II 

Calendar No. 290 

113TH CONGRESS 

2D 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, Mr. HARKIN, Mr. BEGICH, and 

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

JANUARY 6, 2014 

Reported by Mr. HARKIN, with an amendment 

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

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’’. 


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1 SEC. 2. DEFINITIONS. 

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

3 U.S.C. 3002) is amended— 

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

5 following: 

6 ‘‘(1) The term ‘abuse’ means the knowing in7 fliction of physical or psychological harm or the 

8 knowing deprivation of goods or services that are 

9 necessary to meet essential needs or to avoid phys10 ical or psychological harm.’’; 

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

12 following: 

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

14 Center’ means an entity, network, or consortium es15 tablished by a State as part of the State system of 

16 long-term care, to provide a coordinated and inte17 grated system for older individuals and individuals 

18 with disabilities (as defined in section 3 of the Amer19 icans with Disabilities Act of 1990 (42 U.S.C. 

20 12102)), and the caregivers of older individuals and 

21 individuals with disabilities, that provides— 

22 ‘‘(A) comprehensive information on the full 

23 range of available public and private long-term 

24 care programs, options, service providers, and 

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1 term care services, and Federal or State pro2 grams that provide long-term care services and 

3 supports through home and community-based 

4 service programs; 

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

6 individuals in assessing their existing or antici7 pated long-term care needs and goals, and de8 veloping and implementing a person-centered 

9 plan for long-term care that is consistent with 

10 the desires of such an individual and designed 

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

12 and circumstances; 

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

14 range of publicly supported long-term care serv15 ices and supports for which the individuals may 

16 be eligible, including home and community17 based service options, by serving as a conven18 ient point of entry for such programs and sup19 ports; and 

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

21 aging, centers for independent living described 

22 in part C of title VII of the Rehabilitation Act 

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

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1 nity-based services for individuals who are at 

2 risk for residing in, or who reside in, institu3 tional settings, so that the individuals have the 

4 choice to remain in or to return to the commu5 nity.’’; 

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

7 health,’’ after ‘‘bone density,’’; 

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

9 the following: 

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

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

12 to— 

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

14 in, and prosecute elder abuse, neglect, and 

15 exploitation; and 

16 ‘‘(ii) protect older individuals with di17 minished capacity while maximizing their 

18 autonomy; and 

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

20 recognition of an older individual’s rights, in21 cluding the right to be free of abuse, neglect, 

22 and exploitation.’’; 

23 (5) in paragraph (18)(A), by striking ‘‘term ‘ex24 ploitation’ means’’ and inserting ‘‘terms ‘exploi25 tation’ and ‘financial exploitation’ mean’’; and 


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

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

3 means such services provided to adults as the Sec4 retary may specify and includes services such as— 

5 ‘‘(A) receiving reports of adult abuse, ne6 glect, or exploitation; 

7 ‘‘(B) investigating the reports described in 

8 subparagraph (A); 

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

10 and other casework and services; and 

11 ‘‘(D) providing, arranging for, or facili12 tating the provision of medical, social service, 

13 economic, legal, housing, law enforcement, or 

14 other protective, emergency, or support serv15 ices.’’. 

16 SEC. 3. ADMINISTRATION ON AGING. 

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

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

19 (1) in subsection (d)(3)— 

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

21 ‘‘and’’ at the end; 

22 (B) in subparagraph (L)— 

23 (i) by striking ‘‘Older Americans Act 

24 Amendments of 1992’’ and inserting 


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1 ‘‘Older Americans Act Reauthorization Act 

2 of 2013’’; and 

3 (ii) by striking ‘‘712(h)(4).’’ and in4 serting ‘‘712(h)(5); and’’; and 

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

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

7 to responding to elder abuse, neglect, and exploi8 tation in long-term care facilities, and publish a re9 port of such best practices.’’; and 

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

11 subparagraph (A), by inserting ‘‘, and in coordina12 tion with the heads of State adult protective services 

13 programs and the Director of the Office of Long14 Term Care Ombudsman Programs’’ after ‘‘and serv15 ices’’. 

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

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

18 (1) in subsection (a)— 

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

20 and economic’’ before ‘‘needs of older individ21 uals’’; 

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

23 and economic’’ before ‘‘welfare’’; 


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1 (C) in paragraph (14), by inserting ‘‘(in2 cluding the Health Resources and Services Ad3 ministration)’’ after ‘‘other agencies’’; 

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

5 at the end; 

6 (E) in paragraph (28), by striking the pe7 riod and inserting a semicolon; and 

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

9 ‘‘(29) provide information and technical assist10 ance to States, area agencies on aging, and service 

11 providers, in collaboration with relevant Federal 

12 agencies, on providing efficient, person-centered 

13 transportation services, including across geographic 

14 boundaries; 

15 ‘‘(30) identify model programs and provide in16 formation and technical assistance to States, area 

17 agencies on aging, and service providers (including 

18 providers operating multipurpose senior centers), to 

19 support the modernization of multipurpose senior 

20 centers; and 

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

22 best practices with States, area agencies on aging, 

23 and Aging and Disability Resource Centers, on how 

24 to collaborate and coordinate services with health 

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1 ters, as defined in section 1905(l)(2)(B) of the So2 cial Security Act (42 U.S.C. 1396d(l)(2)(B)), in 

3 order to improve care coordination for individuals 

4 with multiple chronic illnesses.’’; 

