2016 Older Americans Act Reauthorization

Frequently Asked Questions

Note: These questions are a result of ACL’s internal review of the Older Americans Act 

Reauthorization Act of 2016 (P.L. 114-144). As we engage with stakeholders to implement the 

changes to the Older Americans Act (OAA), we expect to add new questions and answers to this 

list. If you have further questions, please email us at OAA2016@acl.hhs.gov.

Q. When does the bill become law? 

A. President Obama signed the Older Americans Act Reauthorization Act of 2016 into law 

 on April 19, 2016. 

Q. When will the changes be implemented?

A. ACL is reviewing the language to determine exactly how implementing it will affect the 

aging network and other ACL grantees, the programs we support, and the people we 

collectively serve. Information regarding implementation will be shared through frequently 

asked questions, webinars, technical assistance briefings, and other mechanisms. As 

information is available, it will be shared via ACL.gov, ACL social media, and network 

communications, as well as through ACL Updates, which you can receive by registering. 

Q. Will ACL post an updated compilation of the OAA on its website?

A. Yes. The compilation is available on ACL.gov and can be accessed at 

http://www.aoa.acl.gov/AoA_Programs/OAA/reauthorization/2016/docs/OlderAmericans-Act-of-1965-Compilation.pdf. 

AGING AND DISABILITY RESOURCE CENTERS (ADRCs) 

Q. What changes were made to Aging and Disability Resource Centers (ADRCs) in the 

reauthorized Act? 

A. In general, the ADRC changes in the OAA provide greater clarification of terms, place 

greater emphasis on home- and community-based services (HCBS), and provide states 

more flexibility when defining their ADRCs.

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The new definition provided for ADRCs gives states more flexibility by changing the 

term “entity” to “entity, network or consortium.” This change reflects the approach states 

have taken since the last reauthorization of the OAA. 

The reauthorized law now provides more specificity on who ADRCs serve by adding, 

“for older individuals and individuals with disabilities... and the caregivers of older 

individuals and individuals with disabilities.” 

 With the reauthorization, greater emphasis has been placed on providing assistance that 

includes information about federal and state HCBS, and there were some minor changes 

on how person-centered counseling is defined. In addition, the “Access” function of 

ADRCs was modified to change the term “consumer” to “individual” and to add 

language that emphasized the importance of HCBS as part of the range of publiclyfunded LTSS. 

Finally, additional language was added to ensure that ADRCs cooperate with area 

agencies on aging, centers for independent living, and other community-based 

organizations to support individuals “who are at risk for residing in, or who reside in, 

institutional settings, so that the individuals have the choice to remain in or to return to 

the community.” 

AREA PLANS

Q. How does the new requirement in Sec. 306 that area agency on aging plans include 

procedures to increase public awareness regarding elder abuse, neglect, and 

exploitation differ from/relate to the existing requirement for state plans to address

elder abuse?

A. This language is more specific. It explicitly states that that AAAs should include in their 

plans activities and procedures to increase public awareness and remove barriers to 

prevention and investigation of, and response to, elder abuse, neglect, and exploitation in 

coordination with states, Title VII funding and activities, and other appropriate partners. 

DISEASE PREVENTION AND HEALTH PROMOTION SERVICES

Q. What effect does adding the term “evidence-based” to Title III-D have? 

A. This language affirms the language in ACL’s annual appropriations bills (since 2012) that 

requires the funds under Title III-D to be spent only on evidence-based health promotion 

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 programs. ACL has developed guidance to help States meet this requirement, available 

at: http://www.aoa.acl.gov/AoA_Programs/HPW/Title_IIID/index.aspx. 

Q. How does the addition of the term “oral health” to the definition of “disease 

prevention and health promotion services” in section 102 (a)14(B) relate to 

programs funded under Title IIID? 

A. The addition of “oral health” to the OAA Title I definition of disease prevention and 

health promotion highlights that oral health is a crucial component of the health and 

wellness of older adults. 

