114TH CONGRESS 

1ST SESSION S. 192 

AN ACT 

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, 
2 

†S 192 ES

1 SECTION 1. SHORT TITLE. 

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

3 Reauthorization Act of 2015’’. 

4 SEC. 2. DEFINITIONS. 

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

6 U.S.C. 3002) is amended— 

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

8 following: 

9 ‘‘(1) The term ‘abuse’ means the knowing in10 fliction of physical or psychological harm or the 

11 knowing deprivation of goods or services that are 

12 necessary to meet essential needs or to avoid phys13 ical or psychological harm.’’; 

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

15 following: 

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

17 such services provided to adults as the Secretary 

18 may specify and includes services such as— 

19 ‘‘(A) receiving reports of adult abuse, ne20 glect, or exploitation; 

21 ‘‘(B) investigating the reports described in 

22 subparagraph (A); 

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

24 and other casework and services; and 

25 ‘‘(D) providing, arranging for, or facili26 tating the provision of medical, social service, 
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1 economic, legal, housing, law enforcement, or 

2 other protective, emergency, or support serv3 ices.’’; 

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

5 following: 

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

7 Center’ means an entity, network, or consortium es8 tablished by a State as part of the State system of 

9 long-term care, to provide a coordinated and inte10 grated system for older individuals and individuals 

11 with disabilities (as defined in section 3 of the Amer12 icans with Disabilities Act of 1990 (42 U.S.C. 

13 12102)), and the caregivers of older individuals and 

14 individuals with disabilities, that provides— 

15 ‘‘(A) comprehensive information on the full 

16 range of available public and private long-term 

17 care programs, options, service providers, and 

18 resources within a community, including infor19 mation on the availability of integrated long20 term care services, and Federal or State pro21 grams that provide long-term care services and 

22 supports through home and community-based 

23 service programs; 

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

25 individuals in assessing their existing or antici-
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1 pated long-term care needs and goals, and de2 veloping and implementing a person-centered 

3 plan for long-term care that is consistent with 

4 the desires of such an individual and designed 

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

6 and circumstances; 

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

8 range of publicly-supported long-term care serv9 ices and supports for which the individuals may 

10 be eligible, including home and community11 based service options, by serving as a conven12 ient point of entry for such programs and sup13 ports; and 

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

15 aging, centers for independent living described 

16 in part C of title VII of the Rehabilitation Act 

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

18 community-based entities, information and re19 ferrals regarding available home and commu20 nity-based services for individuals who are at 

21 risk for residing in, or who reside in, institu22 tional settings, so that the individuals have the 

23 choice to remain in or to return to the commu24 nity.’’; 
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1 (4) in paragraph (14)(B), by inserting ‘‘oral 

2 health,’’ after ‘‘bone density,’’; 

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

4 the following: 

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

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

7 to— 

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

9 in, and prosecute elder abuse, neglect, and 

10 exploitation; and 

11 ‘‘(ii) protect older individuals with di12 minished capacity while maximizing their 

13 autonomy; and 

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

15 recognition of an older individual’s rights, in16 cluding the right to be free of abuse, neglect, 

17 and exploitation.’’; and 

18 (6) in paragraph (18)(A), by striking ‘‘term ‘ex19 ploitation’ means’’ and inserting ‘‘terms ‘exploi20 tation’ and ‘financial exploitation’ mean’’. 

21 SEC. 3. ADMINISTRATION ON AGING. 

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

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

24 (1) in subsection (d)(3)— 
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1 (A) in subparagraph (H), by striking 

2 ‘‘202(a)(21)’’ and inserting ‘‘202(a)(18)’’; 

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

4 ‘‘and’’ at the end; 

5 (C) in subparagraph (L)— 

6 (i) by striking ‘‘Older Americans Act 

7 Amendments of 1992’’ and inserting 

8 ‘‘Older Americans Act Reauthorization Act 

9 of 2015’’; and 

10 (ii) by striking ‘‘712(h)(4).’’ and in11 serting ‘‘712(h)(5); and’’; and 

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

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

14 to responding to elder abuse, neglect, and exploi15 tation in long-term care facilities, and publish a re16 port of such best practices.’’; and 

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

18 subparagraph (A), by inserting ‘‘, and in coordina19 tion with the heads of State adult protective services 

20 programs and the Director of the Office of Long21 Term Care Ombudsman Programs’’ after ‘‘and serv22 ices’’. 