5 (2) in subsection (b)— 

6 (A) in paragraph (5)— 

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

8 ‘‘and’’ after the semicolon; 

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

10 ‘‘and’’ after the semicolon; and 

11 (iii) by adding at the end the fol12 lowing: 

13 ‘‘(D) when feasible, developing, in con14 sultation with States and national organiza15 tions, a consumer-friendly tool to assist older 

16 individuals and their families in choosing home 

17 and community-based services, with a particular 

18 focus on ways for consumers to assess how pro19 viders protect the health, safety, welfare, and 

20 rights, including the rights provided under sec21 tion 314, of older individuals;’’; and 

22 (B) in paragraph (8)— 

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

24 ‘‘to identify and articulate goals of care 

25 and’’ after ‘‘individuals’’; 


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1 (ii) in subparagraph (D)— 

2 (I) by inserting ‘‘respond to or’’ 

3 before ‘‘plan’’; and 

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

5 care needs; and’’ and inserting ‘‘long6 term care needs;’’; 

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

8 ‘‘and’’ at the end; and 

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

11 ‘‘(F) to provide information and referrals 

12 regarding available home and community-based 

13 services for individuals who are at risk for re14 siding in, or who reside in, institutional set15 tings, so that the individuals have the choice to 

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

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

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

19 ensure that programs authorized under this Act include 

20 appropriate training in the prevention of abuse, neglect, 

21 and exploitation and provision of services that address 

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

23 (c) AUTHORIZATION OF APPROPRIATIONS.—Section 

24 216 of the Older Americans Act of 1965 (42 U.S.C. 

25 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 01:15 Jan 07, 2014 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6401 E:\BILLS\S1562.RS 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. 

7 SECTION 1. SHORT TITLE. 

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

9 Reauthorization Act of 2014’’. 

10 SEC. 2. DEFINITIONS. 

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

12 U.S.C. 3002) is amended— 

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

14 following: 

15 ‘‘(1) The term ‘abuse’ means the knowing inflic16 tion of physical or psychological harm or the knowing 

17 deprivation of goods or services that are necessary to 

18 meet essential needs or to avoid physical or psycho19 logical harm.’’; 

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

21 following: 

22 ‘‘(3) The term ‘adult protective services’ means 

23 such services provided to adults as the Secretary may 

24 specify and includes services such as— 


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1 ‘‘(A) receiving reports of adult abuse, ne2 glect, or exploitation; 

3 ‘‘(B) investigating the reports described in 

4 subparagraph (A); 

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

6 and other casework and services; and 

7 ‘‘(D) providing, arranging for, or facili8 tating the provision of medical, social service, 

9 economic, legal, housing, law enforcement, or 

10 other protective, emergency, or support services.’’; 

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

12 following: 

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

14 Center’ means an entity, network, or consortium es15 tablished by a State as part of the State system of 

16 long-term care, to provide a coordinated and inte17 grated system for older individuals and individuals 

18 with disabilities (as defined in section 3 of the Ameri19 cans with Disabilities Act of 1990 (42 U.S.C. 

20 12102)), and the caregivers of older individuals and 

21 individuals with disabilities, that provides— 

22 ‘‘(A) comprehensive information on the full 

23 range of available public and private long-term 

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1 tion on the availability of integrated long-term 

2 care services, and Federal or State programs 

3 that provide long-term care services and supports 

4 through home and community-based service pro5 grams; 

6 ‘‘(B) person-centered counseling to assist in7 dividuals in assessing their existing or antici8 pated long-term care needs and goals, and devel9 oping and implementing a person-centered plan 

10 for long-term care that is consistent with the de11 sires of such an individual and designed to meet 

12 the individual’s specific needs, goals, and cir13 cumstances; 

14 ‘‘(C) access for individuals to the full range 

15 of publicly-supported long-term care services and 

16 supports for which the individuals may be eligi17 ble, including home and community-based serv18 ice options, by serving as a convenient point of 

19 entry for such programs and supports; and 

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

21 aging, centers for independent living described in 

22 part C of title VII of the Rehabilitation Act of 

23 1973 (29 U.S.C. 796f et seq.), and other commu24 nity-based entities, information and referrals re25 garding available home and community-based 


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1 services for individuals who are at risk for resid2 ing in, or who reside in, institutional settings, so 

3 that the individuals have the choice to remain in 

4 or to return to the community.’’; 

5 (4) in paragraph (14)(B), by inserting ‘‘oral 

6 health,’’ after ‘‘bone density,’’; 

7 (5) by striking paragraph (17) and inserting the 

8 following: 

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

10 ‘‘(A) from a societal perspective, efforts to— 

11 ‘‘(i) prevent, detect, treat, intervene in, 

12 and prosecute elder abuse, neglect, and ex13 ploitation; and 

14 ‘‘(ii) protect older individuals with di15 minished capacity while maximizing their 

16 autonomy; and 

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

18 recognition of an older individual’s rights, in19 cluding the right to be free of abuse, neglect, and 

20 exploitation.’’; and 

21 (6) in paragraph (18)(A), by striking ‘‘term ‘ex22 ploitation’ means’’ and inserting ‘‘terms ‘exploitation’ 

23 and ‘financial exploitation’ mean’’. 


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1 SEC. 3. ADMINISTRATION ON AGING. 