With regard to Title III-D, any oral health activities—like all activities funded through 

Title III-D—would need to be part of an evidence-based program. ACL’s criteria for 

what can be considered an evidence-based program can be found here: 

http://www.aoa.acl.gov/AoA_Programs/HPW/Title_IIID/index.aspx. 

ELDER ABUSE 

Q. What are the implications of the addition of subsections (5) and (12) to Section 

721(b), related to elder abuse? 

A. When a bill is reauthorized, it is common to include examples of activities that would be 

 appropriate uses of the funding. The 2016 OAA reauthorization includes two new 

examples of activities that would be allowable uses of a state’s Section 721 funding: the 

 collection and submission of data related to abuse, neglect, and exploitation; and 

 supporting and studying innovative practices to address abuse, neglect, and exploitation. 

This language change does not mean these activities are required. 

FUNDING FORMULA 

Q. How will formula grant funding be distributed under the reauthorized OAA?

A. The formula grant distributions for Titles III, Parts B, C1, C2, and D will depend on the 

amount of funding appropriated for each, compared to the funding appropriated in the 

previous fiscal year. 

 

• If a fiscal year’s appropriation increases by any amount, stays the same, or decreases 

by less than 1%, from the previous fiscal year: 

o All “minimum amount states/territories” will receive the new minimum amount.

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o During FY 2017 – 2019, all “hold harmless states/territories” will receive 99% of 

the prior year’s funding amount. Starting in FY 2020 and going forward (until 

there is a new reauthorization), the hold harmless amount will be the FY 2019 

amount. 

o Depending on the amount of the increase, some of these states/territories 

may no longer be included in the hold harmless category and instead may 

receive additional allocations based on the new population data. 

o All other “population states/territories” will receive allocations based on new 

population data, after the minimum/hold harmless state/territory amounts are 

calculated.

• If the new fiscal year’s appropriation decreases by 1% or more compared to the 

previous fiscal year, each state/territory will receive the prior year’s funding, minus 

the same percentage as the overall decrease. 

Q. Do these changes apply to all the formula grants? 

A. No. The formula language changes in Sec. 304(a)(3)(D) apply to Title III, Parts B,C & 

D. The formula calculation was not changed for Title III-E or Title VII.

FUNDING LEVELS

Q. Are the new authorization levels the amount of funding that programs will receive? 

A. The authorization levels are intended to provide guidance regarding the appropriate 

amount of funds to carry out the authorized activities of a program. The amount 

appropriated by Congress in each fiscal year will determine the funding levels for ACLfunded programs. 

HOLOCAUST SURVIVORS

Q: How will ACL implement the new provision in Sec. 10 of the OAA entitled 

“Guidance on Serving Holocaust Survivors?” 

A: ACL will engage experts and organizations serving Holocaust survivors to solicit 

comments and input regarding this new provision. The recently initiated clearance 

process detailed in the “Program Instruction: Guidance for the Development and 

Submission of State Plans on Aging, State Plan Amendments and the Intrastate Funding 

Formula” will serve as the mechanism for obtaining input on this provision. All 

stakeholders, and the public, are welcome to provide input pertaining to the 

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implementation of this provision. Once the clearance process is complete, ACL will 

develop a set of guidelines and issue them in conjunction with its annual guidance to 

states on the development and submission of their State Plan on Aging. 

HOME- AND COMMUNITY-BASED SERVICES

 

Q. What effect does adding the terms “chronic condition self-care management, or falls 

prevention services” to Title III Part B, section 321(a)(1) have? 

A. This language affirms that Title III-B supportive services may include programs and 

services that relate to chronic condition self-care management and falls prevention. These 

activities were never excluded from Title III-B services, but now their inclusion is 

explicit. 

LEGAL ASSISTANCE 

Q. Was appropriation authority for the Legal Assistance Development Program 

deleted in the reauthorized Older Americans Act?