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

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

25 (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 

18 transportation services, including across geographic 

19 boundaries; 

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 

5 care entities, such as Federally-qualified health cen6 ters, as defined in section 1905(l)(2)(B) of the So7 cial Security Act (42 U.S.C. 1396d(l)(2)(B)), in 

8 order to improve care coordination for individuals 

9 with multiple 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 con19 sultation with States and national organiza20 tions, a consumer-friendly tool to assist older 

21 individuals and their families in choosing home 

22 and community-based services, with a particular 

23 focus on ways for consumers to assess how pro24 viders protect the health, safety, welfare, and 
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1 rights, including the rights provided under sec2 tion 314, of 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 fol16 lowing: 

17 ‘‘(F) to provide information and referrals 

18 regarding available home and community-based 

19 services for individuals who are at risk for re20 siding in, or who reside in, institutional set21 tings, so that the individuals have the choice to 

22 remain in or to return to the community;’’; and 

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

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

25 ensure that programs authorized under this Act include 
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1 appropriate training in the prevention of abuse, neglect, 

2 and exploitation and provision of services that address 

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

4 (c) REPORTS.—Section 207(a) of the Older Ameri5 cans Act of 1965 (42 U.S.C. 3018(a)) is amended— 

6 (1) in paragraph (2), by striking ‘‘202(a)(19)’’ 

7 and inserting ‘‘202(a)(16)’’; and 

8 (2) in paragraph (4), by striking ‘‘202(a)(17)’’ 

9 and inserting ‘‘202(a)(14)’’. 

10 (d) AUTHORIZATION OF APPROPRIATIONS.—Section 

11 216 of the Older Americans Act of 1965 (42 U.S.C. 

12 3020f) is amended— 

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

14 2009, 2010, and 2011’’ and inserting ‘‘2016, 2017, 

15 and 2018’’; 

16 (2) in subsection (b)— 

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

18 ‘‘202(a)(21)’’; and 

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

20 and 2011’’ and inserting ‘‘2016, 2017, and 

21 2018’’; and 

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

23 2009, 2010, and 2011’’ and inserting ‘‘2016, 2017, 

24 and 2018’’. 
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1 SEC. 4. STATE AND COMMUNITY PROGRAMS ON AGING. 

2 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 

3 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) 

4 is amended— 

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

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

7 of fiscal years 2016 through 2018.’’; 

8 (2) in subsection (b)— 

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

10 years 2007’’ and all that follows and inserting 

11 ‘‘each of fiscal years 2016 through 2018.’’; and 

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

13 years 2007’’ and all that follows and inserting 

14 ‘‘each of fiscal years 2016 through 2018.’’; 

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

16 2007’’ and all that follows and inserting ‘‘each of 

17 fiscal years 2016 through 2018.’’; and 

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

19 inserting ‘‘2011 and each of fiscal years 2016 

20 through 2018’’. 

21 (b) ALLOTMENT.—Section 304 of the Older Ameri22 cans Act of 1965 (42 U.S.C. 3024) is amended— 

23 (1) in subsection (a)(3), by striking subpara24 graph (D) and inserting the following: 

25 ‘‘(D)(i) For each of fiscal years 2016 through 2018, 

26 no State shall be allotted an amount that is less than 99 
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1 percent of the amount allotted to such State for the pre2 vious fiscal year. 