2 (a) BEST PRACTICES.—Section 201 of the Older Amer3 icans Act of 1965 (42 U.S.C. 3011) is amended— 

4 (1) in subsection (d)(3)— 

5 (A) in subparagraph (K), by striking ‘‘and’’ 

6 at the end; 

7 (B) in subparagraph (L)— 

8 (i) by striking ‘‘Older Americans Act 

9 Amendments of 1992’’ and inserting ‘‘Older 

10 Americans Act Reauthorization Act of 

11 2014’’; and 

12 (ii) by striking ‘‘712(h)(4).’’ and in13 serting ‘‘712(h)(5); and’’; and 

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

15 ‘‘(M) collect and analyze best practices related to 

16 responding to elder abuse, neglect, and exploitation in 

17 long-term care facilities, and publish a report of such 

18 best practices.’’; and 

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

20 subparagraph (A), by inserting ‘‘, and in coordina21 tion with the heads of State adult protective services 

22 programs and the Director of the Office of Long-Term 

23 Care Ombudsman Programs’’ after ‘‘and services’’. 

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

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

26 (1) in subsection (a)— 


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

2 and economic’’ before ‘‘needs of older individ3 uals’’; 

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

5 and economic’’ before ‘‘welfare’’; 

6 (C) in paragraph (14), by inserting ‘‘(in7 cluding the Health Resources and Services Ad8 ministration)’’ after ‘‘other agencies’’; 

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

10 at the end; 

11 (E) in paragraph (28), by striking the pe12 riod and inserting a semicolon; and 

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

14 ‘‘(29) provide information and technical assist15 ance to States, area agencies on aging, and service 

16 providers, in collaboration with relevant Federal 

17 agencies, on providing efficient, person-centered trans18 portation services, including across geographic bound19 aries; 

20 ‘‘(30) identify model programs and provide in21 formation and technical assistance to States, area 

22 agencies on aging, and service providers (including 

23 providers operating multipurpose senior centers), to 

24 support the modernization of multipurpose senior 

25 centers; and 


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

2 best practices with States, area agencies on aging, 

3 and Aging and Disability Resource Centers, on how 

4 to collaborate and coordinate services with health care 

5 entities, such as Federally-qualified health centers, as 

6 defined in section 1905(l)(2)(B) of the Social Security 

7 Act (42 U.S.C. 1396d(l)(2)(B)), in order to improve 

8 care coordination for individuals with multiple 

9 chronic illnesses.’’; 

10 (2) in subsection (b)— 

11 (A) in paragraph (5)— 

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

13 ‘‘and’’ after the semicolon; 

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

15 ‘‘and’’ after the semicolon; and 

16 (iii) by adding at the end the fol17 lowing: 

18 ‘‘(D) when feasible, developing, in consulta19 tion with States and national organizations, a 

20 consumer-friendly tool to assist older individuals 

21 and their families in choosing home and commu22 nity-based services, with a particular focus on 

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1 cluding the rights provided under section 314, of 

2 older individuals;’’; 

3 (B) in paragraph (8)— 

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

5 ‘‘to identify and articulate goals of care 

6 and’’ after ‘‘individuals’’; 

7 (ii) in subparagraph (D)— 

8 (I) by inserting ‘‘respond to or’’ 

9 before ‘‘plan’’; and 

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

11 care needs; and’’ and inserting ‘‘long12 term care needs;’’; 

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

14 ‘‘and’’ at the end; and 

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

16 ‘‘(F) to provide information and referrals 

17 regarding available home and community-based 

18 services for individuals who are at risk for resid19 ing in, or who reside in, institutional settings, so 

20 that the individuals have the choice to remain in 

21 or to return to the community;’’; and 

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

23 ‘‘(g) The Assistant Secretary shall, as appropriate, en24 sure that programs authorized under this Act include ap25 propriate training in the prevention of abuse, neglect, and 


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1 exploitation and provision of services that address elder jus2 tice and the exploitation of older individuals.’’. 

3 (c) AUTHORIZATION OF APPROPRIATIONS.—Section 

4 216 of the Older Americans Act of 1965 (42 U.S.C. 3020f) 

5 is amended— 

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

7 2009, 2010, and 2011’’ and inserting ‘‘2014, 2015, 

8 2016, 2017, and 2018’’; 

9 (2) in subsection (b)— 

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

11 ‘‘202(a)(21)’’; and 

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

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

14 2017, and 2018’’; and 

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

16 2009, 2010, and 2011’’ and inserting ‘‘2014, 2015, 

17 2016, 2017, and 2018’’. 

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

19 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 

20 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) 

21 is amended— 

22 (1) in subsection (a)(1), by striking ‘‘fiscal years 

23 2007’’ and all that follows and inserting ‘‘each of fis24 cal years 2014 through 2018.’’; 

25 (2) in subsection (b)— 


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

2 years 2007’’ and all that follows and inserting 

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

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

5 years 2007’’ and all that follows and inserting 

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

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

8 2007’’ and all that follows and inserting ‘‘each of fis9 cal years 2014 through 2018.’’; and 

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

11 inserting ‘‘2011 and each of fiscal years 2014 through 

12 2018’’. 

