II 

Calendar No. 616 

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, Ms. MIKULSKI, and Mr. 

JOHNSON) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

SEPTEMBER 19, 2006 

Reported by Mr. ENZI, with an amendment 

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

A BILL 

To amend the Older Americans Act of 1965 to authorize 

appropriations for fiscal years 2007 through 2011, and 

for other purposes. 

1 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’’. 


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1 SEC. 2. DEFINITIONS. 

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

3 U.S.C. 3002) is amended— 

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

5 ‘‘(D) evidence-based health promotion pro6 grams, including programs related to the pre7 vention and mitigation of the effects of chronic 

8 disease (including osteoporosis, hypertension, 

9 obesity, diabetes, and cardiovascular disease), 

10 alcohol and substance abuse reduction, smoking 

11 cessation, weight loss and control, stress man12 agement, falls prevention, physical activity, and 

13 improved nutrition;’’; 

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

15 the following: 

16 ‘‘(24) The term ‘exploitation’ means the fraudu17 lent or otherwise illegal, unauthorized, or improper 

18 act or process of an individual, including a caregiver 

19 or fiduciary (as such terms are defined in section 

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

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

22 that results in depriving an older individual of right23 ful access to, or use of, benefits, resources, belong24 ings, or assets.’’; 

25 (3) in paragraph (29)(E)— 


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

2 end; 

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

4 the end and inserting ‘‘; and’’; and 

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

6 ‘‘(iii) older individuals at risk for in7 stitutional placement.’’; 

8 (4) in paragraph (32)(D), by inserting ‘‘, in9 cluding an assisted living facility,’’ after ‘‘home’’; 

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

11 the following: 

12 ‘‘(5)(A) The term ‘neglect’ means— 

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

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

15 provide the goods or services that are necessary 

16 to maintain the health or safety of an older in17 dividual; or 

18 ‘‘(ii) self-neglect. 

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

20 inability, due to physical or mental impairment or 

21 diminished capacity, to perform essential self-care 

22 tasks including— 

23 ‘‘(i) obtaining essential food, clothing, shel24 ter, and medical care; 


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1 ‘‘(ii) obtaining goods and services nec2 essary to maintain physical health, mental 

3 health, or general safety; or 

4 ‘‘(iii) managing one’s own financial af5 fairs.’’; and 

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

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

8 Center’ means a center established by a State as 

9 part of the State’s system of long-term care, to pro10 vide a coordinated system for providing— 

11 ‘‘(A) comprehensive information on avail12 able public and private long-term care pro13 grams, options, and resources; 

14 ‘‘(B) personal counseling to assist individ15 uals in assessing their existing or anticipated 

16 long-term care needs, and developing and imple17 menting a plan for long-term care designed to 

18 meet their specific needs and circumstances; 

19 and 

20 ‘‘(C) consumer access to the range of pub21 licly-supported long-term care programs for 

22 which consumers may be eligible, by serving as 

23 a convenient point of entry for such programs. 

24 ‘‘(45) The term ‘at risk for institutional place25 ment’ means, with respect to an older individual, 


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1 that such individual is unable to perform at least 

2 two activities of daily living without substantial as3 sistance (including verbal reminding, physical cuing, 

4 or supervision), including such an older individual 

5 that is determined by the State involved to be in 

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

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

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

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

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

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

12 that are— 

13 ‘‘(A) intended to assist individuals in cop14 ing with, and to the extent practicable compen15 sating for, functional impairments in carrying 

16 out activities of daily living; 

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

18 care setting (including a small community care 

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

20 large community care setting as defined in sub21 section (h)(1), of section 1929 of the Social Se22 curity Act (42 U.S.C. 1396t)), or in a long23 term care facility; and 

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

25 cure a medical disease or condition. 


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

2 approach to providing services (including programs, 

3 benefits, supports, and technology) under this Act 

4 intended to assist an older individual with activities 

5 of daily living, in which— 

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

7 duration, scope, provider, and location of such 

8 services) are planned, budgeted, and purchased 

9 under the direction and control of such indi10 vidual; 

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

12 information and assistance as is necessary and 

13 appropriate to enable such individual to make 

14 informed decisions about the individual’s service 

15 options; 

16 ‘‘(C) the needs, capabilities, and pref17 erences of such individual with respect to such 

18 services, and such individual’s ability to direct 

19 and control the individual’s receipt of such serv20 ices, are assessed by the area agency on aging 

21 involved or the local provider agency; 

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

23 subparagraph (C), upon request, the area agen24 cy on aging assists such individual and the indiVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 vidual’s family, caregiver, or legal representa2 tive in developing— 

3 ‘‘(i) a plan of services for such indi4 vidual that specifies which services such in5 dividual will be responsible for directing; 

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

7 family members (and others whose partici8 pation is sought by such individual) in pro9 viding services under such plan; and 

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

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

12 agency involved provides for oversight of such 

13 individual’s self-directed receipt of services, in14 cluding steps to ensure the quality of services 

15 provided and the appropriate use of funds 

16 under this Act. 

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

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

19 and activities administered by a State that provide, 

20 support, or facilitate access to long-term care to in21 dividuals in such State.’’. 


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1 SEC. 3. OFFICE OF ELDER ABUSE PREVENTION AND SERV2 ICES. 

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

4 U.S.C. 3011) is amended by adding at the end the fol5 lowing: 

6 ‘‘(e)(1) In this subsection, the terms defined in sec7 tion 751 shall have the meanings given those terms in that 

8 section. 

9 ‘‘(2) The Secretary is authorized to establish or des10 ignate within the Administration (as defined in section 

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

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

13 acting through the head of the Office of Elder Abuse Pre14 vention and Services to— 

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

16 long-term plan for— 

17 ‘‘(i) carrying out elder justice programs 

18 and activities relating to— 

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

20 treatment, and intervention, and response; 

21 ‘‘(II) training of individuals regarding 

22 the matters described in subclause (I); and 

23 ‘‘(III) the improvement of the elder 

24 justice system in the United States; 

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

26 disseminating data relating to the abuse, neVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 glect, and exploitation of elders (and, in the dis2 cretion of the Secretary, vulnerable adults), in3 cluding collecting, maintaining, and dissemi4 nating such data under section 753 after con5 sultation with the Attorney General and work6 ing with experts from the Department of Jus7 tice described in section 753(b)(1); 

8 ‘‘(iii) disseminating information concerning 

9 best practices regarding, and providing training 

10 on, carrying out activities related to abuse, ne11 glect, and exploitation of elders (and, in the dis12 cretion of the Secretary, vulnerable adults); 

13 ‘‘(iv) in conjunction with the necessary ex14 perts, conducting research related to abuse, ne15 glect, and exploitation of elders (and, in the dis16 cretion of the Secretary, vulnerable adults); 

17 ‘‘(v) providing technical assistance to 

18 States and other eligible entities that provide or 

19 fund the provision of the services described in 

20 subtitle B of title VII; and 

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

22 national incidence and prevalence of elder 

23 abuse, neglect, and exploitation in all settings; 


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1 ‘‘(B) implement the overall policy and a strat2 egy to carry out the plan described in subparagraph 

3 (A); and 

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

5 justice issues and administer such programs relating 

6 to elder abuse, neglect, and exploitation as the Sec7 retary determines to be appropriate. 

8 ‘‘(4) The Secretary, acting through the Assistant Sec9 retary, may issue such regulations as may be necessary 

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

11 SEC. 4. FUNCTIONS OF THE ASSISTANT SECRETARY. 

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

13 U.S.C. 3012) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (12)— 

16 (i) by striking ‘‘carry on’’ and insert17 ing the following: 

18 ‘‘(B) carry on’’; and 

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

20 the following: 

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

22 the Administrator of the Centers for Medicare & 

23 Medicaid Services to implement and build awareness 

24 of programs providing new benefits affecting older 

25 individuals; and’’; 


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1 (B) by striking paragraph (20) and insert2 ing the following: 

3 ‘‘(20)(A) provide technical assistance and sup4 port for outreach and benefits enrollment assistance 

5 to support efforts— 

6 ‘‘(i) to inform older individuals with great7 est economic need, who may be eligible to par8 ticipate, but who are not participating, in Fed9 eral and State programs for which the individ10 uals are eligible, about the programs; and 

11 ‘‘(ii) to enroll the individuals in the pro12 grams; 

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

14 partners administering the Federal programs, make 

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

16 experienced entity to establish a National Center on 

17 Senior Benefits Outreach and Enrollment, which 

18 shall— 

19 ‘‘(i) maintain and update web-based deci20 sion support and enrollment tools, and inte21 grated, person-centered systems, designed to in22 form older individuals about the full range of 

23 benefits for which the individuals may be eligi24 ble under Federal and State programs; 


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

2 older individuals with greatest economic need 

3 and enroll the individuals in the programs; 

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

5 and Disability Resource Centers, and other 

6 public and private State and community-based 

7 organizations, including faith-based organiza8 tions and coalitions, to serve as benefits enroll9 ment centers for the programs; 

10 ‘‘(iv) develop and maintain an information 

11 clearinghouse on best practices and the most 

12 cost-effective methods for finding and enrolling 

13 older individuals with greatest economic need in 

14 the programs; and 

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

16 Federal agency partners administering the Fed17 eral programs, training and technical assistance 

18 on the most effective outreach, screening, en19 rollment, and follow-up strategies for the Fed20 eral and State programs.’’; 

21 (C) in paragraph (26)(D)— 

22 (i) by striking ‘‘gaps in’’; 

23 (ii) by inserting ‘‘(including services 

24 that would permit such individuals to re25 ceive long-term care in home and commuVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 nity-based settings)’’ after ‘‘individuals’’; 

2 and 

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

4 (D) in paragraph (27), by striking the pe5 riod at the end and inserting ‘‘; and’’; and 

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

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

8 technical assistance to support the provision of evi9 dence-based disease prevention and health promotion 

10 services.’’; and 

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

12 following: 

13 ‘‘(b) To promote the development and implementa14 tion of comprehensive, coordinated systems at Federal, 

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

16 home and community-based settings, in a manner respon17 sive to the needs and preferences of older individuals and 

18 their family caregivers, the Assistant Secretary shall, con19 sistent with the applicable provisions of this title— 

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

21 other Federal agencies and departments (other than 

22 the Administration on Aging) responsible for formu23 lating and implementing programs, benefits, and 

24 services related to providing long-term care, and 

25 may make grants, contracts, and cooperative agreeVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 ments with funds received from those other Federal 

2 agencies and departments; 

3 ‘‘(2) conduct research and demonstration 

4 projects to identify innovative, cost-effective strate5 gies for modifying State systems of long-term care 

6 to— 

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

8 of older individuals and family caregivers; 

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

10 for institutional placement, to permit such indi11 viduals to remain in home and community12 based settings; and 

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

14 implementation (through area agencies on 

15 aging, service providers, and such other entities 

16 as the Assistant Secretary determines to be ap17 propriate) of evidence-based programs to assist 

18 older individuals and their family caregivers in 

19 learning about and making behavioral changes 

20 intended to reduce the risk of injury, disease, 

21 and disability among older individuals; 

22 ‘‘(3) facilitate, in coordination with the Admin23 istrator of the Centers for Medicare & Medicaid 

24 Services, including the provision of such care 

25 through self-directed care models that— 


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

2 needs and preferences of an individual at risk 

3 for institutional placement to help such indi4 vidual avoid unnecessary institutional placement 

5 and depletion of income and assets to qualify 

6 for benefits under the Medicaid program under 

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

8 1396 et seq.); 

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

10 of such individual and provide the option— 

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

12 control the receipt of supportive services 

13 provided; or 

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

15 was appointed by the individual, or is le16 gally acting on the individual’s behalf, in 

17 order to represent or advise the individual 

18 in financial or service coordination matters 

19 (referred to in this paragraph as a ‘rep20 resentative’ of the individual), to direct 

21 and control the receipt of those services; 

22 and 

23 ‘‘(C) assist an older individual (or, as ap24 propriate, a representative of the individual) to 

25 develop a plan for long-term support, including 


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1 selecting, budgeting for, and purchasing home 

2 and community-based long-term care and sup3 portive services; 

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

5 lead role with respect to issues concerning home and 

6 community-based long-term care, including— 

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

8 President determines to be appropriate) or oth9 erwise participating in departmental and inter10 departmental activities concerning long-term 

11 care; and 

12 ‘‘(B) reviewing and commenting on depart13 mental rules, regulations, and policies related to 

14 providing long-term care; and 

15 ‘‘(C) making recommendations to the Sec16 retary with respect to home and community17 based long-term care, including recommenda18 tions based on findings made through projects 

19 conducted under paragraph (2); 

20 ‘‘(5) promote, in coordination with other appro21 priate Federal agencies— 

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

23 the importance of planning in advance for long24 term care; and 


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1 ‘‘(B) the availability of information and re2 sources to assist in such planning; 

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

4 or contracts, a national technical assistance program 

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

6 community-based service providers funded under this 

7 Act in implementing home and community-based 

8 long-term care systems, including evidence-based 

9 programs; 

10 ‘‘(7) develop, in collaboration with the Adminis11 trator of the Centers for Medicare & Medicaid Serv12 ices, performance standards and measures for use by 

13 States to determine the extent to which their sys14 tems of long-term care fulfill the objectives described 

15 in this subsection; and 

16 ‘‘(8) conduct such other activities as the Assist17 ant Secretary determines to be appropriate. 

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

19 the Chief Executive Officer of the Corporation for Na20 tional and Community Service, shall— 

21 ‘‘(1) encourage and permit volunteer groups 

22 (including organizations carrying out national serv23 ice programs and including organizations of youth in 

24 secondary or postsecondary school) that are active in 

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1 pate and be involved individually or through rep2 resentative groups in supportive service and civic en3 gagement programs or activities to the maximum ex4 tent feasible; 

5 ‘‘(2) develop a comprehensive strategy for uti6 lizing older individuals to address critical local needs 

7 of national concern; and 

8 ‘‘(3) encourage other community capacity-build9 ing initiatives involving older individuals.’’. 

10 SEC. 5. FEDERAL AGENCY CONSULTATION. 

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

12 U.S.C. 3013) is amended— 

13 (1) in subsection (a)(3)(A)— 

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

15 to low-income minority older individuals and 

16 older individuals residing in rural areas)’’ and 

17 inserting ‘‘(with particular attention to low-in18 come older individuals, including low-income 

19 minority older individuals, older individuals 

20 with limited English proficiency, and older indi21 viduals residing in rural areas)’’; and 

22 (B) by striking ‘‘section 507’’ and insert23 ing ‘‘section 516’’; 

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

25 following: 


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1 ‘‘(19) Sections 4 and 5 of the Assistive Tech2 nology Act of 1998 (29 U.S.C. 3003, 3004).’’; and 

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

4 ‘‘(c)(1) The Secretary, in collaboration with the Sec5 retary of Housing and Urban Development and with the 

6 other Federal officials specified in paragraph (2), shall es7 tablish an interagency coordinating committee (referred to 

8 in this subsection as the ‘Committee’) focusing on the co9 ordination of agencies with respect to aging issues, par10 ticularly issues related to demographic changes and hous11 ing needs among older individuals. 

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

13 the Secretary of Labor, the Secretary of Housing and 

14 Urban Development, the Attorney General, the Secretary 

15 of Transportation, the Secretary of the Treasury, the Sec16 retary of Agriculture, the Commissioner of Social Secu17 rity, the Surgeon General, the Administrator of the Cen18 ters for Medicare & Medicaid Services, the Director of the 

19 Centers for Disease Control and Prevention, the Director 

20 of the National Institutes of Health, the Assistant Sec21 retary for Children and Families, the Administrator of the 

22 National Highway Traffic Safety Administration, and 

23 such other Federal officials as the Secretary of Health and 

24 Human Services determines to be appropriate. 


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

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

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

4 Secretary of Housing and Urban Development and the 

5 Secretary of Health and Human Services shall alternate 

6 as chairpersons of the Committee, each serving as chair7 person for a period of 2 years. 

8 ‘‘(4) The Committee shall— 

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

10 that assist older individuals in finding and affording 

11 housing, health care, and other services, including 

12 those Federal programs and services that assist 

13 older individuals in accessing health care, transpor14 tation, supportive services, and assistance with daily 

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

16 older individuals live; 

17 ‘‘(B) monitor, evaluate, and recommend im18 provements in programs and services administered, 

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

20 agencies to assist older individuals in meeting their 

21 housing, health care, and other service needs and 

22 make any recommendations about how the agencies 

23 can better carry out and provide the programs and 

24 services to house and serve older individuals; 

25 ‘‘(C) recommend ways to— 


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1 ‘‘(i) facilitate aging in place of older indi2 viduals, by identifying and making available the 

3 programs and services necessary to enable older 

4 individuals to remain in their homes as the in5 dividuals age; 

6 ‘‘(ii) reduce duplication by Federal agen7 cies of programs and services to assist older in8 dividuals in meeting their housing, health care, 

9 and other service needs; 

10 ‘‘(iii) ensure collaboration among and with11 in agencies in providing and making available 

12 the programs and services so that older individ13 uals are able to easily access needed programs 

14 and services; 

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

16 housing, health care, and other services to older 

17 individuals by— 

18 ‘‘(I) holding individual meetings with 

19 State representatives; 

20 ‘‘(II) providing ongoing technical as21 sistance to States about better meeting the 

22 needs of older individuals; and 

23 ‘‘(III) working with States to des24 ignate State liaisons for the Committee; 


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1 ‘‘(v) identify model programs and services 

2 to assist older individuals in meeting their hous3 ing, health care, and other service needs, in4 cluding model— 

5 ‘‘(I) programs linking housing, health 

6 care, and other services; 

7 ‘‘(II) financing products offered by 

8 government, quasi-government, and private 

9 sector entities; and 

10 ‘‘(III) innovations in technology appli11 cations that give older individuals access to 

12 information on available services or that 

13 help in providing services to older individ14 uals; 

15 ‘‘(vi) collect and disseminate information 

16 about older individuals and the programs and 

17 services available to the individuals to ensure 

18 that the individuals can access comprehensive 

19 information; and 

20 ‘‘(vii) work with the Federal Interagency 

21 Forum on Aging-Related Statistics, the Bureau 

22 of the Census, and member agencies— 

23 ‘‘(I) to collect and maintain data re24 lating to the housing, health care, and 

25 other service needs of older individuals so 


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1 that all such data can be accessed in one 

2 place on a designated website; and 

3 ‘‘(II) to identify and address unmet 

4 data needs; 

5 ‘‘(D) make recommendations to guide policy 

6 and program development across Federal agencies 

7 with respect to demographic changes among older 

8 individuals; and 

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

10 all appropriate and interested parties, including pub11 lic health interest and research groups and founda12 tions about the activities described in subparagraphs 

13 (A) through (D). 

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

15 submit to the President, the Committee on Financial Serv16 ices of the House of Representatives, the Committee on 

17 Education and the Workforce of the House of Representa18 tives, the Committee on Banking, Housing, and Urban Af19 fairs of the Senate, the Committee on Health, Education, 

20 Labor, and Pensions of the Senate, and the Special Com21 mittee on Aging of the Senate, a report that— 

22 ‘‘(A) describes the activities and accomplish23 ments of the Committee in working with Federal, 

24 State, and local governments, and private organizaVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 tions, in coordinating programs and services to meet 

2 the requirements of paragraph (4); 

3 ‘‘(B) assesses the level of Federal assistance re4 quired to meet the needs described in paragraph (4); 

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

6 each agency that is a member of the interagency co7 ordinating committee established under paragraph 

8 (1) that describes the barriers and impediments, in9 cluding barriers and impediments in statutory and 

10 regulatory law, to the access and use by older indi11 viduals of programs and services administered by 

12 such agency; and 

13 ‘‘(D) makes recommendations for appropriate 

14 legislative and administrative actions to meet the 

15 needs described in paragraph (4) and for coordi16 nating programs and services designed to meet those 

17 needs. 

18 ‘‘(6)(A) The Secretary of Health and Human Serv19 ices, after consultation with the Secretary of Housing and 

20 Urban Development, shall appoint an executive director 

21 of the Committee. 

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

23 Government employee may be detailed to the Committee 

24 without reimbursement, and such detail shall be without 

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


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1 SEC. 6. ADMINISTRATION. 

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

3 U.S.C. 3016) is amended— 

4 (1) in subsection (a)— 

5 (A) in paragraph (1)— 

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

7 ‘‘and’’ at the end; 

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

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

10 and 

11 (iii) by striking subparagraph (E); 

12 and 

13 (B) in paragraph (2)— 

14 (i) in subparagraph (A)— 

15 (I) by amending clause (i) to 

16 read as follows: 

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

18 evidence-based programs to support improved nutri19 tion and regular physical activity for older individ20 uals;’’; 

21 (II) by amending clause (iii) to 

22 read as follows: 

23 ‘‘(iii) conducting outreach and disseminating 

24 evidence-based information to nutrition service pro25 viders about the benefits of healthful diets and reg26 ular physical activity, including information about 


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1 the most current Dietary Guidelines for Americans 

2 published under section 301 of the National Nutri3 tion Monitoring and Related Research Act of 1990 

4 (7 U.S.C. 5341), the Food Guide Pyramid published 

5 by the Secretary of Agriculture, and advances in nu6 trition science;’’; 

7 (III) in clause (vii) by striking 

8 ‘‘and’’ at the end; and 

9 (IV) by striking clause (viii) and 

10 inserting the following: 

11 ‘‘(viii) disseminating guidance that describes 

12 strategies for improving the nutritional quality of 

13 meals provided under title III; and 

14 ‘‘(ix) providing technical assistance to the re15 gional offices of the Administration with respect to 

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

17 and 

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

19 to read as follows: 

20 ‘‘(i) have expertise in nutrition and meal plan21 ning; and’’. 

22 SEC. 7. EVALUATION. 

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

24 (42 U.S.C. 3017(g)) is amended by striking the first sen25 tence and inserting the following: ‘‘From the total amount 


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

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

not more than 1 3 ⁄2 of 1 percent of such amount, for pur4 poses of conducting evaluations under this section, either 

5 directly or by grant or contract.’’. 

6 SEC. 8. REPORTS. 

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

8 1965 (42 U.S.C. 3018(b)(2)) is amended— 

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

10 and inserting ‘‘the Workforce’’; and 

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

12 and Human Resources’’ and inserting ‘‘Health, Edu13 cation, Labor, and Pensions’’. 

14 SEC. 9. CONTRACTUAL, COMMERCIAL AND PRIVATE PAY 

15 RELATIONSHIPS; APPROPRIATE USE OF ACT 

16 FUNDS. 

17 (a) PRIVATE PAY RELATIONSHIPS; APPROPRIATE

18 USE OF ACT FUNDS.—Section 212 of the Older Ameri19 cans Act (42 U.S.C. 3020c) is amended to read as follows: 

20 ‘‘SEC. 212. CONTRACTING AND GRANT AUTHORITY; PRI21 VATE PAY RELATIONSHIPS; APPROPRIATE 

22 USE OF FUNDS. 

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

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


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1 or a contract under this Act from entering into an agree2 ment— 

3 ‘‘(1) with a profitmaking organization; 

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

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

6 cost (including an administrative cost) incurred by 

7 such recipient to carry out a contract or commercial 

8 relationship for the benefit of older individuals or 

9 their family caregivers, whether such contract or re10 lationship is carried out to implement a provision of 

11 this Act or to conduct activities inherently associated 

12 with implementing such provision; or 

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

14 age or income (including the family caregiver of such 

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

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

17 receive such services based on the fair market value 

18 of such services. 

