II 

112TH CONGRESS 

1ST SESSION S. 1750 

To amend the Older Americans Act of 1965 to establish a Home Care 

Consumer Bill of Rights, to establish State Home Care Ombudsman 

Programs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 20, 2011 

Mr. FRANKEN (for himself, Mr. CASEY, and Mr. WHITEHOUSE) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL 

To amend the Older Americans Act of 1965 to establish 

a Home Care Consumer Bill of Rights, to establish State 

Home Care Ombudsman Programs, 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 ‘‘Home Care Consumer 

5 Bill of Rights Act’’. 


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1 TITLE I—HOME CARE BILL OF 

2 RIGHTS 

3 SEC. 101. ADMINISTRATION ON AGING. 

4 Section 201(e)(2) of the Older Americans Act of 

5 1965 (42 U.S.C. 3011(e)(2)) is amended— 

6 (1) in subparagraph (A), by striking ‘‘and’’ at 

7 the end; 

8 (2) in subparagraph (B), by striking the period 

9 and inserting ‘‘; and’’; and 

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

11 ‘‘(C) to establish best practices for State-based 

12 enforcement of a Home Care Consumer Bill of 

13 Rights through a Plan for Enforcement, as such Bill 

14 and Plan are outlined in section 705, not later than 

15 6 months after the date of enactment of the Home 

16 Care Consumer Bill of Rights Act, and to make 

17 those best practices available to States, and to the 

18 public through the National Center on Elder Abuse; 

19 ‘‘(D) to assist States with the development of 

20 Home Care Consumer Bills of Rights and Plans for 

21 Enforcement, to support the shift from institutional 

22 care to home and community-based long-term serv23 ices and supports and ensure that home care con24 sumers, as defined in section 736, have basic protecVerDate Mar 15 2010 03:24 Oct 22, 2011 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1750.IS S1750

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1 tions as outlined in subsections (b) and (c) of section 

2 705; 

3 ‘‘(E) to develop a process for review and ap4 proval of States’ Home Care Consumer Bills of 

5 Rights and Plans for Enforcement, not later than 6 

6 months after the date of enactment of the Home 

7 Care Consumer Bill of Rights Act; and 

8 ‘‘(F) to review and approve States’ Home Care 

9 Consumer Bills of Rights and Plans for Enforce10 ment through that process.’’. 

11 SEC. 102. ADDITIONAL STATE PLAN REQUIREMENTS. 

12 (a) IN GENERAL.—Section 705 of the Older Ameri13 cans Act of 1965 (42 U.S.C. 3058d) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (6), by striking ‘‘and’’ at 

16 the end; 

17 (B) in paragraph (7), by striking the pe18 riod and inserting ‘‘; and’’; and 

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

20 ‘‘(8) subject to section 102(b) of the Home 

21 Care Consumer Bill of Rights Act, an assurance— 

22 ‘‘(A) that the State has a Home Care Con23 sumer Bill of Rights and a Plan for Enforce24 ment of such a Bill, developed in accordance 

25 with the procedures described under paragraph 


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1 (2) and as approved by the Assistant Secretary, 

2 and include a copy of the Bill and Plan; or 

3 ‘‘(B) at the discretion of the Assistant Sec4 retary, in the event the State does not have an 

5 approved Home Care Consumer Bill of Rights 

6 and Plan for Enforcement, that the State has 

7 an alternative such as a proposal for developing 

8 and submitting for approval a Home Care Con9 sumer Bill of Rights and Plan for Enforce10 ment.’’; 

11 (2) by redesignating subsection (b) as sub12 section (d); 

13 (3) by inserting after subsection (a) the fol14 lowing: 

15 ‘‘(b) HOME CARE CONSUMER BILL OF RIGHTS.— 

16 The Home Care Consumer Bill of Rights referred to in 

17 subsection (a)(8) shall, at a minimum— 

18 ‘‘(1) address a home care consumer’s right to 

19 basic safety by— 

20 ‘‘(A) affirming that home care consumers 

21 are protected from physical, sexual, mental, and 

22 verbal abuse, neglect, and exploitation, includ23 ing financial exploitation; 

24 ‘‘(B) affirming that home care consumers 

25 are served by providers who are properly 


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1 trained and are providing home care services 

2 within their scope of practice and the scope of 

3 their certification or licensure (if such a certifi4 cation or licensure is required by the applicable 

5 State); 

6 ‘‘(C) affirming that such providers main7 tain the confidentiality of all personal, financial, 

8 and medical information of home care con9 sumers; and 

10 ‘‘(D) affirming that providers respect the 

11 personal property of home care consumers, and 

12 in the event of consumer reports of theft or 

13 loss, investigate and report back to the con14 sumer the results of the investigation; 

15 ‘‘(2) address a home care consumer’s right to 

16 access information by— 

17 ‘‘(A) affirming that home care consumers 

18 are informed of their rights under this sub19 section and subsection (c) within 2 weeks after 

20 the start of home care services, and about the 

21 entities the consumers may contact if their 

22 rights are violated, including the name and con23 tact information for State and local agencies re24 sponsible for enforcing the Home Care Con25 sumer Bill of Rights; 


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1 ‘‘(B) affirming that home care con2 sumers— 

3 ‘‘(i) are informed of the cost of home 

4 care services prior to receiving those serv5 ices, whether the cost of those services are 

6 covered under health insurance, long-term 

7 care insurance, or other private and public 

8 programs, and any charges the consumer 

9 will be expected to pay; and 

10 ‘‘(ii) are given advance notice of any 

11 changes to those costs or services; and 

12 ‘‘(C) affirming that home care consumers 

13 have access to information about the availability 

14 of the home care services provided in the com15 munity involved and have the ability to choose 

16 among home care services and providers of 

17 home care services available in the community; 

18 ‘‘(3) address a home care consumer’s right to 

19 choice, participation, and self-determination by— 

20 ‘‘(A) affirming that home care consumers 

21 can participate in the planning of their home 

22 care services, including making choices about 

23 aspects of their care and services that are im24 portant to them, choosing providers and sched25 ules to the extent practicable, receiving reasonVerDate Mar 15 2010 03:24 Oct 22, 2011 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1750.IS S1750

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1 able accommodation of their needs and pref2 erences, and involving anyone they chose to par3 ticipate with them in that planning; 