A: Statutory language governing the Legal Assistance Development Program was retained 

and the program is still in effect under Title VII Section 731 and Section 307(a)(13). The 

Section 702(c) authorization of appropriations specifically for the Legal Assistance 

Development Program was struck, and a new authorization for appropriations was added, 

combining Chapters 3 (Elder Abuse Prevention) and 4 (Legal Assistance Development). 

Q. Are entities eligible to receive an award under Section 420(a)(1) to provide a legal 

assistance support system required to be national non-profit organizations? 

A. No. Any non-profit organization experienced in providing support and technical 

assistance on a nation-wide basis to states, area agencies on aging, legal assistance 

 providers, ombudsmen, elder abuse prevention programs, and other organizations 

 interested in the legal rights of older individuals may receive an award under the revised 

language in Section 420(c).

LONG-TERM CARE OMBUDSMAN

Q. How does ACL plan to implement the language requiring ACL’s Director of the 

Office of Long-Term Care Ombudsman Programs to collect and analyze data 

related to elder abuse, neglect, and exploitation in long-term care facilities? Does 

ACL plan to require additional reporting? 

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A. ACL plans to collect and analyze the reports received through its National Ombudsman 

Reporting System (NORS) related to abuse, neglect, and exploitation in long-term care 

 facilities. These reports include numbers of complaints in these topic areas as well as 

narratives of case examples and systems-level advocacy work. 

ACL is preparing to propose revisions to NORS that would collect additional relevant 

 information (including information on perpetrators in abuse, neglect, or exploitation 

 complaints) and significantly improve ACL’s ability to analyze complaint-related data 

 (through collection of disaggregated data). Other than these previously anticipated 

 updates to NORS, ACL does not anticipate additional reporting burdens on 

grantees/states. 

 In order to meet the statutory requirement to publish a report on these practices, ACL 

 plans to incorporate its analysis into the AoA annual report to Congress, and disseminate 

the analysis to grantees, Long-Term Care Ombudsman programs, and other stakeholders 

 in coordination with its National Ombudsman Resource Center. 

Q. What is the effect of the deletion of the word “older” in the definition of “resident”?

A. This change clarifies that the Long-Term Care (LTC) Ombudsman program has the 

authority to serve (and utilize OAA appropriations to serve) residents of long-term care 

facilities, regardless of age. Section 711(6) now reads “The term ‘resident’ means an 

individual who resides in a long-term care facility.” This definition applies only to Title 

VII Chapter 2, Ombudsman Programs. 

We note that this amendment will not require a change to the LTC Ombudsman Rule (45 

CFR 1327), which became effective July 1, 2016. Nowhere in that rule are LTC 

Ombudsman program functions or duties limited by the age of the resident served (see, 

e.g., 45 CFR 1327.13(a) regarding Ombudsman functions, 45 CFR 1327.19(a) regarding 

duties of the representatives of the Office). Additionally, AoA has long held that states 

are not prohibited from using OAA funds to support Ombudsman services to younger 

residents of long-term care facilities, even though the OAA is designed to primarily 

benefit individuals over age 60. 

Q. What is the significance of the addition of fiscal management to the responsibilities 

of the State Long-Term Care Ombudsman?

A. Section 712(a)(2) requires that the “Office [of the State Long-Term Care Ombudsman]

shall be headed by an individual, to be known as the State Long-Term Care 

Ombudsman...” The 2016 amendments add additional detail to this paragraph, requiring 

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that “[t]he Ombudsman shall be responsible for the management, including the fiscal 

management, of the Office.” 

Consistent with this requirement, the LTC Ombudsman Rule provides: 

“The Ombudsman, as head of the Office, shall have responsibility for the 

leadership and management of the Office in coordination with the State agency, 

and, where applicable, any other agency carrying out the Ombudsman program...” 

“Fiscal management. The Ombudsman shall determine the use of the fiscal 

resources appropriated or otherwise available for the operation of the Office. 