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

20 agreement described in subsection (a) may not— 

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

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

23 VI, without the prior recommendation of the Direc24 tor of the Office for American Indian, Alaska NaVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 tive, and Native Hawaiian Aging and the prior ap2 proval of the Assistant Secretary); 

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

4 the effect of, paying, reimbursing, or otherwise com5 pensating an entity under such agreement in an 

6 amount that exceeds the fair market value of the 

7 goods or services furnished by such entity under 

8 such agreement; 

9 ‘‘(3) result in the displacement of services oth10 erwise available to an older individual with greatest 

11 social need, an older individual with greatest eco12 nomic need, or an older individual who is at risk for 

13 institutional placement; or 

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

15 or be inconsistent with the objective of serving the 

16 needs of older individuals, as determined by the As17 sistant Secretary.’’. 

18 SEC. 10. NUTRITION EDUCATION. 

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

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

21 ‘‘SEC. 214. NUTRITION EDUCATION. 

22 ‘‘The Assistant Secretary, in consultation with the 

23 Secretary of Agriculture, shall conduct outreach and pro24 vide technical assistance to agencies and organizations 

25 that serve older individuals to assist such agencies and orVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 ganizations to carry out integrated health promotion and 

2 disease prevention programs that— 

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

4 ‘‘(2) include— 

5 ‘‘(A) nutrition education; 

6 ‘‘(B) physical activity; and 

7 ‘‘(C) other activities to modify behavior 

8 and to improve health literacy, including pro9 viding information on optimal nutrient intake, 

10 through education and counseling in accordance 

11 with section 339(2)(J).’’. 

12 SEC. 11. PENSION COUNSELING AND INFORMATION PRO13 GRAMS. 

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

15 U.S.C. 3020e–1) is amended— 

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

17 income retirees’’ and inserting ‘‘, low-income retir18 ees, and older individuals with limited English pro19 ficiency’’; 

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

21 (2) to read as follows: 

22 ‘‘(2) The ability of the entity to perform effec23 tive outreach to affected populations, particularly 

24 populations with limited English proficiency and 


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1 other populations that are identified as in need of 

2 special outreach.’’; and 

3 (3) in subsection (h)(2), by inserting ‘‘(includ4 ing individuals with limited English proficiency)’’ 

5 after ‘‘individuals’’. 

6 SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 

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

8 U.S.C. 3020f) is amended— 

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

10 2003, 2004, and 2005’’ and inserting ‘‘2007, 2008, 

11 2009, 2010, and 2011.’’; and 

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

13 ‘‘year’’ and all that follows through ‘‘years’’, and in14 serting ‘‘years 2007, 2008, 2009, 2010, and 2011’’. 

15 SEC. 13. PURPOSE; ADMINISTRATION. 

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

17 1965 (42 U.S.C. 3021(a)(2)) is amended— 

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

19 the end; 

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

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

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

23 ‘‘(F) organizations with experience in providing 

24 senior volunteer services, such as Federal volunteer 

25 programs administered by the Corporation for NaVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00031 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 tional and Community Service and designed to pro2 vide training, placement, and stipends for volunteers 

3 in community service settings.’’. 

4 SEC. 14. AUTHORIZATION OF APPROPRIATIONS; USES OF 

5 FUNDS. 

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

7 U.S.C. 3023) is amended— 

8 (1) in subsections (a)(1), (b), and (d), by strik9 ing ‘‘year 2001’’ and all that follows through 

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

11 2007, 2008, 2009, 2010, and 2011’’; and 

12 (2) in subsection (e)— 

13 (A) in paragraph (1) by striking 

14 ‘‘$125,000,000’’ and all that follows and insert15 ing ‘‘$160,000,000 for fiscal year 2007.’’; and 

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

17 sums’’ and all that follows and inserting 

18 ‘‘$170,000,000 for fiscal year 2008, 

19 $180,000,000 for fiscal year 2009, 

20 $190,000,000 for fiscal year 2010, and 

21 $200,000,000 for fiscal year 2011.’’. 

22 SEC. 15. ALLOTMENTS. 

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

24 1965 (42 U.S.C. 3024(d)(1)(A)) is amended to read as 

25 follows: 


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

2 determines, but not more than 10 percent 

3 thereof, shall be available for paying such per4 centage as the agency determines, but not more 

5 than 75 percent, of the cost of administration 

6 of area plans; and 

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

8 fiscal year among fiscal years 2007 through 

9 2011 for which the amount appropriated under 

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

11 not less than 110 percent of that appropriated 

12 amount for fiscal year 2006, an amount equal 

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

14 used by the area agencies on aging in the State 

15 to carry out the assessment described in section 

16 306(b);’’. 

17 SEC. 16. ORGANIZATION. 

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

19 U.S.C. 3025) is amended— 

20 (1) in subsection (a)— 

21 (A) in paragraph (1)(E)— 

22 (i) by striking ‘‘(with particular atten23 tion to low-income minority individuals and 

24 older individuals residing in rural areas)’’ 

25 each place it appears and inserting ‘‘(with 


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1 particular attention to low-income older in2 dividuals, including low-income minority 

3 older individuals, older individuals with 

4 limited English proficiency, and older indi5 viduals residing in rural areas)’’; and 

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

7 (B) in paragraph (2)— 

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

9 with particular attention to low-income mi10 nority individuals and older individuals re11 siding in rural areas’’ and inserting ‘‘(with 

12 particular attention to low-income older in13 dividuals, including low-income minority 

14 older individuals, older individuals with 

15 limited English proficiency, and older indi16 viduals residing in rural areas)’’; and 

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

18 the period and inserting ‘‘; and’’; and 

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

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

21 section, promote the development and implementa22 tion of a comprehensive, coordinated system in such 

23 State for providing long-term care in home and com24 munity-based settings, in a manner responsive to the 


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1 needs and preferences of older individuals and their 

2 family caregivers, by— 

3 ‘‘(A) collaborating, coordinating, and con4 sulting with other agencies in such State re5 sponsible for formulating, implementing, and 

6 administering programs, benefits, and services 

7 related to providing long-term care; 

8 ‘‘(B) participating in any State govern9 ment activities concerning long-term care, in10 cluding reviewing and commenting on any State 

11 rules, regulations, and policies related to long12 term care; 

13 ‘‘(C) conducting analyses and making rec14 ommendations with respect to strategies for 

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

16 to better— 

17 ‘‘(i) respond to the needs and pref18 erences of older individuals and family 

19 caregivers; 

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

21 providers, of long-term care in home and 

22 community-based settings; 

23 ‘‘(iii) target services to older individ24 uals at risk for institutional placement, to 


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1 permit such individuals to remain in home 

2 and community-based settings; and 

3 ‘‘(iv) implement (through area agen4 cies on aging, service providers, and such 

5 other entities as the State determines to be 

6 appropriate) programs to assist older indi7 viduals and their family caregivers in 

8 learning about and making behavioral 

9 changes intended to reduce the risk of in10 jury, disease, and disability among older 

11 individuals; and 

12 ‘‘(D) providing for the availability and dis13 tribution (through public education campaigns, 

14 Aging and Disability Resource Centers, area 

15 agencies on aging, and other appropriate 

16 means) of information relating to— 

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

18 long-term care; and 

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

20 private long-term care programs, options, 

21 and resources.’’; and 

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

23 following: 

24 ‘‘(6) Nothing in this section shall prevent the Com25 monwealth of Puerto Rico from designating, with the apVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 proval of the Assistant Secretary, a single planning and 

2 service area to cover all the older individuals in the Com3 monwealth.’’. 

4 SEC. 17. AREA PLANS. 

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

6 U.S.C. 3026) is amended— 

7 (1) in subsection (a)— 

8 (A) in paragraph (1)— 

9 (i) by striking ‘‘(with particular atten10 tion to low-income minority individuals and 

11 older individuals residing in rural areas)’’ 

12 and inserting ‘‘(with particular attention to 

13 low-income older individuals, including low14 income minority older individuals, older in15 dividuals with limited English proficiency, 

16 and older individuals residing in rural 

17 areas)’’; 

18 (ii) by striking ‘‘(with particular at19 tention to low-income minority individ20 uals)’’ and inserting ‘‘(with particular at21 tention to low-income older individuals, in22 cluding low-income minority older individ23 uals, older individuals with limited English 

24 proficiency, and older individuals residing 

25 in rural areas)’’; and 


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

2 individuals at risk for institutional place3 ment residing in such area,’’ after ‘‘indi4 viduals) residing in such area,’’; 

5 (B) in paragraph (2)(A)— 

6 (i) by inserting after ‘‘transpor7 tation,’’ the following: ‘‘health services (in8 cluding mental health services),’’; and 

9 (ii) by inserting after ‘‘information 

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

11 include information and assistance to con12 sumers on availability of services under 

13 part B and how to receive benefits under 

14 and participate in publicly supported pro15 grams for which the consumer may be eli16 gible)’’; 

17 (C) in paragraph (4)— 

18 (i) in subparagraph (A)— 

19 (I) by amending clause (i) to 

20 read as follows: 

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

22 aging will— 

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

24 State policy, for providing services to older indi25 viduals with greatest economic need, older indiVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00038 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 viduals with greatest social need, and older in2 dividuals at risk for institutional placement; 

3 ‘‘(II) include specific objectives for pro4 viding services to low-income minority older in5 dividuals, older individuals with limited English 

6 proficiency, and older individuals residing in 

7 rural areas; and 

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

9 methods to achieve such objectives;’’; and 

10 (II) in clause (ii) by inserting 

11 ‘‘(including older individuals with lim12 ited English proficiency)’’ after ‘‘low 

13 income minority individuals’’ each 

14 place it appears; and 

15 (ii) in subparagraph (B)— 

16 (I) by moving the left margin of 

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

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

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

20 and 

21 (II) in clause (i)— 

22 (aa) in subclause (V) by 

23 striking ‘‘with limited English24 speaking ability; and’’ and insertVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00039 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 ing ‘‘with limited English pro2 ficiency;’’; and 

3 (bb) by adding at the end 

4 the following: 

5 ‘‘(VII) older individuals at risk for in6 stitutional placement; and’’; 

7 (D) in paragraph (5), by inserting ‘‘and in8 dividuals at risk for institutional placement’’ 

9 after ‘‘severe disabilities’’; 

10 (E) in paragraph (6)— 

11 (i) in subparagraph (C)— 

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

13 ‘‘and’’ at the end; 

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

15 ‘‘and’’ at the end; and 

16 (III) by inserting after clause (ii) 

17 the following: 

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

19 providing direct services delivered to older indi20 viduals and individuals with disabilities needing 

21 such services and, if possible, work in coordina22 tion with entities carrying out volunteer pro23 grams (including programs administered by the 

24 Corporation for National and Community Serv25 ices) designed to provide training, placement, 


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1 and stipends for volunteers in community serv2 ice settings.’’; 

3 (ii) in subparagraph (D)— 

4 (I) by inserting ‘‘family care5 givers of such individuals,’’ after 

6 ‘‘Act,’’; and 

7 (II) by inserting ‘‘service pro8 viders, representatives of the business 

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

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

11 ‘‘(including mental health screening)’’ be12 fore ‘‘provided’’ each place it appears; 

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

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

15 shall, consistent with this section, facilitate the area16 wide development and implementation of a com17 prehensive, coordinated system for providing long18 term care in home and community-based settings, in 

19 a manner responsive to the needs and preferences of 

20 older individuals and their family caregivers, by— 

21 ‘‘(A) collaborating, coordinating, and con22 sulting with other local public and private agen23 cies and organizations responsible for admin24 istering programs, benefits, and services related 

25 to providing long-term care; 


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1 ‘‘(B) conducting analyses and making rec2 ommendations with respect to strategies for 

3 modifying the local system of long-term care to 

4 better— 

5 ‘‘(i) respond to the needs and pref6 erences of older individuals and family 

7 caregivers; 

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

9 providers, of long-term care in home and 

10 community-based settings; 

11 ‘‘(iii) target services to older individ12 uals at risk for institutional placement, to 

13 permit such individuals to remain in home 

14 and community-based settings; and 

15 ‘‘(iv) implement (through the agency 

16 or service providers), evidence-based pro17 grams to assist older individuals and their 

18 family caregivers in learning about and 

19 making behavioral changes intended to re20 duce the risk of injury, disease, and dis21 ability among older individuals; and 

22 ‘‘(C) providing for the availability and dis23 tribution (through public education campaigns, 

24 Aging and Disability Resource Centers, and 


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1 other appropriate means) of information relat2 ing to— 

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

4 long-term care; and 

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

6 private long-term care programs, options, 

7 and resources.’’; 

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

9 (H) by redesignating paragraph (16) as 

10 paragraph (15); and 

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

12 ‘‘(16) provide assurances that funds received 

13 under this title will be used— 

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

15 older individuals giving priority to older individ16 uals identified in paragraph (4)(A)(i); and 

17 ‘‘(B) in compliance with the assurances 

18 specified in paragraph (13) and the limitations 

19 specified in section 212(b); and 

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

21 furnishing of services under this Act, consistent with 

22 self-directed care. 

23 ‘‘(18) include information detailing how the 

24 area agency on aging will coordinate activities, and 

25 develop long-range emergency plans, with local and 


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1 State emergency response agencies, relief organiza2 tions, local and State governments, and any other 

3 institutions that have responsibility for disaster re4 lief service delivery.’’; 

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

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

7 (3) by inserting after subsection (a) the fol8 lowing: 

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

10 may include in the area plan an assessment of how pre11 pared the area agency on aging and service providers in 

12 the planning and service area are for a change in the num13 ber of older individuals during the 10-year period following 

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

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

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

17 ‘‘(2) Such assessment may include— 

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

19 older individuals in the planning and service area; 

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

21 such individuals, including individuals with low in22 comes, individuals with greatest economic need, mi23 nority older individuals, older individuals residing in 

24 rural areas, and older individuals with limited 

25 English proficiency; 


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

2 and services provided by such area agency can be 

3 improved, and how resource levels can be adjusted to 

4 meet the needs of the changing population of older 

5 individuals in the planning and service area; and 

6 ‘‘(D) an analysis of how the change in the num7 ber of individuals age 85 and older in the planning 

8 and service area is expected to affect the need for 

9 supportive services. 

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

11 government officials, State agencies, tribal organizations, 

12 or local entities, may make recommendations to govern13 ment officials in the planning and service area and the 

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

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

16 needs of older individuals for— 

17 ‘‘(A) health and human services; 

18 ‘‘(B) land use; 

19 ‘‘(C) housing; 

20 ‘‘(D) transportation; 

21 ‘‘(E) public safety; 

22 ‘‘(F) workforce and economic development; 

23 ‘‘(G) recreation; 

24 ‘‘(H) education; 

25 ‘‘(I) civic engagement; 


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1 ‘‘(J) emergency preparedness; and 

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

3 agency.’’. 

4 SEC. 18. STATE PLANS. 

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

6 (42 U.S.C. 3027(a)) is amended— 

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

8 306(b)’’ and inserting ‘‘section 306(c)’’; 

9 (2) in paragraph (4), by striking ‘‘, with par10 ticular attention to low-income minority individuals 

11 and older individuals residing in rural areas’’ and in12 serting ‘‘(with particular attention to low-income mi13 nority older individuals, older individuals with lim14 ited English proficiency, and older individuals resid15 ing in rural areas)’’; 

16 (3) by striking paragraph (15); 

17 (4) by redesignating paragraph (14) as para18 graph (15); 

19 (5) by inserting after paragraph (13) the fol20 lowing: 

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

22 year preceding the fiscal year for which such plan is 

23 prepared— 

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

25 minority older individuals in the State, includVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00046 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 ing the number of low-income minority older in2 dividuals with limited English proficiency; and 

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

4 the service needs of the low-income minority 

5 older individuals described in subparagraph (A), 

6 including the plan to meet the needs of low-in7 come minority older individuals with limited 

8 English proficiency.’’; 

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

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

11 minority individuals and older individuals residing in 

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

13 ‘‘(with particular attention to low-income older indi14 viduals, including low-income minority older individ15 uals, older individuals with limited English pro16 ficiency, and older individuals residing in rural 

17 areas)’’; and 

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

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

20 area agencies on aging will provide, to the extent 

21 feasible, for the furnishing of services under this 

22 Act, consistent with self-directed care. 

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

24 of the State, an assessment of how prepared the 

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


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1 model, for a change in the number of older individ2 uals during the 10-year period following the fiscal 

3 year for which the plan is submitted. 

4 ‘‘(B) Such assessment may include— 

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

6 older individuals in the State; 

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

8 affect such individuals, including individuals 

9 with low incomes, individuals with great eco10 nomic need, minority older individuals, older in11 dividuals residing in rural areas, and older indi12 viduals with limited English proficiency; 

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

14 policies, and services provided by the State can 

15 be improved, including coordinating with area 

16 agencies on aging, and how resource levels can 

17 be adjusted to meet the needs of the changing 

18 population of older individuals in the State; and 

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

20 number of individuals age 85 and older in the 

21 State is expected to affect the need for sup22 portive services. 

23 ‘‘(29) The plan shall include information detail24 ing how the State will coordinate activities, and de25 velop long-range emergency preparedness plans, with 


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1 area agencies on aging, local emergency response 

2 agencies, relief organizations, local governments, and 

3 any other institutions that have responsibility for 

4 disaster relief service delivery. 

5 ‘‘(30) The plan shall include information de6 scribing the involvement of the head of the State 

7 agency in the development, revision, and implemen8 tation of emergency preparedness plans, including 

9 the State Public Health Emergency Preparedness 

10 and Response Plan. 

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

12 shall implement an Aging and Disability Resource 

13 Center— 

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

15 source of information on the full range of op16 tions for long-term care, including both institu17 tional and home and community-based care, 

18 that are available in the State; 

19 ‘‘(B) to provide personalized and con20 sumer-friendly assistance to empower individ21 uals to make informed decisions about their 

22 long-term care options; 

23 ‘‘(C) to provide coordinated and stream24 lined access to all publicly funded long-term 

25 care options so that consumers can obtain the 


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1 care they need through a single intake, assess2 ment, and eligibility determination process; 

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

4 their long-term care needs; and 

5 ‘‘(E) to assist, in coordination with the en6 tity carrying out the health insurance informa7 tion, counseling, and assistance program (re8 ceiving funding under section 4360 of the Om9 nibus Budget Reconciliation Act of 1990 (42 

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

11 and prospective beneficiaries, under the Medi12 care program established under title XVIII of 

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

14 seq.) in understanding and accessing prescrip15 tion drug and preventative health benefits 

16 under the provisions of, and amendments made 

17 by, the Medicare Prescription Drug, Improve18 ment, and Modernization Act of 2003.’’. 

19 SEC. 19. PAYMENTS. 

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

21 1965 (42 U.S.C. 3029(b)(2)) is amended by striking ‘‘the 

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

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

24 in section 304(d)(1)(D)’’. 


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1 SEC. 20. NUTRITION SERVICES INCENTIVE PROGRAM. 

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

3 U.S.C. 3030a) is amended— 

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

5 following: 

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

7 shall promptly and equitably disburse amounts received 

8 under this subsection to recipients of grants and con9 tracts.’’; 

10 (2) in subsection (c)— 

11 (A) in paragraph (1), by inserting ‘‘, in12 cluding bonus commodities,’’ after ‘‘agricultural 

13 commodities’’; 

14 (B) in paragraph (2), by inserting ‘‘, in15 cluding bonus commodities,’’ after ‘‘food com16 modities’’; and 

17 (C) in paragraph (3), by inserting ‘‘, in18 cluding bonus commodities,’’ after ‘‘Dairy prod19 ucts’’; 

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

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

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

23 inserting ‘‘2007’’. 

24 SEC. 21. CONSUMER CONTRIBUTIONS. 

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

26 U.S.C. 3030c–2) is amended— 


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1 (1) in subsection (b)— 

2 (A) in paragraph (1)— 

3 (i) by striking ‘‘provided that’’ and in4 serting ‘‘if’’; and 

5 (ii) by adding at the end the fol6 lowing: ‘‘Such contributions shall be en7 couraged for individuals whose self-de8 clared income is at or above 200 percent of 

9 the poverty line, at contribution levels 

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

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

12 to supplement (not supplant) funds received 

13 under this Act’’ after ‘‘given’’; 

14 (2) in subsection (c)(2), by striking ‘‘(with par15 ticular attention to low-income minority individuals 

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

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

18 older individuals, including low-income minority 

19 older individuals, older individuals with limited 

20 English proficiency, and older individuals residing in 

21 rural areas)’’; and 

22 (3) in subsection (d), by striking ‘‘with par23 ticular attention to low-income and minority older 

24 individuals and older individuals residing in rural 

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


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1 low-income older individuals, including low-income 

2 minority older individuals, older individuals with lim3 ited English proficiency, and older individuals resid4 ing in rural areas)’’. 

5 SEC. 22. SUPPORTIVE SERVICES AND SENIOR CENTERS. 

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

7 (42 U.S.C. 3030d(a)) is amended— 

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

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

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

11 and inserting ‘‘provision of devices and services (in12 cluding provision of assistive technology devices and 

13 assistive technology services)’’; 

14 (3) in paragraph (14)(B) by inserting ‘‘(includ15 ing mental health)’’ after ‘‘health’’; 

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

17 the end and inserting a semicolon; 

18 (5) by redesignating paragraph (23) as para19 graph (24); and 

20 (6) by inserting after paragraph (22) the fol21 lowing: 

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

23 agencies on aging, and local service providers in car24 rying out and coordinating activities for older indi25 viduals with respect to mental health services, inVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00053 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 cluding outreach for, education concerning, and 

2 screening for such services, and referral to such 

3 services for treatment; and’’. 

4 SEC. 23. NUTRITION SERVICES. 

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

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

7 insert the following: 

8 ‘‘SEC. 330. PURPOSE. 

9 ‘‘It is the purpose of this part to promote socializa10 tion and the health and well-being of older individuals by 

11 assisting such individuals to gain access to nutrition serv12 ices to delay the onset of adverse health conditions.’’. 

13 SEC. 24. CONGREGATE NUTRITION PROGRAM. 

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

15 U.S.C. 3030e) is amended— 

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

17 ‘‘projects that—’’; 

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

19 first place it appears; 

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

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

22 following: 

23 ‘‘(3) provide nutrition education, nutrition 

24 counseling, and other nutrition services, as appro25 priate, based on the needs of meal participants.’’. 


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1 SEC. 25. HOME DELIVERED NUTRITION SERVICES. 

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

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

4 ‘‘SEC. 336. PROGRAM AUTHORIZED. 

5 ‘‘The Assistant Secretary shall establish and carry 

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

7 approved under section 307 for the establishment and op8 eration of nutrition projects for older individuals that pro9 vide— 

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

11 rural area where such frequency is not feasible (as 

12 defined by the Assistant Secretary by rule) and a 

13 lesser frequency is approved by the State agency) at 

14 least 1 home delivered meal per day, which may con15 sist of hot, cold, frozen, dried, canned, fresh, or sup16 plemental foods and any additional meals that the 

17 recipient of a grant or contract under this subpart 

18 elects to provide; and 

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

20 and other nutrition services as appropriate, based on 

21 the needs of meal recipients.’’. 

22 SEC. 26. CRITERIA. 

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

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


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1 ‘‘SEC. 337. CRITERIA. 

2 ‘‘The Assistant Secretary, in consultation with recog3 nized experts in the fields of nutrition science, dietetics, 

4 meal planning and food service management, and aging, 

5 shall develop minimum criteria of efficiency and quality 

6 for the furnishing of home delivered meal services for 

7 projects described in section 336.’’. 