4 ‘‘(B) affirming that home care consumers 

5 are provided with sufficient information to 

6 make informed decisions, are fully informed in 

7 advance about any proposed changes in care 

8 and services, and are involved in the decision9 making process regarding those changes; and 

10 ‘‘(C) affirming that home care consumers 

11 can refuse services and receive an explanation 

12 of the consequences of doing so; 

13 ‘‘(4) address a home care consumer’s right to 

14 receive care and services provided in a way that pro15 motes each consumer’s dignity and individuality; 

16 ‘‘(5) address a home care consumer’s right to 

17 redress grievances by— 

18 ‘‘(A) affirming that home care consumers 

19 are able to voice grievances about the quality of 

20 their home care services, the number of hours 

21 of service, and violations of their rights, receive 

22 prompt responses to those concerns, and are in23 formed about the entities the consumers may 

24 contact to state those grievances in order to 


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1 have the grievances addressed in an appropriate 

2 and timely manner, and without retaliation; and 

3 ‘‘(B) affirming that home care consumers 

4 are able to assert their rights under this sub5 section and subsection (c) without retaliation; 

6 ‘‘(6) address the role and responsibilities that 

7 fiduciaries may have in securing the rights of home 

8 care consumers affirmed under the Home Care Con9 sumer Bill of Rights; and 

10 ‘‘(7) meet any other guidelines determined to be 

11 appropriate by the Assistant Secretary. 

12 ‘‘(c) PLAN FOR ENFORCEMENT.—In developing the 

13 Plan for Enforcement referred to in subsection (a)(8), the 

14 State shall take into account the best practices established 

15 under section 201(e)(2)(C). The Plan shall include a de16 scription of how State entities with a role in protecting 

17 older individuals, such as home care services licensing 

18 agencies, adult protective services agencies, the Office of 

19 the State Long-Term Care Ombudsman (if the office has 

20 jurisdiction over home and community-based long-term 

21 care), local law enforcement agencies, and other entities 

22 determined to be appropriate by the Assistant Secretary, 

23 will coordinate activities to enforce the Home Care Con24 sumer Bill of Rights.’’; and 

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


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1 ‘‘(e) DEFINITION.—In this section, the term ‘home 

2 care consumer’ and ‘home care services’ have the mean3 ings given the terms in section 736.’’. 

4 (b) APPLICATION OF REQUIREMENT TO SUBMIT

5 STATE HOME CARE CONSUMER BILL OF RIGHTS AND

6 PLAN FOR ENFORCEMENT.— 

7 (1) IN GENERAL.—The requirement for a State 

8 to provide an assurance, and either a Home Care 

9 Consumer Bill of Rights and a Plan for Enforce10 ment of such Bill or an alternative, under paragraph 

11 (8) of section 705(a) of the Older Americans Act of 

12 1965 (as added by subsection (a)) shall apply to 

13 States beginning on the date (referred to in this sub14 section as the ‘‘application date’’) that is 1 year 

15 after the date of the establishment of best practices 

16 under section 201(e)(2)(C) of such Act (as added by 

17 section 101). 

18 (2) FIRST SUBMISSION AFTER APPLICATION

19 DATE.—A State shall comply with paragraph (8) of 

20 section 705(a) of the Older Americans Act of 1965 

21 (as added by subsection (a)) in whichever of the fol22 lowing 2 submissions occurs first with respect to 

23 such State after the application date described under 

24 paragraph (1): 


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1 (A) The submission of a new State plan 

2 under section 307 of the Older Americans Act 

3 of 1965 (42 U.S.C. 3027). 

4 (B) The submission of an annual revision 

5 to a State plan submitted under such section 

6 307. 

7 (3) ONGOING SUBMISSIONS.—After complying 

8 with paragraph (8) of section 705(a) of the Older 

9 Americans Act of 1965 (as added by subsection (a)) 

10 in a submission in accordance with paragraph (2) of 

11 this subsection, a State shall comply with such para12 graph (8) in each new State plan submitted under 

13 section 307 of the Older Americans Act of 1965 (42 

14 U.S.C. 3027). 

15 SEC. 103. PREVENTION OF ELDER ABUSE, NEGLECT, AND 

16 EXPLOITATION. 

17 Section 721(b) of the Older Americans Act of 1965 

18 (42 U.S.C. 3058i(b)) is amended— 

19 (1) in paragraph (11), by striking ‘‘and’’ at the 

20 end; 

21 (2) in paragraph (12), by striking the period 

22 and inserting ‘‘; and’’; and 

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

24 ‘‘(13) developing a State Home Care Consumer 

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1 scribed in section 705) to protect home care con2 sumers (as defined in section 736) from abuse, ne3 glect, and exploitation.’’. 

4 SEC. 104. NATIONAL ADULT PROTECTIVE SERVICES RE5 SOURCE CENTER. 

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

7 U.S.C. 3011) is amended by adding at the end the fol8 lowing: 

9 ‘‘(g)(1) The Assistant Secretary shall, by grant or 

10 contract with a national nonprofit entity, establish a Na11 tional Adult Protective Services Resource Center (referred 

12 to in this subsection as the ‘Center’). The purposes of the 

13 Center are to improve the capacity of State and local adult 

14 protective services programs to respond effectively to 

15 abuse, neglect, and exploitation of vulnerable adults, in16 cluding home care consumers and residents of long-term 

17 care facilities, and to coordinate with the Home Care Om18 budsman Program and Long-Term Care Ombudsman 

19 Program to protect home care consumers and residents 

20 most effectively. 

21 ‘‘(2) The nonprofit entity awarded a grant or con22 tract under this subsection shall have expertise in, and 

23 representation by, State and local adult protective services 

24 programs. 