13 (b) CONFORMING AMENDMENT.—Section 304(b) of the 

14 Older Americans Act of 1965 (42 U.S.C. 3024(b)) is amend15 ed by striking ‘‘subpart 1 of’’. 

16 (c) PLANNING AND SERVICE AREAS.—Section 

17 305(b)(5)(C)(i)(III) of the Older Americans Act of 1965 (42 

18 U.S.C. 3025(b)(5)(C)(i)(III)) is amended by striking ‘‘plan19 ning and services areas’’ and inserting ‘‘planning and serv20 ice areas’’. 

21 (d) AREA PLANS.—Section 306 of the Older Americans 

22 Act of 1965 (42 U.S.C. 3026) is amended— 

23 (1) in subsection (a)— 

24 (A) in paragraph (1), by striking ‘‘estab25 lishment, maintenance, or construction of multiVerDate Mar 15 2010 01:15 Jan 07, 2014 Jkt 039200 PO 00000 Frm 00048 Fmt 6652 Sfmt 6203 E:\BILLS\S1562.RS S1562

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1 purpose senior centers,’’ and inserting ‘‘establish2 ment, maintenance, modernization, or construc3 tion of multipurpose senior centers (including a 

4 plan to use the skills and services of older indi5 viduals in paid and unpaid work, including 

6 multigenerational and older individual to older 

7 individual work),’’; and 

8 (B) in paragraph (6)— 

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

10 ‘‘and’’ at the end; and 

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

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

13 and with the State agency responsible for elder 

14 abuse prevention services, increase public aware15 ness of elder abuse, neglect, and exploitation, and 

16 remove barriers to education, prevention, inves17 tigation, and treatment of elder abuse, neglect, 

18 and exploitation, as appropriate;’’; and 

19 (2) in subsection (b)(3)— 

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

21 at the end; 

22 (B) by redesignating subparagraph (K) as 

23 subparagraph (L); and 

24 (C) by inserting after subparagraph (J) the 

25 following: 


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

2 and exploitation; and’’. 

3 (e) NUTRITION SERVICES INCENTIVE PROGRAM.—Sec4 tion 311(e) of the Older Americans Act of 1965 (42 U.S.C. 

5 3030a(e)) is amended by striking ‘‘fiscal year 2007’’ and 

6 all that follows and inserting ‘‘each of fiscal years 2014 

7 through 2018.’’. 

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

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

10 (1) in subsection (a)— 

11 (A) in paragraph (1), by striking ‘‘or refer12 ral services’’ and inserting ‘‘referral, chronic con13 dition self-care management, or falls prevention 

14 services’’; 

15 (B) in paragraph (8), by striking ‘‘(includ16 ing’’ and all that follows and inserting the fol17 lowing: ‘‘(including mental and behavioral 

18 health screening and falls prevention services 

19 screening) to detect or prevent (or both) illnesses 

20 and injuries that occur most frequently in older 

21 individuals;’’ and 

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

23 the semicolon the following: ‘‘, and screening for 

24 elder abuse, neglect, and exploitation’’; 


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

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

5 development of intergenerational shared site models 

6 for programs or projects, consistent with the purposes 

7 of this Act’’; and 

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

9 ‘‘(e) In this section, the term ‘adult child with a dis10 ability’ means a child who— 

11 ‘‘(1) is age 18 or older; 

12 ‘‘(2) is financially dependent on an older indi13 vidual who is a parent of the child; and 

14 ‘‘(3) has a disability.’’. 

15 (g) HOME DELIVERED NUTRITION SERVICES PRO16 GRAM.—Section 336(1) of the Older Americans Act of 1965 

17 (42 U.S.C. 3030f(1)) is amended by striking ‘‘canned’’ and 

18 all that follows through ‘‘meals’’ and inserting ‘‘canned, or 

19 fresh foods and, as appropriate, supplemental foods, and 

20 any additional meals’’. 

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

22 Americans Act of 1965 (42 U.S.C. 3030g–21) is amended 

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

24 inserting ‘‘utilize’’; and 

25 (2) in paragraph (2)— 


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

2 at the end; 

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

4 period and inserting ‘‘, and’’; and 

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

6 ‘‘(L) where feasible, encourages the use of lo7 cally grown foods in meal programs and identi8 fies potential partnerships and contracts with 

9 local producers and providers of locally grown 

10 foods.’’. 

11 (i) EVIDENCE-BASED DISEASE PREVENTION AND

12 HEALTH PROMOTION SERVICES PROGRAM.—Part D of title 

13 III of the Older Americans Act of 1965 (42 U.S.C. 3030m 

14 et seq.) is amended— 

15 (1) in the part heading, by inserting ‘‘EVI16 DENCE-BASED’’ before ‘‘DISEASE’’; and 

17 (2) in section 361(a), by inserting ‘‘evidence18 based’’ after ‘‘to provide’’. 

19 (j) OLDER RELATIVE CAREGIVERS.— 

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

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

22 3030s et seq.) is amended by striking the subpart 

23 heading for subpart 1. 

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

25 U.S.C. 3030s) is amended— 


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1 (A) in subsection (a)— 

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

3 who is an individual with a disability’’; 

4 and 

5 (ii) by striking paragraph (2) and in6 serting the following: 

7 ‘‘(2) INDIVIDUAL WITH A DISABILITY.—The term 

8 ‘individual with a disability’ means an individual 

9 with a disability, as defined in section 3 of the Amer10 icans with Disabilities Act of 1990 (42 U.S.C. 

11 12102), who is not less than age 18 and not more 

12 than age 59. 