8 SEC. 27. NUTRITION. 

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

10 U.S.C. 3030g–21) is amended— 

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

12 ‘‘(1) solicit the advice and expertise of a dieti13 tian or other individual with education and training 

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

15 available, an individual with comparable expertise in 

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

17 (2) in paragraph (2)— 

18 (A) in subparagraph (A)(i), to read as fol19 lows: 

20 ‘‘(i) comply with the most recent Die21 tary Guidelines for Americans, published 

22 by the Secretary and the Secretary of Ag23 riculture, and’’; and 

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

25 ‘‘joint’’ after ‘‘encourages’’; and 


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1 (C) in subparagraph (G), to read as fol2 lows: 

3 ‘‘(G) ensures that meal providers solicit 

4 the advice and expertise of— 

5 ‘‘(i) a dietitian or other individual de6 scribed in paragraph (1), 

7 ‘‘(ii) meal participants, and 

8 ‘‘(iii) other individuals knowledgeable 

9 with regard to the needs of older individ10 uals,’’; and 

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

12 at the end; and 

13 (E) in subparagraph (J), to read as fol14 lows: 

15 ‘‘(J) provides for nutrition screening and 

16 nutrition education, and nutrition assessment 

17 and counseling if appropriate; and 

18 ‘‘(K) encourages individuals who distribute 

19 nutrition services under subpart 2 to provide, to 

20 homebound older individuals, available medical 

21 information approved by health care profes22 sionals, such as informational brochures and in23 formation on how to get vaccines, including vac24 cines for influenza, pneumonia, and shingles, in 

25 the individuals’ communities.’’. 


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1 SEC. 28. STUDY OF NUTRITION PROJECTS. 

2 (a) STUDY.— 

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

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

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

6 3017(g)) to enter into a contract with the Food and 

7 Nutrition Board of the Institute of Medicine of the 

8 National Academy of Sciences, for the purpose of es9 tablishing an independent panel of experts that will 

10 conduct an evidence-based study of the nutrition 

11 projects authorized under such Act. 

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

13 data are available, include— 

14 (A) an evaluation of the effect of the nutri15 tion projects authorized by such Act on— 

16 (i) improvement of the health status, 

17 including nutritional status, of participants 

18 in the projects; 

19 (ii) prevention of hunger and food in20 security of the participants; and 

21 (iii) continuation of the ability of the 

22 participants to live independently; 

23 (B) a cost-benefit analysis of nutrition 

24 projects authorized by such Act, including the 

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1 gram under title XIX of the Social Security Act 

2 (42 U.S.C. 1396 et seq.); and 

3 (C) an analysis of how nutrition projects 

4 authorized by such Act may be modified to im5 prove the outcomes described in subparagraph 

6 (A), including by improving the nutritional 

7 quality of the meals provided through the 

8 projects and undertaking other potential strate9 gies to improve the nutritional status of the 

10 participants. 

11 (b) REPORTS.— 

12 (1) REPORT TO THE ASSISTANT SECRETARY.— 

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

14 the Assistant Secretary a report containing the re15 sults of the evidence-based study described in sub16 section (a), including any recommendations resulting 

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

18 (2) REPORT TO CONGRESS.—The Assistant 

19 Secretary shall submit a report containing the re20 sults described in paragraph (1) to the Committee 

21 on Education and the Workforce of the House of 

22 Representatives and the Committee on Health, Edu23 cation, Labor, and Pensions of the Senate. 

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

25 establish the independent panel of experts described in 


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

2 the enactment of this Act. The panel shall submit the re3 port described in subsection (b)(1) to the Assistant Sec4 retary not later than 24 months after the date of the en5 actment of this Act. 

6 SEC. 29. IMPROVING INDOOR AIR QUALITY IN BUILDINGS 

7 WHERE OLDER INDIVIDUALS CONGREGATE. 

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

9 U.S.C. 3030m) is amended by adding at the end the fol10 lowing: 

11 ‘‘(c) The Assistant Secretary shall work in consulta12 tion with qualified experts to provide information on meth13 ods of improving indoor air quality in buildings where 

14 older individuals congregate.’’. 

15 SEC. 30. CAREGIVER SUPPORT PROGRAM DEFINITIONS. 

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

17 U.S.C. 3030s) is amended— 

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

19 child with mental retardation or a related develop20 mental disability’’ after ‘‘age’’; 

21 (2) in paragraph (2), by inserting before the pe22 riod the following: ‘‘or an individual with Alz23 heimer’s disease or a related disorder with neuro24 logical and organic brain dysfunction who is 50 

25 years of age or older’’; 


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1 (3) in paragraph (3)— 

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

3 appears and inserting ‘‘child (including an adult 

4 child with mental retardation or a related devel5 opmental disability)’’; 

6 (B) by striking ‘‘a child by blood or mar7 riage’’ and inserting ‘‘such a child by blood, 

8 marriage, or adoption’’; and 

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

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

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

12 (5) by inserting after paragraph (1) the fol13 lowing: 

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

15 ‘developmental disability’ has the meaning given the 

16 term in section 102 of the Developmental Disabil17 ities Assistance and Bill of Rights Act of 2000 (42 

18 U.S.C. 15002).’’. 

19 SEC. 31. CAREGIVER SUPPORT PROGRAM. 

20 Section 373 of the National Family Support Care21 giver Act (42 U.S.C. 3030s–1) is amended— 

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

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

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

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


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1 in making decisions and solving problems relating to 

2 their caregiving roles;’’; 

3 (2) in subsection (c)(2)— 

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

5 follows and inserting a period; and 

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

7 providing services for family caregivers under 

8 this subpart, the State shall give priority for 

9 services to family caregivers who provide care 

10 for older individuals.’’; and 

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

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

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

14 trained volunteers to expand the provision of the available 

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

16 work in coordination with entities carrying out volunteer 

17 programs (including programs administered by the Cor18 poration for National and Community Service) designed 

19 to provide training, placement, and stipends for volunteers 

20 in community service settings.’’; and 

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

22 the following: ‘‘The reports shall describe any mech23 anisms used in the State to provide to persons who 

24 are family caregivers, or grandparents or older indi25 viduals who are relative caregivers, information 


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1 about and access to various services so that the per2 sons can better carry out their care responsibil3 ities.’’; and 

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

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

6 2010, and 2011’’. 

7 SEC. 32. ACTIVITIES AND PROGRAMS OF NATIONAL SIG8 NIFICANCE. 

9 Section 376(a) of the National Family Support Care10 giver Act (42 U.S.C. 3030s–12(a)) is amended— 

11 (1) by striking the title heading and inserting 

12 the following: 

13 ‘‘SEC. 376. ACTIVITIES AND PROGRAMS OF NATIONAL SIG14 NIFICANCE.’’; 

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

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

17 (4) by striking ‘‘program’’ and inserting ‘‘ac18 tivities that include’’; 

19 (5) by striking ‘‘research.’’ and inserting ‘‘re20 search, and programs that include— 

21 ‘‘(1) multigenerational programs, including pro22 grams that provide supports for grandparents and 

23 other older individuals who are relative caregivers 

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

25 kinship navigator programs), and programs that 


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1 sustain and replicate innovative multigenerational 

2 family support programs involving volunteers who 

3 are older individuals; 

4 ‘‘(2) programs providing support and informa5 tion to families who have a child with a disability or 

6 chronic illness, and to other families in need of fam7 ily support programs; 

8 ‘‘(3) programs addressing unique issues faced 

9 by rural caregivers; 

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

11 individuals with Alzheimer’s disease and related de12 mentia and their caregivers; and 

13 ‘‘(5) programs supporting caregivers in the 

14 roles the caregivers carry out in health promotion 

15 and disease prevention.’’; and 

16 (6) by striking subsection (b). 

17 SEC. 33. GRANT PROGRAMS. 

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

19 U.S.C. 3032) is amended— 

20 (1) in subsection (a)— 

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

22 the end; 

23 (B) by redesignating paragraph (9) as 

24 paragraph (11); and 


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

2 following: 

3 ‘‘(9) planning activities to prepare communities 

4 for the aging of the population, which activities may 

5 include— 

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

7 ‘‘(B) activities to coordinate the activities 

8 of State and local agencies in order to meet the 

9 needs of older individuals; and 

10 ‘‘(C) training and technical assistance to 

11 support States, area agencies on aging, and 

12 tribal organizations receiving grants under part 

13 A of title VI, in engaging in community plan14 ning activities; and 

15 ‘‘(10) the development, implementation, and as16 sessment of technology-based service models and 

17 best practices, to support the use of health moni18 toring and assessment technologies, communication 

19 devices, assistive technologies, and other technologies 

20 that may remotely connect family and professional 

21 caregivers to frail older individuals residing in home 

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

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

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

25 (42 U.S.C. 3032a(a)) is amended to read as follows: 


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

2 grants to institutions of higher education, including his3 torically Black colleges or universities, Hispanic-serving 

4 institutions, Hispanic Centers of Excellence in Applied 

5 Gerontology, and other educational institutions that serve 

6 the needs of minority students, to provide education and 

7 training that prepare students for careers in the field of 

8 aging.’’. 

9 SEC. 35. HEALTH CARE SERVICE DEMONSTRATION 

10 PROJECTS IN RURAL AREAS. 

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

12 U.S.C. 3032c) is amended— 

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

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

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

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

17 SEC. 36. TECHNICAL ASSISTANCE AND INNOVATION TO IM18 PROVE TRANSPORTATION FOR OLDER INDI19 VIDUALS. 

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

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


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

2 IMPROVE TRANSPORTATION FOR OLDER IN3 DIVIDUALS. 

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

5 or contracts to nonprofit organizations to improve trans6 portation services for older individuals. 

7 ‘‘(b) USE OF FUNDS.— 

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

9 receiving a grant or contract under subsection (a) 

10 shall use the funds received through such grant or 

11 contract to carry out a demonstration project, or to 

12 provide technical assistance to assist local transit 

13 providers, area agencies on aging, senior centers, 

14 and local senior support groups, to encourage and 

15 facilitate coordination of Federal, State, and local 

16 transportation services and resources for older indi17 viduals. The organization may use the funds to de18 velop and carry out an innovative transportation 

19 demonstration project to create transportation serv20 ices for older individuals. 

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

22 demonstration project or providing technical assist23 ance under paragraph (1) the organization may 

24 carry out activities that include— 

25 ‘‘(A) developing innovative approaches for 

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1 portation services, including volunteer driver 

2 programs, economically sustainable transpor3 tation programs, and programs that allow older 

4 individuals to transfer their automobiles to a 

5 provider of transportation services in exchange 

6 for the services; 

7 ‘‘(B) preparing information on transpor8 tation options and resources for older individ9 uals and organizations serving such individuals, 

10 and disseminating the information by estab11 lishing and operating a toll-free telephone num12 ber; 

13 ‘‘(C) developing models and best practices 

14 for providing comprehensive integrated trans15 portation services for older individuals, includ16 ing services administered by the Secretary of 

17 Transportation, by providing ongoing technical 

18 assistance to agencies providing services under 

19 title III and by assisting in coordination of pub20 lic and community transportation services; and 

21 ‘‘(D) providing special services to link sen22 iors to transportation services not provided 

23 under title III. 

24 ‘‘(c) ECONOMICALLY SUSTAINABLE TRANSPOR25 TATION.—In this section, the term ‘economically sustainVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00068 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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1 able transportation’ means demand responsive transpor2 tation for older individuals— 

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

4 and 

5 ‘‘(2) that the provider will provide without re6 ceiving Federal or other public financial assistance, 

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

8 the services under this section.’’. 

9 SEC. 37. COMMUNITY PLANNING. 

10 Title IV of the Older Americans Act of 1965 is 

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

12 the following: 

13 ‘‘SEC. 416A. COMMUNITY PLANNING FOR THE AGING POPU14 LATION. 

15 ‘‘The Secretary may establish, either directly or 

16 through grants or contracts, a national technical assist17 ance program to assist States and area agencies on aging 

18 funded under this Act in planning efforts to prepare com19 munities for the aging of the population.’’. 

20 SEC. 38. DEMONSTRATION, SUPPORT, AND RESEARCH 

21 PROJECTS FOR MULTIGENERATIONAL AC22 TIVITIES AND CIVIC ENGAGEMENT ACTIVI23 TIES. 

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

25 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 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00072 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS 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 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00073 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS 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 

25 this section, including all required indicators deVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00103 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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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 

24 assistance to eligible employees regarding man25 agement practices using methods that are demVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00121 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS S3570

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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 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00127 Fmt 6652 Sfmt 6401 E:\BILLS\S3570.RS 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.’’. 

12 SECTION 1. SHORT TITLE. 

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

14 Amendments of 2006’’. 

15 SEC. 2. DEFINITIONS. 

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

17 U.S.C. 3002) is amended— 

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

19 ‘‘(D) evidence-based health promotion pro20 grams, including programs related to the preven21 tion and mitigation of the effects of chronic dis22 ease (including osteoporosis, hypertension, obe23 sity, diabetes, and cardiovascular disease), alco24 hol and substance abuse reduction, smoking ces25 sation, weight loss and control, stress manageVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00131 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 ment, falls prevention, physical activity, and im2 proved nutrition;’’; 

3 (2) by striking paragraph (24) and inserting the 

4 following: 

5 ‘‘(24) The term ‘exploitation’ means the fraudu6 lent or otherwise illegal, unauthorized, or improper 

7 act or process of an individual, including a caregiver 

8 or fiduciary (as such terms are defined in section 

9 751), that uses the resources of an older individual for 

10 monetary or personal benefit, profit, or gain, or that 

11 results in depriving an older individual of rightful 

12 access to, or use of, benefits, resources, belongings, or 

13 assets.’’; 

14 (3) in paragraph (29)(E)— 

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

16 end; 

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

18 the end and inserting ‘‘; and’’; and 

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

20 ‘‘(iii) older individuals at risk for in21 stitutional placement.’’; 

22 (4) in paragraph (32)(D), by inserting ‘‘, includ23 ing an assisted living facility,’’ after ‘‘home’’; 

24 (5) by striking paragraph (34) and inserting the 

25 following: 


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1 ‘‘(34)(A) The term ‘neglect’ means— 

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

3 (as such terms are defined in section 751) to pro4 vide the goods or services that are necessary to 

5 maintain the health or safety of an older indi6 vidual; or 

7 ‘‘(ii) self-neglect. 

8 ‘‘(B) The term ‘self-neglect’ means an adult’s in9 ability, due to physical or mental impairment or di10 minished capacity, to perform essential self-care tasks 

11 including— 

12 ‘‘(i) obtaining essential food, clothing, shel13 ter, and medical care; 

14 ‘‘(ii) obtaining goods and services necessary 

15 to maintain physical health, mental health, or 

16 general safety; or 

17 ‘‘(iii) managing one’s own financial af18 fairs.’’; and 

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

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

21 Center’ means a center established by a State as part 

22 of the State system of long-term care, to provide a co23 ordinated system for providing— 


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1 ‘‘(A) comprehensive information on avail2 able public and private long-term care programs, 

3 options, and resources; 

4 ‘‘(B) personal counseling to assist individ5 uals in assessing their existing or anticipated 

6 long-term care needs, and developing and imple7 menting a plan for long-term care designed to 

8 meet their specific needs and circumstances; and 

9 ‘‘(C) consumer access to the range of pub10 licly-supported long-term care programs for 

11 which consumers may be eligible, by serving as 

12 a convenient point of entry for such programs. 

13 ‘‘(45) The term ‘at risk for institutional place14 ment’ means, with respect to an older individual, that 

15 such individual is unable to perform at least 2 activi16 ties of daily living without substantial assistance (in17 cluding verbal reminding, physical cuing, or super18 vision), including such an older individual that is de19 termined by the State involved to be in need of place20 ment in a long-term care facility. 

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

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

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


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1 ‘‘(47) Except as provided in section 751, the 

2 term ‘long-term care’ means any services, care, or 

3 items (including assistive devices) that are— 

4 ‘‘(A) intended to assist individuals in cop5 ing with, and to the extent practicable compen6 sating for, functional impairments in carrying 

7 out activities of daily living; 

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

9 care setting (including a small community care 

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

11 large community care setting as defined in sub12 section (h)(1), of section 1929 of the Social Secu13 rity Act (42 U.S.C. 1396t)), or in a long-term 

14 care facility; and 

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

16 cure a medical disease or condition. 

17 ‘‘(48) The term ‘self-directed care’ means an ap18 proach to providing services (including programs, 

19 benefits, supports, and technology) under this Act in20 tended to assist an older individual with activities of 

21 daily living, in which— 

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

23 duration, scope, provider, and location of such 

24 services) are planned, budgeted, and purchased 


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1 under the direction and control of such indi2 vidual; 

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

4 information and assistance as is necessary and 

5 appropriate to enable such individual to make 

6 informed decisions about the individual’s service 

7 options; 

8 ‘‘(C) the needs, capabilities, and preferences 

9 of such individual with respect to such services, 

10 and such individual’s ability to direct and con11 trol the individual’s receipt of such services, are 

12 assessed by the area agency on aging involved or 

13 the local provider agency; 

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

15 subparagraph (C), upon request, the area agency 

16 on aging assists such individual and the individ17 ual’s family, caregiver, or legal representative in 

18 developing— 

19 ‘‘(i) a plan of services for such indi20 vidual that specifies which services such in21 dividual will be responsible for directing; 

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

23 family members (and others whose partici24 pation is sought by such individual) in pro25 viding services under such plan; and 


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

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

3 agency involved provides for oversight of such in4 dividual’s self-directed receipt of services, includ5 ing steps to ensure the quality of services pro6 vided and the appropriate use of funds under 

7 this Act. 

8 ‘‘(49) The term ‘State system of long-term care’ 

9 means the Federal, State, and local programs and ac10 tivities administered by a State that provide, support, 

11 or facilitate access to long-term care to individuals in 

12 such State.’’. 

13 SEC. 3. OFFICE OF ELDER ABUSE PREVENTION AND SERV14 ICES. 

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

16 U.S.C. 3011) is amended by adding at the end the following: 

17 ‘‘(e)(1) In this subsection, the terms defined in section 

18 751 shall have the meanings given those terms in that sec19 tion. 

20 ‘‘(2) The Secretary is authorized to establish or des21 ignate within the Administration (as defined in section 

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

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

24 acting through the head of the Office of Elder Abuse Preven25 tion and Services to— 


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

2 long-term plan for— 

3 ‘‘(i) carrying out elder justice programs and 

4 activities relating to— 

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

6 treatment, intervention, and response; 

7 ‘‘(II) training of individuals regarding 

8 the matters described in subclause (I); and 

9 ‘‘(III) the improvement of the elder jus10 tice system in the United States; 

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

12 disseminating data relating to the abuse, neglect, 

13 and exploitation of elders (and, in the discretion 

14 of the Secretary, vulnerable adults), including 

15 collecting, maintaining, and disseminating such 

16 data under section 753 after consultation with 

17 the Attorney General and working with experts 

18 from the Department of Justice described in sec19 tion 753(b)(1); 

20 ‘‘(iii) disseminating information concerning 

21 best practices regarding, and providing training 

22 on, carrying out activities related to abuse, ne23 glect, and exploitation of elders (and, in the dis24 cretion of the Secretary, vulnerable adults); 


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1 ‘‘(iv) in conjunction with the necessary ex2 perts, conducting research related to abuse, ne3 glect, and exploitation of elders (and, in the dis4 cretion of the Secretary, vulnerable adults); 

5 ‘‘(v) providing technical assistance to States 

6 and other eligible entities that provide or fund 

7 the provision of the services described in subtitle 

8 B of title VII; and 

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

10 national incidence and prevalence of elder abuse, 

11 neglect, and exploitation in all settings; 

12 ‘‘(B) implement the overall policy and a strategy 

13 to carry out the plan described in subparagraph (A); 

14 and 

15 ‘‘(C) provide advice to the Secretary on elder jus16 tice issues and administer such programs relating to 

17 elder abuse, neglect, and exploitation as the Secretary 

18 determines to be appropriate. 

19 ‘‘(4) The Secretary, acting through the Assistant Sec20 retary, may issue such regulations as may be necessary to 

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

22 SEC. 4. FUNCTIONS OF THE ASSISTANT SECRETARY. 

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

24 U.S.C. 3012) is amended— 

25 (1) in subsection (a)— 


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1 (A) in paragraph (12)— 

2 (i) by striking ‘‘carry on’’ and insert3 ing the following: 

4 ‘‘(B) carry on’’; and 

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

6 the following: 

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

8 the Administrator of the Centers for Medicare & Med9 icaid Services to implement and build awareness of 

10 programs providing new benefits affecting older indi11 viduals; and’’; 

12 (B) by striking paragraph (20) and insert13 ing the following: 

14 ‘‘(20)(A) provide technical assistance and sup15 port for outreach and benefits enrollment assistance to 

16 support efforts— 

17 ‘‘(i) to inform older individuals with great18 est economic need, who may be eligible to par19 ticipate, but who are not participating, in Fed20 eral and State programs for which the individ21 uals are eligible, about the programs; and 

22 ‘‘(ii) to enroll the individuals in the pro23 grams; 

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

25 partners administering the Federal programs, make a 


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1 grant to or enter into a contract with a qualified, ex2 perienced entity to establish a National Center on 

3 Senior Benefits Outreach and Enrollment, which 

4 shall— 

5 ‘‘(i) maintain and update web-based deci6 sion support and enrollment tools, and inte7 grated, person-centered systems, designed to in8 form older individuals about the full range of 

9 benefits for which the individuals may be eligible 

10 under Federal and State programs; 

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

12 older individuals with greatest economic need 

13 and enroll the individuals in the programs; 

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

15 and Disability Resource Centers, and other pub16 lic and private State and community-based or17 ganizations, including faith-based organizations 

18 and coalitions, to serve as benefits enrollment 

19 centers for the programs; 

20 ‘‘(iv) develop and maintain an information 

21 clearinghouse on best practices and the most cost22 effective methods for finding and enrolling older 

23 individuals with greatest economic need in the 

24 programs; and 


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

2 Federal agency partners administering the Fed3 eral programs, training and technical assistance 

4 on the most effective outreach, screening, enroll5 ment, and follow-up strategies for the Federal 

6 and State programs.’’; 

7 (C) in paragraph (26)— 

8 (i) in subparagraph (D)— 

9 (I) by striking ‘‘gaps in’’; and 

10 (II) by inserting ‘‘(including serv11 ices that would permit such individ12 uals to receive long-term care in home 

13 and community-based settings)’’ after 

14 ‘‘individuals’’; and 

15 (ii) in subparagraph (E), by striking 

16 ‘‘and’’ at the end; 

17 (D) in paragraph (27), by striking the pe18 riod at the end and inserting ‘‘; and’’; and 

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

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

21 technical assistance to support the provision of evi22 dence-based disease prevention and health promotion 

23 services.’’; and 

24 (2) by striking subsections (b) and (c) and in25 serting the following: 


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1 ‘‘(b) To promote the development and implementation 

2 of comprehensive, coordinated systems at Federal, State, 

3 and local levels that enable older individuals to receive long4 term care in home and community-based settings, in a 

5 manner responsive to the needs and preferences of the older 

6 individuals and their family caregivers, the Assistant Sec7 retary shall, consistent with the applicable provisions of 

8 this title— 

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

10 other Federal agencies and departments (other than 

11 the Administration on Aging) responsible for formu12 lating and implementing programs, benefits, and 

13 services related to providing long-term care, and may 

14 make grants, contracts, and cooperative agreements 

15 with funds received from those other Federal agencies 

16 and departments; 

17 ‘‘(2) conduct research and demonstration projects 

18 to identify innovative, cost-effective strategies for 

19 modifying State systems of long-term care to— 

20 ‘‘(A) respond to the needs and preferences of 

21 older individuals and family caregivers; 

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

23 for institutional placement, to permit such indi24 viduals to remain in home and community-based 