Where local Ombudsman entities are designated, the Ombudsman shall approve 

the allocations of Federal and State funds provided to such entities, subject to 

applicable Federal and State laws and policies. The Ombudsman shall determine 

that program budgets and expenditures of the Office and local Ombudsman 

entities are consistent with laws, policies and procedures governing the 

Ombudsman program.” 

Q. What is the effect of the provision related to residents transitioning from a longterm care facility to a home care setting?

A. In the 2016 amendments, Congress added a new provision: 

712(a)(3) FUNCTIONS.—The Ombudsman... shall, personally or through 

representatives of the Office... 

(I) when feasible, continue to carry out the functions described in this section on behalf 

of residents transitioning from a long-term care facility to a home care setting; ...

While not requiring that the LTC Ombudsman program perform additional functions, this 

provision does require that, when feasible, these functions (such as complaint resolution 

and representing resident interests before governmental agencies) shall extend to an 

additional population, i.e. individuals who are transitioning from a long-term care facility 

to a home care setting. Additionally, this provision provides authority for the LTC 

Ombudsman program to utilize OAA appropriations to serve this expanded service 

population. 

ACL interprets the term “when feasible” to mean that Ombudsman programs shall serve 

this expanded population when adequate resources exist, without diminishing services to 

the resident population. 

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ACL interprets this provision to authorize the use of OAA appropriations by states for 

LTC Ombudsman program services to individuals living in a home care setting only 

during a transition period. Therefore, LTC Ombudsman program services to individuals 

living in a home-care setting should be limited to the time of transition, not indefinitely. 

States which find it feasible to provide services to this expanded population should 

develop policies and procedures to implement this provision, including a definition of a 

period of transition in such policies and procedures. For comparison, we note that the 

CMS Money Follows the Person demonstration project provides nursing facility residents 

with eligibility for transition services for up to 365 days. 

This provision does not prohibit states from using other funding sources and authorities 

to provide ombudsman services through the LTC Ombudsman program to individuals 

who receive long-term supports and services in a home-care setting for periods longer 

than a transition period or who have not transitioned out of a long-term care facility.

Q. What is the effect of the requirement for the state agency to ensure that 

representatives of the Office of the State LTC Ombudsman have “private and 

unimpeded” access to LTC facilities and residents?

A. ACL interprets this amendment (at section 712(b)(1)(A)) to mean that the state agency 

must ensure that the state’s LTC Ombudsman program has the legal authority to: 

1) access LTC facilities without interference 

2) access residents of LTC facilities without interference, and 

3) communicate with residents privately and to protect the information provided by 

residents from disclosure. 

ACL believes that, by complying with the following relevant provisions of the LTC 

Ombudsman Rule, state agencies will be in compliance with this statutory requirement as 

well:

• The state agency shall ensure that the LTC Ombudsman program has sufficient 

authority and access to facilities, residents and needed information in order to 

perform required functions, responsibilities, and duties. 45 CFR 1327.15(b) 

• The policies and procedures for the LTC Ombudsman program shall include 

provisions related to access to facilities and residents pursuant to 45 CFR 

1327.11(e)(2). 

• The state agency shall ensure that it has mechanisms to prohibit, investigate 

allegations of, and provide sanctions for interference, retaliation or reprisals by a 

long-term care facility, or other entity or individual against the LTC Ombudsman 

program. 45 CFR 1327.15(i) 

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• The LTC Ombudsman program shall offer privacy to the resident for the purpose 

of confidentially providing information and hearing, investigating and resolving 

complaints. 45 CFR 1327.19(b)(2)(i). 

• The policies and procedures for the LTC Ombudsman program shall include 

provisions related to the disclosure of resident-identifying information and other 

Ombudsman program information. 45 CFR 1327.11(e)(3). 