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

14 ‘older relative caregiver’ means a caregiver who— 

15 ‘‘(A)(i) is age 55 or older; and 

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

17 in-home and community care to, and is the pri18 mary caregiver for, a child or an individual 

19 with a disability; 

20 ‘‘(B) in the case of a caregiver for a child— 

21 ‘‘(i) is the grandparent, 

22 stepgrandparent, or other relative (other 

23 than the parent) by blood, marriage, or 

24 adoption, of the child; 


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

2 child because the biological or adoptive par3 ents are unable or unwilling to serve as the 

4 primary caregivers of the child; and 

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

6 child, such as legal custody, adoption, or 

7 guardianship, or is raising the child infor8 mally; and 

9 ‘‘(C) in the case of a caregiver for an indi10 vidual with a disability, is the parent, grand11 parent, or other relative by blood, marriage, or 

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

13 and 

14 (B) in subsection (b)— 

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

16 follows through ‘‘family caregivers’’ and in17 serting ‘‘part, for family caregivers’’; 

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

19 a period; and 

20 (iii) by striking paragraph (2). 

21 (k) NATIONAL FAMILY CAREGIVER SUPPORT PRO22 GRAM.—Section 373 of the Older Americans Act of 1965 

23 (42 U.S.C. 3030s–1) is amended— 


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1 (1) in subsection (a)(2), by striking ‘‘grand2 parents or older individuals who are relative care3 givers.’’ and inserting ‘‘older relative caregivers.’’; 

4 (2) in subsection (c)— 

5 (A) in paragraph (1), in the matter pre6 ceding subparagraph (A), by striking ‘‘grand7 parents and older individuals who are relative 

8 caregivers, and who’’ and inserting ‘‘older rel9 ative caregivers, who’’; and 

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

11 older individuals providing care to individuals 

12 with severe disabilities, including children with 

13 severe disabilities’’ and inserting ‘‘to older rel14 ative caregivers of children with severe disabil15 ities, or individuals with disabilities who have 

16 severe disabilities’’; 

17 (3) in subsection (e)(3), by striking ‘‘grand18 parents or older individuals who are relative care19 givers’’ and inserting ‘‘older relative caregivers’’; 

20 (4) in subsection (f)(1)(A), by striking ‘‘for fiscal 

21 years 2007, 2008, 2009, 2010, and 2011’’ and insert22 ing ‘‘for a fiscal year’’; and 

23 (5) in subsection (g)(2)(C), by striking ‘‘grand24 parents and older individuals who are relative careVerDate Mar 15 2010 01:15 Jan 07, 2014 Jkt 039200 PO 00000 Frm 00055 Fmt 6652 Sfmt 6203 E:\BILLS\S1562.RS S1562

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1 givers of a child who is not more than 18 years of 

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

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

4 amended by striking ‘‘this subpart’’ each place it appears 

5 and inserting ‘‘this part’’. 

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

7 LONGEVITY. 

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

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

10 (1) in subsection (a)— 

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

12 at the end; 

13 (B) by redesignating paragraph (13) as 

14 paragraph (14); and 

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

16 following: 

17 ‘‘(13) continuing support for program integrity 

18 initiatives concerning the Medicare program under 

19 title XVIII of the Social Security Act (42 U.S.C. 1395 

20 et seq.) that train senior volunteers to prevent and 

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

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

23 2007’’ and all that follows through ‘‘2011’’ and insert24 ing ‘‘for each of fiscal years 2014 through 2018’’. 


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1 (b) NATIVE AMERICAN PROGRAMS.—Section 418(b) of 

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

3 amended by striking ‘‘a national meeting to train’’ and in4 serting ‘‘national trainings for’’. 

5 (c) LEGAL ASSISTANCE FOR OLDER AMERICANS.— 

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

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

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

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

10 3032j) are repealed. 

11 (e) CONFORMING AMENDMENT.—Section 417(a)(1)(A) 

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

13 3032f(a)(1)(A)) is amended by striking ‘‘grandparents and 

14 other older individuals who are relative caregivers’’ and in15 serting ‘‘older relative caregivers (as defined in section 

16 372)’’. 

17 SEC. 6. COMMUNITY SERVICE SENIOR OPPORTUNITIES. 

18 Section 517(a) of the Older Americans Act of 1965 (42 

19 U.S.C. 3056o(a)) is amended by striking ‘‘fiscal years 2007, 

20 2008, 2009, 2010, and 2011’’ and inserting ‘‘each of fiscal 

21 years 2014 through 2018’’. 

22 SEC. 7. GRANTS FOR NATIVE AMERICANS. 

23 Section 643(2) of the Older Americans Act of 1965 (42 

24 U.S.C. 3057n(2)) is amended by striking ‘‘fiscal year 2011’’ 

25 and inserting ‘‘each of fiscal years 2014 through 2018’’. 


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

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

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

5 amended by striking ‘‘older’’. 