25 settings; and 


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

2 implementation (through area agencies on aging, 

3 service providers, and such other entities as the 

4 Assistant Secretary determines to be appro5 priate) of evidence-based programs to assist older 

6 individuals and their family caregivers in learn7 ing about and making behavioral changes in8 tended to reduce the risk of injury, disease, and 

9 disability among older individuals; 

10 ‘‘(3) facilitate, in coordination with the Admin11 istrator of the Centers for Medicare & Medicaid Serv12 ices, the provision of such care through self-directed 

13 care models that— 

14 ‘‘(A) provide for the assessment of the needs 

15 and preferences of an individual at risk for in16 stitutional placement to help such individual 

17 avoid unnecessary institutional placement and 

18 depletion of income and assets to qualify for ben19 efits under the Medicaid program under title 

20 XIX of the Social Security Act (42 U.S.C. 1396 

21 et seq.); 

22 ‘‘(B) respond to the needs and preferences of 

23 such individual and provide the option— 


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

2 control the receipt of supportive services 

3 provided; or 

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

5 was appointed by the individual, or is le6 gally acting on the individual’s behalf, in 

7 order to represent or advise the individual 

8 in financial or service coordination matters 

9 (referred to in this paragraph as a ‘rep10 resentative’ of the individual), to direct and 

11 control the receipt of those services; and 

12 ‘‘(C) assist an older individual (or, as ap13 propriate, a representative of the individual) to 

14 develop a plan for long-term support, including 

15 selecting, budgeting for, and purchasing home 

16 and community-based long-term care and sup17 portive services; 

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

19 lead role with respect to issues concerning home and 

20 community-based long-term care, including— 

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

22 President determines to be appropriate) or other23 wise participating in departmental and inter24 departmental activities concerning long-term 

25 care; and 


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1 ‘‘(B) reviewing and commenting on depart2 mental rules, regulations, and policies related to 

3 providing long-term care; and 

4 ‘‘(C) making recommendations to the Sec5 retary with respect to home and community6 based long-term care, including recommendations 

7 based on findings made through projects con8 ducted under paragraph (2); 

9 ‘‘(5) promote, in coordination with other appro10 priate Federal agencies— 

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

12 the importance of planning in advance for long13 term care; and 

14 ‘‘(B) the availability of information and re15 sources to assist in such planning; 

16 ‘‘(6) implement in each State an Aging and Dis17 ability Resource Center— 

18 ‘‘(A) to serve as a visible and trusted source 

19 of information on the full range of options for 

20 long-term care, including both institutional and 

21 home and community-based care, that are avail22 able in the State; 

23 ‘‘(B) to provide personalized and consumer24 friendly assistance to empower individuals to 


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1 make informed decisions about their long-term 

2 care options; 

3 ‘‘(C) to provide coordinated and stream4 lined access to all publicly funded long-term care 

5 options so that consumers can obtain the care 

6 they need through a single intake, assessment, 

7 and eligibility determination process; 

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

9 their long-term care needs; and 

10 ‘‘(E) to assist, in coordination with the en11 tity carrying out the health insurance informa12 tion, counseling, and assistance program (receiv13 ing funding under section 4360 of the Omnibus 

14 Budget Reconciliation Act of 1990 (42 U.S.C. 

15 1395b–4)) in the State, beneficiaries, and pro16 spective beneficiaries, under the Medicare pro17 gram established under title XVIII of the Social 

18 Security Act (42 U.S.C. 1395 et seq.) in under19 standing and accessing prescription drug and 

20 preventative health benefits under the provisions 

21 of, and amendments made by, the Medicare Pre22 scription Drug, Improvement, and Moderniza23 tion Act of 2003; 

24 ‘‘(7) establish, either directly or through grants 

25 or contracts, a national technical assistance program 


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

2 community-based service providers funded under this 

3 Act in implementing home and community-based 

4 long-term care systems, including evidence-based pro5 grams; 

6 ‘‘(8) develop, in collaboration with the Adminis7 trator of the Centers for Medicare & Medicaid Serv8 ices, performance standards and measures for use by 

9 States to determine the extent to which their State 

10 systems of long-term care fulfill the objectives de11 scribed in this subsection; and 

12 ‘‘(9) conduct such other activities as the Assist13 ant Secretary determines to be appropriate. 

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

15 the Chief Executive Officer of the Corporation for National 

16 and Community Service, shall— 

17 ‘‘(1) encourage and permit volunteer groups (in18 cluding organizations carrying out national service 

19 programs and including organizations of youth in 

20 secondary or postsecondary school) that are active in 

21 supportive services and civic engagement to partici22 pate and be involved individually or through rep23 resentative groups in supportive service and civic en24 gagement programs or activities to the maximum ex25 tent feasible; 


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1 ‘‘(2) develop a comprehensive strategy for uti2 lizing older individuals to address critical local needs 

3 of national concern; and 

4 ‘‘(3) encourage other community capacity-build5 ing initiatives involving older individuals.’’. 

6 SEC. 5. FEDERAL AGENCY CONSULTATION. 

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

8 U.S.C. 3013) is amended— 

9 (1) in subsection (a)(3)(A)— 

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

11 to low-income minority older individuals and 

12 older individuals residing in rural areas)’’ and 

13 inserting ‘‘(with particular attention to low-in14 come older individuals, including low-income 

15 minority older individuals, older individuals 

16 with limited English proficiency, and older indi17 viduals residing in rural areas)’’; and 

18 (B) by striking ‘‘section 507’’ and inserting 

19 ‘‘section 516’’; 

20 (2) in subsection (b)— 

21 (A) in paragraph (17), by striking ‘‘and’’ 

22 at the end; 

23 (B) in paragraph (18), by striking the pe24 riod and inserting ‘‘, and’’; and 

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


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1 ‘‘(19) sections 4 and 5 of the Assistive Tech2 nology Act of 1998 (29 U.S.C. 3003, 3004).’’; and 

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

4 ‘‘(c)(1) The Secretary, in collaboration with the Sec5 retary of Housing and Urban Development and with the 

6 other Federal officials specified in paragraph (2), shall es7 tablish an interagency coordinating committee (referred to 

8 in this subsection as the ‘Committee’) focusing on the co9 ordination of agencies with respect to aging issues, particu10 larly issues related to demographic changes and housing 

11 needs among older individuals. 

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

13 Secretary of Labor, the Secretary of Housing and Urban 

14 Development, the Attorney General, the Secretary of Trans15 portation, the Secretary of the Treasury, the Secretary of 

16 Agriculture, the Commissioner of Social Security, the Sur17 geon General, the Administrator of the Centers for Medicare 

18 & Medicaid Services, the Director of the Centers for Disease 

19 Control and Prevention, the Director of the National Insti20 tutes of Health, the Assistant Secretary for Children and 

21 Families, the Administrator of the National Highway Traf22 fic Safety Administration, and such other Federal officials 

23 as the Secretary of Health and Human Services determines 

24 to be appropriate. 


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

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

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

4 Secretary of Housing and Urban Development and the Sec5 retary of Health and Human Services shall alternate as 

6 chairpersons of the Committee, each serving as chairperson 

7 for a period of 2 years. 

8 ‘‘(4) The Committee shall— 

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

10 that assist older individuals in finding and affording 

11 housing, health care, and other services, including 

12 those Federal programs and services that assist older 

13 individuals in accessing health care, transportation, 

14 supportive services, and assistance with daily activi15 ties, at the place or close to the place where the older 

16 individuals live; 

17 ‘‘(B) monitor, evaluate, and recommend im18 provements in programs and services administered, 

19 funded, or financed by Federal, State, and local agen20 cies to assist older individuals in meeting their hous21 ing, health care, and other service needs and make 

22 any recommendations about how the agencies can bet23 ter carry out and provide the programs and services 

24 to house and serve older individuals; 

25 ‘‘(C) recommend ways to— 


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1 ‘‘(i) facilitate aging in place of older indi2 viduals, by identifying and making available the 

3 programs and services necessary to enable older 

4 individuals to remain in their homes as the indi5 viduals age; 

6 ‘‘(ii) reduce duplication by Federal agencies 

7 of programs and services to assist older individ8 uals in meeting their housing, health care, and 

9 other service needs; 

10 ‘‘(iii) ensure collaboration among and with11 in agencies in providing and making available 

12 the programs and services so that older individ13 uals are able to easily access needed programs 

14 and services; 

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

16 housing, health care, and other services to older 

17 individuals by— 

18 ‘‘(I) holding individual meetings with 

19 State representatives; 

20 ‘‘(II) providing ongoing technical as21 sistance to States about better meeting the 

22 needs of older individuals; and 

23 ‘‘(III) working with States to designate 

24 State liaisons for the Committee; 


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1 ‘‘(v) identify model programs and services 

2 to assist older individuals in meeting their hous3 ing, health care, and other service needs, includ4 ing model— 

5 ‘‘(I) programs linking housing, health 

6 care, and other services; 

7 ‘‘(II) financing products offered by 

8 government, quasi-government, and private 

9 sector entities; and 

10 ‘‘(III) innovations in technology appli11 cations that give older individuals access to 

12 information on available services or that 

13 help in providing services to older individ14 uals; 

15 ‘‘(vi) collect and disseminate information 

16 about older individuals and the programs and 

17 services available to the individuals to ensure 

18 that the individuals can access comprehensive in19 formation; and 

20 ‘‘(vii) work with the Federal Interagency 

21 Forum on Aging-Related Statistics, the Bureau 

22 of the Census, and member agencies— 

23 ‘‘(I) to collect and maintain data relat24 ing to the housing, health care, and other 

25 service needs of older individuals so that all 


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1 such data can be accessed in 1 place on a 

2 designated website; and 

3 ‘‘(II) to identify and address unmet 

4 data needs; 

5 ‘‘(D) make recommendations to guide policy and 

6 program development across Federal agencies with re7 spect to demographic changes among older individ8 uals; and 

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

10 all appropriate and interested parties, including pub11 lic health interest and research groups and founda12 tions about the activities described in subparagraphs 

13 (A) through (D). 

14 ‘‘(5) Each year, the Committee shall prepare and sub15 mit to the President, the Committee on Financial Services 

16 of the House of Representatives, the Committee on Edu17 cation and the Workforce of the House of Representatives, 

18 the Committee on Banking, Housing, and Urban Affairs 

19 of the Senate, the Committee on Health, Education, Labor, 

20 and Pensions of the Senate, and the Special Committee on 

21 Aging of the Senate, a report that— 

22 ‘‘(A) describes the activities and accomplish23 ments of the Committee in working with Federal, 

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1 tions, in coordinating programs and services to meet 

2 the requirements of paragraph (4); 

3 ‘‘(B) assesses the level of Federal assistance re4 quired to meet the needs described in paragraph (4); 

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

6 each agency that is a member of the interagency co7 ordinating committee established under paragraph (1) 

8 that describes the barriers and impediments, includ9 ing barriers and impediments in statutory and regu10 latory law, to the access and use by older individuals 

11 of programs and services administered by such agen12 cy; and 

13 ‘‘(D) makes recommendations for appropriate 

14 legislative and administrative actions to meet the 

15 needs described in paragraph (4) and for coordi16 nating programs and services designed to meet those 

17 needs. 

18 ‘‘(6)(A) The Secretary of Health and Human Services, 

19 after consultation with the Secretary of Housing and Urban 

20 Development, shall appoint an executive director of the 

21 Committee. 

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

23 Government employee may be detailed to the Committee 

24 without reimbursement, and such detail shall be without 

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


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1 SEC. 6. ADMINISTRATION. 

2 Section 205(a) of the Older Americans Act of 1965 (42 

3 U.S.C. 3016(a)) is amended— 

4 (1) in paragraph (1)— 

5 (A) in subparagraph (C), by adding ‘‘and’’ 

6 at the end; 

7 (B) in subparagraph (D), by striking ‘‘; 

8 and’’ at the end and inserting a period; and 

9 (C) by striking subparagraph (E); and 

10 (2) in paragraph (2)— 

11 (A) in subparagraph (A)— 

12 (i) by amending clause (i) to read as 

13 follows: 

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

15 evidence-based programs to support improved nutri16 tion and regular physical activity for older individ17 uals;’’; 

18 (ii) by amending clause (iii) to read as 

19 follows: 

20 ‘‘(iii) conducting outreach and disseminating 

21 evidence-based information to nutrition service pro22 viders about the benefits of healthful diets and regular 

23 physical activity, including information about the 

24 most current Dietary Guidelines for Americans pub25 lished under section 301 of the National Nutrition 

26 Monitoring and Related Research Act of 1990 (7 


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1 U.S.C. 5341), the Food Guide Pyramid published by 

2 the Secretary of Agriculture, and advances in nutri3 tion science;’’; 

4 (iii) in clause (vii) by striking ‘‘and’’ 

5 at the end; and 

6 (iv) by striking clause (viii) and in7 serting the following: 

8 ‘‘(viii) disseminating guidance that describes 

9 strategies for improving the nutritional quality of 

10 meals provided under title III; and 

11 ‘‘(ix) providing technical assistance to the re12 gional offices of the Administration with respect to 

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

14 and 

15 (B) by amending subparagraph (C)(i) to 

16 read as follows: 

17 ‘‘(i) have expertise in nutrition and meal plan18 ning; and’’. 

19 SEC. 7. EVALUATION. 

20 Section 206(g) of the Older Americans Act of 1965 (42 

21 U.S.C. 3017(g)) is amended by striking the first sentence 

22 and inserting the following: ‘‘From the total amount appro23 priated for each fiscal year to carry out title III, the Sec24 retary may use such sums as may be necessary, but not 

more than 1 25 ⁄2 of 1 percent of such amount, for purposes 


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1 of conducting evaluations under this section, either directly 

2 or by grant or contract.’’. 

3 SEC. 8. REPORTS. 

4 Section 207(b)(2) of the Older Americans Act of 1965 

5 (42 U.S.C. 3018(b)(2)) is amended— 

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

7 and inserting ‘‘the Workforce’’; and 

8 (2) in subparagraph (C), by striking ‘‘Labor and 

9 Human Resources’’ and inserting ‘‘Health, Edu10 cation, Labor, and Pensions’’. 

11 SEC. 9. CONTRACTUAL, COMMERCIAL, AND PRIVATE PAY 

12 RELATIONSHIPS; APPROPRIATE USE OF ACT 

13 FUNDS. 

14 (a) PRIVATE PAY RELATIONSHIPS; APPROPRIATE USE

15 OF ACT FUNDS.—Section 212 of the Older Americans Act 

16 (42 U.S.C. 3020c) is amended to read as follows: 

17 ‘‘SEC. 212. CONTRACTING AND GRANT AUTHORITY; PRIVATE 

18 PAY RELATIONSHIPS; APPROPRIATE USE OF 

19 FUNDS. 

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

21 shall not be construed to prevent a recipient of a grant or 

22 a contract under this Act from entering into an agree23 ment— 

24 ‘‘(1) with a profitmaking organization; 


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

2 grant or contract are used to pay part or all of a cost 

3 (including an administrative cost) incurred by such 

4 recipient to carry out a contract or commercial rela5 tionship for the benefit of older individuals or their 

6 family caregivers, whether such contract or relation7 ship is carried out to implement a provision of this 

8 Act or to conduct activities inherently associated with 

9 implementing such provision; or 

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

11 age or income (including the family caregiver of such 

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

13 may voluntarily pay, such individual’s own private 

14 expense, to receive such services based on the fair 

15 market value of such services. 

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

17 agreement described in subsection (a) may not— 

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

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

20 VI, without the prior recommendation of the Director 

21 of the Office for American Indian, Alaska Native, and 

22 Native Hawaiian Aging and the prior approval of the 

23 Assistant Secretary); 

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

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1 pensating an entity under such agreement in an 

2 amount that exceeds the fair market value of the goods 

3 or services furnished by such entity under such agree4 ment; 

5 ‘‘(3) result in the displacement of services other6 wise available to an older individual with greatest so7 cial need, an older individual with greatest economic 

8 need, or an older individual who is at risk for insti9 tutional placement; or 

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

11 or be inconsistent with the objective of serving the 

12 needs of older individuals, as determined by the As13 sistant Secretary.’’. 

14 SEC. 10. NUTRITION EDUCATION. 

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

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

17 ‘‘SEC. 214. NUTRITION EDUCATION. 

18 ‘‘The Assistant Secretary, in consultation with the Sec19 retary of Agriculture, shall conduct outreach and provide 

20 technical assistance to agencies and organizations that serve 

21 older individuals to assist such agencies and organizations 

22 to carry out integrated health promotion and disease pre23 vention programs that— 

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

25 ‘‘(2) include— 


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1 ‘‘(A) nutrition education; 

2 ‘‘(B) physical activity; and 

3 ‘‘(C) other activities to modify behavior and 

4 to improve health literacy, including providing 

5 information on optimal nutrient intake, through 

6 education and counseling in accordance with sec7 tion 339(2)(J).’’. 

8 SEC. 11. PENSION COUNSELING AND INFORMATION PRO9 GRAMS. 

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

11 U.S.C. 3020e–1) is amended— 

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

13 income retirees’’ and inserting ‘‘, low-income retirees, 

14 and older individuals with limited English pro15 ficiency’’; 

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

17 to read as follows: 

18 ‘‘(2) The ability of the entity to perform effective 

19 outreach to affected populations, particularly popu20 lations with limited English proficiency and other 

21 populations that are identified as in need of special 

22 outreach.’’; and 

23 (3) in subsection (h)(2), by inserting ‘‘(including 

24 individuals with limited English proficiency)’’ after 

25 ‘‘individuals’’. 


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1 SEC. 12. AUTHORIZATION OF APPROPRIATIONS. 

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

3 U.S.C. 3020f) is amended— 

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

5 2003, 2004, and 2005’’ and inserting ‘‘2007, 2008, 

6 2009, 2010, and 2011.’’; and 

7 (2) in subsections (b) and (c) by striking ‘‘year’’ 

8 and all that follows through ‘‘years’’, and inserting 

9 ‘‘years 2007, 2008, 2009, 2010, and 2011’’. 

10 SEC. 13. PURPOSE; ADMINISTRATION. 

11 Section 301(a)(2) of the Older Americans Act of 1965 

12 (42 U.S.C. 3021(a)(2)) is amended— 

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

14 the end; 

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

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

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

18 ‘‘(F) organizations with experience in providing 

19 senior volunteer services, such as Federal volunteer 

20 programs administered by the Corporation for Na21 tional and Community Service and designed to pro22 vide training, placement, and stipends for volunteers 

23 in community service settings.’’. 


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1 SEC. 14. AUTHORIZATION OF APPROPRIATIONS; USES OF 

2 FUNDS. 

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

4 U.S.C. 3023) is amended— 

5 (1) in subsections (a)(1), (b), and (d), by strik6 ing ‘‘year 2001’’ and all that follows through ‘‘years’’ 

7 each place it appears, and inserting ‘‘years 2007, 

8 2008, 2009, 2010, and 2011’’; and 

9 (2) in subsection (e)— 

10 (A) in paragraph (1) by striking 

11 ‘‘$125,000,000’’ and all that follows and insert12 ing ‘‘$160,000,000 for fiscal year 2007.’’; and 

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

14 sums’’ and all that follows and inserting 

15 ‘‘$170,000,000 for fiscal year 2008, $180,000,000 

16 for fiscal year 2009, $190,000,000 for fiscal year 

17 2010, and $200,000,000 for fiscal year 2011.’’. 

18 SEC. 15. ALLOTMENTS. 

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

20 1965 (42 U.S.C. 3024(d)(1)(A)) is amended to read as fol21 lows: 

22 ‘‘(A)(i) such amount as the State agency deter23 mines, but not more than 10 percent thereof, shall be 

24 available for paying such percentage as the agency 

25 determines, but not more than 75 percent, of the cost 

26 of administration of area plans; and 


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

2 year among fiscal years 2007 through 2011 for which 

3 the amount appropriated under subsections (a) 

4 through (d) of section 303 is not less than 110 percent 

5 of that appropriated amount for fiscal year 2006, an 

6 amount equal to 1 percent of the State’s allotment 

7 shall be used by the area agencies on aging in the 

8 State to carry out the assessment described in section 

9 306(b);’’. 

10 SEC. 16. ORGANIZATION. 

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

12 U.S.C. 3025) is amended— 

13 (1) in subsection (a)— 

14 (A) in paragraph (1)(E)— 

15 (i) by striking ‘‘(with particular atten16 tion to low-income minority individuals 

17 and older individuals residing in rural 

18 areas)’’ each place it appears and inserting 

19 ‘‘(with particular attention to low-income 

20 older individuals, including low-income mi21 nority older individuals, older individuals 

22 with limited English proficiency, and older 

23 individuals residing in rural areas)’’; and 

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

25 (B) in paragraph (2)— 


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

2 with particular attention to low-income mi3 nority individuals and older individuals re4 siding in rural areas’’ and inserting ‘‘(with 

5 particular attention to low-income older in6 dividuals, including low-income minority 

7 older individuals, older individuals with 

8 limited English proficiency, and older indi9 viduals residing in rural areas)’’; and 

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

11 the period and inserting ‘‘; and’’; and 

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

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

14 section, promote the development and implementation 

15 of a State system of long-term care that is a com16 prehensive, coordinated system that enables older in17 dividuals to receive long-term care in home and com18 munity-based settings, in a manner responsive to the 

19 needs and preferences of the older individuals and 

20 their family caregivers, by— 

21 ‘‘(A) collaborating, coordinating, and con22 sulting with other agencies in such State respon23 sible for formulating, implementing, and admin24 istering programs, benefits, and services related 

25 to providing long-term care; 


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1 ‘‘(B) participating in any State government 

2 activities concerning long-term care, including 

3 reviewing and commenting on any State rules, 

4 regulations, and policies related to long-term 

5 care; 

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

8 modifying the State system of long-term care to 

9 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 agencies 

21 on aging, service providers, and such other 

22 entities as the State determines to be appro23 priate) programs to assist older individuals 

24 and their family caregivers in learning 

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1 tended to reduce the risk of injury, disease, 

2 and disability among older individuals; and 

3 ‘‘(D) providing for the availability and dis4 tribution (through public education campaigns, 

5 Aging and Disability Resource Centers, area 

6 agencies on aging, and other appropriate means) 

7 of information relating to— 

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

9 long-term care; and 

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

11 private long-term care programs, options, 

12 and resources.’’; and 

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

14 following: 

15 ‘‘(6) Nothing in this section shall prevent the Common16 wealth of Puerto Rico from designating, with the approval 

17 of the Assistant Secretary, a single planning and service 

18 area to cover all the older individuals in the Common19 wealth.’’. 

