```

[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 192 Reported in Senate (RS)]

                                                        Calendar No. 12
114th CONGRESS
  1st Session
                                 S. 192

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

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            January 20, 2015

  Mr. Alexander (for himself, Mrs. Murray, Mr. Burr, Mr. Sanders, Mr. 
  Hatch, Mr. Isakson, Ms. Murkowski, Ms. Collins, Mr. Coons, and Mr. 
Leahy) introduced the following bill; which was read twice and referred 
       to the Committee on Health, Education, Labor, and Pensions

                            February 3, 2015

              Reported by Mr. Alexander, without amendment

_______________________________________________________________________

                                 A BILL

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

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Older Americans Act Reauthorization 
Act of 2015''.

SEC. 2. DEFINITIONS.

    Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is 
amended--
            (1) by striking paragraph (1) and inserting the following:
            ``(1) The term `abuse' means the knowing infliction of 
        physical or psychological harm or the knowing deprivation of 
        goods or services that are necessary to meet essential needs or 
        to avoid physical or psychological harm.'';
            (2) by striking paragraph (3) and inserting the following:
            ``(3) The term `adult protective services' means such 
        services provided to adults as the Secretary may specify and 
        includes services such as--
                    ``(A) receiving reports of adult abuse, neglect, or 
                exploitation;
                    ``(B) investigating the reports described in 
                subparagraph (A);
                    ``(C) case planning, monitoring, evaluation, and 
                other casework and services; and
                    ``(D) providing, arranging for, or facilitating the 
                provision of medical, social service, economic, legal, 
                housing, law enforcement, or other protective, 
                emergency, or support services.'';
            (3) by striking paragraph (4) and inserting the following:
            ``(4) The term `Aging and Disability Resource Center' means 
        an entity, network, or consortium established by a State as 
        part of the State system of long-term care, to provide a 
        coordinated and integrated system for older individuals and 
        individuals with disabilities (as defined in section 3 of the 
        Americans with Disabilities Act of 1990 (42 U.S.C. 12102)), and 
        the caregivers of older individuals and individuals with 
        disabilities, that provides--
                    ``(A) comprehensive information on the full range 
                of available public and private long-term care 
                programs, options, service providers, and resources 
                within a community, including information on the 
                availability of integrated long-term care services, and 
                Federal or State programs that provide long-term care 
                services and supports through home and community-based 
                service programs;
                    ``(B) person-centered counseling to assist 
                individuals in assessing their existing or anticipated 
                long-term care needs and goals, and developing and 
                implementing a person-centered plan for long-term care 
                that is consistent with the desires of such an 
                individual and designed to meet the individual's 
                specific needs, goals, and circumstances;
                    ``(C) access for individuals to the full range of 
                publicly-supported long-term care services and supports 
                for which the individuals may be eligible, including 
                home and community-based service options, by serving as 
                a convenient point of entry for such programs and 
                supports; and
                    ``(D) in cooperation with area agencies on aging, 
                centers for independent living described in part C of 
                title VII of the Rehabilitation Act of 1973 (29 U.S.C. 
                796f et seq.), and other community-based entities, 
                information and referrals regarding available home and 
                community-based services for individuals who are at 
                risk for residing in, or who reside in, institutional 
                settings, so that the individuals have the choice to 
                remain in or to return to the community.'';
            (4) in paragraph (14)(B), by inserting ``oral health,'' 
        after ``bone density,'';
            (5) by striking paragraph (17) and inserting the following:
            ``(17) The term `elder justice' means--
                    ``(A) from a societal perspective, efforts to--
                            ``(i) prevent, detect, treat, intervene in, 
                        and prosecute elder abuse, neglect, and 
                        exploitation; and
                            ``(ii) protect older individuals with 
                        diminished capacity while maximizing their 
                        autonomy; and
                    ``(B) from an individual perspective, the 
                recognition of an older individual's rights, including 
                the right to be free of abuse, neglect, and 
                exploitation.''; and
            (6) in paragraph (18)(A), by striking ``term `exploitation' 
        means'' and inserting ``terms `exploitation' and `financial 
        exploitation' mean''.

SEC. 3. ADMINISTRATION ON AGING.

    (a) Best Practices.--Section 201 of the Older Americans Act of 1965 
(42 U.S.C. 3011) is amended--
            (1) in subsection (d)(3)--
                    (A) in subparagraph (H), by striking ``202(a)(21)'' 
                and inserting ``202(a)(18)'';
                    (B) in subparagraph (K), by striking ``and'' at the 
                end;
                    (C) in subparagraph (L)--
                            (i) by striking ``Older Americans Act 
                        Amendments of 1992'' and inserting ``Older 
                        Americans Act Reauthorization Act of 2015''; 
                        and
                            (ii) by striking ``712(h)(4).'' and 
                        inserting ``712(h)(5); and''; and
                    (D) by adding at the end the following:
            ``(M) collect and analyze best practices related to 
        responding to elder abuse, neglect, and exploitation in long-
        term care facilities, and publish a report of such best 
        practices.''; and
            (2) in subsection (e)(2), in the matter preceding 
        subparagraph (A), by inserting ``, and in coordination with the 
        heads of State adult protective services programs and the 
        Director of the Office of Long-Term Care Ombudsman Programs'' 
        after ``and services''.
