II 

113TH CONGRESS 

1ST SESSION S. 1562 

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

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 30, 2013 

Mr. SANDERS (for himself, Mr. ALEXANDER, and Mr. HARKIN) introduced the 

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

Health, Education, Labor, and Pensions 

A BILL 

To reauthorize the Older Americans Act of 1965, 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 Reauthorization Act of 2013’’. 

6 SEC. 2. DEFINITIONS. 

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

8 U.S.C. 3002) is amended— 

9 (1) by striking paragraph (1) and inserting the 

10 following: 


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1 ‘‘(1) The term ‘abuse’ means the knowing in2 fliction of physical or psychological harm or the 

3 knowing deprivation of goods or services that are 

4 necessary to meet essential needs or to avoid phys5 ical or psychological harm.’’; 

6 (2) by striking paragraph (4) and inserting the 

7 following: 

8 ‘‘(4) The term ‘Aging and Disability Resource 

9 Center’ means an entity, network, or consortium es10 tablished by a State as part of the State system of 

11 long-term care, to provide a coordinated and inte12 grated system for older individuals and individuals 

13 with disabilities (as defined in section 3 of the Amer14 icans with Disabilities Act of 1990 (42 U.S.C. 

15 12102)), and the caregivers of older individuals and 

16 individuals with disabilities, that provides— 

17 ‘‘(A) comprehensive information on the full 

18 range of available public and private long-term 

19 care programs, options, service providers, and 

20 resources within a community, including infor21 mation on the availability of integrated long22 term care services, and Federal or State pro23 grams that provide long-term care services and 

24 supports through home and community-based 

25 service programs; 


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1 ‘‘(B) person-centered counseling to assist 

2 individuals in assessing their existing or antici3 pated long-term care needs and goals, and de4 veloping and implementing a person-centered 

5 plan for long-term care that is consistent with 

6 the desires of such an individual and designed 

7 to meet the individual’s specific needs, goals, 

8 and circumstances; 

9 ‘‘(C) access for individuals to the full 

10 range of publicly supported long-term care serv11 ices and supports for which the individuals may 

12 be eligible, including home and community13 based service options, by serving as a conven14 ient point of entry for such programs and sup15 ports; and 

16 ‘‘(D) in cooperation with area agencies on 

17 aging, centers for independent living described 

18 in part C of title VII of the Rehabilitation Act 

19 of 1973 (29 U.S.C. 796f et seq.), and other 

20 community-based entities, information and re21 ferrals regarding available home and commu22 nity-based services for individuals who are at 

23 risk for residing in, or who reside in, institu24 tional settings, so that the individuals have the 


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1 choice to remain in or to return to the commu2 nity.’’; 

3 (3) in paragraph (14)(B), by inserting ‘‘oral 

4 health,’’ after ‘‘bone density,’’; 

5 (4) by striking paragraph (17) and inserting 

6 the following: 

7 ‘‘(17) The term ‘elder justice’ means— 

8 ‘‘(A) from a societal perspective, efforts 

9 to— 

10 ‘‘(i) prevent, detect, treat, intervene 

11 in, and prosecute elder abuse, neglect, and 

12 exploitation; and 

13 ‘‘(ii) protect older individuals with di14 minished capacity while maximizing their 

15 autonomy; and 

16 ‘‘(B) from an individual perspective, the 

17 recognition of an older individual’s rights, in18 cluding the right to be free of abuse, neglect, 

19 and exploitation.’’; 

20 (5) in paragraph (18)(A), by striking ‘‘term ‘ex21 ploitation’ means’’ and inserting ‘‘terms ‘exploi22 tation’ and ‘financial exploitation’ mean’’; and 

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


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1 ‘‘(55) The term ‘adult protective services’ 

2 means such services provided to adults as the Sec3 retary may specify and includes services such as— 

4 ‘‘(A) receiving reports of adult abuse, ne5 glect, or exploitation; 

6 ‘‘(B) investigating the reports described in 

7 subparagraph (A); 

8 ‘‘(C) case planning, monitoring, evaluation, 

9 and other casework and services; and 

10 ‘‘(D) providing, arranging for, or facili11 tating the provision of medical, social service, 

12 economic, legal, housing, law enforcement, or 

13 other protective, emergency, or support serv14 ices.’’. 

15 SEC. 3. ADMINISTRATION ON AGING. 

16 (a) BEST PRACTICES.—Section 201 of the Older 

17 Americans Act of 1965 (42 U.S.C. 3011) is amended— 

18 (1) in subsection (d)(3)— 

19 (A) in subparagraph (K), by striking 

20 ‘‘and’’ at the end; 

21 (B) in subparagraph (L)— 

22 (i) by striking ‘‘Older Americans Act 

23 Amendments of 1992’’ and inserting 

24 ‘‘Older Americans Act Reauthorization Act 

25 of 2013’’; and 


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1 (ii) by striking ‘‘712(h)(4).’’ and in2 serting ‘‘712(h)(5); and’’; and 

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

4 ‘‘(M) collect and analyze best practices related 

5 to responding to elder abuse, neglect, and exploi6 tation in long-term care facilities, and publish a re7 port of such best practices.’’; and 

8 (2) in subsection (e)(2), in the matter preceding 

9 subparagraph (A), by inserting ‘‘, and in coordina10 tion with the heads of State adult protective services 

11 programs and the Director of the Office of Long12 Term Care Ombudsman Programs’’ after ‘‘and serv13 ices’’. 