25 ‘‘(3) The Center shall— 


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1 ‘‘(A) collect and disseminate information re2 garding, and increase public awareness of, the role 

3 of adult protective services programs in investigating 

4 the abuse, neglect (including self-neglect), and ex5 ploitation of vulnerable adults, including home care 

6 consumers and residents of long-term care facilities, 

7 and in intervening to protect the consumers and 

8 residents from abuse; 

9 ‘‘(B) develop, distribute, and provide training 

10 and technical assistance for adult protective services 

11 program investigators and supervisors investigating 

12 the abuse, neglect (including self-neglect), and ex13 ploitation of vulnerable adults, including home care 

14 consumers and residents of long-term care facilities, 

15 and intervening to protect the consumers and resi16 dents from further abuse; 

17 ‘‘(C) develop, distribute, and provide training to 

18 home care and long-term care professionals and oth19 ers on recognizing, reporting (including regarding 

20 mandatory reporting requirements), and responding 

21 to the abuse, neglect (including self-neglect), and fi22 nancial exploitation of vulnerable adults, including 

23 home care consumers and residents of long-term 

24 care facilities; 


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1 ‘‘(D) compile and disseminate reports on re2 search and best practices for adult protective serv3 ices programs and other programs on effective re4 sponses to the abuse, neglect (including self-neglect), 

5 and exploitation of vulnerable adults, including home 

6 care consumers and residents of long-term care fa7 cilities; 

8 ‘‘(E) work with the National Ombudsman Re9 source Center and State and local home care om10 budsman programs and long-term care ombudsman 

11 programs to develop and disseminate training, prac12 tice standards, and policies regarding— 

13 ‘‘(i) the roles and responsibilities of adult 

14 protective services and ombudsman programs; 

15 ‘‘(ii) confidentiality and abuse reporting 

16 issues and protocols; and 

17 ‘‘(iii) effective ways to maximize the re18 sources of adult protective services programs 

19 for the benefit of home care consumers and 

20 residents of long-term care facilities; and 

21 ‘‘(F) establish a data system to collect informa22 tion on the abuse, neglect (including self-neglect), 

23 and exploitation of home care consumers and resi24 dents of long-term care facilities and to measure the 


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1 effectiveness of the activities carried out by the Cen2 ter. 

3 ‘‘(4) In this subsection, the terms ‘home care con4 sumer’ and ‘home care ombudsman program’ have the 

5 meanings given the terms in section 736.’’. 

6 TITLE II—STATE HOME CARE 

7 OMBUDSMAN PROGRAMS 

8 SEC. 201. PROGRAM. 

9 Section 701 of the Older Americans Act of 1965 (42 

10 U.S.C. 3058) is amended by inserting ‘‘and grants’’ after 

11 ‘‘allotments’’. 

12 SEC. 202. AUTHORIZATION OF APPROPRIATIONS. 

13 Chapter 1 of subtitle A of title VII of the Older Amer14 icans Act of 1965 is amended by inserting after section 

15 702 (42 U.S.C. 3058a) the following: 

16 ‘‘SEC. 702A. AUTHORIZATION OF APPROPRIATIONS FOR 

17 STATE HOME CARE OMBUDSMAN PROGRAM. 

18 ‘‘There are authorized to be appropriated to carry out 

19 chapter 5 such sums as may be necessary for fiscal year 

20 2012 and each subsequent fiscal year.’’. 

21 SEC. 203. GRANTS. 

22 Section 703 of the Older Americans Act of 1965 (42 

23 U.S.C. 3058b) is amended by adding at the end the fol24 lowing: 


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1 ‘‘(d) GRANTS FOR STATE HOME CARE OMBUDSMAN

2 PROGRAMS.— 

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

4 shall use funds made available under section 702A 

5 to award grants, on a competitive basis, to States 

6 for State Home Care Ombudsman Programs. 

7 ‘‘(2) CONSIDERATIONS.—In selecting States to 

8 receive the grants, the Assistant Secretary shall con9 sider— 

10 ‘‘(A) a State’s current financial support 

11 (as of the date of consideration) for home care 

12 ombudsman services; 

13 ‘‘(B) a State’s commitment to preventing 

14 conflict of interest between providers of home 

15 care services and providers of home care om16 budsman services; and 

17 ‘‘(C) other criteria determined by the As18 sistant Secretary. 

19 ‘‘(3) PRIORITIES.—In selecting States to receive 

20 the grants, the Assistant Secretary may give first 

21 priority to States that are providing home care om22 budsman services to home care consumers on the 

23 date of enactment of section 737, and seek to en24 hance the home care ombudsman programs through 

25 which the States provide the services.’’. 


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1 SEC. 204. ELIGIBILITY. 

2 (a) ORGANIZATION.—Section 704 of the Older Amer3 icans Act of 1965 (42 U.S.C. 3058c) is amended, in the 

4 matter preceding paragraph (1), by inserting ‘‘or grants’’ 

5 after ‘‘allotments’’. 

6 (b) ADDITIONAL REQUIREMENTS.—Section 705(a) of 

7 the Older Americans Act of 1965 (42 U.S.C. 3058d(a)) 

8 is amended— 

9 (1) in the matter preceding paragraph (1), by 

10 inserting ‘‘or grant’’ after ‘‘allotment’’; and 

11 (2) in paragraph (4), by striking ‘‘enactment of 

12 this subtitle’’ and inserting ‘‘enactment of the chap13 ter’’. 

14 SEC. 205. STATE HOME CARE OMBUDSMAN PROGRAMS. 

15 Subtitle A of title VII of the Older Americans Act 

16 of 1965 (42 U.S.C. 3058 et seq.) is amended by adding 

17 at the end the following: 

18 ‘‘CHAPTER 5—STATE HOME CARE 

19 OMBUDSMAN PROGRAMS 

20 ‘‘SEC. 736. DEFINITIONS. 

21 ‘‘In this chapter: 

22 ‘‘(1) HOME CARE CONSUMER.—The term ‘home 

23 care consumer’ means a person who receives services 

24 in the person’s home or community to promote inde25 pendence and reduce the necessity for residence in 

26 a long-term care facility, which may include— 


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1 ‘‘(A) home care services provided through 

2 this Act, the Medicare program under title 

3 XVIII of the Social Security Act (42 U.S.C. 

4 1395 et seq.), the Medicaid program under title 

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

6 et seq.), or another public or private funding 

7 source; or 

8 ‘‘(B) home care services determined to be 

9 appropriate by a State operating a State Home 

10 Care Ombudsman Program. 

11 ‘‘(2) HOME CARE OMBUDSMAN PROGRAM.—The 

12 term ‘home care ombudsman program’ means a 

13 State Home Care Ombudsman Program described in 

14 section 737(a)(1). 

15 ‘‘(3) HOME CARE OMBUDSMAN REPRESENTA16 TIVE.—The term ‘home care ombudsman represent17 ative’ includes an employee or volunteer who rep18 resents an entity designated under section 

19 737(a)(5)(A) and who is individually designated by 

20 the Ombudsman. 