    (b) Training.--Section 202 of the Older Americans Act of 1965 (42 
U.S.C. 3012) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (5), by inserting ``health and 
                economic'' before ``needs of older individuals'';
                    (B) in paragraph (7), by inserting ``health and 
                economic'' before ``welfare'';
                    (C) in paragraph (14), by inserting ``(including 
                the Health Resources and Services Administration)'' 
                after ``other agencies'';
                    (D) in paragraph (27), by striking ``and'' at the 
                end;
                    (E) in paragraph (28), by striking the period and 
                inserting a semicolon; and
                    (F) by adding at the end the following:
            ``(29) provide information and technical assistance to 
        States, area agencies on aging, and service providers, in 
        collaboration with relevant Federal agencies, on providing 
        efficient, person-centered transportation services, including 
        across geographic boundaries;
            ``(30) identify model programs and provide information and 
        technical assistance to States, area agencies on aging, and 
        service providers (including providers operating multipurpose 
        senior centers), to support the modernization of multipurpose 
        senior centers; and
            ``(31) provide technical assistance to and share best 
        practices with States, area agencies on aging, and Aging and 
        Disability Resource Centers, on how to collaborate and 
        coordinate services with health care entities, such as 
        Federally-qualified health centers, as defined in section 
        1905(l)(2)(B) of the Social Security Act (42 U.S.C. 
        1396d(l)(2)(B)), in order to improve care coordination for 
        individuals with multiple chronic illnesses.'';
            (2) in subsection (b)--
                    (A) in paragraph (5)--
                            (i) in subparagraph (B), by striking 
                        ``and'' after the semicolon;
                            (ii) in subparagraph (C), by inserting 
                        ``and'' after the semicolon; and
                            (iii) by adding at the end the following:
                    ``(D) when feasible, developing, in consultation 
                with States and national organizations, a consumer-
                friendly tool to assist older individuals and their 
                families in choosing home and community-based services, 
                with a particular focus on ways for consumers to assess 
                how providers protect the health, safety, welfare, and 
                rights, including the rights provided under section 
                314, of older individuals;'';
                    (B) in paragraph (8)--
                            (i) in subparagraph (B), by inserting ``to 
                        identify and articulate goals of care and'' 
                        after ``individuals'';
                            (ii) in subparagraph (D)--
                                    (I) by inserting ``respond to or'' 
                                before ``plan''; and
                                    (II) by striking ``future long-term 
                                care needs; and'' and inserting ``long-
                                term care needs;'';
                            (iii) in subparagraph (E), by adding 
                        ``and'' at the end; and
                            (iv) by adding at the end the following:
                    ``(F) to provide information and referrals 
                regarding available home and community-based services 
                for individuals who are at risk for residing in, or who 
                reside in, institutional settings, so that the 
                individuals have the choice to remain in or to return 
                to the community;''; and
            (3) by adding at the end the following:
    ``(g) The Assistant Secretary shall, as appropriate, ensure that 
programs authorized under this Act include appropriate training in the 
prevention of abuse, neglect, and exploitation and provision of 
services that address elder justice and the exploitation of older 
individuals.''.
    (c) Reports.--Section 207(a) of the Older Americans Act of 1965 (42 
U.S.C. 3018(a)) is amended--
            (1) in paragraph (2), by striking ``202(a)(19)'' and 
        inserting ``202(a)(16)''; and
            (2) in paragraph (4), by striking ``202(a)(17)'' and 
        inserting ``202(a)(14)''.
    (d) Authorization of Appropriations.--Section 216 of the Older 
Americans Act of 1965 (42 U.S.C. 3020f) is amended--
            (1) in subsection (a), by striking ``2007, 2008, 2009, 
        2010, and 2011'' and inserting ``2016, 2017, and 2018'';
            (2) in subsection (b)--
                    (A) by striking ``202(a)(24)'' and inserting 
                ``202(a)(21)''; and
                    (B) by striking ``2007, 2008, 2009, 2010, and 
                2011'' and inserting ``2016, 2017, and 2018''; and
            (3) in subsection (c), by striking ``2007, 2008, 2009, 
        2010, and 2011'' and inserting ``2016, 2017, and 2018''.

SEC. 4. STATE AND COMMUNITY PROGRAMS ON AGING.