14 (b) TRAINING.—Section 202 of the Older Americans 

15 Act of 1965 (42 U.S.C. 3012) is amended— 

16 (1) in subsection (a)— 

17 (A) in paragraph (5), by inserting ‘‘health 

18 and economic’’ before ‘‘needs of older individ19 uals’’; 

20 (B) in paragraph (7), by inserting ‘‘health 

21 and economic’’ before ‘‘welfare’’; 

22 (C) in paragraph (14), by inserting ‘‘(in23 cluding the Health Resources and Services Ad24 ministration)’’ after ‘‘other agencies’’; 


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1 (D) in paragraph (27), by striking ‘‘and’’ 

2 at the end; 

3 (E) in paragraph (28), by striking the pe4 riod and inserting a semicolon; and 

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

6 ‘‘(29) provide information and technical assist7 ance to States, area agencies on aging, and service 

8 providers, in collaboration with relevant Federal 

9 agencies, on providing efficient, person-centered 

10 transportation services, including across geographic 

11 boundaries; 

12 ‘‘(30) identify model programs and provide in13 formation and technical assistance to States, area 

14 agencies on aging, and service providers (including 

15 providers operating multipurpose senior centers), to 

16 support the modernization of multipurpose senior 

17 centers; and 

18 ‘‘(31) provide technical assistance to and share 

19 best practices with States, area agencies on aging, 

20 and Aging and Disability Resource Centers, on how 

21 to collaborate and coordinate services with health 

22 care entities, such as Federally-qualified health cen23 ters, as defined in section 1905(l)(2)(B) of the So24 cial Security Act (42 U.S.C. 1396d(l)(2)(B)), in 


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1 order to improve care coordination for individuals 

2 with multiple chronic illnesses.’’; 

3 (2) in subsection (b)— 

4 (A) in paragraph (5)— 

5 (i) in subparagraph (B), by striking 

6 ‘‘and’’ after the semicolon; 

7 (ii) in subparagraph (C), by inserting 

8 ‘‘and’’ after the semicolon; and 

9 (iii) by adding at the end the fol10 lowing: 

11 ‘‘(D) when feasible, developing, in con12 sultation with States and national organiza13 tions, a consumer-friendly tool to assist older 

14 individuals and their families in choosing home 

15 and community-based services, with a particular 

16 focus on ways for consumers to assess how pro17 viders protect the health, safety, welfare, and 

18 rights, including the rights provided under sec19 tion 314, of older individuals;’’; and 

20 (B) in paragraph (8)— 

21 (i) in subparagraph (B), by inserting 

22 ‘‘to identify and articulate goals of care 

23 and’’ after ‘‘individuals’’; 

24 (ii) in subparagraph (D)— 


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1 (I) by inserting ‘‘respond to or’’ 

2 before ‘‘plan’’; and 

3 (II) by striking ‘‘future long-term 

4 care needs; and’’ and inserting ‘‘long5 term care needs;’’; 

6 (iii) in subparagraph (E), by adding 

7 ‘‘and’’ at the end; and 

8 (iv) by adding at the end the fol9 lowing: 

10 ‘‘(F) to provide information and referrals 

11 regarding available home and community-based 

12 services for individuals who are at risk for re13 siding in, or who reside in, institutional set14 tings, so that the individuals have the choice to 

15 remain in or to return to the community.’’; and 

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

17 ‘‘(g) The Assistant Secretary shall, as appropriate, 

18 ensure that programs authorized under this Act include 

19 appropriate training in the prevention of abuse, neglect, 

20 and exploitation and provision of services that address 

21 elder justice and the exploitation of older individuals.’’. 

22 (c) AUTHORIZATION OF APPROPRIATIONS.—Section 

23 216 of the Older Americans Act of 1965 (42 U.S.C. 

24 3020f) is amended— 


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1 (1) in subsection (a), by striking ‘‘2007, 2008, 

2 2009, 2010, and 2011’’ and inserting ‘‘2014, 2015, 

3 2016, 2017, and 2018’’; 

4 (2) in subsection (b)— 

5 (A) by striking ‘‘202(a)(24)’’ and inserting 

6 ‘‘202(a)(21)’’; and 

7 (B) by striking ‘‘2007, 2008, 2009, 2010, 

8 and 2011’’ and inserting ‘‘2014, 2015, 2016, 

9 2017, and 2018’’; and 

10 (3) in subsection (c), by striking ‘‘2007, 2008, 

11 2009, 2010, and 2011’’ and inserting ‘‘2014, 2015, 

12 2016, 2017, and 2018’’. 

13 SEC. 4. STATE AND COMMUNITY PROGRAMS ON AGING. 

14 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 

15 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) 

16 is amended— 

17 (1) in subsection (a)(1), by striking ‘‘fiscal 

18 years 2007’’ and all that follows and inserting ‘‘each 

19 of fiscal years 2014 through 2018.’’; 

20 (2) in subsection (b)— 

21 (A) in paragraph (1), by striking ‘‘fiscal 

22 years 2007’’ and all that follows and inserting 

23 ‘‘each of fiscal years 2014 through 2018.’’; and 


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1 (B) in paragraph (2), by striking ‘‘fiscal 

2 years 2007’’ and all that follows and inserting 

3 ‘‘each of fiscal years 2014 through 2018.’’; 

4 (3) in subsection (d), by striking ‘‘fiscal years 

5 2007’’ and all that follows and inserting ‘‘each of 

6 fiscal years 2014 through 2018.’’; and 

7 (4) in subsection (e)(2), by striking ‘‘2011’’ and 

8 inserting ‘‘2011 and each of fiscal years 2014 

9 through 2018’’. 