3 ‘‘(ii) For fiscal year 2019 and each subsequent fiscal 

4 year, no State shall be allotted an amount that is less than 

5 100 percent of the amount allotted to such State for fiscal 

6 year 2018.’’; and 

7 (2) in subsection (b), by striking ‘‘subpart 1 

8 of’’. 

9 (c) PLANNING AND SERVICE AREAS.—Section 

10 305(b)(5)(C)(i)(III) of the Older Americans Act of 1965 

11 (42 U.S.C. 3025(b)(5)(C)(i)(III)) is amended by striking 

12 ‘‘planning and services areas’’ and inserting ‘‘planning 

13 and service areas’’. 

14 (d) AREA PLANS.—Section 306 of the Older Ameri15 cans Act of 1965 (42 U.S.C. 3026) is amended— 

16 (1) in subsection (a)— 

17 (A) in paragraph (1), by striking ‘‘estab18 lishment, maintenance, or construction of multi19 purpose senior centers,’’ and inserting ‘‘estab20 lishment, maintenance, modernization, or con21 struction of multipurpose senior centers (includ22 ing a plan to use the skills and services of older 

23 individuals in paid and unpaid work, including 

24 multigenerational and older individual to older 

25 individual work),’’; and 
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1 (B) in paragraph (6)— 

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

3 ‘‘and’’ at the end; and 

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

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

7 and with the State agency responsible for elder 

8 abuse prevention services, increase public 

9 awareness of elder abuse, neglect, and exploi10 tation, and remove barriers to education, pre11 vention, investigation, and treatment of elder 

12 abuse, neglect, and exploitation, as appro13 priate;’’; and 

14 (2) in subsection (b)(3)— 

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

16 at the end; 

17 (B) by redesignating subparagraph (K) as 

18 subparagraph (L); and 

19 (C) by inserting after subparagraph (J) 

20 the following: 

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

22 and exploitation; and’’. 

23 (e) STATE PLANS.—Section 307(a)(2)(A) of the 

24 Older Americans Act of 1965 (42 U.S.C. 3027(a)(2)(A)) 
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1 is amended by striking ‘‘202(a)(29)’’ and inserting 

2 ‘‘202(a)(26)’’. 

3 (f) 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 2016 through 2018.’’. 

8 (g) 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’’; 

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’’; 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 (h) HOME DELIVERED NUTRITION SERVICES PRO16 GRAM.—Section 336(1) of the Older Americans Act of 

17 1965 (42 U.S.C. 3030f(1)) is amended by striking 

18 ‘‘canned’’ and all that follows through ‘‘meals’’ and insert19 ing ‘‘canned, or fresh foods and, as appropriate, supple20 mental foods, and any additional meals’’. 

21 (i) 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 

7 locally grown foods in meal programs and iden8 tifies potential partnerships and contracts with 

9 local producers and providers of locally grown 

10 foods.’’. 

11 (j) EVIDENCE-BASED DISEASE PREVENTION AND

12 HEALTH PROMOTION SERVICES PROGRAM.—Part D of 

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

14 3030m 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 (k) 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’’; and 

4 (ii) by striking paragraph (2) and in5 serting the following: 

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

7 term ‘individual with a disability’ means an indi8 vidual with a disability, as defined in section 3 of the 

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

10 12102), who is not less than age 18 and not more 

11 than age 59. 

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

13 ‘older relative caregiver’ means a caregiver who— 

14 ‘‘(A)(i) is age 55 or older; and 

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

16 in-home and community care to, and is the pri17 mary caregiver for, a child or an individual with 

18 a disability; 

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

20 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 

3 parents are unable or unwilling to serve as 

4 the 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 (l) 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 fis21 cal years 2007, 2008, 2009, 2010, and 2011’’ and 

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

23 (5) in subsection (g)(2)(C), by striking ‘‘grand24 parents and older individuals who are relative care-
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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 (m) CONFORMING AMENDMENT.—Part E of title III 

4 is amended by striking ‘‘this subpart’’ each place it ap5 pears 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. 