21 ‘‘(4) HOME CARE SERVICES.—The term ‘home 

22 care services’ means home and community-based 

23 services to promote independence and reduce the ne24 cessity for residence in a long-term care facility, in25 cluding personal care services designed to assist an 


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1 individual in the activities of daily living such as 

2 bathing, exercising, personal grooming, and getting 

3 in and out of bed. 

4 ‘‘(5) LOCAL HOME CARE OMBUDSMAN ENTI5 TY.—The term ‘local home care Ombudsman entity’ 

6 means an entity designated under section 

7 737(a)(5)(A) to carry out the duties described in 

8 section 737(a)(5)(B) with respect to a planning and 

9 service area or other substate area. 

10 ‘‘(6) OFFICE; OMBUDSMAN.—The terms ‘Office’ 

11 and ‘Ombudsman’, used without further modifica12 tion, have the meanings given the terms in section 

13 711. 

14 ‘‘SEC. 737. PROGRAM. 

15 ‘‘(a) ESTABLISHMENT.— 

16 ‘‘(1) IN GENERAL.—In order to be eligible to 

17 receive a grant under section 703(d) from funds ap18 propriated under section 702A and made available to 

19 carry out this chapter, a State agency shall, in ac20 cordance with this section, agree to carry out a 

21 State Home Care Ombudsman Program within the 

22 Office of the State Long-Term Care Ombudsman. 

23 ‘‘(2) HOME CARE OMBUDSMAN PROGRAM.—The 

24 home care ombudsman program shall be carried out 

25 by the Ombudsman. 


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1 ‘‘(3) FUNCTIONS.—In carrying out the home 

2 care ombudsman program, the Ombudsman, person3 ally or through representatives of the home care om4 budsman program— 

5 ‘‘(A) shall identify, investigate, and resolve 

6 complaints that— 

7 ‘‘(i) are made by, or on behalf of, 

8 home care consumers; 

9 ‘‘(ii) relate to action, inaction, or deci10 sions, that may adversely affect the health, 

11 safety, welfare, or rights of home care con12 sumers (including the welfare and rights of 

13 home care consumers with respect to the 

14 appointment and activities of guardians 

15 and representative payees), of— 

16 ‘‘(I) entities responsible for de17 termining eligibility for home care 

18 services, such as State and local gov19 ernments; and 

20 ‘‘(II) entities responsible for de21 termining availability of home care 

22 services, such as managed care orga23 nizations; or 

24 ‘‘(iii) relate to action, inaction, or de25 cisions, regarding informing home care 


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1 consumers about their eligibility for, or the 

2 availability of, home care services, of— 

3 ‘‘(I) providers, or representatives 

4 of providers, of home care services; 

5 ‘‘(II) public agencies; 

6 ‘‘(III) health and social service 

7 agencies; and 

8 ‘‘(IV) entities providing con9 sumer-directed services under a con10 sumer-directed program; 

11 ‘‘(B) shall provide services to protect the 

12 health, safety, welfare, and rights of home care 

13 consumers; 

14 ‘‘(C) shall inform home care consumers 

15 about means of obtaining services provided by 

16 providers or agencies described in subparagraph 

17 (A)(ii) or services described in subparagraph 

18 (B); 

19 ‘‘(D) shall, in conjunction with other enti20 ties, such as area agencies on aging, conduct 

21 public education about the home care ombuds22 man program and its services, including the 

23 rights of home care workers to report concerns 

24 to the ombudsman in order to protect the 


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1 health, safety, welfare, and rights of home care 

2 consumers; 

3 ‘‘(E) shall ensure that home care con4 sumers and complainants receive timely re5 sponses from representatives of the home care 

6 ombudsman program to complaints; 

7 ‘‘(F) shall represent the interests of home 

8 care consumers before governmental agencies 

9 and seek administrative, legal, and other rem10 edies to protect the health, safety, welfare, and 

11 rights of the home care consumers, including 

12 issues related to the sufficiency of the home 

13 care workforce and its availability to meet the 

14 needs of home care consumers; 

15 ‘‘(G) shall provide administrative and tech16 nical assistance to entities designated under 

17 paragraph (5) to assist the entities in partici18 pating in the home care ombudsman program; 

19 ‘‘(H) shall provide for training representa20 tives of the home care ombudsman program; 

21 ‘‘(I) shall— 

22 ‘‘(i) promote the development of cit23 izen organizations, to participate in the 

24 home care ombudsman program; 


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1 ‘‘(ii) analyze, comment on, and mon2 itor the development and implementation 

3 of Federal, State, and local laws, regula4 tions, and other governmental policies and 

5 actions, that pertain to the health, safety, 

6 welfare, and rights of home care con7 sumers, with respect to the adequacy of 

8 home care services in the State, including 

9 issues related to the sufficiency of the 

10 home care workforce and its availability to 

11 meet the needs of home care consumers; 

12 ‘‘(iii) recommend any changes in such 

13 laws, regulations, policies, and actions as 

14 the Ombudsman determines to be appro15 priate; and 

16 ‘‘(iv) facilitate public comment on the 

17 laws, regulations, policies, and actions; and 

18 ‘‘(J) shall carry out other activities as the 

19 Assistant Secretary determines to be appro20 priate. 

21 ‘‘(4) CONTRACTS AND ARRANGEMENTS.— 

22 ‘‘(A) IN GENERAL.— 

23 ‘‘(i) AGENCIES AND ORGANIZA24 TIONS.—Except as provided in subpara25 graph (B), the State agency shall carry out 


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1 the home care ombudsman program, di2 rectly, or by contract or other arrangement 

3 with any public agency or nonprofit private 

4 organization. 

5 ‘‘(ii) AREA AGENCIES ON AGING.—The 

6 State agency shall determine whether to 

7 enter into contracts or arrangements with 

8 area agencies on aging to carry out the 

9 home care ombudsman program, based on 

10 the structure of the State’s existing (as of 

11 the date of the determination) long-term 

12 care ombudsman program and the poten13 tial for conflicts of interest in the home 

14 and community-based services system in 

15 the State. A State agency may carry out a 

16 home care ombudsman program through 

17 area agencies on aging in the State, if the 

18 area agencies on aging— 

19 ‘‘(I) have existing (as of the date 

20 of the determination) consumer pro21 tection systems in place to prevent 

22 such conflicts of interest; or 

23 ‘‘(II) establish adequate proce24 dures to prevent conflicts of interest 

25 under the program. 


