(IV) case review and assistance to 

18 make the elders safer at home or to find 

19 appropriate placement in safer environ20 ments, including shelters, and, in some cir21 cumstances long-term care facilities, other 

22 residential care facilities, and hospitals; 

23 ‘‘(3) to eligible entities to establish or continue 

24 volunteer programs that focus on the issues of elder 


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1 abuse, neglect, and exploitation, or to provide related 

2 services; 

3 ‘‘(4) to eligible entities to support multidisci4 plinary elder justice activities, such as— 

5 ‘‘(A) supporting and studying team ap6 proaches for bringing a coordinated multidisci7 plinary or interdisciplinary response to elder 

8 abuse, neglect, and exploitation, including a re9 sponse from individuals in social service, health 

10 care, public safety, and legal disciplines; 

11 ‘‘(B) establishing a State or tribal coordi12 nating council, which shall identify the indi13 vidual State’s or Indian tribe’s needs and pro14 vide the Secretary with information and rec15 ommendations relating to efforts by the State 

16 or Indian tribe to combat elder abuse, neglect, 

17 and exploitation; 

18 ‘‘(C) providing training, technical assist19 ance, and other methods of support to groups 

20 carrying out multidisciplinary efforts at the 

21 State or Indian tribe level (referred to in some 

22 States as ‘State Working Groups’); 

23 ‘‘(D) broadening and studying various 

24 models for elder fatality and serious injury re25 view teams, to make recommendations about 


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1 their composition, protocols, functions, timing, 

2 roles, and responsibilities, with a goal of pro3 ducing models and information that will allow 

4 for replication based on the needs of other 

5 States, Indian tribes, and communities; or 

6 ‘‘(E) carrying out such other interdiscipli7 nary or multidisciplinary efforts as the Assist8 ant Secretary determines to be appropriate; 

9 ‘‘(5) to eligible entities to provide training for 

10 individuals with respect to issues of elder abuse, ne11 glect, and exploitation, consisting of— 

12 ‘‘(A) training within a discipline; or 

13 ‘‘(B) cross-training activities that permit 

14 individuals in multiple disciplines to train to15 gether, fostering communication, coordinating 

16 efforts, and ensuring collaboration; 

17 ‘‘(6) to eligible entities to address underserved 

18 populations of elders, such as— 

19 ‘‘(A) elders living in rural locations; 

20 ‘‘(B) elders in minority populations; or 

21 ‘‘(C) low-income elders; 

22 ‘‘(7) to eligible entities to provide incentives for 

23 individuals to train for, seek, and maintain employ24 ment providing direct care in a long-term care facil25 ity, such as— 


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1 ‘‘(A) to eligible entities to provide incen2 tives to participants in programs carried out 

3 under part A of title IV, and section 403(a)(5), 

4 of the Social Security Act (42 U.S.C. 601 et 

5 seq., 603(a)(5)) to train for and seek employ6 ment providing direct care in a long-term care 

7 facility; 

8 ‘‘(B) to long-term care facilities to carry 

9 out programs through which the facilities— 

10 ‘‘(i) offer, to employees who provide 

11 direct care to residents of a long-term care 

12 facility, continuing training and varying 

13 levels of professional certification, based on 

14 observed clinical care practices and the 

15 amount of time the employees spend pro16 viding direct care; and 

17 ‘‘(ii) provide, or make arrangements 

18 with employers to provide, bonuses or 

19 other increased compensation or benefits to 

20 employees who achieve professional certifi21 cation under such a program; or 

22 ‘‘(C) to long-term care facilities to enable 

23 the facilities to provide training and technical 

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1 onstrated to promote retention of employees of 

2 the facilities, such as— 

3 ‘‘(i) the establishment of basic human 

4 resource policies that reward high perform5 ance, including policies that provide for im6 proved wages and benefits on the basis of 

7 job reviews; or 

8 ‘‘(ii) the establishment of other pro9 grams that promote the provision of high 

10 quality care, such as a continuing edu11 cation program that provides additional 

12 hours of training, including on-the-job 

13 training, for employees who are certified 

14 nurse aides; 

15 ‘‘(8) to encourage the establishment of eligible 

16 partnerships to develop collaborative and innovative 

17 approaches to improve the quality of, including pre18 venting abuse, neglect, and exploitation in, long-term 

19 care; or 

20 ‘‘(9) to eligible entities to establish multidisci21 plinary panels to address and develop best practices 

22 concerning methods of— 

23 ‘‘(A) improving the quality of long-term 

24 care; and 


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1 ‘‘(B) addressing abuse, including resident2 to-resident abuse, in long-term care. 

3 ‘‘(d) ADMINISTRATIVE EXPENSES.—A State or In4 dian tribe that receives a grant under this section shall 

5 not use more than 5 percent of the funds made available 

6 through the grant to pay for administrative expenses. 