20 1395 et seq.) that train senior volunteers to prevent 

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

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

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

24 and inserting ‘‘for each of fiscal years 2016 through 

25 2018’’. 
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1 (b) NATIVE AMERICAN PROGRAMS.—Section 418(b) 

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

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

4 inserting ‘‘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 

12 417(a)(1)(A) of the Older Americans Act of 1965 (42 

13 U.S.C. 3032f(a)(1)(A)) is amended by striking ‘‘grand14 parents and other older individuals who are relative care15 givers’’ and inserting ‘‘older relative caregivers (as defined 

16 in section 372)’’. 

17 SEC. 6. COMMUNITY SERVICE SENIOR OPPORTUNITIES. 

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

19 (42 U.S.C. 3056o(a)) is amended by striking ‘‘fiscal years 

20 2007, 2008, 2009, 2010, and 2011’’ and inserting ‘‘each 

21 of fiscal years 2016 through 2018’’. 

22 SEC. 7. GRANTS FOR NATIVE AMERICANS. 

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

24 (42 U.S.C. 3057n(2)) is amended by striking ‘‘fiscal year 
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1 2011’’ and inserting ‘‘each of fiscal years 2016 through 

2 2018’’. 

3 SEC. 8. VULNERABLE ELDER RIGHTS PROTECTION ACTIVI4 TIES. 

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

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

7 is amended by striking ‘‘older’’. 

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

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

10 amended— 

11 (1) in subsection (a)— 

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

13 the following: ‘‘The Ombudsman shall be re14 sponsible for the management, including the fis15 cal management, of the Office.’’; 

16 (B) in paragraph (3)— 

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

18 clause (i) and inserting the following: 

19 ‘‘(i) are made by, or on behalf of, resi20 dents, including residents with limited or 

21 no decisionmaking capacity and who have 

22 no known legal representative, and if such 

23 a resident is unable to communicate con24 sent for an Ombudsman to work on a com25 plaint directly involving the resident, the 
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1 Ombudsman shall seek evidence to indicate 

2 what outcome the resident would have 

3 communicated (and, in the absence of evi4 dence to the contrary, shall assume that 

5 the resident wishes to have the resident’s 

6 health, safety, welfare, and rights pro7 tected) and shall work to accomplish that 

8 outcome; and’’; 

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

10 ‘‘regular and timely’’ and inserting ‘‘reg11 ular, timely, private, and unimpeded’’; 

12 (iii) in subparagraph (H)(iii)— 

13 (I) by inserting ‘‘, actively en14 courage, and assist in’’ after ‘‘provide 

15 technical support for’’; and 

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

17 semicolon; 

18 (iv) by redesignating subparagraph (I) 

19 as subparagraph (J); and 

20 (v) by inserting after subparagraph 

21 (H) the following: 

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

23 the functions described in this section on behalf 

24 of residents transitioning from a long-term care 

25 facility to a home care setting; and’’; 
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1 (C) in paragraph (5)(B)— 

2 (i) in clause (vi)— 

3 (I) by inserting ‘‘, actively en4 courage, and assist in’’ after ‘‘sup5 port’’; and 

6 (II) by striking ‘‘and’’ after the 

7 semicolon; 

8 (ii) by redesignating clause (vii) as 

9 clause (viii); and 

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

11 following: 

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

13 complaints described in clause (iii) that are 

14 made by or on behalf of residents with lim15 ited or no decisionmaking capacity and 

16 who have no known legal representative, 

17 and if such a resident is unable to commu18 nicate consent for an Ombudsman to work 

19 on a complaint directly involving the resi20 dent, the Ombudsman shall seek evidence 

21 to indicate what outcome the resident 

22 would have communicated (and, in the ab23 sence of evidence to the contrary, shall as24 sume that the resident wishes to have the 

25 resident’s health, safety, welfare, and 
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1 rights protected) and shall work to accom2 plish that outcome; and’’; 