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1 ‘‘(B) LICENSING AND CERTIFICATION OR2 GANIZATIONS; ASSOCIATIONS.—The State agen3 cy may not enter into the contract or other ar4 rangement described in subparagraph (A) 

5 with— 

6 ‘‘(i) an agency or organization that is 

7 responsible for licensing or certifying home 

8 care services in the State; or 

9 ‘‘(ii) an association (or an affiliate of 

10 such an association) of providers of home 

11 care services. 

12 ‘‘(5) DESIGNATION OF LOCAL HOME CARE OM13 BUDSMAN ENTITIES AND HOME CARE OMBUDSMAN

14 REPRESENTATIVES.— 

15 ‘‘(A) DESIGNATION.—In carrying out the 

16 duties of the Office, the Ombudsman may des17 ignate an entity as a local home care Ombuds18 man entity (and, in doing so, the Ombudsman 

19 shall, if a local Ombudsman entity has already 

20 been designated, designate such local Ombuds21 man entity as the local home care Ombudsman 

22 entity), and may designate an employee or vol23 unteer to represent the entity. 

24 ‘‘(B) DUTIES.—An individual so des25 ignated, in accordance with the policies and 


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1 procedures established by the Ombudsman and 

2 the State agency— 

3 ‘‘(i) shall provide services to protect 

4 the health, safety, welfare, and rights of 

5 home care consumers; 

6 ‘‘(ii) shall ensure that home care con7 sumers in the service area of the entity 

8 have timely responses to complaints and 

9 requests for assistance; 

10 ‘‘(iii) shall identify, investigate, and 

11 resolve complaints made by or on behalf of 

12 home care consumers that relate to action, 

13 inaction, or decisions, that may adversely 

14 affect the health, safety, welfare, or rights 

15 of home care consumers; 

16 ‘‘(iv) shall represent the interests of 

17 home care consumers before government 

18 agencies and seek administrative, legal, 

19 and other remedies to protect the health, 

20 safety, welfare, and rights of home care 

21 consumers; 

22 ‘‘(v) shall— 

23 ‘‘(I) review, and if necessary, 

24 comment on any existing and pro25 posed laws, regulations, and other 


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1 government policies and actions, that 

2 pertain to the rights and well-being of 

3 home care consumers; and 

4 ‘‘(II) facilitate the ability of the 

5 public to comment on the laws, regu6 lations, policies, and actions; and 

7 ‘‘(vi) shall make referrals for services 

8 to protect and provide for the health, safe9 ty, educational needs, welfare, and rights 

10 of family or household members (including 

11 children) of home care consumers; and 

12 ‘‘(vii) shall carry out other activities 

13 that the Ombudsman determines to be ap14 propriate. 

15 ‘‘(C) ELIGIBILITY FOR DESIGNATION.— 

16 Entities eligible to be designated as local home 

17 care Ombudsman entities, and individuals eligi18 ble to be designated as home care ombudsman 

19 representatives of such entities, shall— 

20 ‘‘(i) have demonstrated capability to 

21 carry out the duties established in section 

22 712(a)(5)(B); 

23 ‘‘(ii) be free of conflicts of interest 

24 and not stand to gain financially through 

25 an action or potential action brought on 


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1 behalf of individuals the Ombudsman 

2 serves; and 

3 ‘‘(iii) meet such additional require4 ments as the Ombudsman may specify. 

5 ‘‘(D) POLICIES AND PROCEDURES.— 

6 ‘‘(i) IN GENERAL.—The State agency 

7 shall establish, in accordance with the Om8 budsman, policies and procedures for moni9 toring local home care Ombudsman entities 

10 designated to carry out the duties estab11 lished in section 712(a)(5)(B). 

12 ‘‘(ii) POLICIES.—In a case in which 

13 the entities are grantees or the home care 

14 ombudsman representatives are employees, 

15 of area agencies on aging, the State agency 

16 shall develop the policies in consultation 

17 with the area agencies on aging. The poli18 cies shall provide for participation and 

19 comment by the agencies and for resolu20 tion of concerns with respect to case activ21 ity. 

22 ‘‘(iii) CONFIDENTIALITY AND DISCLO23 SURE.—The State agency shall develop the 

24 policies and procedures in accordance with 

25 all provisions of this subtitle regarding 


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1 confidentiality and conflict of interest for 

2 providers of home care services. 

3 ‘‘(b) PROCEDURES FOR ACCESS.— 

4 ‘‘(1) IN GENERAL.—The State shall ensure that 

5 representatives of the home care ombudsman pro6 gram shall have— 

7 ‘‘(A) access to home care consumers and 

8 their homes with permission of the home care 

9 consumer involved or a legal representative; 

10 ‘‘(B)(i) appropriate access to review all 

11 records of a home care consumer, if— 

12 ‘‘(I) the representative of the home 

13 care ombudsman program has the permis14 sion of the home care consumer, or the 

15 legal representative of the home care con16 sumer; or 

17 ‘‘(II) the home care consumer is un18 able to consent to the review and has no 

19 legal representative; or 

20 ‘‘(ii) such access to the records as is nec21 essary to investigate a complaint if— 

22 ‘‘(I) a legal guardian of the home care 

23 consumer refuses to give the permission; 

24 ‘‘(II) a representative of the home 

25 care ombudsman program has reasonable 


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1 cause to believe that the guardian is not 

2 acting in the best interests of the home 

3 care consumer; and 

4 ‘‘(III) the representative obtains the 

5 approval of the Ombudsman; 

6 ‘‘(C) access to the administrative records, 

7 policies, and documents, to which home care 

8 consumers have, or the general public has ac9 cess, of the provider of home care services; and 

10 ‘‘(D) access to and, on request, copies of 

11 all licensing and certification records main12 tained by the State with respect to the provider 

13 of home care services. 

14 ‘‘(2) PROCEDURES.—The State agency shall es15 tablish procedures to ensure the access described in 

16 paragraph (1). 