ACL recognizes that, in many states, the state agency does not have the authority to make 

requirements of long-term care facilities, but we expect that it can work with other 

appropriate state agencies to provide for this authority. 

Q. What is the significance of the requirement that the state agency shall ensure 

Ombudsman participation in training?

A. Section 712(h)(4) says that the state agency shall ensure that the Ombudsman or a 

designee participates in training provided by the National Ombudsman Resource Center 

established in section 202(a)(18). ACL interprets this to mean that the state LTC 

Ombudsman (or his/her designee) will regularly participate in training provided by the 

ACL-funded National Ombudsman Resource Center. Currently, such training includes, 

but is not limited to, orientation training for new state LTC Ombudsmen and an annual 

training conference designed for state LTC Ombudsmen. 

The LTC Ombudsman Rule requires state agencies to provide opportunities for training 

for the Ombudsman and representatives of the Office in order to maintain expertise to 

serve as effective advocates for residents. Further, the rule clarifies that state agencies 

may utilize funds appropriated under Title III and/or Title VII of the Act in order to 

provide access to such training opportunities. 45 CFR 1327.15(c). 

Q: How does the revised language in section 712(f) (regarding LTC Ombudsman 

programs and conflict of interest) alter the requirements to states regarding 

conflicts of interest as set forth in 45 CFR 1327.21? 

A. State agencies must follow the requirements of the statute, including, but not limited to, 

the following provisions which are not incorporated into the Rule: 

• Ensuring that the Ombudsman is not employed by or participating in a “related 

organization” (i.e. related to long-term care facilities) and has not been employed 

by such organization within 1 year. Sec. 712(f)(1)(C).

• Identifying, reporting, and remedying conflicts of interest related to long-term 

care services generally, not only related to facilities. Sec. 712(f)(2)(A)(iii)-(v). 

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ACL plans to make changes to the National Ombudsman Reporting System 

consistent with this reporting requirement.

No revision of the conflict of interest provisions of the LTC Ombudsman Program 

Rule is anticipated at this time, as the provisions of 45 CFR 1327.21 regarding 

conflicts of interest are sufficiently consistent with the 2016 OAA Reauthorization.

NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM

Q. What changes were made to the National Family Caregiver Support Program 

(Title III-E)?

A. Section 372(a) has been updated to include new definitions for “individual with a 

disability” and “older relative caregiver,” which replaces “grandparents and older 

individuals who are relative caregivers.” These new definitions allow the National Family 

Caregiver Support Program to be more inclusive of older-relative caregivers, including 

people who are 55 or older who are parents of individuals with disabilities. The priority 

populations outlined in Section 373(c)(2) are updated to make them consistent with the 

new and updated definitions. 

 

Additionally, Section 373 (g)(2)(C) has been revised to clarify that a state may use not 

more than 10 percent of the total (both federal and non-federal)dollars available to the 

state to provide support services to older-relative caregivers.

NUTRITION SERVICES

Q. What changes were made to the use of supplemental foods in home-delivered meals? 

A. The language in Section 336(1) describing home-delivered meals previously read: 

“...hot, cold, frozen, dried, canned, fresh, or supplemental foods and any additional 

meals...” and now reads “...hot, cold, frozen, dried, canned, or fresh foods and, as 

appropriate, supplemental foods, and any additional meals...”

 This change from “or supplemental foods” to “and, as appropriate, supplemental foods” 

clarifies the current practice – if needed, supplemental foods can be part of a homedelivered meal. Supplemental foods are nutrition-related items used to maintain health or

nutritional status, but they do not, alone, qualify as a “meal” under the OAA. 

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Q. How did the use of a dietician in OAA nutrition projects change? 

A. Section 339(1) was changed from “solicit the expertise of a dietician or other individual 

with equivalent education and training....” to “utilize the expertise of a dietician or other 

individual with equivalent education and training...” This change means that states must

use (“utilize”) the expertise of such an individual, rather than just ask for (“solicit”) that 

expertise.

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