10 (b) CONFORMING AMENDMENT.—Section 304(b) of 

11 the Older Americans Act of 1965 (42 U.S.C. 3024(b)) is 

12 amended by striking ‘‘subpart 1 of’’. 

13 (c) PLANNING AND SERVICE AREAS.—Section 

14 305(b)(5)(C)(i)(III) of the Older Americans Act of 1965 

15 (42 U.S.C. 3025(b)(5)(C)(i)(III)) is amended by striking 

16 ‘‘planning and services areas’’ and inserting ‘‘planning 

17 and service areas’’. 

18 (d) AREA PLANS.—Section 306 of the Older Ameri19 cans Act of 1965 (42 U.S.C. 3026) is amended— 

20 (1) in subsection (a)— 

21 (A) in paragraph (1), by striking ‘‘estab22 lishment, maintenance, or construction of multi23 purpose senior centers,’’ and inserting ‘‘estab24 lishment, maintenance, modernization, or con25 struction of multipurpose senior centers (includVerDate Mar 15 2010 02:48 Oct 03, 2013 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1562.IS S1562

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1 ing a plan to use the skills and services of older 

2 individuals in paid and unpaid work, including 

3 multigenerational and older individual to older 

4 individual work),’’; and 

5 (B) in paragraph (6)— 

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

7 ‘‘and’’ at the end; and 

8 (ii) by adding at the end the fol9 lowing: 

10 ‘‘(H) in coordination with the State agency 

11 and with the State agency responsible for elder 

12 abuse prevention services, increase public 

13 awareness of elder abuse, neglect, and exploi14 tation, and remove barriers to education, pre15 vention, investigation, and treatment of elder 

16 abuse neglect, and exploitation education, as 

17 appropriate;’’; and 

18 (2) in subsection (b)(3)— 

19 (A) in subparagraph (J), by striking ‘‘and’’ 

20 at the end; 

21 (B) by redesignating subparagraph (K) as 

22 subparagraph (L); and 

23 (C) by inserting after subparagraph (J) 

24 the following: 


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1 ‘‘(K) protection from elder abuse, neglect, 

2 and exploitation; and’’. 

3 (e) NUTRITION SERVICES INCENTIVE PROGRAM.— 

4 Section 311(e) of the Older Americans Act of 1965 (42 

5 U.S.C. 3030a(e)) is amended by striking ‘‘fiscal year 

6 2007’’ and all that follows and inserting ‘‘each of fiscal 

7 years 2014 through 2018.’’. 

8 (f) SUPPORTIVE SERVICES.—Section 321 of the 

9 Older Americans Act of 1965 (42 U.S.C. 3030d) is 

10 amended— 

11 (1) in subsection (a)— 

12 (A) in paragraph (1), by striking ‘‘or refer13 ral services’’ and inserting ‘‘referral, chronic 

14 condition self-care management, or falls preven15 tion services’’; 

16 (B) in paragraph (8), by striking ‘‘(includ17 ing’’ and all that follows and inserting the fol18 lowing: ‘‘(including mental and behavioral 

19 health screening and falls prevention services 

20 screening) to detect or prevent (or both) ill21 nesses and injuries that occur most frequently 

22 in older individuals;’’ and 

23 (C) in paragraph (15), by inserting before 

24 the semicolon the following: ‘‘, and screening 

25 for elder abuse, neglect, and exploitation’’; 


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1 (2) in subsection (b)(1), by inserting ‘‘or mod2 ernization’’ after ‘‘construction’’; and 

3 (3) in subsection (c), by inserting before the pe4 riod the following: ‘‘, and pursue opportunities for 

5 the development of intergenerational shared site 

6 models for programs or projects, consistent with the 

7 purposes of this Act’’. 

8 (g) HOME DELIVERED NUTRITION SERVICES PRO9 GRAM.—Section 336(a)(1) of the Older Americans Act of 

10 1965 (42 U.S.C. 3030f(a)(1)) is amended by striking 

11 ‘‘canned’’ and all that follows through ‘‘meals’’ and insert12 ing ‘‘canned, or fresh foods and, as appropriate, supple13 mental foods, and any additional meals’’. 

14 (h) NUTRITION SERVICES.—Section 339 of the Older 

15 Americans Act of 1965 (42 U.S.C. 3030g–21) is amend16 ed— 

17 (1) in paragraph (1), by striking ‘‘solicit’’ and 

18 inserting ‘‘utilize’’; and 

19 (2) in paragraph (2)— 

20 (A) in subparagraph (J), by striking ‘‘and’’ 

21 at the end; 

22 (B) in subparagraph (K), by striking the 

23 period and inserting ‘‘; and’’; and 

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


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1 ‘‘(L) where feasible, encourages the use of 

2 locally grown foods in meal programs and iden3 tifies potential partnerships and contracts with 

4 local producers and providers of locally grown 

5 foods.’’. 

6 (i) EVIDENCE-BASED DISEASE PREVENTION AND

7 HEALTH PROMOTION SERVICES PROGRAM.—Part D of 

8 title III of the Older Americans Act of 1965 (42 U.S.C. 

9 3030m et seq.) is amended— 

10 (1) in the part heading, by inserting ‘‘EVI11 DENCE-BASED’’ before ‘‘DISEASE’’; and 

12 (2) in section 361(a), by inserting ‘‘evidence13 based’’ after ‘‘to provide’’. 