    (a) Authorization of Appropriations.--Section 303 of the Older 
Americans Act of 1965 (42 U.S.C. 3023) is amended--
            (1) in subsection (a)(1), by striking ``fiscal years 2007'' 
        and all that follows and inserting ``each of fiscal years 2016 
        through 2018.'';
            (2) in subsection (b)--
                    (A) in paragraph (1), by striking ``fiscal years 
                2007'' and all that follows and inserting ``each of 
                fiscal years 2016 through 2018.''; and
                    (B) in paragraph (2), by striking ``fiscal years 
                2007'' and all that follows and inserting ``each of 
                fiscal years 2016 through 2018.'';
            (3) in subsection (d), by striking ``fiscal years 2007'' 
        and all that follows and inserting ``each of fiscal years 2016 
        through 2018.''; and
            (4) in subsection (e)(2), by striking ``2011'' and 
        inserting ``2011 and each of fiscal years 2016 through 2018''.
    (b) Allotment.--Section 304 of the Older Americans Act of 1965 (42 
U.S.C. 3024) is amended--
            (1) in subsection (a)(3), by striking subparagraph (D) and 
        inserting the following:
    ``(D)(i) For each of fiscal years 2016 through 2018, no State shall 
be allotted an amount that is less than 99 percent of the amount 
allotted to such State for the previous fiscal year.
    ``(ii) For fiscal year 2019 and each subsequent fiscal year, no 
State shall be allotted an amount that is less than 100 percent of the 
amount allotted to such State for fiscal year 2018.''; and
            (2) in subsection (b), by striking ``subpart 1 of''.
    (c) Planning and Service Areas.--Section 305(b)(5)(C)(i)(III) of 
the Older Americans Act of 1965 (42 U.S.C. 3025(b)(5)(C)(i)(III)) is 
amended by striking ``planning and services areas'' and inserting 
``planning and service areas''.
    (d) Area Plans.--Section 306 of the Older Americans Act of 1965 (42 
U.S.C. 3026) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``establishment, 
                maintenance, or construction of multipurpose senior 
                centers,'' and inserting ``establishment, maintenance, 
                modernization, or construction of multipurpose senior 
                centers (including a plan to use the skills and 
                services of older individuals in paid and unpaid work, 
                including multigenerational and older individual to 
                older individual work),''; and
                    (B) in paragraph (6)--
                            (i) in subparagraph (G), by adding ``and'' 
                        at the end; and
                            (ii) by adding at the end the following:
                    ``(H) in coordination with the State agency and 
                with the State agency responsible for elder abuse 
                prevention services, increase public awareness of elder 
                abuse, neglect, and exploitation, and remove barriers 
                to education, prevention, investigation, and treatment 
                of elder abuse, neglect, and exploitation, as 
                appropriate;''; and
            (2) in subsection (b)(3)--
                    (A) in subparagraph (J), by striking ``and'' at the 
                end;
                    (B) by redesignating subparagraph (K) as 
                subparagraph (L); and
                    (C) by inserting after subparagraph (J) the 
                following:
                    ``(K) protection from elder abuse, neglect, and 
                exploitation; and''.
    (e) State Plans.--Section 307(a)(2)(A) of the Older Americans Act 
of 1965 (42 U.S.C. 3027(a)(2)(A)) is amended by striking ``202(a)(29)'' 
and inserting ``202(a)(26)''.
    (f) Nutrition Services Incentive Program.--Section 311(e) of the 
Older Americans Act of 1965 (42 U.S.C. 3030a(e)) is amended by striking 
``fiscal year 2007'' and all that follows and inserting ``each of 
fiscal years 2016 through 2018.''.
    (g) Supportive Services.--Section 321 of the Older Americans Act of 
1965 (42 U.S.C. 3030d) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by striking ``or referral 
                services'' and inserting ``referral, chronic condition 
                self-care management, or falls prevention services'';
                    (B) in paragraph (8), by striking ``(including'' 
                and all that follows and inserting the following: 
                ``(including mental and behavioral health screening and 
                falls prevention services screening) to detect or 
                prevent (or both) illnesses and injuries that occur 
                most frequently in older individuals;'' and
                    (C) in paragraph (15), by inserting before the 
                semicolon the following: ``, and screening for elder 
                abuse, neglect, and exploitation'';
            (2) in subsection (b)(1), by inserting ``or modernization'' 
        after ``construction'';
            (3) in subsection (c), by inserting before the period the 
        following: ``, and pursue opportunities for the development of 
        intergenerational shared site models for programs or projects, 
        consistent with the purposes of this Act''; and
            (4) by adding at the end the following:
    ``(e) In this section, the term `adult child with a disability' 
means a child who--
            ``(1) is age 18 or older;
            ``(2) is financially dependent on an older individual who 
        is a parent of the child; and
            ``(3) has a disability.''.