20 SEC. 17. AREA PLANS. 

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

22 U.S.C. 3026) is amended— 

23 (1) in subsection (a)— 

24 (A) in paragraph (1)— 


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

3 and older individuals residing in rural 

4 areas)’’ and inserting ‘‘(with particular at5 tention to low-income older individuals, in6 cluding low-income minority older individ7 uals, older individuals with limited English 

8 proficiency, and older individuals residing 

9 in rural 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 ‘‘individ21 uals) residing in such area,’’; 

22 (B) in paragraph (2)(A)— 

23 (i) by inserting after ‘‘transportation,’’ 

24 the following: ‘‘health services (including 

25 mental health services),’’; and 


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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 eligi8 ble)’’; 

9 (C) in paragraph (4)— 

10 (i) in subparagraph (A)— 

11 (I) by amending clause (i) to read 

12 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 indi19 viduals 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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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 ‘‘low6 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; and 

13 (II) in clause (i)— 

14 (aa) in subclause (V) by 

15 striking ‘‘with limited English16 speaking ability; and’’ and insert17 ing ‘‘with limited English pro18 ficiency;’’; and 

19 (bb) by adding at the end the 

20 following: 

21 ‘‘(VII) older individuals at risk for in22 stitutional placement; and’’; 

23 (D) in paragraph (5), by inserting ‘‘and in24 dividuals at risk for institutional placement’’ 

25 after ‘‘severe disabilities’’; 


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1 (E) in paragraph (6)— 

2 (i) in subparagraph (C)— 

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

4 ‘‘and’’ at the end; 

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

6 ‘‘and’’ at the end; and 

7 (III) by inserting after clause (ii) 

8 the following: 

9 ‘‘(iii) make use of trained volunteers in pro10 viding direct services delivered to older individ11 uals and individuals with disabilities needing 

12 such services and, if possible, work in coordina13 tion with entities carrying out volunteer pro14 grams (including programs administered by the 

15 Corporation for National and Community Serv16 ices) designed to provide training, placement, 

17 and stipends for volunteers in community service 

18 settings;’’; 

19 (ii) in subparagraph (D)— 

20 (I) by inserting ‘‘family care21 givers of such individuals,’’ after 

22 ‘‘Act,’’; and 

23 (II) by inserting ‘‘service pro24 viders, representatives of the business 

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


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

2 ‘‘(including mental health screening)’’ before 

3 ‘‘provided’’ each place it appears; 

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

5 ‘‘(7) provide that the area agency on aging shall, 

6 consistent with this section, facilitate the area-wide 

7 development and implementation of a comprehensive, 

8 coordinated system that enables older individuals to 

9 receive long-term care in home and community-based 

10 settings, in a manner responsive to the needs and 

11 preferences of the older individuals and their family 

12 caregivers, by— 

13 ‘‘(A) collaborating, coordinating, and con14 sulting with other local public and private agen15 cies and organizations responsible for admin16 istering programs, benefits, and services related 

17 to providing long-term care; 

18 ‘‘(B) conducting analyses and making rec19 ommendations with respect to strategies for 

20 modifying the local system of long-term care to 

21 better— 

22 ‘‘(i) respond to the needs and pref23 erences of older individuals and family 

24 caregivers; 


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

2 providers, of long-term care in home and 

3 community-based settings; 

4 ‘‘(iii) target services to older individ5 uals at risk for institutional placement, to 

6 permit such individuals to remain in home 

7 and community-based settings; and 

8 ‘‘(iv) implement (through the agency or 

9 service providers), evidence-based programs 

10 to assist older individuals and their family 

11 caregivers in learning about and making 

12 behavioral changes intended to reduce the 

13 risk of injury, disease, and disability 

14 among older individuals; and 

15 ‘‘(C) providing for the availability and dis16 tribution (through public education campaigns, 

17 Aging and Disability Resource Centers, and 

18 other appropriate means) of information relating 

19 to— 

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

21 long-term care; and 

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

23 private long-term care programs, options, 

24 and resources.’’; 

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


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1 (H) by redesignating paragraph (16) as 

2 paragraph (15); and 

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

4 ‘‘(16) provide assurances that funds received 

5 under this title will be used— 

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

7 older individuals giving priority to older indi8 viduals identified in paragraph (4)(A)(i); and 

9 ‘‘(B) in compliance with the assurances 

10 specified in paragraph (13) and the limitations 

11 specified in section 212(b); 

12 ‘‘(17) provide, to the extent feasible, for the fur13 nishing of services under this Act, consistent with self14 directed care; and 

15 ‘‘(18) include information detailing how the area 

16 agency on aging will coordinate activities, and de17 velop long-range emergency plans, with local and 

18 State emergency response agencies, relief organiza19 tions, local and State governments, and any other in20 stitutions that have responsibility for disaster relief 

21 service delivery.’’; 

22 (2) by redesignating subsections (b), (c), (d), and 

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

24 (3) by inserting after subsection (a) the fol25 lowing: 


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

2 may include in the area plan an assessment of how pre3 pared the area agency on aging and service providers in 

4 the planning and service area are for a change in the num5 ber of older individuals during the 10-year period following 

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

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

8 on aging shall include the assessment in the area plan. 

9 ‘‘(2) Such assessment may include— 

10 ‘‘(A) the projected change in the number of older 

11 individuals in the planning and service area; 

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

13 such individuals, including individuals with low in14 comes, individuals with greatest economic need, mi15 nority older individuals, older individuals residing in 

16 rural areas, and older individuals with limited 

17 English proficiency; 

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

19 and services provided by such area agency can be im20 proved, and how resource levels can be adjusted to 

21 meet the needs of the changing population of older in22 dividuals in the planning and service area; and 

23 ‘‘(D) an analysis of how the change in the num24 ber of individuals age 85 and older in the planning 


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1 and service area is expected to affect the need for sup2 portive services. 

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

4 government officials, State agencies, tribal organizations, or 

5 local entities, may make recommendations to government 

6 officials in the planning and service area and the State, 

7 on actions determined by the area agency to build the ca8 pacity in the planning and service area to meet the needs 

9 of older individuals for— 

10 ‘‘(A) health and human services; 

11 ‘‘(B) land use; 

12 ‘‘(C) housing; 

13 ‘‘(D) transportation; 

14 ‘‘(E) public safety; 

15 ‘‘(F) workforce and economic development; 

16 ‘‘(G) recreation; 

17 ‘‘(H) education; 

18 ‘‘(I) civic engagement; 

19 ‘‘(J) emergency preparedness; and 

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

21 agency.’’. 

22 SEC. 18. STATE PLANS. 

23 Section 307(a) of the Older Americans Act of 1965 (42 

24 U.S.C. 3027(a)) is amended— 


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

2 306(b)’’ and inserting ‘‘section 306(c)’’; 

3 (2) in paragraph (4), by striking ‘‘, with par4 ticular attention to low-income minority individuals 

5 and older individuals residing in rural areas’’ and 

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

7 minority older individuals, older individuals with 

8 limited English proficiency, and older individuals re9 siding in rural areas)’’; 

10 (3) by striking paragraph (15); 

11 (4) by redesignating paragraph (14) as para12 graph (15); 

13 (5) by inserting after paragraph (13) the fol14 lowing: 

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

16 year preceding the fiscal year for which such plan is 

17 prepared— 

18 ‘‘(A) identify the number of low-income mi19 nority older individuals in the State, including 

20 the number of low-income minority older indi21 viduals with limited English proficiency; and 

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

23 service needs of the low-income minority older 

24 individuals described in subparagraph (A), in25 cluding the plan to meet the needs of low-income 


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1 minority older individuals with limited English 

2 proficiency.’’; 

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

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

5 minority individuals and older individuals residing 

6 in rural areas)’’ each place it appears and inserting 

7 ‘‘(with particular attention to low-income older indi8 viduals, including low-income minority older individ9 uals, older individuals with limited English pro10 ficiency, and older individuals residing in rural 

11 areas)’’; and 

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

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

14 area agencies on aging will provide, to the extent fea15 sible, for the furnishing of services under this Act, 

16 consistent with self-directed care. 

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

18 of the State, an assessment of how prepared the State 

19 is, under the State’s statewide service delivery model, 

20 for a change in the number of older individuals dur21 ing the 10-year period following the fiscal year for 

22 which the plan is submitted. 

23 ‘‘(B) Such assessment may include— 

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

25 older individuals in the State; 


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

2 affect such individuals, including individuals 

3 with low incomes, individuals with great eco4 nomic need, minority older individuals, older in5 dividuals residing in rural areas, and older in6 dividuals with limited English proficiency; 

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

8 policies, and services provided by the State can 

9 be improved, including coordinating with area 

10 agencies on aging, and how resource levels can be 

11 adjusted to meet the needs of the changing popu12 lation of older individuals in the State; and 

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

14 number of individuals age 85 and older in the 

15 State is expected to affect the need for supportive 

16 services. 

17 ‘‘(29) The plan shall include information detail18 ing how the State will coordinate activities, and de19 velop long-range emergency preparedness plans, with 

20 area agencies on aging, local emergency response 

21 agencies, relief organizations, local governments, State 

22 agencies responsible for emergency preparedness, and 

23 any other institutions that have responsibility for dis24 aster relief service delivery. 


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1 ‘‘(30) The plan shall include information de2 scribing the involvement of the head of the State agen3 cy in the development, revision, and implementation 

4 of emergency preparedness plans, including the State 

5 Public Health Emergency Preparedness and Response 

6 Plan.’’. 

7 SEC. 19. PAYMENTS. 

8 Section 309(b)(2) of the Older Americans Act of 1965 

9 (42 U.S.C. 3029(b)(2)) is amended by striking ‘‘the non10 Federal share required prior to fiscal year 1981’’ and in11 serting ‘‘10 percent of the cost of the services specified in 

12 section 304(d)(1)(D)’’. 

13 SEC. 20. NUTRITION SERVICES INCENTIVE PROGRAM. 

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

15 U.S.C. 3030a) is amended— 

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

17 following: 

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

19 shall promptly and equitably disburse amounts received 

20 under this subsection to recipients of grants and contracts.’’; 

21 (2) in subsection (c)— 

22 (A) in paragraph (1), by inserting ‘‘, in23 cluding bonus commodities,’’ after ‘‘agricultural 

24 commodities’’; 


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1 (B) in paragraph (2), by inserting ‘‘, in2 cluding bonus commodities,’’ after ‘‘food com3 modities’’; and 

4 (C) in paragraph (3), by inserting ‘‘, in5 cluding bonus commodities,’’ after ‘‘Dairy prod6 ucts’’; 

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

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

9 (4) in subsection (e), by striking ‘‘2001’’ and in10 serting ‘‘2007’’. 

11 SEC. 21. CONSUMER CONTRIBUTIONS. 

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

13 U.S.C. 3030c–2) is amended— 

14 (1) in subsection (b)— 

15 (A) in paragraph (1)— 

16 (i) by striking ‘‘provided that’’ and in17 serting ‘‘if’’; and 

18 (ii) by adding at the end the following: 

19 ‘‘Such contributions shall be encouraged for 

20 individuals whose self-declared income is at 

21 or above 200 percent of the poverty line, at 

22 contribution levels based on the actual cost 

23 of services.’’; and 


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

2 to supplement (not supplant) funds received 

3 under this Act’’ after ‘‘given’’; 

4 (2) in subsection (c)(2), by striking ‘‘(with par5 ticular attention to low-income minority individuals 

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

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

8 older individuals, including low-income minority 

9 older individuals, older individuals with limited 

10 English proficiency, and older individuals residing in 

11 rural areas)’’; and 

12 (3) in subsection (d), by striking ‘‘with par13 ticular attention to low-income and minority older 

14 individuals and older individuals residing in rural 

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

16 low-income older individuals, including low-income 

17 minority older individuals, older individuals with 

18 limited English proficiency, and older individuals re19 siding in rural areas)’’. 

20 SEC. 22. SUPPORTIVE SERVICES AND SENIOR CENTERS. 

21 Section 321(a) of the Older Americans Act of 1965 (42 

22 U.S.C. 3030d(a)) is amended— 

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

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


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1 (2) in paragraph (11) by striking ‘‘services’’ and 

2 inserting ‘‘provision of devices and services (including 

3 provision of assistive technology devices and assistive 

4 technology services)’’; 

5 (3) in paragraph (14)(B) by inserting ‘‘(includ6 ing mental health)’’ after ‘‘health’’; 

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

8 the end and inserting a semicolon; 

9 (5) by redesignating paragraph (23) as para10 graph (24); and 

11 (6) by inserting after paragraph (22) the fol12 lowing: 

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

14 agencies on aging, and local service providers in car15 rying out and coordinating activities for older indi16 viduals with respect to mental health services, includ17 ing outreach for, education concerning, and screening 

18 for such services, and referral to such services for 

19 treatment; and’’. 

20 SEC. 23. NUTRITION SERVICES. 

21 After the part heading of part C of title III of the Older 

22 Americans Act of 1965 (42 U.S.C. 3030e et seq.), insert the 

23 following: 


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1 ‘‘SEC. 330. PURPOSE. 

2 ‘‘It is the purpose of this part to promote socialization 

3 and the health and well-being of older individuals by assist4 ing such individuals to gain access to nutrition services to 

5 delay the onset of adverse health conditions.’’. 

6 SEC. 24. CONGREGATE NUTRITION PROGRAM. 

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

8 U.S.C. 3030e) is amended— 

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

10 ‘‘projects that—’’; 

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

12 first place it appears; 

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

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

15 following: 

16 ‘‘(3) provide nutrition education, nutrition coun17 seling, and other nutrition services, as appropriate, 

18 based on the needs of meal participants.’’. 

19 SEC. 25. HOME DELIVERED NUTRITION SERVICES. 

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

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

22 ‘‘SEC. 336. PROGRAM AUTHORIZED. 

23 ‘‘The Assistant Secretary shall establish and carry out 

24 a program to make grants to States under State plans ap25 proved under section 307 for the establishment and operVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00184 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 ation of nutrition projects for older individuals that pro2 vide— 

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

4 area where such frequency is not feasible (as defined 

5 by the Assistant Secretary by rule) and a lesser fre6 quency is approved by the State agency) at least 1 

7 home delivered meal per day, which may consist of 

8 hot, cold, frozen, dried, canned, fresh, or supplemental 

9 foods and any additional meals that the recipient of 

10 a grant or contract under this subpart elects to pro11 vide; and 

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

13 and other nutrition services as appropriate, based on 

14 the needs of meal recipients.’’. 

15 SEC. 26. CRITERIA. 

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

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

18 ‘‘SEC. 337. CRITERIA. 

19 ‘‘The Assistant Secretary, in consultation with recog20 nized experts in the fields of nutrition science, dietetics, 

21 meal planning and food service management, and aging, 

22 shall develop minimum criteria of efficiency and quality 

23 for the furnishing of home delivered meal services for 

24 projects described in section 336.’’. 


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1 SEC. 27. NUTRITION. 

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

3 U.S.C. 3030g–21) is amended— 

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

5 ‘‘(1) solicit the advice and expertise of a dieti6 tian or other individual with education and training 

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

8 available, an individual with comparable expertise in 

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

10 (2) in paragraph (2)— 

11 (A) in subparagraph (A)(i), to read as fol12 lows: 

13 ‘‘(i) comply with the most recent Die14 tary Guidelines for Americans, published by 

15 the Secretary and the Secretary of Agri16 culture, and’’; 

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

18 ‘‘joint’’ after ‘‘encourages’’; 

19 (C) in subparagraph (G), to read as follows: 

20 ‘‘(G) ensures that meal providers solicit the 

21 advice and expertise of— 

22 ‘‘(i) a dietitian or other individual de23 scribed in paragraph (1), 

24 ‘‘(ii) meal participants, and 


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1 ‘‘(iii) other individuals knowledgeable 

2 with regard to the needs of older individ3 uals,’’; 

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

5 at the end; and 

6 (E) in subparagraph (J), to read as follows: 

7 ‘‘(J) provides for nutrition screening and 

8 nutrition education, and nutrition assessment 

9 and counseling if appropriate; and 

10 ‘‘(K) encourages individuals who distribute 

11 nutrition services under subpart 2 to provide, to 

12 homebound older individuals, available medical 

13 information approved by health care profes14 sionals, such as informational brochures and in15 formation on how to get vaccines, including vac16 cines for influenza, pneumonia, and shingles, in 

17 the individuals’ communities.’’. 

18 SEC. 28. STUDY OF NUTRITION PROJECTS. 

19 (a) STUDY.— 

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

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

22 the Older Americans Act of 1965 (42 U.S.C. 3017(g)) 

23 to enter into a contract with the Food and Nutrition 

24 Board of the Institute of Medicine of the National 

25 Academy of Sciences, for the purpose of establishing 


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1 an independent panel of experts that will conduct an 

2 evidence-based study of the nutrition projects author3 ized under such Act. 

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

5 are available, include— 

6 (A) an evaluation of the effect of the nutri7 tion projects authorized by such Act on— 

8 (i) improvement of the health status, 

9 including nutritional status, of participants 

10 in the projects; 

11 (ii) prevention of hunger and food in12 security of the participants; and 

13 (iii) continuation of the ability of the 

14 participants to live independently; 

15 (B) a cost-benefit analysis of nutrition 

16 projects authorized by such Act, including the 

17 potential to affect costs of the Medicaid program 

18 under title XIX of the Social Security Act (42 

19 U.S.C. 1396 et seq.); and 

20 (C) an analysis of how nutrition projects 

21 authorized by such Act may be modified to im22 prove the outcomes described in subparagraph 

23 (A), including by improving the nutritional 

24 quality of the meals provided through the 

25 projects and undertaking other potential strateVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00188 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 gies to improve the nutritional status of the par2 ticipants. 

3 (b) REPORTS.— 

4 (1) REPORT TO THE ASSISTANT SECRETARY.— 

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

6 the Assistant Secretary a report containing the results 

7 of the evidence-based study described in subsection 

8 (a), including any recommendations resulting from 

9 the analysis described in subsection (a)(2)(C). 

10 (2) REPORT TO CONGRESS.—The Assistant Sec11 retary shall submit a report containing the results de12 scribed in paragraph (1) to the Committee on Edu13 cation and the Workforce of the House of Representa14 tives and the Committee on Health, Education, 

15 Labor, and Pensions of the Senate. 

16 (c) TIMING.—The Food and Nutrition Board shall es17 tablish the independent panel of experts described in sub18 section (a) not later than 90 days after the date of the enact19 ment of this Act. The panel shall submit the report described 

20 in subsection (b)(1) to the Assistant Secretary not later 

21 than 24 months after the date of the enactment of this Act. 


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1 SEC. 29. IMPROVING INDOOR AIR QUALITY IN BUILDINGS 

2 WHERE OLDER INDIVIDUALS CONGREGATE. 

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

4 U.S.C. 3030m) is amended by adding at the end the fol5 lowing: 

6 ‘‘(c) The Assistant Secretary shall work in consultation 

7 with qualified experts to provide information on methods 

8 of improving indoor air quality in buildings where older 

9 individuals congregate.’’. 

10 SEC. 30. CAREGIVER SUPPORT PROGRAM DEFINITIONS. 

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

12 U.S.C. 3030s) is amended— 

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

14 child with mental retardation or a related develop15 mental disability’’ after ‘‘age’’; 

16 (2) in paragraph (2), by inserting before the pe17 riod the following: ‘‘or an individual with Alzheimer’s 

18 disease or a related disorder with neurological and or19 ganic brain dysfunction who is 50 years of age or 

20 older’’; 

21 (3) in paragraph (3)— 

22 (A) by striking ‘‘child’’ the first place it ap23 pears and inserting ‘‘child (including an adult 

24 child with mental retardation or a related devel25 opmental disability)’’; 


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1 (B) by striking ‘‘a child by blood or mar2 riage’’ and inserting ‘‘such a child by blood, 

3 marriage, or adoption’’; and 

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

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

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

7 (5) by inserting after paragraph (1) the fol8 lowing: 

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

10 ‘developmental disability’ has the meaning given the 

11 term in section 102 of the Developmental Disabilities 

12 Assistance and Bill of Rights Act of 2000 (42 U.S.C. 

13 15002).’’. 

14 SEC. 31. CAREGIVER SUPPORT PROGRAM. 

15 Section 373 of the National Family Support Caregiver 

16 Act (42 U.S.C. 3030s–1) is amended— 

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

18 to assist’’ and all that follows through the end and in19 serting the following: ‘‘assist the caregivers in the 

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

21 in making decisions and solving problems relating to 

22 their caregiving roles;’’; 

23 (2) in subsection (c)(2)— 

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

25 follows and inserting a period; and 


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

2 providing services for family caregivers under 

3 this subpart, the State shall give priority for 

4 services to family caregivers who provide care for 

5 older individuals.’’; 

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

7 ‘‘(d) USE OF VOLUNTEERS.—In carrying out this sub8 part, each area agency on aging shall make use of trained 

9 volunteers to expand the provision of the available services 

10 described in subsection (b) and shall, if possible, work in 

11 coordination with entities carrying out volunteer programs 

12 (including programs administered by the Corporation for 

13 National and Community Service) designed to provide 

14 training, placement, and stipends for volunteers in commu15 nity service settings.’’; 

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

17 following: ‘‘The reports shall describe any mechanisms 

18 used in the State to provide to persons who are fam19 ily caregivers, or grandparents or older individuals 

20 who are relative caregivers, information about and 

21 access to various services so that the persons can bet22 ter carry out their care responsibilities.’’; and 

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

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

25 2010, and 2011’’. 


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1 SEC. 32. ACTIVITIES AND PROGRAMS OF NATIONAL SIGNIFI2 CANCE. 

3 Section 376(a) of the National Family Support Care4 giver Act (42 U.S.C. 3030s–12(a)) is amended— 

5 (1) by striking the title heading and inserting 

6 the following: 

7 ‘‘SEC. 376. ACTIVITIES AND PROGRAMS OF NATIONAL SIG8 NIFICANCE.’’; 

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

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

11 (4) by striking ‘‘program’’ and inserting ‘‘activi12 ties that include’’; 

13 (5) by striking ‘‘research.’’ and inserting ‘‘re14 search, and programs that include— 

15 ‘‘(1) multigenerational programs, including pro16 grams that provide supports for grandparents and 

17 other older individuals who are relative caregivers (as 

18 defined in section 372) raising children (such as kin19 ship navigator programs), and programs that sustain 

20 and replicate innovative multigenerational family 

21 support programs involving volunteers who are older 

22 individuals; 

23 ‘‘(2) programs providing support and informa24 tion to families who have a child with a disability or 

25 chronic illness, and to other families in need of family 

26 support programs; 


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1 ‘‘(3) programs addressing unique issues faced by 

2 rural caregivers; 

3 ‘‘(4) programs focusing on the needs of older in4 dividuals with Alzheimer’s disease and related demen5 tia and their caregivers; and 

6 ‘‘(5) programs supporting caregivers in the roles 

7 the caregivers carry out in health promotion and dis8 ease prevention.’’; and 

9 (6) by striking subsection (b). 

10 SEC. 33. GRANT PROGRAMS. 

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

12 U.S.C. 3032) is amended— 

13 (1) in subsection (a)— 

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

15 the end; 

16 (B) by redesignating paragraph (9) as 

17 paragraph (11); and 

18 (C) by inserting after paragraph (8) the fol19 lowing: 

20 ‘‘(9) planning activities to prepare communities 

21 for the aging of the population, which activities may 

22 include— 

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


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1 ‘‘(B) activities to coordinate the activities of 

2 State and local agencies in order to meet the 

3 needs of older individuals; and 

4 ‘‘(C) training and technical assistance to 

5 support States, area agencies on aging, and trib6 al organizations receiving grants under part A 

7 of title VI, in engaging in community planning 

8 activities; 

9 ‘‘(10) the development, implementation, and as10 sessment of technology-based service models and best 

11 practices, to support the use of health monitoring and 

12 assessment technologies, communication devices, as13 sistive technologies, and other technologies that may 

14 remotely connect family and professional caregivers to 

15 frail older individuals residing in home and commu16 nity-based settings or rural areas; and’’. 

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

18 Section 412(a) of the Older Americans Act of 1965 (42 

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

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

21 grants to institutions of higher education, including histori22 cally Black colleges or universities, Hispanic-serving insti23 tutions, Hispanic Centers of Excellence in Applied Geron24 tology, and other educational institutions that serve the 


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1 needs of minority students, to provide education and train2 ing that prepare students for careers in the field of aging.’’. 