3 (2) in subsection (b)— 

4 (A) in paragraph (1)— 

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

6 ‘‘access’’ and inserting ‘‘private and 

7 unimpeded access’’; and 

8 (ii) in subparagraph (B)— 

9 (I) in clause (i)— 

10 (aa) in the matter preceding 

11 subclause (I), by striking ‘‘the 

12 medical and social records of a’’ 

13 and inserting ‘‘all files, records, 

14 and other information concerning 

15 a’’; and 

16 (bb) in subclause (II), by 

17 striking ‘‘to consent’’ and insert18 ing ‘‘to communicate consent’’; 

19 and 

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

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

22 records’’ and inserting ‘‘the files, 

23 records, and information’’; and 

24 (B) by adding at the end the following: 
26 

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1 ‘‘(3) HEALTH OVERSIGHT AGENCY.—For pur2 poses of section 264(c) of the Health Insurance 

3 Portability and Accountability Act of 1996 (includ4 ing regulations issued under that section) (42 U.S.C. 

5 1320d–2 note), the Ombudsman and a representa6 tive of the Office shall be considered a ‘health over7 sight agency,’ so that release of residents’ individ8 ually identifiable health information to the Ombuds9 man or representative is not precluded in cases in 

10 which the requirements of clause (i) or (ii) of para11 graph (1)(B), or the requirements of paragraph 

12 (1)(D), are otherwise met.’’; 

13 (3) in subsection (c)(2)(D), by striking 

14 ‘‘202(a)(21)’’ and inserting ‘‘202(a)(18)’’; 

15 (4) in subsection (d)— 

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

17 and inserting ‘‘files, records, and other informa18 tion’’; and 

19 (B) in paragraph (2)— 

20 (i) in subparagraph (A)— 

21 (I) by striking ‘‘files and 

22 records’’ each place such term appears 

23 and inserting ‘‘files, records, and 

24 other information’’; and 
27 

†S 192 ES

1 (II) by striking ‘‘and’’ after the 

2 semicolon; 

3 (ii) in subparagraph (B)— 

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

5 and inserting ‘‘files, records, or other 

6 information’’; and 

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

8 period at the end and inserting ‘‘; 

9 and’’; and 

10 (iii) by adding at the end the fol11 lowing: 

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

13 ensure that the Ombudsman may disclose infor14 mation as needed in order to best serve resi15 dents with limited or no decisionmaking capac16 ity who have no known legal representative and 

17 are unable to communicate consent, in order for 

18 the Ombudsman to carry out the functions and 

19 duties described in paragraphs (3)(A) and 

20 (5)(B) of subsection (a).’’; and 

21 (5) by striking subsection (f) and inserting the 

22 following: 

23 ‘‘(f) CONFLICT OF INTEREST.— 

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

25 The State agency shall— 
28 

†S 192 ES

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

2 of the immediate family of an individual, in3 volved in the designation of the Ombudsman 

4 (whether by appointment or otherwise) or the 

5 designation of an entity designated under sub6 section (a)(5), is subject to a conflict of inter7 est; 

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

9 the Office, representative of a local Ombudsman 

10 entity, or member of the immediate family of 

11 the officer, employee, or representative, is sub12 ject to a conflict of interest; and 

13 ‘‘(C) ensure that the Ombudsman— 

14 ‘‘(i) does not have a direct involve15 ment in the licensing or certification of a 

16 long-term care facility or of a provider of 

17 a long-term care service; 

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

19 investment interest (represented by equity, 

20 debt, or other financial relationship) in a 

21 long-term care facility or a long-term care 

22 service; 

23 ‘‘(iii) is not employed by, or partici24 pating in the management of, a long-term 

25 care facility or a related organization, and 
29 

†S 192 ES

1 has not been employed by such a facility or 

2 organization within 1 year before the date 

3 of the determination involved; 

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

5 right to receive, directly or indirectly, re6 muneration (in cash or in kind) under a 

7 compensation arrangement with an owner 

8 or operator of a long-term care facility; 

9 ‘‘(v) does not have management re10 sponsibility for, or operate under the su11 pervision of an individual with manage12 ment responsibility for, adult protective 

13 services; and 

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

15 in another fiduciary capacity for residents 

16 of long-term care facilities in an official ca17 pacity (as opposed to serving as a guardian 

18 or fiduciary for a family member, in a per19 sonal capacity). 