    (h) Home Delivered Nutrition Services Program.--Section 336(1) of 
the Older Americans Act of 1965 (42 U.S.C. 3030f(1)) is amended by 
striking ``canned'' and all that follows through ``meals'' and 
inserting ``canned, or fresh foods and, as appropriate, supplemental 
foods, and any additional meals''.
    (i) Nutrition Services.--Section 339 of the Older Americans Act of 
1965 (42 U.S.C. 3030g-21) is amended
            (1) in paragraph (1), by striking ``solicit'' and inserting 
        ``utilize''; and
            (2) in paragraph (2)--
                    (A) in subparagraph (J), by striking ``and'' at the 
                end;
                    (B) in subparagraph (K), by striking the period and 
                inserting ``, and''; and
                    (C) by adding at the end the following:
                    ``(L) where feasible, encourages the use of locally 
                grown foods in meal programs and identifies potential 
                partnerships and contracts with local producers and 
                providers of locally grown foods.''.
    (j) Evidence-Based Disease Prevention and Health Promotion Services 
Program.--Part D of title III of the Older Americans Act of 1965 (42 
U.S.C. 3030m et seq.) is amended--
            (1) in the part heading, by inserting ``Evidence-Based'' 
        before ``Disease''; and
            (2) in section 361(a), by inserting ``evidence-based'' 
        after ``to provide''.
    (k) Older Relative Caregivers.--
            (1) Technical amendment.--Part E of title III of the Older 
        Americans Act of 1965 (42 U.S.C. 3030s et seq.) is amended by 
        striking the subpart heading for subpart 1.
            (2) Definitions.--Section 372 of such Act (42 U.S.C. 3030s) 
        is amended--
                    (A) in subsection (a)--
                            (i) in paragraph (1), by striking ``or who 
                        is an individual with a disability''; and
                            (ii) by striking paragraph (2) and 
                        inserting the following:
            ``(2) Individual with a disability.--The term `individual 
        with a disability' means an individual with a disability, as 
        defined in section 3 of the Americans with Disabilities Act of 
        1990 (42 U.S.C. 12102), who is not less than age 18 and not 
        more than age 59.
            ``(3) Older relative caregiver.--The term `older relative 
        caregiver' means a caregiver who--
                    ``(A)(i) is age 55 or older; and
                    ``(ii) lives with, is the informal provider of in-
                home and community care to, and is the primary 
                caregiver for, a child or an individual with a 
                disability;
                    ``(B) in the case of a caregiver for a child--
                            ``(i) is the grandparent, stepgrandparent, 
                        or other relative (other than the parent) by 
                        blood, marriage, or adoption, of the child;
                            ``(ii) is the primary caregiver of the 
                        child because the biological or adoptive 
                        parents are unable or unwilling to serve as the 
                        primary caregivers of the child; and
                            ``(iii) has a legal relationship to the 
                        child, such as legal custody, adoption, or 
                        guardianship, or is raising the child 
                        informally; and
                    ``(C) in the case of a caregiver for an individual 
                with a disability, is the parent, grandparent, or other 
                relative by blood, marriage, or adoption, of the 
                individual with a disability.''; and
                    (B) in subsection (b)--
                            (i) by striking ``subpart'' and all that 
                        follows through ``family caregivers'' and 
                        inserting ``part, for family caregivers'';
                            (ii) by striking ``; and'' and inserting a 
                        period; and
                            (iii) by striking paragraph (2).
    (l) National Family Caregiver Support Program.--Section 373 of the 
Older Americans Act of 1965 (42 U.S.C. 3030s-1) is amended--
            (1) in subsection (a)(2), by striking ``grandparents or 
        older individuals who are relative caregivers.'' and inserting 
        ``older relative caregivers.'';
            (2) in subsection (c)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by striking ``grandparents and older 
                individuals who are relative caregivers, and who'' and 
                inserting ``older relative caregivers, who''; and
                    (B) in paragraph (2)(B), by striking ``to older 
                individuals providing care to individuals with severe 
                disabilities, including children with severe 
                disabilities'' and inserting ``to older relative 
                caregivers of children with severe disabilities, or 
                individuals with disabilities who have severe 
                disabilities'';
            (3) in subsection (e)(3), by striking ``grandparents or 
        older individuals who are relative caregivers'' and inserting 
        ``older relative caregivers'';
            (4) in subsection (f)(1)(A), by striking ``for fiscal years 
        2007, 2008, 2009, 2010, and 2011'' and inserting ``for a fiscal 
        year''; and
            (5) in subsection (g)(2)(C), by striking ``grandparents and 
        older individuals who are relative caregivers of a child who is 
        not more than 18 years of age'' and inserting ``older relative 
        caregivers''.
    (m) Conforming Amendment.--Part E of title III is amended by 
striking ``this subpart'' each place it appears and inserting ``this 
part''.