3 SEC. 35. HEALTH CARE SERVICE DEMONSTRATION 

4 PROJECTS IN RURAL AREAS. 

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

6 U.S.C. 3032c) is amended— 

7 (1) in subsection (a), by inserting ‘‘mental health 

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

9 (2) in subsection (b)(1)(B)(i), by inserting ‘‘men10 tal health,’’ after ‘‘public health,’’. 

11 SEC. 36. TECHNICAL ASSISTANCE AND INNOVATION TO IM12 PROVE TRANSPORTATION FOR OLDER INDI13 VIDUALS. 

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

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

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

17 IMPROVE TRANSPORTATION FOR OLDER IN18 DIVIDUALS. 

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

20 or contracts to nonprofit organizations to improve trans21 portation services for older individuals. 

22 ‘‘(b) USE OF FUNDS.— 

23 ‘‘(1) IN GENERAL.—A nonprofit organization re24 ceiving a grant or contract under subsection (a) shall 

25 use the funds received through such grant or contract 


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1 to carry out a demonstration project, or to provide 

2 technical assistance to assist local transit providers, 

3 area agencies on aging, senior centers, and local sen4 ior support groups, to encourage and facilitate coordi5 nation of Federal, State, and local transportation 

6 services and resources for older individuals. The orga7 nization may use the funds to develop and carry out 

8 an innovative transportation demonstration project to 

9 create transportation services for older individuals. 

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

11 demonstration project or providing technical assist12 ance under paragraph (1) the organization may 

13 carry out activities that include— 

14 ‘‘(A) developing innovative approaches for 

15 improving access by older individuals to trans16 portation services, including volunteer driver 

17 programs, economically sustainable transpor18 tation programs, and programs that allow older 

19 individuals to transfer their automobiles to a 

20 provider of transportation services in exchange 

21 for the services; 

22 ‘‘(B) preparing information on transpor23 tation options and resources for older individ24 uals and organizations serving such individuals, 

25 and disseminating the information by estabVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00197 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 lishing and operating a toll-free telephone num2 ber; 

3 ‘‘(C) developing models and best practices 

4 for providing comprehensive integrated transpor5 tation services for older individuals, including 

6 services administered by the Secretary of Trans7 portation, by providing ongoing technical assist8 ance to agencies providing services under title 

9 III and by assisting in coordination of public 

10 and community transportation services; and 

11 ‘‘(D) providing special services to link sen12 iors to transportation services not provided 

13 under title III. 

14 ‘‘(c) ECONOMICALLY SUSTAINABLE TRANSPOR15 TATION.—In this section, the term ‘economically sustainable 

16 transportation’ means demand responsive transportation 

17 for older individuals— 

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

19 and 

20 ‘‘(2) that the provider will provide without re21 ceiving Federal or other public financial assistance, 

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

23 the services under this section.’’. 


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1 SEC. 37. COMMUNITY PLANNING. 

2 Title IV of the Older Americans Act of 1965 is amend3 ed by inserting after section 416 (42 U.S.C. 3032e) the fol4 lowing: 

5 ‘‘SEC. 416A. COMMUNITY PLANNING FOR THE AGING POPU6 LATION. 

7 ‘‘The Secretary may establish, either directly or 

8 through grants or contracts, a national technical assistance 

9 program to assist States and area agencies on aging funded 

10 under this Act in planning efforts to prepare communities 

11 for the aging of the population.’’. 

12 SEC. 38. DEMONSTRATION, SUPPORT, AND RESEARCH 

13 PROJECTS FOR MULTIGENERATIONAL AC14 TIVITIES AND CIVIC ENGAGEMENT ACTIVI15 TIES. 

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

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

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

19 PROJECTS FOR MULTIGENERATIONAL AC20 TIVITIES AND CIVIC ENGAGEMENT ACTIVI21 TIES. 

22 ‘‘(a) GRANTS AND CONTRACTS.—The Assistant Sec23 retary shall award grants and enter into contracts with eli24 gible organizations to— 

25 ‘‘(1) conduct productivity and cost-benefit re26 search to determine the effectiveness of engaging older 


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1 individuals in paid and unpaid positions with public 

2 and nonprofit organizations; 

3 ‘‘(2) develop a national agenda and blueprint for 

4 creating paid and unpaid positions for older individ5 uals with public and nonprofit organizations to in6 crease the capacity of the organizations to provide 

7 needed services to communities; 

8 ‘‘(3) carry out demonstration and support 

9 projects to provide older individuals with 

10 multigenerational activities, and civic engagement ac11 tivities, designed to meet critical community needs; 

12 and 

13 ‘‘(4) carry out demonstration projects to coordi14 nate multigenerational activities and civic engage15 ment activities, and facilitate development of and 

16 participation in multigenerational activities. 

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

18 use funds made available under a grant awarded, or a con19 tract entered into, under subsection (a)— 

20 ‘‘(1)(A) to conduct the research described in sub21 section (a)(1); 

22 ‘‘(B) to develop the national agenda and blue23 print described in subsection (a)(2); 

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

25 project described in subsection (a)(3); or 


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1 ‘‘(D) to carry out a demonstration project de2 scribed in subsection (a)(4); and 

3 ‘‘(2) to evaluate the project involved in accord4 ance with subsection (f). 

5 ‘‘(c) PREFERENCE.—In awarding grants and entering 

6 into contracts under subsection (a) to carry out a dem7 onstration or support project described in subsection (a)(3), 

8 the Assistant Secretary shall give preference to— 

9 ‘‘(1) eligible organizations with a demonstrated 

10 record of carrying out multigenerational activities or 

11 civic engagement activities; 

12 ‘‘(2) eligible organizations proposing 

13 multigenerational activity service projects that will 

14 serve older individuals and communities with the 

15 greatest need (with particular attention to low-income 

16 minority older individuals, older individuals with 

17 limited English proficiency, older individuals resid18 ing in rural areas, and low-income minority commu19 nities); 

20 ‘‘(3) eligible organizations proposing civic en21 gagement activity service projects that will serve com22 munities with the greatest need; and 

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

24 develop meaningful roles and assignments that use the 


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1 time, skills, and experience of older individuals to 

2 serve public and nonprofit organizations. 

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

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

5 submit an application to the Assistant Secretary at such 

6 time, in such manner, and accompanied by such informa7 tion as the Assistant Secretary may reasonably require. 

8 ‘‘(e) ELIGIBLE ORGANIZATIONS.—Organizations eligi9 ble to receive a grant or enter into a contract under sub10 section (a)— 

11 ‘‘(1) to carry out activities described in sub12 section (a)(1), shall be research or academic organiza13 tions with the capacity to conduct productivity and 

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

15 ‘‘(2) to carry out activities described in sub16 section (a)(2), shall be organizations with the capac17 ity to develop the national agenda and blueprint de18 scribed in subsection (a)(2); 

19 ‘‘(3) to carry out activities described in sub20 section (a)(3), shall be organizations that provide 

21 paid or unpaid positions for older individuals to 

22 serve in multigenerational activities, or civic engage23 ment activities, designed to meet critical community 

24 needs and use the full range of time, skills, and expe25 rience of older individuals; and 


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1 ‘‘(4) to carry out activities described in sub2 section (a)(4), shall be organizations with the capac3 ity to facilitate and coordinate activities as described 

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

5 multigenerational coordinators. 

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

7 ‘‘(1) EVALUATION.—Each organization receiving 

8 a grant or a contract under subsection (a) to carry 

9 out a demonstration or support project under sub10 section (a)(3) shall evaluate the multigenerational ac11 tivities or civic engagement activities assisted under 

12 the project to determine the effectiveness of the activi13 ties involved, the impact of such activities on the com14 munity being served and the organization providing 

15 the activities, and the impact of such activities on 

16 older individuals involved in such project. 

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

18 report to the Assistant Secretary containing the eval19 uation not later than 6 months after the expiration 

20 of the period for which the grant or contract is in ef21 fect. 

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

23 after the Assistant Secretary receives the reports described 

24 in subsection (f)(2), the Assistant Secretary shall prepare 

25 and submit to the Speaker of the House of Representatives 


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1 and the President pro tempore of the Senate a report that 

2 assesses the evaluations and includes, at a minimum— 

3 ‘‘(1) the names or descriptive titles of the dem4 onstration, support, and research projects funded 

5 under subsection (a); 

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

7 the projects; 

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

9 that conducted the projects; 

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

11 projects carried out under subsection (a)(3), a de12 scription of the methods and success of the projects in 

13 recruiting older individuals as employees and volun14 teers to participate in the projects; 

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

16 projects carried out under subsection (a)(3), a de17 scription of the success of the projects in retaining 

18 older individuals involved in the projects as employees 

19 and as volunteers; 

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

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

22 of turnover of older individual employees and volun23 teers in the projects; 


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1 ‘‘(7) a strategy for disseminating the findings re2 sulting from the projects described in paragraph (1); 

3 and 

4 ‘‘(8) any policy change recommendations relat5 ing to the projects. 

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

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

8 ‘civic engagement activity’ includes an opportunity 

9 that uses the time, skills, and experience of older indi10 viduals, in paid or unpaid positions with a public or 

11 nonprofit organization, to help address the unmet 

12 human, educational, health care, environmental, and 

13 public safety needs, and nurture and sustain active 

14 participation in community affairs. 

15 ‘‘(2) MULTIGENERATIONAL ACTIVITY.—The term 

16 ‘multigenerational activity’ includes an opportunity 

17 that uses the time, skills, and experience of older indi18 viduals, in paid or unpaid positions with a public or 

19 nonprofit organization, to serve as a mentor or ad20 viser in a child care program, a youth day care pro21 gram, an educational assistance program, an at-risk 

22 youth intervention program, a juvenile delinquency 

23 treatment program, a before- or after-school program, 

24 or a family support program. 


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1 ‘‘(3) MULTIGENERATIONAL COORDINATOR.—The 

2 term ‘multigenerational coordinator’ means a person 

3 who— 

4 ‘‘(A) builds the capacity of public and non5 profit organizations to develop meaningful roles 

6 and assignments, that use the time, skill, and ex7 perience of older individuals to serve those orga8 nizations; and 

9 ‘‘(B) nurtures productive, sustainable work10 ing relationships between— 

11 ‘‘(i) individuals from the generations 

12 with older individuals; and 

13 ‘‘(ii) individuals in younger genera14 tions.’’. 

15 SEC. 39. NATIVE AMERICAN PROGRAMS. 

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

17 1965 (42 U.S.C. 3032g)(a)(2)(B)(i)) is amended by insert18 ing ‘‘(including mental health)’’ after ‘‘health’’. 

19 SEC. 40. MULTIDISCIPLINARY CENTERS AND MULTIDISCI20 PLINARY SYSTEMS. 

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

22 U.S.C. 3032h) is amended— 

23 (1) by striking the title and inserting the fol24 lowing: 


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1 ‘‘SEC. 419. MULTIDISCIPLINARY CENTERS AND MULTIDISCI2 PLINARY SYSTEMS.’’; 

3 (2)(A) in subsection (b)(2), by redesignating sub4 paragraphs (A) through (G) as clauses (i) through 

5 (vii), respectively; 

6 (B) in subsection (c)(2), by redesignating sub7 paragraphs (A) through (D) as clauses (i) through 

8 (iv), respectively; and 

9 (C) by aligning the margins of the clauses de10 scribed in subparagraphs (A) and (B) with the mar11 gins of clause (iv) of section 418(a)(2)(A) of such Act; 

12 (3)(A) in subsection (b), by redesignating para13 graphs (1) and (2) as subparagraphs (A) and (B), re14 spectively; 

15 (B) in subsection (c), by redesignating para16 graphs (1) and (2) as subparagraphs (A) and (B), re17 spectively; and 

18 (C) by aligning the margins of the subpara19 graphs described in subparagraphs (A) and (B) with 

20 the margins of subparagraph (D) of section 420(a)(1) 

21 of such Act; 

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

23 that follows through ‘‘The’’ and inserting the fol24 lowing: 

25 ‘‘(a) MULTIDISCIPLINARY CENTERS.— 

26 ‘‘(1) PROGRAM AUTHORIZED.—The’’; 


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1 (5) in subsection (b)— 

2 (A) by striking the following: 

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

4 ‘‘(2) USE OF FUNDS.—’’; and 

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

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

7 (6) in subsection (c)— 

8 (A) by striking the following: 

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

10 ‘‘(3) DATA.—’’; 

11 (B) by striking ‘‘subsection (a)’’ and insert12 ing ‘‘paragraph (1)’’; 

13 (C) by striking ‘‘such subsection’’ and in14 serting ‘‘such paragraph’’; 

15 (D) by striking ‘‘paragraph (1)’’ and insert16 ing ‘‘subparagraph (A)’’; and 

17 (E) by striking ‘‘this section’’ and inserting 

18 ‘‘this subsection’’; and 

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

20 ‘‘(b) MULTIDISCIPLINARY HEALTH SERVICES IN COM21 MUNITIES.— 

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

23 Secretary shall make grants to States, on a competi24 tive basis, for the development and operation of— 


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

2 health screening and treatment services for older 

3 individuals who lack access to such services; and 

4 ‘‘(B) programs to— 

5 ‘‘(i) increase public awareness regard6 ing the benefits of prevention and treatment 

7 of mental disorders in older individuals; 

8 ‘‘(ii) reduce the stigma associated with 

9 mental disorders in older individuals and 

10 other barriers to the diagnosis and treat11 ment of the disorders; and 

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

13 discrimination regarding mental disorders 

14 in older individuals. 

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

16 grant under this subsection for a State, a State agen17 cy shall submit an application to the Assistant Sec18 retary at such time, in such manner, and containing 

19 such information as the Assistant Secretary may re20 quire. 

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

22 State agency that receives funds through a grant 

23 made under this subsection shall allocate the funds to 

24 area agencies on aging to carry out this subsection in 

25 planning and service areas in the State. In allocating 


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1 the funds, the State agency shall give priority to 

2 planning and service areas in the State— 

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

4 ‘‘(B) in which there are large numbers of 

5 older individuals. 

6 ‘‘(4) AREA COORDINATION OF SERVICES WITH

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

8 more efficiently and effectively deliver services to older 

9 individuals, each area agency on aging shall— 

10 ‘‘(A) coordinate services described in para11 graph (1) with other community agencies, and 

12 voluntary organizations, providing similar or re13 lated services; and 

14 ‘‘(B) to the greatest extent practicable, inte15 grate outreach and educational activities with 

16 existing (as of the date of the integration) health 

17 care and social service providers serving older 

18 individuals in the planning and service area in19 volved. 

20 ‘‘(5) RELATIONSHIP TO OTHER FUNDING

21 SOURCES.—Funds made available under this part 

22 shall supplement, and not supplant, any Federal, 

23 State, and local funds expended by a State or unit of 

24 general purpose local government (including an area 


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1 agency on aging) to provide the services described in 

2 paragraph (1). 

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

4 ‘mental health screening and treatment services’ 

5 means patient screening, diagnostic services, care 

6 planning and oversight, therapeutic interventions, 

7 and referrals, that are— 

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

9 intervention and treatment protocols (to the ex10 tent such protocols are available) for mental dis11 orders prevalent in older individuals; and 

12 ‘‘(B) coordinated and integrated with the 

13 services of social service, mental health, and 

14 health care providers in an area in order to— 

15 ‘‘(i) improve patient outcomes; and 

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

17 feasible, the continuing independence of 

18 older individuals who are residing in the 

19 area.’’. 

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

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

22 (42 U.S.C. 3031 et seq.) is amended by adding at the end 

23 the following: 


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

2 PLACE. 

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

4 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible enti5 ty’— 

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

7 service organization, a community-based non8 profit organization, an area agency on aging or 

9 other local government agency, a tribal organiza10 tion, or another entity that— 

11 ‘‘(i) the Assistant Secretary determines 

12 to be appropriate to carry out a project 

13 under this part; and 

14 ‘‘(ii) demonstrates a record of, and ex15 perience in, providing or administering 

16 group and individual health and social 

17 services for older individuals; and 

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

19 housing under the congregate housing services 

20 program carried out under section 802 of the 

21 Cranston-Gonzalez National Affordable Housing 

22 Act (42 U.S.C. 8011) or the multifamily service 

23 coordinator program carried out under section 

24 202(g) of the Housing Act of 1959 (12 U.S.C. 

25 1701q(g)). 


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1 ‘‘(2) NATURALLY OCCURRING RETIREMENT COM2 MUNITY.—The term ‘Naturally Occurring Retirement 

3 Community’ means a residential building, a housing 

4 complex, an area (including a rural area) of single 

5 family residences, or a neighborhood composed of age6 integrated housing— 

7 ‘‘(A) where— 

8 ‘‘(i) 40 percent of the heads of house9 holds are older individuals; or 

10 ‘‘(ii) a critical mass of older individ11 uals exists, based on local factors which, 

12 taken in total, allow an organization to 

13 achieve efficiencies in the provision of 

14 health and social services to older individ15 uals living in the community; and 

16 ‘‘(B) that is not an institutional care or as17 sisted living setting. 

18 ‘‘(b) GRANTS.— 

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

20 shall make grants to eligible entities to enable the en21 tities to pay for developing or carrying out model 

22 aging in place projects. The projects shall permit 

23 aging in place for older individuals, including such 

24 individuals who reside in Naturally Occurring Re25 tirement Communities, which help to sustain the 


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1 independence of older individuals in communities 

2 where the individuals have established personal, fam3 ily, and professional supportive networks. The entities 

4 shall provide comprehensive and coordinated health 

5 and social services through the projects. 

6 ‘‘(2) GRANT PERIODS.—The Assistant Secretary 

7 shall make the grants for periods of 3 years. 

8 ‘‘(c) APPLICATIONS.— 

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

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

11 shall submit an application to the Assistant Secretary 

12 at such time, in such manner, and containing such 

13 information as the Assistant Secretary may require. 

14 ‘‘(2) CONTENTS.—The application shall in15 clude— 

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

17 experience in providing services to older individ18 uals in age-integrated settings; 

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

20 area and a description of the project boundaries 

21 in which the older individuals reside or carry 

22 out activities to sustain their well-being; 

23 ‘‘(C) a description of how the entity will co24 operate and coordinate planning and services, 

25 with agencies and organizations that provide 


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1 publicly supported services for older individuals 

2 within the project boundaries, including the 

3 State agency and area agencies on aging with 

4 planning and service areas within the project 

5 boundaries; 

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

7 to establish cooperative relationships with inter8 ested local entities, including private agencies 

9 and businesses that provide health and social 

10 services, housing entities, community develop11 ment organizations, philanthropic organizations, 

12 foundations, and other non-Federal entities; 

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

14 for referral of residents who may require long15 term care services, including coordination with 

16 local information and referral agencies and 

17 Aging and Disability Resource Centers who serve 

18 as single points of entry to public services; 

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

20 offer opportunities for older individuals to be in21 volved in the governance, oversight, and oper22 ation of the project; 

23 ‘‘(G) an assurance that the entity will sub24 mit to the Assistant Secretary such evaluations 


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1 and reports as the Assistant Secretary may re2 quire; and 

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

4 the project. 

5 ‘‘(d) USE OF FUNDS.— 

6 ‘‘(1) IN GENERAL.—An eligible entity that re7 ceives a grant under subsection (b) shall use the funds 

8 made available through the grant to provide and co9 ordinate, through aging in place projects described in 

10 subsection (b), services that include a comprehensive 

11 and coordinated array of community-based health 

12 and social services, which may include mental health 

13 services, for eligible older individuals. 

14 ‘‘(2) SERVICES.—The services described in para15 graph (1) shall include— 

16 ‘‘(A) providing— 

17 ‘‘(i) case management, case assistance, 

18 and social work services; 

19 ‘‘(ii) health care management and 

20 health care assistance, including disease 

21 prevention and health promotion services; 

22 ‘‘(iii) education, socialization, and rec23 reational activities; and 

24 ‘‘(iv) volunteer opportunities for 

25 project participants; and 


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1 ‘‘(B) coordinating the services provided 

2 under title III for eligible older individuals 

3 served by the project. 

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

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

6 practicable, serve communities of low-income individ7 uals and operate or locate projects and services in or 

8 in close proximity to locations where large concentra9 tions of older individuals have aged in place and re10 sided, such as Naturally Occurring Retirement Com11 munities. 

12 ‘‘(4) SUPPLEMENT NOT SUPPLANT.—Funds made 

13 available to an eligible entity under this section shall 

14 be used to supplement, not supplant, any Federal, 

15 State, or other funds otherwise available to the entity 

16 to provide health and social services to eligible older 

17 individuals. 

18 ‘‘(e) COMPETITIVE GRANTS FOR TECHNICAL ASSIST19 ANCE.— 

20 ‘‘(1) GRANTS.—The Assistant Secretary shall (or 

21 shall make a grant, on a competitive basis, to an eli22 gible nonprofit organization, to enable the organiza23 tion to)— 

24 ‘‘(A) provide technical assistance to recipi25 ents of grants under subsection (b); and 


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

2 by the Assistant Secretary. 

3 ‘‘(2) ELIGIBLE ORGANIZATION.—To be eligible to 

4 receive a grant under this subsection, an organization 

5 shall be a nonprofit organization (including a part6 nership of nonprofit organizations), that— 

7 ‘‘(A) has experience and expertise in pro8 viding technical assistance to a range of entities 

9 serving older individuals and experience evalu10 ating and reporting on programs; and 

11 ‘‘(B) has demonstrated knowledge of and ex12 pertise in community-based health and social 

13 services. 

14 ‘‘(3) APPLICATION.—To be eligible to receive a 

15 grant under this subsection, an organization (includ16 ing a partnership of nonprofit organizations) shall 

17 submit an application to the Assistant Secretary at 

18 such time, in such manner, and containing such in19 formation as the Assistant Secretary may require, in20 cluding an assurance that the organization will sub21 mit to the Assistant Secretary such evaluations and 

22 reports as the Assistant Secretary may require. 

23 ‘‘(f) REPORT.—The Assistant Secretary shall annually 

24 prepare and submit a report to Congress that shall in25 clude— 


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1 ‘‘(1) the findings resulting from the evaluations 

2 of the model projects conducted under this section; 

3 ‘‘(2) a description of recommended best practices 

4 regarding carrying out health and social service 

5 projects for older individuals aging in place; and 

6 ‘‘(3) recommendations for legislative or adminis7 trative action, as the Assistant Secretary determines 

8 appropriate.’’. 

9 SEC. 42. CHOICES FOR INDEPENDENCE DEMONSTRATION 

10 PROJECTS. 

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

12 (42 U.S.C. 3031 et seq.), as amended by section 41, is fur13 ther amended by adding at the end the following: 

14 ‘‘SEC. 423. CHOICES FOR INDEPENDENCE DEMONSTRATION 

15 PROJECTS. 

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

17 ‘‘(1) CONSUMER.—The term ‘consumer’ means 

18 an older individual, a family member of such indi19 vidual, and any other person seeking information or 

20 assistance with respect to long-term care. 

21 ‘‘(2) HIGH-RISK INDIVIDUAL.—The term ‘high22 risk individual’ means an older individual who— 

23 ‘‘(A) has a functional impairment affecting 

24 the individual’s activities of daily living; 


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1 ‘‘(B) is ineligible for the Medicaid program 

2 under title XIX of the Social Security Act (42 

3 U.S.C. 1396 et seq.); and 

4 ‘‘(C) meets such income and functional sta5 tus criteria as are determined to be appropriate 

6 by the State involved and approved by the As7 sistant Secretary. 

8 ‘‘(3) QUALIFIED EXPENDITURES.—The term 

9 ‘qualified expenditures’ means reported expenditures 

10 of a State under this section that have been reviewed 

11 and approved by the Assistant Secretary. 