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

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

8 (1) in subsection (a)— 

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

10 the following: ‘‘The Ombudsman shall be respon11 sible for the management, including the fiscal 

12 management, of the Office.’’; 

13 (B) in paragraph (3)— 

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

15 clause (i) and inserting the following: 

16 ‘‘(i) are made by, or on behalf of, resi17 dents, including residents with limited or 

18 no decisionmaking capacity and who have 

19 no known legal representative, and if such 

20 a resident is unable to communicate consent 

21 for an Ombudsman to work on a complaint 

22 directly involving the resident, the Ombuds23 man shall seek evidence to indicate what 

24 outcome the resident would have commu25 nicated (and, in the absence of evidence to 

26 the contrary, shall assume that the resident 


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1 wishes to have the resident’s health, safety, 

2 welfare, and rights protected) and shall 

3 work to accomplish that outcome; and’’; 

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

5 ‘‘regular and timely’’ and inserting ‘‘reg6 ular, timely, private, and unimpeded’’; 

7 (iii) in subparagraph (H)(iii)— 

8 (I) by inserting ‘‘, actively en9 courage, and assist in’’ after ‘‘provide 

10 technical support for’’; and 

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

12 semicolon; 

13 (iv) by redesignating subparagraph (I) 

14 as subparagraph (J); and 

15 (v) by inserting after subparagraph 

16 (H) the following: 

17 ‘‘(I) when feasible, continue to carry out the 

18 functions described in this section on behalf of 

19 residents transitioning from a long-term care fa20 cility to a home care setting; and’’; 

21 (C) in paragraph (5)(B)— 

22 (i) in clause (vi)— 

23 (I) by inserting ‘‘, actively en24 courage, and assist in’’ after ‘‘sup25 port’’; and 


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1 (II) by striking ‘‘and’’ after the 

2 semicolon; 

3 (ii) by redesignating clause (vii) as 

4 clause (viii); and 

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

6 following: 

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

8 complaints described in clause (iii) that are 

9 made by or on behalf of residents with lim10 ited or no decisionmaking capacity and who 

11 have no known legal representative, and if 

12 such a resident is unable to communicate 

13 consent for an Ombudsman to work on a 

14 complaint directly involving the resident, 

15 the Ombudsman shall seek evidence to indi16 cate what outcome the resident would have 

17 communicated (and, in the absence of evi18 dence to the contrary, shall assume that the 

19 resident wishes to have the resident’s health, 

20 safety, welfare, and rights protected) and 

21 shall work to accomplish that outcome; 

22 and’’; 

23 (2) in subsection (b)— 

24 (A) in paragraph (1)— 


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

2 ‘‘access’’ and inserting ‘‘private and 

3 unimpeded access’’; and 

4 (ii) in subparagraph (B)— 

5 (I) in clause (i)— 

6 (aa) in the matter preceding 

7 subclause (I), by striking ‘‘the 

8 medical and social records of a’’ 

9 and inserting ‘‘all files, records, 

10 and other information concerning 

11 a’’; and 

12 (bb) in subclause (II), by 

13 striking ‘‘to consent’’ and insert14 ing ‘‘to communicate consent’’; 

15 and 

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

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

18 records’’ and inserting ‘‘the files, 

19 records, and information’’; and 

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

21 ‘‘(3) HEALTH OVERSIGHT AGENCY.—For pur22 poses of section 264(c) of the Health Insurance Port23 ability and Accountability Act of 1996 (including 

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

25 1320d–2 note), the Ombudsman and a representative 


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1 of the Office shall be considered a ‘health oversight 

2 agency,’ so that release of residents’ individually 

3 identifiable health information to the Ombudsman or 

4 representative is not precluded in cases in which the 

5 requirements of clause (i) or (ii) of paragraph (1)(B), 

6 or the requirements of paragraph (1)(D), are other7 wise met.’’; 

8 (3) in subsection (d)— 

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

10 and inserting ‘‘files, records, and other informa11 tion’’; and 

12 (B) in paragraph (2)— 

13 (i) in subparagraph (A)— 

14 (I) by striking ‘‘files and records’’ 

15 each place such term appears and in16 serting ‘‘files, records, and other infor17 mation’’; and 

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

19 semicolon; 

20 (ii) in subparagraph (B)— 

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

22 and inserting ‘‘files, records, or other 

23 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 residents 

9 with limited or no decisionmaking capacity who 

10 have no known legal representative and are un11 able to communicate consent, in order for the 

12 Ombudsman to carry out the functions and du13 ties described in paragraphs (3)(A) and (5)(B) 

14 of subsection (a).’’; and 

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

16 following: 

17 ‘‘(f) CONFLICT OF INTEREST.— 

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

19 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 

24 designation of an entity designated under sub25 section (a)(5), is subject to a conflict of interest; 


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

2 the Office, representative of a local Ombudsman 

3 entity, or member of the immediate family of the 

4 officer, employee, or representative, is subject to 

5 a conflict of interest; and 

6 ‘‘(C) ensure that the Ombudsman— 

7 ‘‘(i) does not have a direct involvement 

8 in the licensing or certification of a long9 term care facility or of a provider of a long10 term care service; 

11 ‘‘(ii) does not have an ownership or in12 vestment interest (represented by equity, 

13 debt, or other financial relationship) in a 

14 long-term care facility or a long-term care 

15 service; 

16 ‘‘(iii) is not employed by, or partici17 pating in the management of, a long-term 

18 care facility or a related organization, and 

19 has not been employed by such a facility or 

20 organization within 1 year before the date 

21 of the determination involved; 

22 ‘‘(iv) does not receive, or have the right 

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1 tion arrangement with an owner or oper2 ator of a long-term care facility; 

3 ‘‘(v) does not have management respon4 sibility for, or operate under the supervision 

5 of an individual with management respon6 sibility for, adult protective services; and 

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

8 in another fiduciary capacity for residents 

9 of long-term care facilities in an official ca10 pacity (as opposed to serving as a guardian 

11 or fiduciary for a family member, in a per12 sonal capacity). 