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

    (a) Grant Programs.--Section 411 of the Older Americans Act of 1965 
(42 U.S.C. 3032) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (12), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (13) as paragraph 
                (14); and
                    (C) by inserting after paragraph (12) the 
                following:
            ``(13) continuing support for program integrity initiatives 
        concerning the Medicare program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.) that train senior 
        volunteers to prevent and identify health care fraud and abuse; 
        and'';
            (2) in subsection (b), by striking ``for fiscal years 
        2007'' and all that follows through ``2011'' and inserting 
        ``for each of fiscal years 2016 through 2018''.
    (b) Native American Programs.--Section 418(b) of the Older 
Americans Act of 1965 (42 U.S.C. 3032g(b)) is amended by striking ``a 
national meeting to train'' and inserting ``national trainings for''.
    (c) Legal Assistance for Older Americans.--Section 420(c) of the 
Older Americans Act of 1965 (42 U.S.C. 3032i(c)) is amended by striking 
``national''.
    (d) Repeals.--Sections 415, 419, and 421 of the Older Americans Act 
of 1965 (42 U.S.C. 3032d, 3032h, 3032j) are repealed.
    (e) Conforming Amendment.--Section 417(a)(1)(A) of the Older 
Americans Act of 1965 (42 U.S.C. 3032f(a)(1)(A)) is amended by striking 
``grandparents and other older individuals who are relative 
caregivers'' and inserting ``older relative caregivers (as defined in 
section 372)''.

SEC. 6. COMMUNITY SERVICE SENIOR OPPORTUNITIES.

    Section 517(a) of the Older Americans Act of 1965 (42 U.S.C. 
3056o(a)) is amended by striking ``fiscal years 2007, 2008, 2009, 2010, 
and 2011'' and inserting ``each of fiscal years 2016 through 2018''.

SEC. 7. GRANTS FOR NATIVE AMERICANS.

    Section 643(2) of the Older Americans Act of 1965 (42 U.S.C. 
3057n(2)) is amended by striking ``fiscal year 2011'' and inserting 
``each of fiscal years 2016 through 2018''.

SEC. 8. VULNERABLE ELDER RIGHTS PROTECTION ACTIVITIES.

    (a) Ombudsman Definitions.--Section 711(6) of the Older Americans 
Act of 1965 (42 U.S.C. 3058f(6)) is amended by striking ``older''.
    (b) Ombudsman Programs.--Section 712 of the Older Americans Act of 
1965 (42 U.S.C. 3058g) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (2), by adding at the end the 
                following: ``The Ombudsman shall be responsible for the 
                management, including the fiscal management, of the 
                Office.'';
                    (B) in paragraph (3)--
                            (i) in subparagraph (A), by striking clause 
                        (i) and inserting the following:
                            ``(i) are made by, or on behalf of, 
                        residents, including residents with limited or 
                        no decisionmaking capacity and who have no 
                        known legal representative, and if such a 
                        resident is unable to communicate consent for 
                        an Ombudsman to work on a complaint directly 
                        involving the resident, the Ombudsman shall 
                        seek evidence to indicate what outcome the 
                        resident would have communicated (and, in the 
                        absence of evidence to the contrary, shall 
                        assume that the resident wishes to have the 
                        resident's health, safety, welfare, and rights 
                        protected) and shall work to accomplish that 
                        outcome; and'';
                            (ii) in subparagraph (D), by striking 
                        ``regular and timely'' and inserting ``regular, 
                        timely, private, and unimpeded'';
                            (iii) in subparagraph (H)(iii)--
                                    (I) by inserting ``, actively 
                                encourage, and assist in'' after 
                                ``provide technical support for''; and
                                    (II) by striking ``and'' after the 
                                semicolon;
                            (iv) by redesignating subparagraph (I) as 
                        subparagraph (J); and
                            (v) by inserting after subparagraph (H) the 
                        following:
                    ``(I) when feasible, continue to carry out the 
                functions described in this section on behalf of 
                residents transitioning from a long-term care facility 
                to a home care setting; and'';
                    (C) in paragraph (5)(B)--
                            (i) in clause (vi)--
                                    (I) by inserting ``, actively 
                                encourage, and assist in'' after 
                                ``support''; and
                                    (II) by striking ``and'' after the 
                                semicolon;
                            (ii) by redesignating clause (vii) as 
                        clause (viii); and
                            (iii) by inserting after clause (vi) the 
                        following:
                            ``(vii) identify, investigate, and resolve 
                        complaints described in clause (iii) that are 
                        made by or on behalf of residents with limited 
                        or no decisionmaking capacity and who have no 
                        known legal representative, and if such a 
                        resident is unable to communicate consent for 
                        an Ombudsman to work on a complaint directly 
                        involving the resident, the Ombudsman shall 
                        seek evidence to indicate what outcome the 
                        resident would have communicated (and, in the 
                        absence of evidence to the contrary, shall 
                        assume that the resident wishes to have the 
                        resident's health, safety, welfare, and rights 
                        protected) and shall work to accomplish that 
                        outcome; and'';
            (2) in subsection (b)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (A), by striking 
                        ``access'' and inserting ``private and 