17 ‘‘(c) REPORTING SYSTEM.—The State agency shall 

18 ensure that the reporting system established in section 

19 712(c) is equipped to— 

20 ‘‘(1) collect and analyze data relating to com21 plaints and conditions concerning home care services 

22 and to home care consumers for the purpose of iden23 tifying and resolving significant problems, including 

24 complaints concerning— 

25 ‘‘(A) quality of services; 


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1 ‘‘(B) quantity of services; 

2 ‘‘(C) availability of services; and 

3 ‘‘(D) denial, reduction, and termination of 

4 services; and 

5 ‘‘(2) submit the data, on a regular basis, to— 

6 ‘‘(A) the agency of the State responsible 

7 for licensing or certifying providers of home 

8 care services in the State; 

9 ‘‘(B) other State and Federal entities that 

10 the Ombudsman determines to be appropriate; 

11 ‘‘(C) the Assistant Secretary; and 

12 ‘‘(D) the National Ombudsman Resource 

13 Center established in section 202(a)(18)(A). 

14 ‘‘(d) DISCLOSURE.— 

15 ‘‘(1) IN GENERAL.—The State agency shall es16 tablish procedures for the disclosure by the Ombuds17 man or local home care Ombudsman entities of files 

18 maintained by the home care ombudsman program, 

19 including records described in subsection (b)(1) or 

20 (c). 

21 ‘‘(2) IDENTITY OF COMPLAINANT OR HOME

22 CARE CONSUMER.—The procedures described in 

23 paragraph (1) shall— 

24 ‘‘(A) provide that, subject to subparagraph 

25 (B), the files and records described in paraVerDate Mar 15 2010 03:24 Oct 22, 2011 Jkt 099200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\S1750.IS S1750

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1 graph (1) may be disclosed only at the discre2 tion of the Ombudsman (or the person des3 ignated by the Ombudsman to disclose the files 

4 and records); and 

5 ‘‘(B) prohibit the disclosure of the identity 

6 of any complainant or home care consumer with 

7 respect to whom the Office maintains such files 

8 or records unless— 

9 ‘‘(i) the complainant or home care 

10 consumer, or the legal representative of the 

11 complainant or home care consumer, con12 sents to the disclosure and the consent is 

13 given in writing; 

14 ‘‘(ii)(I) the complainant or home care 

15 consumer gives consent orally; and 

16 ‘‘(II) the consent is documented con17 temporaneously in a writing made by a 

18 representative of the home care ombuds19 man program in accordance with such re20 quirements as the State agency shall estab21 lish; or 

22 ‘‘(iii) the disclosure is required by 

23 court order. 

24 ‘‘(e) CONSULTATION.—In planning and carrying out 

25 the home care ombudsman program, the State agency 


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1 shall consider the views of area agencies on aging, older 

2 individuals, and providers of home care services and dem3 onstrate how the State agency has taken their views into 

4 consideration. 

5 ‘‘(f) CONFLICT OF INTEREST.—The State agency 

6 shall— 

7 ‘‘(1) ensure that no individual, or member of 

8 the immediate family of an individual, involved in 

9 the designation of the Ombudsman (whether by ap10 pointment or otherwise) or the designation of an en11 tity designated under subsection (a)(5), is subject to 

12 a conflict of interest; 

13 ‘‘(2) ensure that no officer or employee of the 

14 Office, home care ombudsman representative of a 

15 local home care Ombudsman entity, or member of 

16 the immediate family of the officer, employee, or 

17 home care ombudsman representative, is subject to 

18 a conflict of interest; 

19 ‘‘(3) ensure that the Ombudsman— 

20 ‘‘(A) does not have a direct involvement in 

21 the licensing or certification of a provider of 

22 home care services; 

23 ‘‘(B) does not have an ownership or invest24 ment interest (represented by equity, debt, conVerDate Mar 15 2010 03:24 Oct 22, 2011 Jkt 099200 PO 00000 Frm 00032 Fmt 6652 Sfmt 6201 E:\BILLS\S1750.IS S1750

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1 tract, or other financial relationship) in a pro2 vider of home care services; 

3 ‘‘(C) is not employed by, or participating 

4 in the management of, a provider of home care 

5 services; and 

6 ‘‘(D) does not receive, or have the right to 

7 receive, directly or indirectly, remuneration (in 

8 cash or in-kind) under a compensation arrange9 ment with an owner or operator of a provider 

10 of home care services; and 

11 ‘‘(4) establish, and specify in writing, mecha12 nisms to identify and remove conflicts of interest re13 ferred to in paragraphs (1) and (2), and to identify 

14 and eliminate the relationships described in subpara15 graphs (A) through (D) of paragraph (3), including 

16 such mechanisms as— 

17 ‘‘(A) the methods by which the State agen18 cy will examine individuals, and immediate fam19 ily members, to identify the conflicts; and 

20 ‘‘(B) the actions that the State agency will 

21 require the individuals and such family mem22 bers to take to remove such conflicts. 

23 ‘‘(g) LEGAL COUNSEL.—The State agency shall en24 sure that— 


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1 ‘‘(1)(A) adequate legal counsel is available, and 

2 is able, without conflict of interest, to— 

3 ‘‘(i) provide advice and consultation needed 

4 to protect the health, safety, welfare, and rights 

5 of home care consumers; and 

6 ‘‘(ii) assist the Ombudsman and represent7 atives of the home care ombudsman program in 

8 the performance of the official duties of the 

9 Ombudsman and representatives; and 

10 ‘‘(B) legal representation is provided to any 

11 representative of the home care ombudsman pro12 gram against whom suit or other legal action is 

13 brought or threatened to be brought in connection 

14 with the performance of the official duties of the 

15 Ombudsman or such a representative; and 

16 ‘‘(2) the Ombudsman pursues administrative, 

17 legal, and other appropriate remedies on behalf of 

18 home care consumers. 