14 (j) OLDER RELATIVE CAREGIVERS.— 

15 (1) TECHNICAL AMENDMENT.—Part E of title 

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

17 3030s et seq.) is amended by striking the subpart 

18 heading for subpart 1. 

19 (2) DEFINITIONS.—Section 372 of such Act (42 

20 U.S.C. 3030s) is amended— 

21 (A) in subsection (a)— 

22 (i) in paragraph (1), by striking ‘‘or 

23 who is an individual with a disability’’; and 

24 (ii) by striking paragraph (2) and in25 serting the following: 


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1 ‘‘(2) INDIVIDUAL WITH A DISABILITY.—The 

2 term ‘individual with a disability’ means an indi3 vidual with a disability, as defined in section 3 of the 

4 Americans with Disabilities Act of 1990 (42 U.S.C. 

5 12102), who is not less than 18 and not more than 

6 59 years of age. 

7 ‘‘(3) OLDER RELATIVE CAREGIVER.—The term 

8 ‘older relative caregiver’ means a caregiver who— 

9 ‘‘(A)(i) is 55 years of age or older; and 

10 ‘‘(ii) lives with, is the informal provider of 

11 in-home and community care to, and is the pri12 mary caregiver for, a child or an individual with 

13 a disability; 

14 ‘‘(B) in the case of a caregiver for a 

15 child— 

16 ‘‘(i) is the grandparent, stepgrandpar17 ent, or other relative (other than the par18 ent) by blood, marriage, or adoption, of the 

19 child; 

20 ‘‘(ii) is the primary caregiver of the 

21 child because the biological or adoptive 

22 parents are unable or unwilling to serve as 

23 the primary caregivers of the child; and 

24 ‘‘(iii) has a legal relationship to the 

25 child, such as legal custody, adoption, or 


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1 guardianship, or is raising the child infor2 mally; and 

3 ‘‘(C) in the case of a caregiver for an indi4 vidual with a disability, is the parent, grand5 parent, or other relative by blood, marriage, or 

6 adoption, of the individual with a disability.’’; 

7 and 

8 (B) in subsection (b)— 

9 (i) by striking ‘‘subpart’’ and all that 

10 follows through ‘‘family caregivers’’ and in11 serting ‘‘part, for family caregivers’’; 

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

13 a period; and 

14 (iii) by striking paragraph (2). 

15 (k) NATIONAL FAMILY CAREGIVER SUPPORT PRO16 GRAM.—Section 373 of the Older Americans Act of 1965 

17 (42 U.S.C. 3030s–1) is amended— 

18 (1) in subsection (a)(2), by striking ‘‘grand19 parents or older individuals who are relative care20 givers.’’ and inserting ‘‘older relative caregivers.’’; 

21 (2) in subsection (c)— 

22 (A) in paragraph (1), in the matter pre23 ceding subparagraph (A), by striking ‘‘grand24 parents and older individuals who are relative 


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1 caregivers, and who’’ and inserting ‘‘older rel2 ative caregivers, who’’; and 

3 (B) in paragraph (2)(B), by striking ‘‘to 

4 older individuals providing care to individuals 

5 with severe disabilities, including children with 

6 severe disabilities’’ and inserting ‘‘to older rel7 ative caregivers of children with severe disabil8 ities, or individuals with disabilities who have 

9 severe disabilities’’; 

10 (3) in subsection (e)(3), by striking ‘‘grand11 parents or older individuals who are relative care12 givers’’ and inserting ‘‘older relative caregivers’’; 

13 (4) in subsection (f)(1)(A), by striking ‘‘for fis14 cal years 2007, 2008, 2009, 2010, and 2011’’ and 

15 inserting ‘‘for a fiscal year’’; and 

16 (5) in subsection (g)(2)(C), by striking ‘‘grand17 parents and older individuals who are relative care18 givers of a child who is not more than 18 years of 

19 age’’ and inserting ‘‘older relative caregivers’’. 

20 (l) CONFORMING AMENDMENT.—Part E of title III 

21 is amended by striking ‘‘this subpart’’ each place it ap22 pears and inserting ‘‘this part’’. 


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1 SEC. 5. ACTIVITIES FOR HEALTH, INDEPENDENCE, AND 

2 LONGEVITY. 

3 (a) GRANT PROGRAMS.—Section 411 of the Older 

4 Americans Act of 1965 (42 U.S.C. 3032) is amended— 

5 (1) in subsection (a)— 

6 (A) in paragraph (12), by striking ‘‘and’’ 

7 at the end; 

8 (B) by redesignating paragraph (13) as 

9 paragraph (14); and 

10 (C) by inserting after paragraph (12) the 

11 following: 

12 ‘‘(13) continuing support for program integrity 

13 initiatives concerning the Medicare program under 

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

15 1395 et seq.) that train senior volunteers to prevent 

16 and identify health care fraud and abuse; and’’; and 

17 (2) in subsection (b), by striking ‘‘for fiscal 

18 years 2007’’ and all that follows through ‘‘2011’’ 

19 and inserting ‘‘for each of fiscal years 2014 through 

20 2018’’. 

21 (b) NATIVE AMERICAN PROGRAMS.—Section 418(b) 

22 of the Older Americans Act of 1965 (42 U.S.C. 3032g(b)) 

23 is amended by striking ‘‘a national meeting to train’’ and 

24 inserting ‘‘national trainings for’’. 