                        unimpeded access''; and
                            (ii) in subparagraph (B)--
                                    (I) in clause (i)--
                                            (aa) in the matter 
                                        preceding subclause (I), by 
                                        striking ``the medical and 
                                        social records of a'' and 
                                        inserting ``all files, records, 
                                        and other information 
                                        concerning a''; and
                                            (bb) in subclause (II), by 
                                        striking ``to consent'' and 
                                        inserting ``to communicate 
                                        consent''; and
                                    (II) in clause (ii), in the matter 
                                before subclause (I), by striking ``the 
                                records'' and inserting ``the files, 
                                records, and information''; and
                    (B) by adding at the end the following:
            ``(3) Health oversight agency.--For purposes of section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996 (including regulations issued under that section) 
        (42 U.S.C. 1320d-2 note), the Ombudsman and a representative of 
        the Office shall be considered a `health oversight agency,' so 
        that release of residents' individually identifiable health 
        information to the Ombudsman or representative is not precluded 
        in cases in which the requirements of clause (i) or (ii) of 
        paragraph (1)(B), or the requirements of paragraph (1)(D), are 
        otherwise met.'';
            (3) in subsection (c)(2)(D), by striking ``202(a)(21)'' and 
        inserting ``202(a)(18)'';
            (4) in subsection (d)--
                    (A) in paragraph (1), by striking ``files'' and 
                inserting ``files, records, and other information''; 
                and
                    (B) in paragraph (2)--
                            (i) in subparagraph (A)--
                                    (I) by striking ``files and 
                                records'' each place such term appears 
                                and inserting ``files, records, and 
                                other information''; and
                                    (II) by striking ``and'' after the 
                                semicolon;
                            (ii) in subparagraph (B)--
                                    (I) by striking ``files or 
                                records'' and inserting ``files, 
                                records, or other information''; and
                                    (II) in clause (iii), by striking 
                                the period at the end and inserting ``; 
                                and''; and
                            (iii) by adding at the end the following:
                    ``(C) notwithstanding subparagraph (B), ensure that 
                the Ombudsman may disclose information as needed in 
                order to best serve residents with limited or no 
                decisionmaking capacity who have no known legal 
                representative and are unable to communicate consent, 
                in order for the Ombudsman to carry out the functions 
                and duties described in paragraphs (3)(A) and (5)(B) of 
                subsection (a).''; and
            (5) by striking subsection (f) and inserting the following:
    ``(f) Conflict of Interest.--
            ``(1) Individual conflict of interest.--The State agency 
        shall--
                    ``(A) ensure that no individual, or member of the 
                immediate family of an individual, involved in the 
                designation of the Ombudsman (whether by appointment or 
                otherwise) or the designation of an entity designated 
                under subsection (a)(5), is subject to a conflict of 
                interest;
                    ``(B) ensure that no officer or employee of the 
                Office, representative of a local Ombudsman entity, or 
                member of the immediate family of the officer, 
                employee, or representative, is subject to a conflict 
                of interest; and
                    ``(C) ensure that the Ombudsman--
                            ``(i) does not have a direct involvement in 
                        the licensing or certification of a long-term 
                        care facility or of a provider of a long-term 
                        care service;
                            ``(ii) does not have an ownership or 
                        investment interest (represented by equity, 
                        debt, or other financial relationship) in a 
                        long-term care facility or a long-term care 
                        service;
                            ``(iii) is not employed by, or 
                        participating in the management of, a long-term 
                        care facility or a related organization, and 
                        has not been employed by such a facility or 
                        organization within 1 year before the date of 
                        the determination involved;
                            ``(iv) does not receive, or have the right 
                        to receive, directly or indirectly, 
                        remuneration (in cash or in kind) under a 
                        compensation arrangement with an owner or 
                        operator of a long-term care facility;
                            ``(v) does not have management 
                        responsibility for, or operate under the 
                        supervision of an individual with management 
                        responsibility for, adult protective services; 
                        and
                            ``(vi) does not serve as a guardian or in 
                        another fiduciary capacity for residents of 
                        long-term care facilities in an official 
                        capacity (as opposed to serving as a guardian 
                        or fiduciary for a family member, in a personal 
                        capacity).