13 ‘‘(2) ORGANIZATIONAL CONFLICT OF INTER14 EST.— 

15 ‘‘(A) IN GENERAL.—The State agency shall 

16 comply with subparagraph (B)(i) in a case in 

17 which the Office poses an organizational conflict 

18 of interest, including a situation in which the 

19 Office is placed in an organization that— 

20 ‘‘(i) is responsible for licensing, certi21 fying, or surveying long-term care services 

22 in the State; 

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

24 of such an association) of long-term care faVerDate Mar 15 2010 01:15 Jan 07, 2014 Jkt 039200 PO 00000 Frm 00065 Fmt 6652 Sfmt 6203 E:\BILLS\S1562.RS S1562

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1 cilities, or of any other residential facilities 

2 for older individuals; 

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

4 including programs carried out under a 

5 Medicaid waiver approved under section 

6 1115 of the Social Security Act (42 U.S.C. 

7 1315) or under subsection (b) or (c) of sec8 tion 1915 of the Social Security Act (42 

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

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

11 or (k) of section 1915 of the Social Security 

12 Act (42 U.S.C. 1396n); 

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

14 management; 

15 ‘‘(v) sets rates for long-term care serv16 ices; 

17 ‘‘(vi) provides adult protective services; 

18 ‘‘(vii) is responsible for eligibility de19 terminations for the Medicaid program car20 ried out under title XIX of the Social Secu21 rity Act (42 U.S.C. 1396 et seq.); 

22 ‘‘(viii) conducts preadmission screen23 ing for placements in facilities described in 

24 clause (ii); or 


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1 ‘‘(ix) makes decisions regarding admis2 sion or discharge of individuals to or from 

3 such facilities. 

4 ‘‘(B) IDENTIFYING, REMOVING, AND REM5 EDYING ORGANIZATIONAL CONFLICT.— 

6 ‘‘(i) IN GENERAL.—The State agency 

7 may not operate the Office or carry out the 

8 program, directly, or by contract or other 

9 arrangement with any public agency or 

10 nonprofit private organization, in a case in 

11 which there is an organizational conflict of 

12 interest (within the meaning of subpara13 graph (A)) unless such conflict of interest 

14 has been— 

15 ‘‘(I) identified by the State agen16 cy; 

17 ‘‘(II) disclosed by the State agency 

18 to the Assistant Secretary in writing; 

19 and 

20 ‘‘(III) remedied in accordance 

21 with this subparagraph. 

22 ‘‘(ii) ACTION BY ASSISTANT SEC23 RETARY.—In a case in which a potential or 

24 actual organizational conflict of interest 

25 (within the meaning of subparagraph (A)) 


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1 involving the Office is disclosed or reported 

2 to the Assistant Secretary by any person or 

3 entity, the Assistant Secretary shall require 

4 that the State agency, in accordance with 

5 the policies and procedures established by 

6 the State agency under subsection 

7 (a)(5)(D)(iii)— 

8 ‘‘(I) remove the conflict; or 

9 ‘‘(II) submit, and obtain the ap10 proval of the Assistant Secretary for, 

11 an adequate remedial plan that indi12 cates how the Ombudsman will be 

13 unencumbered in fulfilling all of the 

14 functions specified in subsection 

15 (a)(3).’’; and 

16 (5) in subsection (h)— 

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

18 ‘‘older’’; 

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

20 precedes ‘‘procedures’’ and inserting the fol21 lowing: 

22 ‘‘(4) strengthen and update’’; 

23 (C) by redesignating paragraphs (4) 

24 through (9) as paragraphs (5) through (10), re25 spectively; 


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1 (D) by inserting after paragraph (3) the fol2 lowing: 

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

4 participates in training provided by the National 

5 Ombudsman Resource Center established in section 

6 202(a)(18);’’; 

7 (E) in paragraph (6)(A), as redesignated by 

8 subparagraph (B) of this paragraph, by striking 

9 ‘‘paragraph (4)’’ and inserting ‘‘paragraph (5)’’; 

10 (F) in paragraph (7)(A), as redesignated by 

11 subparagraph (B) of this paragraph, by striking 

12 ‘‘subtitle C of the’’ and inserting ‘‘subtitle C of 

13 title I of the’’; and 

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

15 subparagraph (B) of this paragraph, by striking 

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

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

18 Older Americans Act of 1965 (42 U.S.C. 3058h) is amend19 ed— 

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

21 (1) and (2) of section 712(f)’’ and inserting ‘‘subpara22 graphs (A) and (B) of section 712(f)(1)’’; and 

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1 serting ‘‘clauses (i) through (vi) of section 

2 712(f)(1)(C)’’. 