19 ‘‘(h) ADMINISTRATION.— 

20 ‘‘(1) REQUIREMENTS.—The State agency shall 

21 require the Office to— 

22 ‘‘(A) include in its annual report required 

23 in section 712(h)(1)— 

24 ‘‘(i) a description of the activities car25 ried out by the Office as they related to 


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1 the home care ombudsman program in the 

2 year for which the report is prepared; 

3 ‘‘(ii) the data and an analysis of the 

4 data collected under subsection (c); 

5 ‘‘(iii) an evaluation of the problems 

6 experienced by, and the complaints made 

7 by or on behalf of, home care consumers; 

8 ‘‘(iv) recommendations for— 

9 ‘‘(I) improving quality of the care 

10 and life of the home care consumers; 

11 and 

12 ‘‘(II) protecting the health, safe13 ty, welfare, and rights of the home 

14 care consumers; 

15 ‘‘(v)(I) an analysis of the success of 

16 the home care ombudsman program includ17 ing success in providing services to home 

18 care consumers in communities with high 

19 percentages of racial or ethnic minorities; 

20 and 

21 ‘‘(II) identification of barriers that 

22 prevent the optimal operation of the home 

23 care ombudsman program; and 

24 ‘‘(vi) policy, regulatory, and legislative 

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1 lems, to resolve the complaints, to improve 

2 the quality of care and life of home care 

3 consumers, to protect the health, safety, 

4 welfare, and rights of home care con5 sumers, and to remove the barriers; 

6 ‘‘(B) not later than 2 years after the date 

7 of the enactment of this chapter, establish pro8 cedures for the training of the representatives 

9 of the home care ombudsman program, includ10 ing unpaid volunteers, based on best practices 

11 outlined by the Assistant Secretary in the most 

12 recent report submitted under subsection 

13 (m)(1), in consultation with representatives of 

14 citizen groups, providers of home care services, 

15 and the home care ombudsman program, that— 

16 ‘‘(i) specify a minimum number of 

17 hours of initial training; 

18 ‘‘(ii) specify the content of the train19 ing, including training relating to— 

20 ‘‘(I) Federal, State, and local 

21 laws, regulations, and policies, with 

22 respect to providers of home care 

23 services in the State; 

24 ‘‘(II) investigative techniques; 

25 and 


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1 ‘‘(III) such other matters as the 

2 State determines to be appropriate; 

3 and 

4 ‘‘(iii) specify an annual number of 

5 hours of in-service training for all des6 ignated representatives; 

7 ‘‘(C) prohibit any representative of the 

8 home care ombudsman program (other than the 

9 Ombudsman) from carrying out any activity de10 scribed in subparagraphs (A) through (H) of 

11 subsection (a)(3) unless the representative— 

12 ‘‘(i) has received the training required 

13 under subparagraph (B); and 

14 ‘‘(ii) has been approved by the Om15 budsman as qualified to carry out the ac16 tivity on behalf of the Office; 

17 ‘‘(D) coordinate home care ombudsman 

18 services with the protection and advocacy sys19 tems for individuals with developmental disabil20 ities and mental illnesses established under— 

21 ‘‘(i) subtitle C of the Developmental 

22 Disabilities Assistance and Bill of Rights 

23 Act of 2000 (42 U.S.C. 15041 et seq.); 

24 and 


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1 ‘‘(ii) the Protection and Advocacy for 

2 Individuals with Mental Illness Act (42 

3 U.S.C. 10801 et seq.); 

4 ‘‘(E) coordinate, to the greatest extent pos5 sible, home care ombudsman services with legal 

6 assistance provided under section 306(a)(2)(C), 

7 through adoption of memoranda of under8 standing and other means; 

9 ‘‘(F) coordinate services with State and 

10 local law enforcement agencies and courts of 

11 competent jurisdiction; and 

12 ‘‘(G) permit any local home care Ombuds13 man entity to carry out the responsibilities de14 scribed in subparagraph (A), (D), or (E). 

15 ‘‘(2) AUTHORITIES.—The State agency shall re16 quire the Office to— 

17 ‘‘(A) analyze, comment on, and monitor 

18 the development and implementation of Fed19 eral, State, and local laws, regulations, and 

20 other government policies and actions that per21 tain to providers of home care services and 

22 those services, and to the health, safety, wel23 fare, and rights of home care consumers, in the 

24 State, and recommend any changes in such 


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1 laws, regulations, and policies as the Ombuds2 man determines to be appropriate; 

3 ‘‘(B)(i) provide such information as the 

4 Ombudsman determines to be necessary to pub5 lic and private agencies, legislators, and other 

6 persons, regarding— 

7 ‘‘(I) the problems and concerns of 

8 older individuals receiving home care serv9 ices; and 

10 ‘‘(II) recommendations related to the 

11 problems and concerns; and 

12 ‘‘(ii) make available to the public, and sub13 mit to the Assistant Secretary, the chief execu14 tive officer of the State, the State legislature, 

15 the State agency responsible for licensing or 

16 certifying providers of home care services, and 

17 other appropriate governmental entities, each 

18 report prepared under paragraph (1)(A); and 

19 ‘‘(C) permit any local home care Ombuds20 man entity to carry out the responsibilities de21 scribed in subparagraph (A) or (B). 

22 ‘‘(i) LIABILITY.—The State shall ensure that no rep23 resentative of the home care ombudsman program will be 

24 liable under State law for the good faith performance of 

25 official duties. 


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1 ‘‘(j) NONINTERFERENCE.—The State shall— 

2 ‘‘(1) ensure that willful interference with rep3 resentatives of the home care ombudsman program 

4 in the performance of the official duties of the rep5 resentatives (as defined by the Assistant Secretary) 

6 shall be unlawful; 

7 ‘‘(2) prohibit retaliation and reprisals by a pro8 vider of home care services or other entity with re9 spect to any recipient of home and community-based 

10 services, employee, exclusive representative of an em11 ployee, or other person for filing a complaint with, 

12 providing information to, or otherwise cooperating 

13 with any representative of, the home care ombuds14 man program; and 

15 ‘‘(3) provide for appropriate sanctions with re16 spect to the interference, retaliation, and reprisals. 

17 ‘‘(k) COORDINATION WITH ADULT PROTECTIVE

18 SERVICES.— 

19 ‘‘(1) IN GENERAL.—The Ombudsman, in car20 rying out the State Home Care Ombudsman Pro21 gram, shall coordinate activities with the National 

22 Adult Protective Services Resource Center and the 

23 head of the State’s adult protective services program 

24 in a manner that is consistent with the State’s exist25 ing (as of the date of the coordination) protocols for 


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1 coordination of activities between the Ombudsman, 

2 in carrying out the State Long-Term Care Ombuds3 man Program. 

4 ‘‘(2) ESTABLISHMENT OF PROTOCOLS.—If the 

5 protocols described in paragraph (1) do not exist in 

6 the State, the Ombudsman, in conjunction with the 

7 head of the State’s adult protective services pro8 gram, shall establish protocols to coordinate activi9 ties with the intent of better serving vulnerable 

10 adults, which protocols shall— 

11 ‘‘(A) clarify the roles of each program; 

12 ‘‘(B) establish procedures for maintaining 

13 a working relationship; 

14 ‘‘(C) outline mutual expectations; and 

15 ‘‘(D) establish procedures for coordinating 

16 activities with law enforcement. 