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1 (c) LEGAL ASSISTANCE FOR OLDER AMERICANS.— 

2 Section 420(c) of the Older Americans Act of 1965 (42 

3 U.S.C. 3032i(c)) is amended by striking ‘‘national’’. 

4 (d) REPEALS.—Sections 415, 419, and 421 of the 

5 Older Americans Act of 1965 (42 U.S.C. 3032d, 3032h, 

6 3032j) is repealed. 

7 (e) CONFORMING AMENDMENT.—Section 417(a)(1) 

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

9 3032f(a)(1)) is amended by striking ‘‘grandparents and 

10 other older individuals who are relative caregivers’’ and 

11 inserting ‘‘older relative caregivers (as defined in section 

12 372)’’. 

13 SEC. 6. COMMUNITY SERVICE SENIOR OPPORTUNITIES. 

14 Section 517(a) of the Older Americans Act of 1965 

15 (42 U.S.C. 3056o(a)) is amended by striking ‘‘fiscal years 

16 2007, 2008, 2009, 2010, and 2011’’ and inserting ‘‘each 

17 of fiscal years 2014 through 2018’’. 

18 SEC. 7. GRANTS FOR NATIVE AMERICANS. 

19 Section 643(2) of the Older Americans Act of 1965 

20 (42 U.S.C. 3057n(2)) is amended by striking ‘‘fiscal year 

21 2011’’ and inserting ‘‘each of fiscal years 2014 through 

22 2018’’. 


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1 SEC. 8. VULNERABLE ELDER RIGHTS PROTECTION ACTIVI2 TIES. 

3 (a) OMBUDSMAN DEFINITIONS.—Section 711(6) of 

4 the Older Americans Act of 1965 (42 U.S.C. 3058f(6)) 

5 is amended by striking ‘‘older’’. 

6 (b) OMBUDSMAN PROGRAMS.—Section 712 of the 

7 Older Americans Act of 1965 (42 U.S.C. 3058g) is 

8 amended— 

9 (1) in subsection (a)— 

10 (A) in paragraph (2), by adding at the end 

11 the following: ‘‘The Ombudsman shall be re12 sponsible for the management, including the fis13 cal management, of the Office.’’; 

14 (B) in paragraph (3)— 

15 (i) in subparagraph (A), by striking 

16 clause (i) and inserting the following: 

17 ‘‘(i) are made by, or on behalf of, resi18 dents, including residents with limited or 

19 no decision-making capacity and who have 

20 no known legal representative, and if such 

21 a resident is unable to communicate con22 sent for an Ombudsman to work on a com23 plaint directly involving the resident, the 

24 Ombudsman shall seek evidence to indicate 

25 what outcome the resident would have 

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1 dence to the contrary, shall assume that 

2 the resident wishes to have the resident’s 

3 health, safety, welfare, and rights pro4 tected) and shall work to accomplish that 

5 outcome; and’’; 

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

7 ‘‘regular and timely’’ and inserting ‘‘reg8 ular, timely, private, and unimpeded’’; 

9 (iii) in subparagraph (H)(iii)— 

10 (I) by inserting ‘‘, actively en11 courage, and assist in’’ after ‘‘provide 

12 technical support for’’; and 

13 (II) by striking ‘‘and’’ after the 

14 semicolon; 

15 (iv) by redesignating subparagraph (I) 

16 as subparagraph (J); and 

17 (v) by inserting after subparagraph 

18 (H) the following: 

19 ‘‘(I) when feasible, continue to carry out 

20 the functions described in this section on behalf 

21 of residents transitioning from a long-term care 

22 facility to a home care setting; and’’; and 

23 (C) in paragraph (5)(B)— 

24 (i) in clause (vi)— 


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1 (I) by inserting ‘‘, actively en2 courage, and assist in’’ after ‘‘sup3 port’’; and 

4 (II) by striking ‘‘and’’ after the 

5 semicolon; 

6 (ii) by redesignating clause (vii) as 

7 clause (viii); and 

8 (iii) by inserting after clause (vi) the 

9 following: 

10 ‘‘(vii) identify, investigate, and resolve 

11 complaints described in clause (iii) that are 

12 made by or on behalf of residents with lim13 ited or no decision-making capacity and 

14 who have no known legal representative, 

15 and if such a resident is unable to commu16 nicate consent for an Ombudsman to work 

17 on a complaint directly involving the resi18 dent, the Ombudsman shall seek evidence 

19 to indicate what outcome the resident 

20 would have communicated (and, in the ab21 sence of evidence to the contrary, shall as22 sume that the resident wishes to have the 

23 resident’s health, safety, welfare, and 

24 rights protected) and shall work to accom25 plish that outcome; and’’; 


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1 (2) in subsection (b)— 

2 (A) in paragraph (1)— 

3 (i) in subparagraph (A), by striking 

4 ‘‘access’’ and inserting ‘‘private and 

5 unimpeded access’’; and 

6 (ii) in subparagraph (B)— 

7 (I) in clause (i)— 

8 (aa) in the matter preceding 

9 subclause (I), by striking ‘‘the 

10 medical and social records of a’’ 

11 and inserting ‘‘all files, records, 

12 and other information concerning 

13 a’’; and 

14 (bb) in subclause (II), by 

15 striking ‘‘to consent’’ and insert16 ing ‘‘to communicate consent’’; 

17 and 

18 (II) in clause (ii), in the matter 

19 before subclause (I), by striking ‘‘the 

20 records’’ and inserting ‘‘the files, 

21 records, and information’’; and 

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

23 ‘‘(3) HEALTH OVERSIGHT AGENCY.—For pur24 poses of section 264(c) of the Health Insurance 

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1 ing regulations issued under that section) (42 U.S.C. 