12 ‘‘(4) SERVICE COORDINATION.—The term ‘service 

13 coordination’ means a coordinated approach taken on 

14 behalf of high-risk older individuals to facilitate the 

15 development and implementation of a long-term care 

16 plan and the choice and independence of the individ17 uals in securing long-term care. 

18 ‘‘(b) AUTHORITY.—The Assistant Secretary shall make 

19 grants on a competitive basis, in accordance with this sec20 tion, to States to enable the States to pay for the Federal 

21 share of the cost of modifying their State systems of long22 term care in order to promote and facilitate— 

23 ‘‘(1) the choice and control of older individuals 

24 and their families in securing long-term care; 


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1 ‘‘(2) the coordination and cost-effectiveness of 

2 State systems of long-term care; 

3 ‘‘(3) the provision of long-term care in home and 

4 community-based settings; and 

5 ‘‘(4) the ability of individuals receiving long6 term care to remain as independent and self-sufficient 

7 as possible. 

8 ‘‘(c) APPLICATIONS BY STATES.—For a State to be eli9 gible to receive a grant under this section, the Governor of 

10 such State shall submit an application to the Assistant Sec11 retary, at such time, in such manner, and containing such 

12 information as the Assistant Secretary may specify, con13 taining a plan for implementation of the component strate14 gies described in subsection (d) and such other information 

15 and assurances as the Secretary determines to be appro16 priate. 

17 ‘‘(d) USE OF FUNDS BY STATES.— 

18 ‘‘(1) COMPONENT STRATEGIES.—A State that re19 ceives funds through a grant made under subsection 

20 (b) shall use the funds to carry out a demonstration 

21 project under this section (directly or by grant or con22 tract) by integrating into the State system of long23 term care the component strategies described in para24 graphs (2) through (5). 


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1 ‘‘(2) PUBLIC EDUCATION.—In carrying out the 

2 demonstration project, the State shall conduct activi3 ties that shall include media campaigns, targeted 

4 mailings, and related activities, to help ensure that 

5 consumers are aware of— 

6 ‘‘(A) the need to plan in advance for long7 term care; 

8 ‘‘(B) available public and private long-term 

9 care options, including private long-term care 

10 insurance; and 

11 ‘‘(C) sources of information and resources 

12 related to long-term care, including the resource 

13 centers described in paragraph (3). 

14 ‘‘(3) AGING AND DISABILITY RESOURCE CEN15 TERS.— 

16 ‘‘(A) IN GENERAL.—The State shall provide 

17 for community-level Aging and Disability Re18 source Centers, which, consistent with section 

19 102(47) and subsection (f), shall provide— 

20 ‘‘(i) comprehensive information on 

21 available public and private long-term care 

22 programs, options, and resources; 

23 ‘‘(ii) personal counseling and service 

24 coordination to assist consumers in assess25 ing their existing or anticipated long-term 


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1 care needs and circumstances, and devel2 oping and implementing a plan for long3 term care designed to meet their specific 

4 needs and circumstances; 

5 ‘‘(iii) a convenient point of entry to 

6 the range of publicly-supported long-term 

7 care programs for which an individual may 

8 be eligible, including the Medicaid program 

9 under title XIX of the Social Security Act 

10 (42 U.S.C. 1396 et seq.), and to such other 

11 public benefit programs as the State deter12 mines to be appropriate; 

13 ‘‘(iv) a single process for consumer in14 take, assessment, and application for bene15 fits under the programs described in clause 

16 (iii), including, where appropriate and fea17 sible, facilitating the determination of an 

18 individual’s eligibility (including facili19 tating that determination in compliance 

20 with the requirements of title XIX of the So21 cial Security Act) under such programs by 

22 collaborating with the appropriate pro23 grammatic office; and 

24 ‘‘(v) the ability— 


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1 ‘‘(I) to respond immediately to a 

2 request for assistance from an indi3 vidual or a family member of the indi4 vidual, in the event of a crisis situa5 tion that could result in placement of 

6 such individual in an institutional 

7 care setting; and 

8 ‘‘(II) to provide (or coordinate the 

9 provision of), such available short-term 

10 assistance as would be necessary and 

11 appropriate to temporarily preclude 

12 the need for such institutional place13 ment, until a plan for home and com14 munity-based long-term care can be de15 veloped and implemented. 

16 ‘‘(B) TRAINING.—In providing for the Cen17 ters, the State shall ensure that the staff of the 

18 Centers is appropriately trained to understand 

19 the interactions between private long-term care 

20 insurance (especially insurance through long21 term care partnership policies) and eligibility 

22 for benefits under the Medicaid program under 

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

24 1396 et seq.). 


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1 ‘‘(4) HEALTHY LIFESTYLE CHOICES.—The State 

2 shall, in accordance with standards established by the 

3 Assistant Secretary, provide for low-cost, community4 level, evidence-based prevention programs and related 

5 tools to assist older individuals and their family care6 givers in learning about and making behavioral 

7 changes intended to reduce the risk of injury, disease, 

8 and disability among older individuals. 

9 ‘‘(5) COMMUNITY LIVING INCENTIVES.— 

10 ‘‘(A) IN GENERAL.—The State shall provide 

11 funding toward and otherwise assist with the 

12 provision of home and community-based long13 term care to individuals at high risk for place14 ment in institutional care (referred to in this 

15 paragraph as ‘high-risk individuals’). The State 

16 shall ensure that individuals at greatest risk for 

17 becoming eligible for benefits under the Medicaid 

18 program receive priority for the home and com19 munity-based long-term care. 

20 ‘‘(B) LONG-TERM CARE PLAN.—The State 

21 shall provide for assessments of the needs and 

22 preferences of high-risk individuals with respect 

23 to long-term care, and based on such assessments, 

24 shall develop with such individuals and their 

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1 tives a plan for long-term care for such individ2 uals, specifying the types of support, providers, 

3 budget, and, if the State elects, cost-sharing con4 tributions involved. 

5 ‘‘(C) ALLOCATION OF FUNDS BASED ON IN6 DIVIDUAL BUDGETS.—The State shall ensure 

7 that the funding described in subparagraph (A) 

8 will be allocated among, and disbursed for, the 

9 budgets of high-risk individuals under long-term 

10 care plans developed for such individuals. 

11 ‘‘(D) OPTION TO PROVIDE CONSUMER-DI12 RECTED CARE.—The State shall provide high13 risk individuals with the option to receive home 

14 and community-based long-term care under this 

15 paragraph in a manner that permits such indi16 viduals to direct and control, in conjunction 

17 with a service coordinator, the selection, plan18 ning, budgeting, and purchasing of such care 

19 (including the amount, duration, scope, pro20 viders, and location of such care), to the extent 

21 determined appropriate and feasible under the 

22 long-term care plan developed under subpara23 graph (B). The service coordinator shall assist 

24 the high-risk individuals in purchasing a range 

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1 wise available or eligible for payment through an 

2 entity carrying out a Federal or State program 

3 or a similar third party, from a qualified pro4 vider that are delivered in home and commu5 nity-based settings and in a manner that best 

6 meets the individuals’ needs and respects the in7 dividuals’ preferences to remain in the least re8 strictive setting possible. 

9 ‘‘(e) FEDERAL SHARE.—The Federal share of the cost 

10 of modifying systems of long-term systems care as described 

11 in subsection (b) shall be not more than 75 percent of such 

12 cost (calculated on an annual basis as the State’s qualified 

13 expenditures for such modifications for such year). 

14 ‘‘(f) SPECIAL PROVISIONS RELATING TO AGING AND

15 DISABILITY RESOURCE CENTERS.—A State shall ensure 

16 that any Aging and Disability Resource Center shall— 

17 ‘‘(1) fully coordinate its activities with any 

18 health insurance information, counseling, and assist19 ance (receiving funding under section 4360 of the 

20 Omnibus Budget Reconciliation Act of 1990 (42 

21 U.S.C. 1395b–4)) in the State; 

22 ‘‘(2) be subject to such controls as the Assistant 

23 Secretary determines to be appropriate to ensure there 

24 is no conflict of interest with respect to any referrals, 


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1 for information or otherwise, made by the Center for 

2 individuals receiving services through the Center; and 

3 ‘‘(3) provide no long-term care services or sup4 plies, with the exception of case management services 

5 provided through area agencies on aging as described 

6 in section 306(a)(8). 

7 ‘‘(g) SPECIAL PROVISIONS RELATING TO OPTION TO

8 PROVIDE CONSUMER-DIRECTED CARE.—Payments made 

9 for a high-risk individual under subsection (d)(5)(D) shall 

10 not be included in the gross income of the high-risk indi11 vidual for purposes of the Internal Revenue Code of 1986 

12 or be treated as income, be treated as assets or benefits, or 

13 otherwise be taken into account, for purposes of determining 

14 the individual’s eligibility for, the amount of benefits for 

15 the individual under, or the amount of cost-sharing re16 quired of the individual by, any other Federal or State pro17 gram, other than the program carried out under this sec18 tion. 

19 ‘‘(h) TECHNICAL ASSISTANCE TO STATES.—The As20 sistant Secretary, directly or by grant or contract, shall 

21 provide for technical assistance to and oversight of States 

22 carrying out demonstration projects under this section, for 

23 purposes of administration, quality assurance, and quality 

24 improvement. 


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1 ‘‘(i) EVALUATION AND REPORT.—The Assistant Sec2 retary, directly or by grant or contract, shall provide for 

3 an evaluation of the demonstration projects carried out 

4 under this section. The Assistant Secretary shall submit to 

5 the President a report containing the findings resulting 

6 from such evaluation not later than 6 months after the ter7 mination of the demonstration projects.’’. 

8 SEC. 43. RESPONSIBILITIES OF ASSISTANT SECRETARY. 

9 Section 432(c)(2)(B) of the Older Americans Act of 

10 1965 (42 U.S.C. 3033a(c)(2)(B)) is amended by inserting 

11 before the period the following: ‘‘, including preparing an 

12 analysis of such services, projects, and programs, and of 

13 how the evaluation relates to improvements in such services, 

14 projects, and programs and in the strategic plan of the Ad15 ministration’’. 

16 SEC. 44. OLDER AMERICAN COMMUNITY SERVICE EMPLOY17 MENT PROGRAM. 

18 (a) IN GENERAL.—Section 502 of the Older Americans 

19 Act of 1965 (42 U.S.C. 3056) is amended— 

20 (1) in subsection (a)(1), by adding at the end the 

21 following: ‘‘For purposes of this paragraph, an under22 employed person shall be considered to be an unem23 ployed person.’’; 

24 (2) in subsection (b)(1)(M), by striking ‘‘minor25 ity, limited English-speaking, and Indian eligible inVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00229 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 dividuals, and eligible individuals who have the 

2 greatest economic need,’’ and inserting ‘‘minority and 

3 Indian eligible individuals, eligible individuals with 

4 limited English proficiency, and eligible individuals 

5 with greatest economic need,’’; and 

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

7 ‘‘(g)(1) Except as provided in paragraphs (2) and (3), 

8 an eligible individual may participate in projects carried 

9 out under this title for a period of not more than 36 months 

10 (whether or not consecutive) in the aggregate. 

11 ‘‘(2) A grantee for a project may extend the period of 

12 participation for not more than 20 percent of the project 

13 participants. In selecting participants for the extended pe14 riod of participation, the grantee shall give priority to— 

15 ‘‘(A) participants who are 65 years old or older 

16 or frail older individuals; and 

17 ‘‘(B) individuals who have more than 1 of the 

18 following barriers to employment: 

19 ‘‘(i) A disability. 

20 ‘‘(ii) Limited English proficiency or low lit21 eracy skills. 

22 ‘‘(iii) A residence in a rural area. 

23 ‘‘(iv) A residence in an area of high unem24 ployment. 


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1 ‘‘(v) Homelessness or a situation that puts 

2 the individual at risk for homelessness. 

3 ‘‘(vi) A failure to find employment after 

4 utilizing services under title I of the Workforce 

5 Investment Act of 1998 (29 U.S.C. 2801 et seq.). 

6 ‘‘(3) A grantee may petition for a waiver of the 36- 

7 month limit described in paragraph (1) if the grantee serves 

8 a high concentration of individuals who are hard-to-serve 

9 individuals because they have more than 1 barrier to em10 ployment as described in paragraph (2)(B), including a 

11 grantee who operates a project in an area in which at least 

12 60 percent of the counties are rural counties, as defined by 

13 the Economic Research Service of the Department of Agri14 culture. 

15 ‘‘(h) It is the sense of the Senate that— 

16 ‘‘(1) the older American community service em17 ployment program was created with the intent of 

18 placing older individuals in community service posi19 tions to provide job training placements; and 

20 ‘‘(2) placing older individuals in community 

21 service positions strengthens the ability of the individ22 uals to become self-sufficient, provides much-needed 

23 volunteer support to organizations who benefit signifi24 cantly from increased civic engagement, and strengthVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00231 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 ens the communities that are served by such organiza2 tions.’’. 

3 (b) DEFINITION.—Section 506(g)(2) of the Older 

4 Americans Act of 1965 (42 U.S.C. 3056d(g)(2)) is amend5 ed— 

6 (1) in subparagraph (A), by striking ‘‘, or the 

7 amount remaining after the application of section 

8 514(e)’’; and 

9 (2) in subparagraph (B), by striking ‘‘, or the 

10 amount remaining after the application of section 

11 514(f)’’. 

12 SEC. 45. PERFORMANCE. 

13 Section 513 of the Older Americans Act of 1965 (42 

14 U.S.C. 3056k) is amended— 

15 (1) in subsection (a)— 

16 (A) in paragraph (1)— 

17 (i) by striking the paragraph designa18 tion and all that follows through ‘‘grantees’’ 

19 and inserting the following: 

20 ‘‘(1) ESTABLISHMENT AND IMPLEMENTATION OF

21 MEASURES.—The Secretary shall establish and imple22 ment, after consultation with the Assistant Secretary, 

23 grantees’’; and 

24 (ii) by adding at the end the following: 

25 ‘‘The Assistant Secretary shall provide recVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00232 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 ommendations to the Secretary on the estab2 lishment and implementation of the per3 formance measures.’’; 

4 (B) in paragraph (2)(B), by adding at the 

5 end the following: 

6 ‘‘(iv) Not less than 60 percent of the 

7 counties, in the areas served by the grantee, 

8 being rural counties as defined by the Eco9 nomic Research Service of the Department 

10 of Agriculture. 

11 ‘‘(v) The areas served by the grantee 

12 comprising a difficult to serve territory due 

13 to limited economies of scale.’’; and 

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

15 ‘‘(6) SPECIAL RULES.— 

16 ‘‘(A) ESTABLISHMENT AND IMPLEMENTA17 TION.—The Secretary shall establish and imple18 ment the performance measures described in this 

19 section, including all required indicators de20 scribed in subsection (b), not later than 1 year 

21 after the date of enactment of the Older Ameri22 cans Act Amendments of 2006. 

23 ‘‘(B) IMPACT ON GRANT COMPETITION.—The 

24 Secretary may not publish a notice announcing 

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1 iting proposals for grants, until the day that is 

2 the later of— 

3 ‘‘(i) the date on which the Secretary 

4 implements all required indicators described 

5 in subsection (b); and 

6 ‘‘(ii) January 1, 2010.’’; and 

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

8 ‘‘(e) EFFECT OF EXEMPTION.—In implementing a per9 formance measure under this section, the Secretary shall not 

10 reduce a score on the performance measure of— 

11 ‘‘(1) a grantee that receives a waiver under sec12 tion 502(g)(3) on the basis that the grantee is extend13 ing the period of participation for project partici14 pants under that section; and 

15 ‘‘(2) a grantee on the basis that the grantee is ex16 tending the period of participation for project partici17 pants under section 502(g)(2).’’. 

18 SEC. 46. COMPETITIVE REQUIREMENTS. 

19 Section 514 of the Older Americans Act of 1965 (42 

20 U.S.C. 3056l) is amended— 

21 (1) by striking subsection (a) and inserting the 

22 following: 

23 ‘‘(a) PROGRAM AUTHORIZED.—In accordance with 

24 section 502(b), the Secretary shall award grants to eligible 

25 applicants, through a competitive process that emphasizes 


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1 meeting performance measures, to carry out projects under 

2 this title for a 4-year period. The Secretary may not con3 duct a grant competition under this title until the day de4 scribed in section 513(a)(6)(B).’’; 

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

6 following: 

7 ‘‘(b) ELIGIBLE APPLICANTS.—An applicant shall be 

8 eligible to receive a grant as described in subsection (a) if 

9 the applicant meets the requirements and criteria described 

10 in section 502(b)(1), subsections (c) and (d), and para11 graphs (2) and (3) of subsection (e).’’; 

12 (3) in subsection (c)— 

13 (A) by redesignating paragraphs (2) 

14 through (7) as paragraphs (4) through (9), re15 spectively; 

16 (B) by inserting after paragraph (1) the fol17 lowing: 

18 ‘‘(2) The applicant’s performance on the required 

19 indicators described in section 513(b), in the case of 

20 an applicant that has previously received a grant 

21 under this title, and the applicant’s ability to meet 

22 the required indicators, in the case of any other ap23 plicant. 

24 ‘‘(3) The applicant’s ability to administer a pro25 gram that provides community service.’’; and 


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1 (C) by striking paragraph (9) and inserting 

2 the following: 

3 ‘‘(9) The applicant’s ability to minimize disrup4 tion in services for project participants and the enti5 ties employing the participants. 

6 ‘‘(10) Any additional criteria that the Secretary 

7 may determine to be appropriate.’’; 

8 (4) in subsection (e)— 

9 (A) in paragraph (2), by striking subpara10 graphs (C) and (D); 

11 (B) in paragraph (3)— 

12 (i) by striking ‘‘(3)’’ and all that fol13 lows through ‘‘In’’ and inserting the fol14 lowing: 

15 ‘‘(3) COMPETITION REQUIREMENTS FOR PUBLIC

16 AND PRIVATE NONPROFIT AGENCIES AND ORGANIZA17 TIONS IN A STATE.—In’’; 

18 (ii) by striking subparagraphs (B) 

19 through (D); and 

20 (iii) by striking ‘‘take corrective ac21 tion’’ and inserting ‘‘provide technical as22 sistance’’; and 

23 (C) in paragraph (4)— 


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1 (i) in the first sentence, by striking 

2 ‘‘paragraph (3)(A)’’ and inserting ‘‘para3 graph (3)’’; and 

4 (ii) by striking the second sentence; 

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

6 and 

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

8 ‘‘(g) GRANTEES SERVING INDIVIDUALS WITH BAR9 RIERS TO EMPLOYMENT.— 

10 ‘‘(1) DEFINITION.—In this subsection, the term 

11 ‘individuals with barriers to employment’ means mi12 nority and Indian individuals, individuals with lim13 ited English proficiency, and individuals with great14 est economic need. 

15 ‘‘(2) SPECIAL CONSIDERATION.—In areas where 

16 a substantial population of individuals with barriers 

17 to employment exists, a grantee that receives a na18 tional grant under this section shall, in selecting sub19 grantees, give special consideration to organizations 

20 (including former recipients of such national grants) 

21 with demonstrated expertise in serving individuals 

22 with barriers to employment. 

23 ‘‘(h) MINORITY-SERVING GRANTEES.—The Secretary 

24 may not promulgate rules or regulations, affecting grantees 

25 in areas where a substantial population of minority indiVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00237 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 viduals exists, that would significantly compromise the 

2 ability of the grantees to serve their targeted population of 

3 minority older individuals.’’. 

4 SEC. 47. DEFINITIONS. 

5 Section 516(2) of the Older Americans Act of 1965 (42 

6 U.S.C. 3056n(2)) is amended— 

7 (1) in the header, by striking ‘‘INDIVIDUALS’’ 

8 and inserting ‘‘INDIVIDUAL’’; 

9 (2) by inserting before ‘‘The term’’ the following: 

10 ‘‘(A) IN GENERAL.—’’; 

11 (3) by striking ‘‘individuals’’ and inserting ‘‘in12 dividual’’; and 

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

14 ‘‘(B) DETERMINATION OF LOW INCOME.— 

15 For purposes of determining income eligibility 

16 under subparagraph (A), the Secretary shall not 

17 include as income— 

18 ‘‘(i) unemployment compensation; 

19 ‘‘(ii) benefits received under title XVI 

20 of the Social Security Act (42 U.S.C. 1381 

21 et seq.); 

22 ‘‘(iii) payments made to or on behalf of 

23 veterans or former members of the Armed 

24 Forces under the laws administered by the 

25 Secretary of Veterans Affairs; or 


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1 ‘‘(iv) 25 percent of the old-age and sur2 vivors insurance benefits received under title 

3 II of the Social Security Act (42 U.S.C. 401 

4 et seq.).’’. 

5 SEC. 48. CLARIFICATION OF MAINTENANCE REQUIREMENT. 

6 (a) IN GENERAL.—Section 614A of the Older Ameri7 cans Act of 1965 (42 U.S.C. 3057e–1) is amended by adding 

8 at the end the following: 

9 ‘‘(c) CLARIFICATION.— 

10 ‘‘(1) DEFINITION.—In this subsection, the term 

11 ‘covered year’ means fiscal year 2006 or a subsequent 

12 fiscal year. 

13 ‘‘(2) CONSORTIA OF TRIBAL ORGANIZATIONS.—If 

14 a tribal organization received a grant under this part 

15 for fiscal year 1991 as part of a consortium, the As16 sistant Secretary shall consider the tribal organiza17 tion to have received a grant under this part for fiscal 

18 year 1991 for purposes of subsections (a) and (b), and 

19 shall apply the provisions of subsections (a) and 

20 (b)(1) (under the conditions described in subsection 

21 (b)) to the tribal organization for each covered year 

22 for which the tribal organization submits an applica23 tion under this part, even if the tribal organization 

24 submits— 


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1 ‘‘(A) a separate application from the re2 maining members of the consortium; or 

3 ‘‘(B) an application as 1 of the remaining 

4 members of the consortium.’’. 

5 (b) EFFECTIVE DATE.—Subsection (a) takes effect on 

6 October 1, 2005. 

7 SEC. 49. NATIVE AMERICANS CAREGIVER SUPPORT PRO8 GRAM. 

9 Section 643 of the Older Americans Act of 1965 (42 

10 U.S.C. 3057n) is amended— 

11 (1) in paragraph (1), by striking ‘‘2001’’ and in12 serting ‘‘2007’’; and 

13 (2) in paragraph (2), by striking ‘‘$5,000,000’’ 

14 and all that follows and inserting ‘‘$6,500,000 for fis15 cal year 2007, $7,000,000 for fiscal year 2008, 

16 $7,500,000 for fiscal year 2009, $8,000,000 for fiscal 

17 year 2010, and $8,500,000 for fiscal year 2011.’’. 

18 SEC. 50. VULNERABLE ELDER RIGHTS PROTECTION ACTIVI19 TIES. 

20 Section 702 of the Older Americans Act of 1965 (42 

21 U.S.C. 3058a) is amended by striking ‘‘2001’’ each place 

22 it appears and inserting ‘‘2007’’. 


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1 SEC. 51. ELDER ABUSE, NEGLECT, AND EXPLOITATION PRE2 VENTION AMENDMENT. 

3 Section 721 of the Older Americans Act of 1965 (42 

4 U.S.C. 3058i) is amended— 

5 (1) in subsection (b)— 

6 (A) by redesignating paragraphs (2) 

7 through (8) as paragraphs (3) through (9), re8 spectively; and 

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

11 ‘‘(2) providing for public education and outreach 

12 to promote financial literacy and prevent identity 

13 theft and financial exploitation of older individuals;’’; 

14 and 

15 (2) in subsection (e)(2)— 

16 (A) by striking ‘‘subsection (b)(8)(B)(i)’’ 

17 and inserting ‘‘subsection (b)(9)(B)(i)’’; and 

18 (B) by striking ‘‘subsection (b)(8)(B)(ii)’’ 

19 and inserting ‘‘subsection (b)(9)(B)(ii)’’. 