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

4 EXPLOITATION.—Section 721 of the Older Americans Act 

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

6 (1) in subsection (b)— 

7 (A) in the matter preceding paragraph (1), 

8 by striking ‘‘(including financial exploitation)’’; 

9 (B) by redesignating paragraphs (5) 

10 through (12) as paragraphs (6) through (13), re11 spectively; 

12 (C) by inserting after paragraph (4) the fol13 lowing: 

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

15 abuse, neglect, and exploitation for the appropriate 

16 database of the Administration or another database 

17 specified by the Assistant Secretary;’’; 

18 (D) in paragraph (10)(C), as redesignated 

19 by subparagraph (B) of this paragraph— 

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

21 as forensic specialists,’’ after ‘‘such per22 sonnel’’; and 

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

24 the comma the following: ‘‘, including proVerDate Mar 15 2010 01:15 Jan 07, 2014 Jkt 039200 PO 00000 Frm 00070 Fmt 6652 Sfmt 6203 E:\BILLS\S1562.RS S1562

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1 grams and arrangements that protect 

2 against financial exploitation’’; and 

3 (E) in paragraph (12), as redesignated by 

4 subparagraph (B) of this paragraph— 

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

6 ‘‘and’’ at the end; and 

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

8 ‘‘(F) supporting and studying innovative 

9 practices in communities to develop partnerships 

10 across disciplines for the prevention, investiga11 tion, and prosecution of abuse, neglect, and ex12 ploitation; and’’; and 

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

14 subparagraph (A)— 

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

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

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

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

19 SEC. 9. BEHAVIORAL HEALTH. 

20 The Older Americans Act of 1965 is amended— 

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

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

23 ‘‘and behavioral’’ after ‘‘mental’’; 

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

25 behavioral’’ after ‘‘mental’’; and 


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

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

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

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

5 (3) in section 202(a)(5) (42 U.S.C. 3012(a)(5)), 

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

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

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

9 behavioral’’ after ‘‘mental’’; and 

10 (B) in paragraph (6)(F), by striking ‘‘men11 tal health services’’ each place such term appears 

12 and inserting ‘‘mental and behavioral health 

13 services’’; and 

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

15 (A) in paragraph (1), as amended by sec16 tion 4(f), by inserting ‘‘and behavioral’’ after 

17 ‘‘mental’’; 

18 (B) in paragraph (14)(B), by inserting 

19 ‘‘and behavioral’’ after ‘‘mental’’; and 

20 (C) in paragraph (23), by inserting ‘‘and 

21 behavioral’’ after ‘‘mental’’. 

22 SEC. 10. STUDY ON TRANSPORTATION SERVICES. 

23 (a) STUDY.— 

24 (1) IN GENERAL.—Because access to transpor25 tation services is critical for millions of older individVerDate Mar 15 2010 01:15 Jan 07, 2014 Jkt 039200 PO 00000 Frm 00072 Fmt 6652 Sfmt 6203 E:\BILLS\S1562.RS S1562

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1 uals in the United States, to allow them to maintain 

2 independence, health, and quality of life, the Comp3 troller General of the United States shall conduct a 

4 study of transportation services for older individuals. 

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

6 Comptroller General— 

7 (A) shall identify challenges and barriers 

8 affecting the aging network in providing, access9 ing, or coordinating efficient and effective trans10 portation services, including challenges and bar11 riers in coordinating services with Federal agen12 cies and programs such as the Department of 

13 Transportation and the Medicaid program under 

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

15 1396 et seq.); and 

16 (B) shall examine any Federal program re17 quirements that may result in challenges or bar18 riers to the coordination of transportation serv19 ices within the aging network at the local level. 

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

21 of enactment of this Act, the Comptroller General shall issue 

22 a report. The report shall contain a detailed description of 

23 the findings and conclusions of the study, including any 

24 recommendations for administrative and other changes to 

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1 work. The Comptroller General shall submit the report to 

2 the Committee on Education and the Workforce of the 

3 House of Representatives and the Committee on Health, 

4 Education, Labor, and Pensions of the Senate. 

5 SEC. 11. GUIDANCE ON SERVING HOLOCAUST SURVIVORS. 

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

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

8 critical to meeting the urgent needs of Holocaust survivors 

9 to age in place with dignity, comfort, security, and quality 

10 of life, the Assistant Secretary for Aging shall issue guid11 ance to States, that shall be applicable to States, area agen12 cies on aging, and providers of services for older individ13 uals, with respect to serving Holocaust survivors, including 

14 guidance on promising practices for conducting outreach to 

15 that population. In developing the guidance, the Assistant 

16 Secretary for Aging shall consult with experts and organi17 zations serving Holocaust survivors, and shall take into ac18 count the possibility that the needs of Holocaust survivors 

19 may differ based on geography. 

20 (b) CONTENTS.—The guidance shall include the fol21 lowing: 

22 (1) How nutrition service providers may meet 

23 the special health-related or other dietary needs of 

24 participants in programs under the Older Americans 


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1 Act of 1965, including needs based on religious, cul2 tural, or ethnic requirements. 

3 (2) How transportation service providers may 

4 address the urgent transportation needs of Holocaust 

5 survivors. 

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

7 address the unique needs of residents of long-term care 

8 facilities for whom institutional settings may produce 

9 sights, sounds, smells, emotions, and routines, that 

10 can induce panic, anxiety, and retraumatization as 

11 a result of experiences from the Holocaust. 

12 (4) How supportive services providers may con13 sider the unique needs of Holocaust survivors. 

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

15 as determined by the Assistant Secretary for Aging, 

16 may serve Holocaust survivors. 

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

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

19 the date of enactment of this Act. 


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Calendar No. 290 

113TH CONGRESS 

2D SESSION S. 1562 

A BILL 

To reauthorize the Older Americans Act of 1965, 

and for other purposes. 

JANUARY 6, 2014 

Reported with an amendment 


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