2 1320d–2 note), the Ombudsman and a representa3 tive of the Office shall be considered a ‘health over4 sight agency,’ so that release of residents’ individ5 ually identifiable health information to the Ombuds6 man or representative is not precluded in cases in 

7 which the requirements of clause (i) or (ii) of para8 graph (1)(B), or the requirements of paragraph 

9 (1)(D), are otherwise met.’’; 

10 (3) in subsection (d)— 

11 (A) in paragraph (1), by striking ‘‘files’’ 

12 and inserting ‘‘files, records, and other informa13 tion’’; and 

14 (B) in paragraph (2)— 

15 (i) in subparagraph (A)— 

16 (I) by striking ‘‘files and 

17 records’’ each place such term appears 

18 and inserting ‘‘files, records, and 

19 other information’’; and 

20 (II) by striking ‘‘and’’ after the 

21 semicolon; 

22 (ii) in subparagraph (B)— 

23 (I) by striking ‘‘files or records’’ 

24 and inserting ‘‘files, records, or other 

25 information’’; and 


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1 (II) in clause (iii), by striking the 

2 period at the end and inserting ‘‘; 

3 and’’; and 

4 (iii) by adding at the end the fol5 lowing: 

6 ‘‘(C) notwithstanding subparagraph (B), 

7 ensure that the Ombudsman may disclose infor8 mation as needed in order to best serve resi9 dents with limited or no decision-making capac10 ity who have no known legal representative and 

11 are unable to communicate consent, in order for 

12 the Ombudsman to carry out the functions and 

13 duties described in paragraphs (3)(A)(i) and 

14 (5)(B)(vi) of subsection (a).’’; 

15 (4) by striking subsection (f) and inserting the 

16 following: 

17 ‘‘(f) CONFLICT OF INTEREST.— 

18 ‘‘(1) INDIVIDUAL CONFLICT OF INTEREST.— 

19 The State agency shall— 

20 ‘‘(A) ensure that no individual, or member 

21 of the immediate family of an individual, in22 volved in the designation of the Ombudsman 

23 (whether by appointment or otherwise) or the 

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1 section (a)(5), is subject to a conflict of inter2 est; 

3 ‘‘(B) ensure that no officer or employee of 

4 the Office, representative of a local Ombudsman 

5 entity, or member of the immediate family of 

6 the officer, employee, or representative, is sub7 ject to a conflict of interest; and 

8 ‘‘(C) ensure that the Ombudsman— 

9 ‘‘(i) does not have a direct involve10 ment in the licensing or certification of a 

11 long-term care facility or of a provider of 

12 a long-term care service; 

13 ‘‘(ii) does not have an ownership or 

14 investment interest (represented by equity, 

15 debt, or other financial relationship) in a 

16 long-term care facility or a long-term care 

17 service; 

18 ‘‘(iii) is not employed by, or partici19 pating in the management of, a long-term 

20 care facility or a related organization, and 

21 has not been employed by such a facility or 

22 organization within 1 year before the date 

23 of the determination involved; 

24 ‘‘(iv) does not receive, or have the 

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1 muneration (in cash or in kind) under a 

2 compensation arrangement with an owner 

3 or operator of a long-term care facility; 

4 ‘‘(v) does not have management re5 sponsibility for, or operate under the su6 pervision of an individual with manage7 ment responsibility for, adult protective 

8 services; and 

9 ‘‘(vi) does not serve as a guardian or 

10 in another fiduciary capacity for residents 

11 of long-term care facilities in an official ca12 pacity (as opposed to serving as a guardian 

13 or fiduciary for a family member, in a per14 sonal capacity). 

15 ‘‘(2) ORGANIZATIONAL CONFLICT OF INTER16 EST.— 

17 ‘‘(A) IN GENERAL.—The State agency 

18 shall comply with subparagraph (B)(i) in a case 

19 in which the Office poses an organizational con20 flict of interest, including a situation in which 

21 the Office is placed in an organization that— 

22 ‘‘(i) is responsible for licensing, certi23 fying or surveying long-term care services 

24 in the State; 


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1 ‘‘(ii) is an association (or an affiliate 

2 of such an association) of long-term care 

3 facilities, or of any other residential facili4 ties for older individuals; 

5 ‘‘(iii) provides long-term care services, 

6 including programs carried out under a 

7 Medicaid waiver approved under section 

8 1115 of the Social Security Act (42 U.S.C. 

9 1315) or under subsection (c) or (b) of 

10 section 1915 of the Social Security Act (42 

11 U.S.C. 1396n), or under a Medicaid State 

12 plan amendment under subsection (i), (j), 

13 or (k) of section 1915 of the Social Secu14 rity Act (42 U.S.C. 1396n); 

15 ‘‘(iv) provides long-term care case 

16 management; 

17 ‘‘(v) sets rates for long-term care 

18 services; 

19 ‘‘(vi) provides adult protective serv20 ices; 

21 ‘‘(vii) is responsible for eligibility de22 terminations for the Medicaid program 

23 carried out under title XIX, of the Social 

24 Security Act (42 U.S.C. 1395 et seq., 1396 

25 et seq.); 


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1 ‘‘(viii) conducts preadmission screen2 ing for placements in facilities described in 

3 clause (ii); or 

4 ‘‘(ix) makes decisions regarding ad5 mission or discharge of individuals to or 

6 from such facilities. 