            ``(2) Organizational conflict of interest.--
                    ``(A) In general.--The State agency shall comply 
                with subparagraph (B)(i) in a case in which the Office 
                poses an organizational conflict of interest, including 
                a situation in which the Office is placed in an 
                organization that--
                            ``(i) is responsible for licensing, 
                        certifying, or surveying long-term care 
                        services in the State;
                            ``(ii) is an association (or an affiliate 
                        of such an association) of long-term care 
                        facilities, or of any other residential 
                        facilities for older individuals;
                            ``(iii) provides long-term care services, 
                        including programs carried out under a Medicaid 
                        waiver approved under section 1115 of the 
                        Social Security Act (42 U.S.C. 1315) or under 
                        subsection (b) or (c) of section 1915 of the 
                        Social Security Act (42 U.S.C. 1396n), or under 
                        a Medicaid State plan amendment under 
                        subsection (i), (j), or (k) of section 1915 of 
                        the Social Security Act (42 U.S.C. 1396n);
                            ``(iv) provides long-term care case 
                        management;
                            ``(v) sets rates for long-term care 
                        services;
                            ``(vi) provides adult protective services;
                            ``(vii) is responsible for eligibility 
                        determinations for the Medicaid program carried 
                        out under title XIX of the Social Security Act 
                        (42 U.S.C. 1396 et seq.);
                            ``(viii) conducts preadmission screening 
                        for placements in facilities described in 
                        clause (ii); or
                            ``(ix) makes decisions regarding admission 
                        or discharge of individuals to or from such 
                        facilities.
                    ``(B) Identifying, removing, and remedying 
                organizational conflict.--
                            ``(i) In general.--The State agency may not 
                        operate the Office or carry out the program, 
                        directly, or by contract or other arrangement 
                        with any public agency or nonprofit private 
                        organization, in a case in which there is an 
                        organizational conflict of interest (within the 
                        meaning of subparagraph (A)) unless such 
                        conflict of interest has been--
                                    ``(I) identified by the State 
                                agency;
                                    ``(II) disclosed by the State 
                                agency to the Assistant Secretary in 
                                writing; and
                                    ``(III) remedied in accordance with 
                                this subparagraph.
                            ``(ii) Action by assistant secretary.--In a 
                        case in which a potential or actual 
                        organizational conflict of interest (within the 
                        meaning of subparagraph (A)) involving the 
                        Office is disclosed or reported to the 
                        Assistant Secretary by any person or entity, 
                        the Assistant Secretary shall require that the 
                        State agency, in accordance with the policies 
                        and procedures established by the State agency 
                        under subsection (a)(5)(D)(iii)--
                                    ``(I) remove the conflict; or
                                    ``(II) submit, and obtain the 
                                approval of the Assistant Secretary 
                                for, an adequate remedial plan that 
                                indicates how the Ombudsman will be 
                                unencumbered in fulfilling all of the 
                                functions specified in subsection 
                                (a)(3).''; and
            (6) in subsection (h)--
                    (A) in paragraph (3)(A)(i), by striking ``older'';
                    (B) in paragraph (4), by striking all that precedes 
                ``procedures'' and inserting the following:
            ``(4) strengthen and update'';
                    (C) by redesignating paragraphs (4) through (9) as 
                paragraphs (5) through (10), respectively;
                    (D) by inserting after paragraph (3) the following:
            ``(4) ensure that the Ombudsman or a designee participates 
        in training provided by the National Ombudsman Resource Center 
        established in section 202(a)(18);'';
                    (E) in paragraph (6)(A), as redesignated by 
                subparagraph (C) of this paragraph, by striking 
                ``paragraph (4)'' and inserting ``paragraph (5)'';
                    (F) in paragraph (7)(A), as redesignated by 
                subparagraph (C) of this paragraph, by striking 
                ``subtitle C of the'' and inserting ``subtitle C of 
                title I of the''; and
                    (G) in paragraph (10), as redesignated by 
                subparagraph (C) of this paragraph, by striking ``(6), 
                or (7)'' and inserting ``(7), or (8)''.
    (c) Ombudsman Regulations.--Section 713 of the Older Americans Act 
of 1965 (42 U.S.C. 3058h) is amended--
            (1) in paragraph (1), by striking ``paragraphs (1) and (2) 
        of section 712(f)'' and inserting ``subparagraphs (A) and (B) 
        of section 712(f)(1)''; and
            (2) in paragraph (2), by striking ``subparagraphs (A) 
        through (D) of section 712(f)(3)'' and inserting ``clauses (i) 
        through (vi) of section 712(f)(1)(C)''.