17 ‘‘(l) MAINTENANCE OF EFFORT.—A State, in using 

18 the funds made available for a fiscal year through a grant 

19 received under section 703(d), shall maintain the expendi20 tures of the State for home care ombudsman services at 

21 a level that is not less than the level of such expenditures 

22 maintained by the State for the preceding fiscal year. 

23 ‘‘(m) EVALUATION.—The Assistant Secretary shall— 

24 ‘‘(1) in conjunction with the Director of the Of25 fice of Long-Term Care Ombudsman Programs and 


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1 the heads of other entities determined to be nec2 essary by the Assistant Secretary, collect and ana3 lyze the data required to be submitted under sub4 section (c) by the States and within 1 year after re5 ceipt of the data, submit a report to Congress out6 lining best practices for carrying out a home care 

7 ombudsman program; and 

8 ‘‘(2) make the report available to States.’’. 

9 TITLE III—QUALITY ASSURANCE 

10 FOR HOME AND COMMUNITY11 BASED SERVICES 

12 SEC. 301. FUNCTIONS OF ASSISTANT SECRETARY. 

13 Section 202(b) of the Older Americans Act of 1965 

14 (42 U.S.C. 3012(b)) is amended— 

15 (1) in paragraph (8)— 

16 (A) in subparagraph (D), by striking 

17 ‘‘and’’ at the end; 

18 (B) in subparagraph (E) by adding ‘‘and’’ 

19 at the end; and 

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

21 ‘‘(F) to provide quality assurance informa22 tion, relating to the standards identified under 

23 paragraph (11)(A), using the methods described 

24 in paragraph (11)(B), about home and commu25 nity-based long-term care programs, service 


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1 providers, and resources, when referring con2 sumers to those programs, providers, or re3 sources;’’; 

4 (2) in paragraph (9)— 

5 (A) in the matter preceding subparagraph 

6 (A), by striking ‘‘and community-based service 

7 providers’’ and inserting ‘‘community-based 

8 service providers, and, for purposes of subpara9 graph (C), Aging and Disability Resource Cen10 ters,’’; 

11 (B) in subparagraph (A), by striking 

12 ‘‘and’’ at the end; 

13 (C) subparagraph (B), by adding ‘‘and’’ at 

14 the end; and 

15 (D) by adding at the end the following: 

16 ‘‘(C) methods, consistent with the methods 

17 described in paragraph (11)(B), to commu18 nicate to consumers quality assurance informa19 tion, relating to the standards identified under 

20 paragraph (11)(A), about home and commu21 nity-based long-term care programs, service 

22 providers, and resources;’’; 

23 (3) in paragraph (10), by striking ‘‘and’’ at the 

24 end; 


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1 (4) by redesignating paragraph (11) as para2 graph (12); and 

3 (5) by inserting after paragraph (10) the fol4 lowing: 

5 ‘‘(11)(A) identify, in consultation with States 

6 (either directly or by entering into a contract under 

7 this subparagraph and considering the recommenda8 tion of the contract recipient) quality assurance 

9 standards for home and community-based long-term 

10 care programs, service providers, and resources 

11 that— 

12 ‘‘(i) shall be designed to ensure the health, 

13 safety, and welfare of consumers who are re14 ferred to such programs, service providers, and 

15 resources by area agencies on aging, Aging and 

16 Disability Resource Centers, and such other en17 tities as the Assistant Secretary determines to 

18 be appropriate; and 

19 ‘‘(ii) shall be identified after the Assistant 

20 Secretary takes into account, at a minimum, 

21 standards for— 

22 ‘‘(I) background checks of service pro23 viders; 

24 ‘‘(II) licensure of agencies and certifi25 cation and training of service providers; 


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1 ‘‘(III) consumer satisfaction regarding 

2 programs, service providers, and resources, 

3 in cases in which consumer satisfaction in4 formation is available; and 

5 ‘‘(IV) such additional matters as the 

6 Assistant Secretary determines to be ap7 propriate; and 

8 ‘‘(B) taking into account the variation in com9 munication infrastructure development among Aging 

10 and Disability Resource Centers, establish consumer11 friendly methods for communicating to consumers, 

12 consistently throughout a State— 

13 ‘‘(i) quality assurance information relating 

14 to the standards identified under subparagraph 

15 (A) about home and community-based long16 term care programs, service providers, and re17 sources to which such consumers are referred to 

18 by area agencies on aging, Aging and Disability 

19 Resource Centers, and such other entities as 

20 the Assistant Secretary determines to be appro21 priate; and 

22 ‘‘(ii)(I) the content of the State certifi23 cation or licensure requirements applicable to 

24 such home and community-based long-term care 

25 programs, service providers, or resources; or 


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1 ‘‘(II) an explanation that the State does 

2 not have certification or licensure requirements 

3 applicable to such home and community-based 

4 long-term care programs, service providers, or 

5 resources; and’’. 

6 SEC. 302. ORGANIZATION. 

7 Section 305(a)(3)(E) of the Older Americans Act of 

8 1965 (42 U.S.C. 3025(a)(3)(E)) is amended— 

9 (1) in the matter before clause (i), by striking 

10 ‘‘information relating to’’; 

11 (2) in clause (i)— 

12 (A) by inserting ‘‘information relating to’’ 

13 after ‘‘(i)’’; and 

14 (B) by striking ‘‘and’’ at the end; 

15 (3) in clause (ii)— 

16 (A) by inserting ‘‘information relating to’’ 

17 after ‘‘(ii)’’; and 

18 (B) by striking the period and inserting ‘‘; 

19 and’’; and 

20 (4) by adding at the end the following: 

21 ‘‘(iii) quality assurance information, 

22 relating to the standards identified under 

23 section 202(b)(11)(A), about home and 

24 community-based long-term care programs, 

25 service providers, and resources, provided 


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1 through methods described in section 

2 202(b)(11)(B), when the Aging and Dis3 ability Resource Centers, area agencies on 

4 aging, and such other entities as the As5 sistant Secretary determines to be appro6 priate, refer consumers to those programs, 

7 providers, and resources in the State.’’. 

Æ 


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