7 ‘‘(B) IDENTIFYING, REMOVING, AND REM8 EDYING ORGANIZATIONAL CONFLICT.— 

9 ‘‘(i) IN GENERAL.—The State agency 

10 may not operate the Office or carry out the 

11 program, directly, or by contract or other 

12 arrangement with any public agency or 

13 nonprofit private organization, in a case in 

14 which there is an organizational conflict of 

15 interest (within the meaning of subpara16 graph (A)) unless such conflict of interest 

17 has been— 

18 ‘‘(I) identified by the State agen19 cy; 

20 ‘‘(II) disclosed by the State agen21 cy to the Assistant Secretary in writ22 ing; and 

23 ‘‘(III) remedied in accordance 

24 with this subparagraph. 


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1 ‘‘(ii) ACTION BY ASSISTANT SEC2 RETARY.—In a case in which a potential or 

3 actual organizational conflict of interest 

4 (within the meaning of subparagraph (A)) 

5 involving the Office is disclosed or reported 

6 to the Assistant Secretary by any person 

7 or entity, the Assistant Secretary shall re8 quire that the State agency, in accordance 

9 with the policies and procedures estab10 lished by the State agency under section 

11 705(a)(5)(D)(iii)— 

12 ‘‘(I) remove the conflict; or 

13 ‘‘(II) submit, and obtain the ap14 proval of the Assistant Secretary for, 

15 an adequate remedial plan that indi16 cates how the Ombudsman will be 

17 unencumbered in fulfilling all of the 

18 functions specified in subsection 

19 (a)(3).’’; and 

20 (5) in subsection (h)— 

21 (A) in paragraph (3)(A)(i), by striking 

22 ‘‘older’’; 

23 (B) in paragraph (4), by striking all that 

24 precedes ‘‘procedures’’ and inserting the fol25 lowing: 


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1 ‘‘(4) strengthen and update’’; 

2 (C) by redesignating paragraphs (4) 

3 through (9) as paragraphs (5) through (10), re4 spectively; 

5 (D) by inserting after paragraph (3) the 

6 following: 

7 ‘‘(4) ensure that the Ombudsman or a designee 

8 participates in training provided by the National 

9 Ombudsman Resource Center established in section 

10 202(a)(18);’’; 

11 (E) in paragraph (6)(A), as redesignated 

12 by subparagraph (B) of this paragraph, by 

13 striking ‘‘paragraph (4)’’ and inserting ‘‘para14 graph (5)’’; 

15 (F) in paragraph (7)(A), as redesignated 

16 by subparagraph (B) of this paragraph, by 

17 striking ‘‘subtitle C of the’’ and inserting ‘‘sub18 title C of title I of the’’; and 

19 (G) in paragraph (10), as redesignated by 

20 subparagraph (B) of this paragraph, by striking 

21 ‘‘(6), or (7)’’ and inserting ‘‘(7), or (8)’’. 

22 (c) OMBUDSMAN REGULATIONS.—Section 713 of the 

23 Older Americans Act of 1965 (42 U.S.C. 3058h) is 

24 amended— 


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1 (1) in paragraph (1), by striking ‘‘paragraphs 

2 (1) and (2) of section 712(f)’’ and inserting ‘‘sub3 paragraphs (A) and (B) of section 712(f)(1)’’; and 

4 (2) in paragraph (2), by striking ‘‘subpara5 graphs (A) through (D) of section 712(f)(3)’’ and 

6 inserting ‘‘clauses (i) through (vi) of section 

7 712(f)(1)(C)’’. 

8 (d) PREVENTION OF ELDER ABUSE, NEGLECT, AND

9 EXPLOITATION.—Section 721 of the Older Americans Act 

10 of 1965 (42 U.S.C. 3058i) is amended— 

11 (1) in subsection (b)— 

12 (A) by redesignating paragraphs (5) 

13 through (12) as paragraphs (6) through (13), 

14 respectively; 

15 (B) by inserting after paragraph (4) the 

16 following: 

17 ‘‘(5) promoting the submission of data on elder 

18 abuse, neglect, and exploitation for the appropriate 

19 database of the Administration or another database 

20 specified by the Assistant Secretary;’’; 

21 (C) in paragraph (10)(C), as redesignated 

22 by paragraph (1) of this subsection— 

23 (i) in clause (ii), by inserting ‘‘, such 

24 as forensic specialists,’’ after ‘‘such per25 sonnel’’; and 


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1 (ii) in clause (v), by inserting before 

2 the comma the following: ‘‘, including pro3 grams and arrangements that protect 

4 against financial exploitation’’; and 

5 (D) in paragraph (12), as redesignated by 

6 paragraph (1) of this subsection— 

7 (i) in subparagraph (D), by striking 

8 ‘‘and’’ at the end; and 

9 (ii) by adding at the end the fol10 lowing: 

11 ‘‘(F) supporting and studying innovative 

12 practices in communities to develop partner13 ships across disciplines for the prevention, in14 vestigation, and prosecution of abuse, neglect, 

15 and exploitation; and’’; and 

16 (2) in subsection (e)(2), in the matter preceding 

17 subparagraph (A)— 

18 (A) by striking ‘‘subsection (b)(9)(B)(i)’’ 

19 and inserting ‘‘subsection (b)(10)(B)(i)’’; and 

20 (B) by striking ‘‘subsection (b)(9)(B)(ii)’’ 

21 and inserting ‘‘subsection (b)(10)(B)(ii)’’. 