    (d) Prevention of Elder Abuse, Neglect, and Exploitation.--Section 
721 of the Older Americans Act of 1965 (42 U.S.C. 3058i) is amended--
            (1) in subsection (b)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``(including financial exploitation)'';
                    (B) by redesignating paragraphs (5) through (12) as 
                paragraphs (6) through (13), respectively;
                    (C) by inserting after paragraph (4) the following:
            ``(5) promoting the submission of data on elder abuse, 
        neglect, and exploitation for the appropriate database of the 
        Administration or another database specified by the Assistant 
        Secretary;'';
                    (D) in paragraph (10)(C), as redesignated by 
                subparagraph (B) of this paragraph--
                            (i) in clause (ii), by inserting ``, such 
                        as forensic specialists,'' after ``such 
                        personnel''; and
                            (ii) in clause (v), by inserting before the 
                        comma the following: ``, including programs and 
                        arrangements that protect against financial 
                        exploitation''; and
                    (E) in paragraph (12), as redesignated by 
                subparagraph (B) of this paragraph--
                            (i) in subparagraph (D), by striking 
                        ``and'' at the end; and
                            (ii) by adding at the end the following:
                    ``(F) supporting and studying innovative practices 
                in communities to develop partnerships across 
                disciplines for the prevention, investigation, and 
                prosecution of abuse, neglect, and exploitation; and''; 
                and
            (2) in subsection (e)(2), in the matter preceding 
        subparagraph (A)--
                    (A) by striking ``subsection (b)(9)(B)(i)'' and 
                inserting ``subsection (b)(10)(B)(i)''; and
                    (B) by striking ``subsection (b)(9)(B)(ii)'' and 
                inserting ``subsection (b)(10)(B)(ii)''.

SEC. 9. BEHAVIORAL HEALTH.

    The Older Americans Act of 1965 is amended--
            (1) in section 102 (42 U.S.C. 3002)--
                    (A) in paragraph (14)(G), by inserting ``and 
                behavioral'' after ``mental'';
                    (B) in paragraph (36), by inserting ``and 
                behavioral'' after ``mental''; and
                    (C) in paragraph (47)(B), by inserting ``and 
                behavioral'' after ``mental'';
            (2) in section 201(f)(1) (42 U.S.C. 3011(f)(1)), by 
        inserting ``and behavioral'' after ``mental'';
            (3) in section 202(a)(5) (42 U.S.C. 3012(a)(5)), by 
        inserting ``and behavioral'' after ``mental'';
            (4) in section 306(a) (42 U.S.C. 3026(a))--
                    (A) in paragraph (2)(A), by inserting ``and 
                behavioral'' after ``mental''; and
                    (B) in paragraph (6)(F), by striking ``mental 
                health services'' each place such term appears and 
                inserting ``mental and behavioral health services''; 
                and
            (5) in section 321(a) (42 U.S.C. 3030d)--
                    (A) in paragraph (1), as amended by section 4(g), 
                by inserting ``and behavioral'' after ``mental'';
                    (B) in paragraph (14)(B), by inserting ``and 
                behavioral'' after ``mental''; and
                    (C) in paragraph (23), by inserting ``and 
                behavioral'' after ``mental''.

SEC. 10. GUIDANCE ON SERVING HOLOCAUST SURVIVORS.

    (a) In General.--Because the services under the Older Americans Act 
of 1965 (42 U.S.C. 3001 et seq.) are critical to meeting the urgent 
needs of Holocaust survivors to age in place with dignity, comfort, 
security, and quality of life, the Assistant Secretary for Aging shall 
issue guidance to States, that shall be applicable to States, area 
agencies on aging, and providers of services for older individuals, 
with respect to serving Holocaust survivors, including guidance on 
promising practices for conducting outreach to that population. In 
developing the guidance, the Assistant Secretary for Aging shall 
consult with experts and organizations serving Holocaust survivors, and 
shall take into account the possibility that the needs of Holocaust 
survivors may differ based on geography.
    (b) Contents.--The guidance shall include the following:
            (1) How nutrition service providers may meet the special 
        health-related or other dietary needs of participants in 
        programs under the Older Americans Act of 1965, including needs 
        based on religious, cultural, or ethnic requirements.
            (2) How transportation service providers may address the 
        urgent transportation needs of Holocaust survivors.
            (3) How State long-term care ombudsmen may address the 
        unique needs of residents of long-term care facilities for whom 
        institutional settings may produce sights, sounds, smells, 
        emotions, and routines, that can induce panic, anxiety, and 
        retraumatization as a result of experiences from the Holocaust.
            (4) How supportive services providers may consider the 
        unique needs of Holocaust survivors.
            (5) How other services provided under that Act, as 
        determined by the Assistant Secretary for Aging, may serve 
        Holocaust survivors.
    (c) Date of Issuance.--The guidance described in subsection (a) 
shall be issued not later than 180 days after the date of enactment of 
this Act.
                                                        Calendar No. 12

114th CONGRESS

  1st Session

                                 S. 192

_______________________________________________________________________

                                 A BILL

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

_______________________________________________________________________

                            February 3, 2015

                       Reported without amendment
```