20 ‘‘(2) ORGANIZATIONAL CONFLICT OF INTER21 EST.— 

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

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

24 in which the Office poses an organizational con-
30 

†S 192 ES

1 flict of interest, including a situation in which 

2 the Office is placed in an organization that— 

3 ‘‘(i) is responsible for licensing, certi4 fying, or surveying long-term care services 

5 in the State; 

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

7 of such an association) of long-term care 

8 facilities, or of any other residential facili9 ties for older individuals; 

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

11 including programs carried out under a 

12 Medicaid waiver approved under section 

13 1115 of the Social Security Act (42 U.S.C. 

14 1315) or under subsection (b) or (c) of 

15 section 1915 of the Social Security Act (42 

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

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

18 or (k) of section 1915 of the Social Secu19 rity Act (42 U.S.C. 1396n); 

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

21 management; 

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

23 services; 

24 ‘‘(vi) provides adult protective serv25 ices; 
31 

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1 ‘‘(vii) is responsible for eligibility de2 terminations for the Medicaid program 

3 carried out under title XIX of the Social 

4 Security Act (42 U.S.C. 1396 et seq.); 

5 ‘‘(viii) conducts preadmission screen6 ing for placements in facilities described in 

7 clause (ii); or 

8 ‘‘(ix) makes decisions regarding ad9 mission or discharge of individuals to or 

10 from such facilities. 

11 ‘‘(B) IDENTIFYING, REMOVING, AND REM12 EDYING ORGANIZATIONAL CONFLICT.— 

13 ‘‘(i) IN GENERAL.—The State agency 

14 may not operate the Office or carry out the 

15 program, directly, or by contract or other 

16 arrangement with any public agency or 

17 nonprofit private organization, in a case in 

18 which there is an organizational conflict of 

19 interest (within the meaning of subpara20 graph (A)) unless such conflict of interest 

21 has been— 

22 ‘‘(I) identified by the State agen23 cy; 
32 

†S 192 ES

1 ‘‘(II) disclosed by the State agen2 cy to the Assistant Secretary in writ3 ing; and 

4 ‘‘(III) remedied in accordance 

5 with this subparagraph. 

6 ‘‘(ii) ACTION BY ASSISTANT SEC7 RETARY.—In a case in which a potential or 

8 actual organizational conflict of interest 

9 (within the meaning of subparagraph (A)) 

10 involving the Office is disclosed or reported 

11 to the Assistant Secretary by any person 

12 or entity, the Assistant Secretary shall re13 quire that the State agency, in accordance 

14 with the policies and procedures estab15 lished by the State agency under sub16 section (a)(5)(D)(iii)— 

17 ‘‘(I) remove the conflict; or 

18 ‘‘(II) submit, and obtain the ap19 proval of the Assistant Secretary for, 

20 an adequate remedial plan that indi21 cates how the Ombudsman will be 

22 unencumbered in fulfilling all of the 

23 functions specified in subsection 

24 (a)(3).’’; and 

25 (6) in subsection (h)— 
33 

†S 192 ES

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

2 ‘‘older’’; 

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

4 precedes ‘‘procedures’’ and inserting the fol5 lowing: 

6 ‘‘(4) strengthen and update’’; 

7 (C) by redesignating paragraphs (4) 

8 through (9) as paragraphs (5) through (10), re9 spectively; 

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

11 following: 

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

13 participates in training provided by the National 

14 Ombudsman Resource Center established in section 

15 202(a)(18);’’; 