22 SEC. 9. BEHAVIORAL HEALTH. 

23 The Older Americans Act of 1965 is amended— 

24 (1) in section 102 (42 U.S.C. 3002)— 


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1 (A) in paragraph (14)(G), by inserting 

2 ‘‘and behavioral’’ after ‘‘mental’’; 

3 (B) in paragraph (36), by inserting ‘‘and 

4 behavioral’’ after ‘‘mental’’; and 

5 (C) in paragraph (47)(B), by inserting 

6 ‘‘and behavioral’’ after ‘‘mental’’; 

7 (2) in section 201(f)(1) (42 U.S.C. 3011(f)(1)), 

8 by inserting ‘‘and behavioral’’ after ‘‘mental’’; 

9 (3) in section 202(a)(5) (42 U.S.C. 

10 3012(a)(5)), by inserting ‘‘and behavioral’’ after 

11 ‘‘mental’’; 

12 (4) in section 306(a) (42 U.S.C. 3026(a))— 

13 (A) in paragraph (2)(A), by inserting ‘‘and 

14 behavioral’’ after ‘‘mental’’; and 

15 (B) in paragraph (6)(F), by striking ‘‘men16 tal health services’’ each place such term ap17 pears and inserting ‘‘mental and behavioral 

18 health services’’; and 

19 (5) in section 321(a) (42 U.S.C. 3030d)— 

20 (A) in paragraph (1), as amended by sec21 tion 4(f), by inserting ‘‘and behavioral’’ after 

22 ‘‘mental’’; 

23 (B) in paragraph (8), as amended by sec24 tion 4(f), by inserting ‘‘and behavioral’’ after 

25 ‘‘mental’’; 


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1 (C) in paragraph (14)(B), by inserting 

2 ‘‘and behavioral’’ after ‘‘mental’’; and 

3 (D) in paragraph (23), by inserting ‘‘and 

4 behavioral’’ after ‘‘mental’’. 

5 SEC. 10. STUDY ON TRANSPORTATION SERVICES. 

6 (a) STUDY.— 

7 (1) IN GENERAL.—Because access to transpor8 tation services is critical for millions of older individ9 uals in the United States, to allow them to maintain 

10 independence, health, and quality of life, the Comp11 troller General of the United States shall conduct a 

12 study of transportation services for older individuals. 

13 (2) CONTENTS.—In conducting the study, the 

14 Comptroller General— 

15 (A) shall identify challenges and barriers 

16 affecting the aging network in providing, ac17 cessing, or coordinating efficient and effective 

18 transportation services, including challenges 

19 and barriers in coordinating services with Fed20 eral agencies and programs such as the Depart21 ment of Transportation and Medicaid program 

22 under title XIX of the Social Security Act (42 

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

24 (B) shall examine any Federal program re25 quirements that may result in challenges or 


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1 barriers to the coordination of transportation 

2 services within the aging network at the local 

3 level. 

4 (b) REPORT.—Not later than 18 months after the 

5 date of enactment of this Act, the Comptroller General 

6 shall issue a report. The report shall contain a detailed 

7 description of the findings and conclusions of the study, 

8 including any recommendations for administrative and 

9 other changes to enhance transportation services provided 

10 by the aging network. The Comptroller General shall sub11 mit the report to the Committee on Education and the 

12 Workforce of the House of Representatives and the Com13 mittee on Health, Education, Labor, and Pensions of the 

14 Senate. 

15 SEC. 11. GUIDANCE ON SERVING HOLOCAUST SURVIVORS. 

16 (a) IN GENERAL.—Because the services under the 

17 Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) 

18 are critical to meeting the urgent needs of Holocaust sur19 vivors to age in place with dignity, comfort, security, and 

20 quality of life, the Assistant Secretary for Aging shall 

21 issue guidance to States, that shall be applicable to States, 

22 area agencies on aging, and providers of services for older 

23 individuals, with respect to serving Holocaust survivors, 

24 including guidance on promising practices for conducting 

25 outreach to that population. In developing the guidance, 


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1 the Assistant Secretary for Aging shall consult with ex2 perts and organizations serving Holocaust survivors, and 

3 shall take into account the possibility that the needs of 

4 Holocaust survivors may differ based on geography. 

5 (b) CONTENTS.—The guidance shall include the fol6 lowing: 

7 (1) How nutrition service providers may meet 

8 the special health-related or other dietary needs of 

9 participants in programs under the Older Americans 

10 Act of 1965, including needs based on religious, cul11 tural, or ethnic requirements. 

12 (2) How transportation service providers may 

13 address the urgent transportation needs of Holo14 caust survivors. 

15 (3) How State long-term care ombudsmen may 

16 address the unique needs of residents of long-term 

17 care facilities for whom institutional settings may 

18 produce sights, sounds, smells, emotions, and rou19 tines, that can induce panic, anxiety, and retrauma20 tization as a result of experiences from the Holo21 caust. 

22 (4) How supportive services providers may con23 sider the unique needs of Holocaust survivors. 


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1 (5) How other services provided under that Act, 

2 as determined by the Assistant Secretary for Aging, 

3 may serve Holocaust survivors. 

4 (c) DATE OF ISSUANCE.—The guidance described in 

5 subsection (a) shall be issued not later than 180 days after 

6 the date of enactment of this Act. 

Æ 


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