7 ‘‘(e) SUPPLEMENT NOT SUPPLANT.—Funds made 

8 available pursuant to this section shall be used to supple9 ment and not supplant other Federal, State, and local (in10 cluding tribal) funds expended to provide activities de11 scribed in subsection (c). 

12 ‘‘(f) MAINTENANCE OF EFFORT.—The State or In13 dian tribe, in using the proceeds of a grant received under 

14 this section, shall maintain the expenditures of the State 

15 or tribe for activities described in subsection (c) at a level 

16 equal to not less than the level of such expenditures main17 tained by the State or tribe for the fiscal year preceding 

18 the fiscal year for which the grant is received. 

19 ‘‘(g) ACCOUNTABILITY MEASURES.—The Assistant 

20 Secretary shall develop accountability measures to ensure 

21 the effectiveness of the activities conducted using funds 

22 made available under this section, including accountability 

23 measures to ensure that the activities described in sub24 section (c)(7) benefit eligible employees and increase the 

25 stability of the long-term care workforce. 


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1 ‘‘(h) EVALUATING PROGRAMS.—The Assistant Sec2 retary shall evaluate the activities conducted using funds 

3 made available under this section and shall use the results 

4 of such evaluation to determine the activities for which 

5 funds made available under this section may be used. 

6 ‘‘(i) COMPLIANCE WITH APPLICABLE LAWS.—In 

7 order to receive funds under this section, an entity shall 

8 comply with all applicable laws, regulations, and guide9 lines. 

10 ‘‘(j) ELIGIBLE PARTNERSHIPS.—In subsection 

11 (c)(8), the term ‘eligible partnership’ means a multidisci12 plinary community partnership consisting of eligible enti13 ties or appropriate individuals, such as a partnership con14 sisting of representatives in a community of nursing facil15 ity providers, State legal assistance developers, advocates 

16 for residents of long-term care facilities, State Long-Term 

17 Care Ombudsmen, surveyors, the State agency with re18 sponsibility for adult protective services, the State agency 

19 with responsibility for licensing long-term care facilities, 

20 law enforcement agencies, courts, family councils, resi21 dents, certified nurse aides, registered nurses, physicians, 

22 and other eligible entities and appropriate individuals. 

23 ‘‘(k) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated to carry out this section 


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1 such sums as may be necessary for each of fiscal years 

2 2005 through 2008. 

3 ‘‘SEC. 753. COLLECTION OF UNIFORM NATIONAL DATA ON 

4 ELDER ABUSE, NEGLECT, AND EXPLOI5 TATION. 

6 ‘‘(a) PURPOSE.—The purpose of this section is to im7 prove, streamline, and promote uniform collection, mainte8 nance, and dissemination of national data relating to the 

9 various types of elder abuse, neglect, and exploitation. 

10 ‘‘(b) PHASE I.— 

11 ‘‘(1) IN GENERAL.—Not later than the date 

12 that is 1 year after the date of enactment of the 

13 Older Americans Act Amendments of 2006, the As14 sistant Secretary, acting through the head of the Of15 fice of Elder Abuse Prevention and Services, after 

16 consultation with the Attorney General and working 

17 with experts in relevant disciplines from the Bureau 

18 of Justice Statistics of the Office of Justice Pro19 grams of the Department of Justice, shall— 

20 ‘‘(A) develop a method for collecting na21 tional data regarding elder abuse, neglect, and 

22 exploitation; and 

23 ‘‘(B) develop uniform national data report24 ing forms adapted to each relevant entity or 

25 discipline (such as health, public safety, social 


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1 and protective services, and law enforcement) 

2 reflecting— 

3 ‘‘(i) the distinct manner in which each 

4 entity or discipline receives and maintains 

5 information; and 

6 ‘‘(ii) the sequence and history of re7 ports to or involvement of different entities 

8 or disciplines, independently, or the se9 quence and history of reports from 1 entity 

10 or discipline to another over time. 

11 ‘‘(2) FORMS.— 

12 ‘‘(A) IN GENERAL.—Subject to subpara13 graph (B), the national data reporting forms 

14 described in paragraph (1)(B) shall incorporate 

15 the definitions of section 751, for use in deter16 mining whether an event is reportable. 

17 ‘‘(B) PROTECTION OF PRIVACY.—In pur18 suing activities under this paragraph, the Sec19 retary shall ensure the protection of individual 

20 health privacy consistent with the regulations 

21 promulgated under section 264(c) of the Health 

22 Insurance Portability and Accountability Act of 

23 1996 and State and local privacy regulations 

24 (as applicable). 

25 ‘‘(c) PHASE II.— 


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1 ‘‘(1) IN GENERAL.—Not later than the date 

2 that is 1 year after the date on which the activities 

3 described in subsection (b)(1) are completed, the 

4 Secretary (or the Secretary’s designee) shall ensure 

5 that the national data reporting forms and data col6 lection methods developed in accordance with such 

7 subsection are pilot tested in 6 States selected by 

8 the Secretary. 