20 SEC. 52. NATIVE AMERICAN ORGANIZATION PROVISIONS. 

21 Section 751(d) of the Older Americans Act of 1965 (42 

22 U.S.C. 3058aa(d)) is amended by striking ‘‘2001’’ and in23 serting ‘‘2007’’. 

24 SEC. 53. ELDER JUSTICE PROGRAMS. 

25 (a) PURPOSES.—The purposes of this section are as 

26 follows: 


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1 (1) To assist States and Indian tribes in devel2 oping a comprehensive multi-disciplinary approach 

3 to elder justice. 

4 (2) To promote research and data collection that 

5 will fill gaps in knowledge about elder abuse, neglect, 

6 and exploitation. 

7 (3) To support innovative and effective activities 

8 of service providers and programs that are designed 

9 to address issues relating to elder abuse, neglect, and 

10 exploitation. 

11 (4) To assist States, Indian tribes, and local 

12 service providers in the development of short- and 

13 long-term strategic plans for the development and co14 ordination of elder justice research, programs, studies, 

15 training, and other efforts. 

16 (5) To promote collaborative efforts and dimin17 ish overlap and gaps in efforts in developing the im18 portant field of elder justice. 

19 (b) ELDER JUSTICE.—Title VII of the Older Ameri20 cans Act of 1965 (42 U.S.C. 3058 et seq.) is amended— 

21 (1) by redesignating subtitles B and C as sub22 titles C and D, respectively; 

23 (2) by redesignating sections 751, and 761 

24 through 764, as sections 761, and 771 through 774, 

25 respectively; and 


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1 (3) by inserting after subtitle A the following: 

2 ‘‘Subtitle B—Elder Justice 

3 Programs 

4 ‘‘SEC. 751. DEFINITIONS. 

5 ‘‘In this subtitle: 

6 ‘‘(1) CAREGIVER.—The term ‘caregiver’ means 

7 an individual who has the responsibility for the care 

8 of an elder, either voluntarily, by contract, by receipt 

9 of payment for care, or as a result of the operation 

10 of law and means a family member or other indi11 vidual who provides (on behalf of such individual or 

12 of a public or private agency, organization, or insti13 tution) compensated or uncompensated care to an 

14 elder. 

15 ‘‘(2) DIRECT CARE.—The term ‘direct care’ 

16 means care by an employee or contractor who pro17 vides assistance or long-term care services to a recipi18 ent. 

19 ‘‘(3) ELDER.—The term ‘elder’ means an older 

20 individual, as defined in section 102. 

21 ‘‘(4) ELDER JUSTICE.—The term ‘elder justice’ 

22 means— 

23 ‘‘(A) efforts to prevent, detect, treat, inter24 vene in, and respond to elder abuse, neglect, and 

25 exploitation and to protect elders with diminVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00243 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 ished capacity while maximizing their auton2 omy; and 

3 ‘‘(B) from an individual perspective, the 

4 recognition of an elder’s rights, including the 

5 right to be free of abuse, neglect, and exploi6 tation. 

7 ‘‘(5) ELIGIBLE ENTITY.—The term ‘eligible enti8 ty’ means a State or local government agency, Indian 

9 tribe, or any other public or private entity, that is en10 gaged in and has expertise in issues relating to elder 

11 justice. 

12 ‘‘(6) FIDUCIARY.—The term ‘fiduciary’— 

13 ‘‘(A) means a person or entity with the 

14 legal responsibility— 

15 ‘‘(i) to make decisions on behalf of and 

16 for the benefit of another person; and 

17 ‘‘(ii) to act in good faith and with 

18 fairness; and 

19 ‘‘(B) includes a trustee, a guardian, a con20 servator, an executor, an agent under a financial 

21 power of attorney or health care power of attor22 ney, or a representative payee. 

23 ‘‘(7) GRANT.—The term ‘grant’ includes a con24 tract, cooperative agreement, or other mechanism for 

25 providing financial assistance. 


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1 ‘‘(8) LAW ENFORCEMENT.—The term ‘law en2 forcement’ means the full range of potential respond3 ers to elder abuse, neglect, and exploitation includ4 ing— 

5 ‘‘(A) police, sheriffs, detectives, public safety 

6 officers, and corrections personnel; 

7 ‘‘(B) prosecutors; 

8 ‘‘(C) medical examiners; 

9 ‘‘(D) investigators; and 

10 ‘‘(E) coroners. 

11 ‘‘(9) LONG-TERM CARE.— 

12 ‘‘(A) IN GENERAL.—The term ‘long-term 

13 care’ means supportive and health services speci14 fied by the Secretary for individuals who need 

15 assistance because the individuals have a loss of 

16 capacity for self-care due to illness, disability, or 

17 vulnerability. 

18 ‘‘(B) LOSS OF CAPACITY FOR SELF-CARE.— 

19 For purposes of subparagraph (A), the term ‘loss 

20 of capacity for self-care’ means an inability to 

21 engage effectively in activities of daily living, in22 cluding eating, dressing, bathing, and manage23 ment of one’s financial affairs. 

24 ‘‘(10) LONG-TERM CARE FACILITY.—The term 

25 ‘long-term care facility’ means a residential care proVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00245 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 vider that arranges for, or directly provides, long2 term care. 

3 ‘‘(11) NURSING FACILITY.—The term ‘nursing 

4 facility’ has the meaning given such term under sec5 tion 1919(a) of the Social Security Act (42 U.S.C. 

6 1396r(a)). 

7 ‘‘(12) STATE LEGAL ASSISTANCE DEVELOPER.— 

8 The term ‘State legal assistance developer’ means an 

9 individual described in section 731. 

10 ‘‘(13) STATE LONG-TERM CARE OMBUDSMAN.— 

11 The term ‘State Long-Term Care Ombudsman’ means 

12 the State Long-Term Care Ombudsman described in 

13 section 712(a)(2). 

14 ‘‘SEC. 752. STATE AND TRIBAL GRANTS TO STRENGTHEN 

15 LONG-TERM CARE AND PROVIDE ASSISTANCE 

16 FOR ELDER JUSTICE PROGRAMS. 

17 ‘‘(a) GRANTS.—The Assistant Secretary may award 

18 grants to States and Indian tribes to enable the States and 

19 tribes to strengthen long-term care and provide assistance 

20 for elder justice programs. 

21 ‘‘(b) APPLICATION.—To be eligible to receive a grant 

22 under this subtitle, a State or Indian tribe shall submit 

23 an application to the Assistant Secretary at such time, in 

24 such manner, and containing such information as the As25 sistant Secretary may require. 


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1 ‘‘(c) USE OF FUNDS.—A State or Indian tribe that 

2 receives a grant under this subtitle may use the funds made 

3 available through the grant to award grants— 

4 ‘‘(1) to eligible entities for the prevention, detec5 tion, assessment, and treatment of, intervention in, 

6 investigation of, and response to elder abuse, neglect, 

7 and exploitation; 

8 ‘‘(2) to eligible entities to examine various types 

9 of elder shelters (in this paragraph referred to as ‘safe 

10 havens’), and to test various safe haven models for es11 tablishing safe havens (at home or elsewhere), that— 

12 ‘‘(A) recognize autonomy and self-deter13 mination, and fully protect the due process 

14 rights of elders; and 

15 ‘‘(B)(i) provide a comprehensive, culturally 

16 sensitive, and multidisciplinary team response to 

17 allegations of elder abuse, neglect, or exploi18 tation; 

19 ‘‘(ii) provide a dedicated, elder-friendly set20 ting; 

21 ‘‘(iii) have the capacity to meet the needs of 

22 elders for care; and 

23 ‘‘(iv) provide various services including— 

24 ‘‘(I) nursing and forensic evaluation; 

25 ‘‘(II) therapeutic intervention; 


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1 ‘‘(III) victim support and advocacy; 

2 and 

3 ‘‘(IV) case review and assistance to 

4 make the elders safer at home or to find ap5 propriate placement in safer environments, 

6 including shelters, and, in some cir7 cumstances long-term care facilities, other 

8 residential care facilities, and hospitals; 

9 ‘‘(3) to eligible entities to establish or continue 

10 volunteer programs that focus on the issues of elder 

11 abuse, neglect, and exploitation, or to provide related 

12 services; 

13 ‘‘(4) to eligible entities to support multidisci14 plinary elder justice activities, such as— 

15 ‘‘(A) supporting and studying team ap16 proaches for bringing a coordinated multidisci17 plinary or interdisciplinary response to elder 

18 abuse, neglect, and exploitation, including a re19 sponse from individuals in social service, health 

20 care, public safety, and legal disciplines; 

21 ‘‘(B) establishing a State or tribal coordi22 nating council, which shall identify the indi23 vidual State’s or Indian tribe’s needs and pro24 vide the Secretary with information and rec25 ommendations relating to efforts by the State or 


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1 Indian tribe to combat elder abuse, neglect, and 

2 exploitation; 

3 ‘‘(C) providing training, technical assist4 ance, and other methods of support to groups 

5 carrying out multidisciplinary efforts at the 

6 State or Indian tribe level (referred to in some 

7 States as ‘State Working Groups’); 

8 ‘‘(D) broadening and studying various mod9 els for elder fatality and serious injury review 

10 teams, to make recommendations about their 

11 composition, protocols, functions, timing, roles, 

12 and responsibilities, with a goal of producing 

13 models and information that will allow for rep14 lication based on the needs of other States, In15 dian tribes, and communities; or 

16 ‘‘(E) carrying out such other interdiscipli17 nary or multidisciplinary efforts as the Assistant 

18 Secretary determines to be appropriate; 

19 ‘‘(5) to eligible entities to provide training for 

20 individuals with respect to issues of elder abuse, ne21 glect, and exploitation, consisting of— 

22 ‘‘(A) training within a discipline; or 

23 ‘‘(B) cross-training activities that permit 

24 individuals in multiple disciplines to train toVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00249 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 gether, fostering communication, coordinating ef2 forts, and ensuring collaboration; 

3 ‘‘(6) to eligible entities to address underserved 

4 populations of elders, such as— 

5 ‘‘(A) elders living in rural locations; 

6 ‘‘(B) elders in minority populations; or 

7 ‘‘(C) low-income elders; 

8 ‘‘(7) to eligible entities to provide incentives for 

9 individuals to train for, seek, and maintain employ10 ment providing direct care in a long-term care facil11 ity, such as— 

12 ‘‘(A) to eligible entities to provide incentives 

13 to participants in programs carried out under 

14 part A of title IV, and section 403(a)(5), of the 

15 Social Security Act (42 U.S.C. 601 et seq., 

16 603(a)(5)) to train for and seek employment pro17 viding direct care in a long-term care facility; 

18 ‘‘(B) to long-term care facilities to carry out 

19 programs through which the facilities— 

20 ‘‘(i) offer, to employees who provide di21 rect care to residents of a long-term care fa22 cility, continuing training and varying lev23 els of professional certification, based on ob24 served clinical care practices and the 


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1 amount of time the employees spend pro2 viding direct care; and 

3 ‘‘(ii) provide, or make arrangements 

4 with employers to provide, bonuses or other 

5 increased compensation or benefits to em6 ployees who achieve professional certifi7 cation under such a program; or 

8 ‘‘(C) to long-term care facilities to enable 

9 the facilities to provide training and technical 

10 assistance to eligible employees regarding man11 agement practices using methods that are dem12 onstrated to promote retention of employees of 

13 the facilities, such as— 

14 ‘‘(i) the establishment of basic human 

15 resource policies that reward high perform16 ance, including policies that provide for im17 proved wages and benefits on the basis of 

18 job reviews; or 

19 ‘‘(ii) the establishment of other pro20 grams that promote the provision of high 

21 quality care, such as a continuing edu22 cation program that provides additional 

23 hours of training, including on-the-job 

24 training, for employees who are certified 

25 nurse aides; 


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1 ‘‘(8) to encourage the establishment of eligible 

2 partnerships to develop collaborative and innovative 

3 approaches to improve the quality of, including pre4 venting abuse, neglect, and exploitation in, long-term 

5 care; or 

6 ‘‘(9) to eligible entities to establish multidisci7 plinary panels to address and develop best practices 

8 concerning methods of— 

9 ‘‘(A) improving the quality of long-term 

10 care; and 

11 ‘‘(B) addressing abuse, including resident12 to-resident abuse, in long-term care. 

13 ‘‘(d) ADMINISTRATIVE EXPENSES.—A State or Indian 

14 tribe that receives a grant under this section shall not use 

15 more than 5 percent of the funds made available through 

16 the grant to pay for administrative expenses. 

17 ‘‘(e) SUPPLEMENT NOT SUPPLANT.—Funds made 

18 available pursuant to this section shall be used to supple19 ment and not supplant other Federal, State, and local (in20 cluding tribal) funds expended to provide activities de21 scribed in subsection (c). 

22 ‘‘(f) MAINTENANCE OF EFFORT.—The State or Indian 

23 tribe, in using the proceeds of a grant received under this 

24 section, shall maintain the expenditures of the State or tribe 

25 for activities described in subsection (c) at a level equal to 


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1 not less than the level of such expenditures maintained by 

2 the State or tribe for the fiscal year preceding the fiscal 

3 year for which the grant is received. 

4 ‘‘(g) ACCOUNTABILITY MEASURES.—The Assistant 

5 Secretary shall develop accountability measures to ensure 

6 the effectiveness of the activities conducted using funds 

7 made available under this section, including accountability 

8 measures to ensure that the activities described in sub9 section (c)(7) benefit eligible employees and increase the sta10 bility of the long-term care workforce. 

11 ‘‘(h) EVALUATING PROGRAMS.—The Assistant Sec12 retary shall evaluate the activities conducted using funds 

13 made available under this section and shall use the results 

14 of such evaluation to determine the activities for which 

15 funds made available under this section may be used. 

16 ‘‘(i) COMPLIANCE WITH APPLICABLE LAWS.—In order 

17 to receive funds under this section, an entity shall comply 

18 with all applicable laws, regulations, and guidelines. 

19 ‘‘(j) ELIGIBLE PARTNERSHIPS.—In subsection (c)(8), 

20 the term ‘eligible partnership’ means a multidisciplinary 

21 community partnership consisting of eligible entities or ap22 propriate individuals, such as a partnership consisting of 

23 representatives in a community of nursing facility pro24 viders, State legal assistance developers, advocates for resi25 dents of long-term care facilities, State Long-Term Care 


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1 Ombudsmen, surveyors, the State agency with responsi2 bility for adult protective services, the State agency with 

3 responsibility for licensing long-term care facilities, law en4 forcement agencies, courts, family councils, residents, cer5 tified nurse aides, registered nurses, physicians, and other 

6 eligible entities and appropriate individuals. 

7 ‘‘(k) 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 2005 

10 through 2008. 

11 ‘‘SEC. 753. COLLECTION OF UNIFORM NATIONAL DATA ON 

12 ELDER ABUSE, NEGLECT, AND EXPLOI13 TATION. 

14 ‘‘(a) PURPOSE.—The purpose of this section is to im15 prove, streamline, and promote uniform collection, mainte16 nance, and dissemination of national data relating to the 

17 various types of elder abuse, neglect, and exploitation. 

18 ‘‘(b) PHASE I.— 

19 ‘‘(1) IN GENERAL.—Not later than the date that 

20 is 1 year after the date of enactment of the Older 

21 Americans Act Amendments of 2006, the Assistant 

22 Secretary, acting through the head of the Office of 

23 Elder Abuse Prevention and Services, after consulta24 tion with the Attorney General and working with ex25 perts in relevant disciplines from the Bureau of JusVerDate Aug 31 2005 02:27 Sep 20, 2006 Jkt 049200 PO 00000 Frm 00254 Fmt 6652 Sfmt 6203 E:\BILLS\S3570.RS S3570

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1 tice Statistics of the Office of Justice Programs of the 

2 Department of Justice, shall— 

3 ‘‘(A) develop a method for collecting na4 tional data regarding elder abuse, neglect, and 

5 exploitation; and 

6 ‘‘(B) develop uniform national data report7 ing forms adapted to each relevant entity or dis8 cipline (such as health, public safety, social and 

9 protective services, and law enforcement) reflect10 ing— 

11 ‘‘(i) the distinct manner in which each 

12 entity or discipline receives and maintains 

13 information; and 

14 ‘‘(ii) the sequence and history of re15 ports to or involvement of different entities 

16 or disciplines, independently, or the se17 quence and history of reports from 1 entity 

18 or discipline to another over time. 

19 ‘‘(2) FORMS.— 

20 ‘‘(A) IN GENERAL.—Subject to subpara21 graph (B), the national data reporting forms de22 scribed in paragraph (1)(B) shall incorporate 

23 the definitions of section 751, for use in deter24 mining whether an event is reportable. 


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1 ‘‘(B) PROTECTION OF PRIVACY.—In pur2 suing activities under this paragraph, the Sec3 retary shall ensure the protection of individual 

4 health privacy consistent with the regulations 

5 promulgated under section 264(c) of the Health 

6 Insurance Portability and Accountability Act of 

7 1996 and State and local privacy regulations (as 

8 applicable). 

9 ‘‘(c) PHASE II.— 

10 ‘‘(1) IN GENERAL.—Not later than the date that 

11 is 1 year after the date on which the activities de12 scribed in subsection (b)(1) are completed, the Sec13 retary (or the Secretary’s designee) shall ensure that 

14 the national data reporting forms and data collection 

15 methods developed in accordance with such subsection 

16 are pilot tested in 6 States selected by the Secretary. 

17 ‘‘(2) ADJUSTMENTS TO THE FORM AND METH18 ODS.—The Secretary, after considering the results of 

19 the pilot testing described in paragraph (1) and con20 sultation with the Attorney General and relevant ex21 perts, shall adjust the national data reporting forms 

22 and data collection methods as necessary. 

23 ‘‘(d) PHASE III.— 

24 ‘‘(1) DISTRIBUTION OF NATIONAL DATA REPORT25 ING FORMS.—After completion of the adjustment to 


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1 the national data reporting forms under subsection 

2 (c)(2), the Secretary shall submit the national data 

3 reporting forms along with instructions to— 

4 ‘‘(A) the heads of the relevant components of 

5 the Department of Health and Human Services, 

6 the Department of Justice, and the Department 

7 of the Treasury, and such other Federal entities 

8 as may be appropriate; and 

9 ‘‘(B) the Governor’s office of each State for 

10 collection from all relevant State entities of data, 

11 including health care, social services, and law 

12 enforcement data. 

13 ‘‘(2) DATA COLLECTION GRANTS.— 

14 ‘‘(A) AUTHORIZATION.—The Secretary is 

15 authorized to award grants to States to improve 

16 data collection activities relating to elder abuse, 

17 neglect, and exploitation. 

18 ‘‘(B) APPLICATION.—To be eligible to re19 ceive a grant under this paragraph, a State shall 

20 submit an application to the Secretary at such 

21 time, in such manner, and containing such in22 formation as the Secretary may require. 

23 ‘‘(C) REQUIREMENTS.—Each State receiv24 ing a grant under this paragraph for a fiscal 

25 year shall report data for the calendar year that 


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1 begins during that fiscal year, using the national 

2 data reporting forms described in paragraph (1). 

3 ‘‘(D) FUNDING.— 

4 ‘‘(i) FIRST YEAR.—For the first fiscal 

5 year for which a State receives grant funds 

6 under this subsection the Secretary shall 

7 initially distribute 50 percent of such funds. 

8 The Secretary shall distribute the remain9 ing funds at the end of the calendar year 

10 that begins during that fiscal year, if the 

11 Secretary determines that the State has 

12 properly reported data required under this 

13 subsection for the calendar year. 

14 ‘‘(ii) SUBSEQUENT YEARS.—Except as 

15 provided in clause (i), the Secretary shall 

16 distribute grant funds to a State under this 

17 subsection for a fiscal year if the Secretary 

18 determines that the State properly reported 

19 data required under this subsection for the 

20 calendar year that ends during that fiscal 

21 year. 

22 ‘‘(3) REQUIRED INFORMATION.—Each report 

23 submitted under this subsection shall— 

24 ‘‘(A) indicate the State and year in which 

25 each event occurred; and 


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1 ‘‘(B) identify the total number of events 

2 that occurred in each State during the year and 

3 the type of each event. 

4 ‘‘(e) REPORT.—Not later than 1 year after the date 

5 of enactment of the Older Americans Act Amendments of 

6 2006 and annually thereafter, the Secretary shall prepare 

7 and submit to the appropriate committees of Congress, in8 cluding to the Committee on Health Education, Labor, and 

9 Pensions and the Special Committee on Aging of the Sen10 ate, a report regarding activities conducted under this sec11 tion. 

12 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are 

13 authorized to be appropriated to carry out this section such 

14 sums as may be necessary for each of fiscal years 2007, 

15 2008, 2009, 2010, and 2011.’’. 

16 SEC. 54. RULE OF CONSTRUCTION. 

17 Subtitle D of title VII of the Older Americans Act of 

18 1965 (42 U.S.C. 3058bb et seq.), as redesignated by section 

19 53(b)(1), is amended by adding at the end the following: 

20 ‘‘SEC. 775. RULE OF CONSTRUCTION. 

21 ‘‘Nothing in this title shall be construed to interfere 

22 with or abridge the right of an older individual to practice 

23 the individual’s religion through reliance on prayer alone 

24 for healing, in a case in which a decision to so practice 

25 the religion— 


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1 ‘‘(1) is contemporaneously expressed by the older 

2 individual— 

3 ‘‘(A) either orally or in writing; 

4 ‘‘(B) with respect to a specific illness or in5 jury that the older individual has at the time of 

6 the decision; and 

7 ‘‘(C) when the older individual is competent 

8 to make the decision; 

9 ‘‘(2) is set forth prior to the occurrence of the ill10 ness or injury in a living will, health care proxy, or 

11 other advance directive document that is validly exe12 cuted and applied under State law; or 

13 ‘‘(3) may be unambiguously deduced from the 

14 older individual’s life history.’’. 

15 SEC. 55. TECHNICAL AMENDMENTS. 

16 The Older Americans Act of 1965 (42 U.S.C. 3001 et 

17 seq.) is amended— 

18 (1) in section 202(e)(1)(A) by striking the semi19 colon at the end and inserting a period; and 

20 (2) by inserting before section 401 the following: 


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1 ‘‘TITLE IV—ACTIVITIES FOR 

2 HEALTH, INDEPENDENCE, 

3 AND LONGEVITY’’. 

4 SEC. 56. CONFORMING AMENDMENTS TO OTHER ACTS. 

5 (a) OLDER AMERICANS ACT AMENDMENTS OF 1987.— 

6 Section 205(1) of the Older Americans Act Amendments of 

7 1987 (42 U.S.C. 3001 note) is amended by striking ‘‘section 

8 102(17) of the Older Americans Act of 1965 (42 U.S.C. 

9 3002(17))’’ and inserting ‘‘section 102 of the Older Ameri10 cans Act of 1965 (42 U.S.C. 3002)’’. 

11 (b) ENERGY CONSERVATION AND PRODUCTION ACT.— 

12 Section 412(6) of the Energy Conservation and Production 

13 Act (42 U.S.C. 6862(6)) is amended by striking ‘‘para14 graphs (4), (5), and (6), respectively, of section 102’’ and 

15 inserting ‘‘section 102’’. 


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Calendar No. 616 

109TH CONGRESS 

2D SESSION S. 3570 

A BILL 

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

SEPTEMBER 19, 2006 

Reported with an amendment 


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