9 ‘‘(2) ADJUSTMENTS TO THE FORM AND METH10 ODS.—The Secretary, after considering the results 

11 of the pilot testing described in paragraph (1) and 

12 consultation with the Attorney General and relevant 

13 experts, shall adjust the national data reporting 

14 forms and data collection methods as necessary. 

15 ‘‘(d) PHASE III.— 

16 ‘‘(1) DISTRIBUTION OF NATIONAL DATA RE17 PORTING FORMS.—After completion of the adjust18 ment to the national data reporting forms under 

19 subsection (c)(2), the Secretary shall submit the na20 tional data reporting forms along with instructions 

21 to— 

22 ‘‘(A) the heads of the relevant components 

23 of the Department of Health and Human Serv24 ices, the Department of Justice, and the DeVerDate Aug 31 2005 04:39 Jun 29, 2006 Jkt 049200 PO 00000 Frm 00127 Fmt 6652 Sfmt 6201 E:\BILLS\S3570.IS S3570

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1 partment of the Treasury, and such other Fed2 eral entities as may be appropriate; and 

3 ‘‘(B) the Governor’s office of each State 

4 for collection from all relevant State entities of 

5 data, including health care, social services, and 

6 law enforcement data. 

7 ‘‘(2) DATA COLLECTION GRANTS.— 

8 ‘‘(A) AUTHORIZATION.—The Secretary is 

9 authorized to award grants to States to improve 

10 data collection activities relating to elder abuse, 

11 neglect, and exploitation. 

12 ‘‘(B) APPLICATION.—To be eligible to re13 ceive a grant under this paragraph, a State 

14 shall submit an application to the Secretary at 

15 such time, in such manner, and containing such 

16 information as the Secretary may require. 

17 ‘‘(C) REQUIREMENTS.—Each State receiv18 ing a grant under this paragraph for a fiscal 

19 year shall report data for the calendar year that 

20 begins during that fiscal year, using the na21 tional data reporting forms described in para22 graph (1). 

23 ‘‘(D) FUNDING.— 

24 ‘‘(i) FIRST YEAR.—For the first fiscal 

25 year for which a State receives grant funds 


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1 under this subsection the Secretary shall 

2 initially distribute 50 percent of such 

3 funds. The Secretary shall distribute the 

4 remaining funds at the end of the calendar 

5 year that begins during that fiscal year, if 

6 the Secretary determines that the State 

7 has properly reported data required under 

8 this subsection for the calendar year. 

9 ‘‘(ii) SUBSEQUENT YEARS.—Except as 

10 provided in clause (i), the Secretary shall 

11 distribute grant funds to a State under 

12 this subsection for a fiscal year if the Sec13 retary determines that the State properly 

14 reported data required under this sub15 section for the calendar year that ends 

16 during that fiscal year. 

17 ‘‘(3) REQUIRED INFORMATION.—Each report 

18 submitted under this subsection shall— 

19 ‘‘(A) indicate the State and year in which 

20 each event occurred; and 

21 ‘‘(B) identify the total number of events 

22 that occurred in each State during the year and 

23 the type of each event. 

24 ‘‘(e) REPORT.—Not later than 1 year after the date 

25 of enactment of the Older Americans Act Amendments of 


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1 2006 and annually thereafter, the Secretary shall prepare 

2 and submit to the appropriate committees of Congress, in3 cluding to the Committee on Health Education, Labor, 

4 and Pensions and the Special Committee on Aging of the 

5 Senate, a report regarding activities conducted under this 

6 section. 

7 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

8 are authorized to be appropriated to carry out this section 

9 such sums as may be necessary for each of fiscal years 

10 2007, 2008, 2009, 2010, and 2011.’’. 

11 SEC. 54. RULE OF CONSTRUCTION. 

12 Subtitle C of title VII of the Older Americans Act 

13 of 1965 (42 U.S.C. 3058 et seq.) is amended by adding 

14 at the end the following: 

15 ‘‘SEC. 765. RULE OF CONSTRUCTION. 

16 ‘‘Nothing in this title shall be construed to interfere 

17 with or abridge the right of an older individual to practice 

18 the individual’s religion through reliance on prayer alone 

19 for healing, in a case in which a decision to so practice 

20 the religion— 

21 ‘‘(1) is contemporaneously expressed by the 

22 older individual— 

23 ‘‘(A) either orally or in writing; 


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1 ‘‘(B) with respect to a specific illness or in2 jury that the older individual has at the time of 

3 the decision; and 

4 ‘‘(C) when the older individual is com5 petent to make the decision; 

6 ‘‘(2) is set forth prior to the occurrence of the 

7 illness or injury in a living will, health care proxy, 

8 or other advance directive document that is validly 

9 executed and applied under State law; or 

10 ‘‘(3) may be unambiguously deduced from the 

11 older individual’s life history.’’. 

Æ 


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