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

17 by subparagraph (C) of this paragraph, by 

18 striking ‘‘paragraph (4)’’ and inserting ‘‘para19 graph (5)’’; 

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

21 by subparagraph (C) of this paragraph, by 

22 striking ‘‘subtitle C of the’’ and inserting ‘‘sub23 title C of title I of the’’; and 
34 

†S 192 ES

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

2 subparagraph (C) of this paragraph, by striking 

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

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

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

6 amended— 

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

8 (1) and (2) of section 712(f)’’ and inserting ‘‘sub9 paragraphs (A) and (B) of section 712(f)(1)’’; and 

10 (2) in paragraph (2), by striking ‘‘subpara11 graphs (A) through (D) of section 712(f)(3)’’ and 

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

13 712(f)(1)(C)’’. 

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

15 EXPLOITATION.—Section 721 of the Older Americans Act 

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

17 (1) in subsection (b)— 

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

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

20 (B) by redesignating paragraphs (5) 

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

22 respectively; 

23 (C) by inserting after paragraph (4) the 

24 following: 
35 

†S 192 ES

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

2 abuse, neglect, and exploitation for the appropriate 

3 database of the Administration or another database 

4 specified by the Assistant Secretary;’’; 

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

6 by subparagraph (B) of this paragraph— 

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

8 as forensic specialists,’’ after ‘‘such per9 sonnel’’; and 

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

11 the comma the following: ‘‘, including pro12 grams and arrangements that protect 

13 against financial exploitation’’; and 

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

15 subparagraph (B) of this paragraph— 

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

17 ‘‘and’’ at the end; and 

18 (ii) by adding at the end the fol19 lowing: 

20 ‘‘(F) supporting and studying innovative 

21 practices in communities to develop partner22 ships across disciplines for the prevention, in23 vestigation, and prosecution of abuse, neglect, 

24 and exploitation; and’’; and 
36 

†S 192 ES

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

2 subparagraph (A)— 

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

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

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

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

7 SEC. 9. BEHAVIORAL HEALTH. 

8 The Older Americans Act of 1965 is amended— 

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

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

11 ‘‘and behavioral’’ after ‘‘mental’’; 

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

13 behavioral’’ after ‘‘mental’’; and 

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

15 ‘‘and behavioral’’ after ‘‘mental’’; 

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

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

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

19 3012(a)(5)), by inserting ‘‘and behavioral’’ after 

20 ‘‘mental’’; 

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

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

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

24 (B) in paragraph (6)(F), by striking ‘‘men25 tal health services’’ each place such term ap-
37 

†S 192 ES

1 pears and inserting ‘‘mental and behavioral 

2 health services’’; and 

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

4 (A) in paragraph (1), as amended by sec5 tion 4(g), by inserting ‘‘and behavioral’’ after 

6 ‘‘mental’’; 

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

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

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

10 behavioral’’ after ‘‘mental’’. 

11 SEC. 10. GUIDANCE ON SERVING HOLOCAUST SURVIVORS. 

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

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

14 are critical to meeting the urgent needs of Holocaust sur15 vivors to age in place with dignity, comfort, security, and 

16 quality of life, the Assistant Secretary for Aging shall 

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

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

19 individuals, with respect to serving Holocaust survivors, 

20 including guidance on promising practices for conducting 

21 outreach to that population. In developing the guidance, 

22 the Assistant Secretary for Aging shall consult with ex23 perts and organizations serving Holocaust survivors, and 

24 shall take into account the possibility that the needs of 

25 Holocaust survivors may differ based on geography. 
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1 (b) CONTENTS.—The guidance shall include the fol2 lowing: 

3 (1) How nutrition service providers may meet 

4 the special health-related or other dietary needs of 

5 participants in programs under the Older Americans 

6 Act of 1965, including needs based on religious, cul7 tural, or ethnic requirements. 

8 (2) How transportation service providers may 

9 address the urgent transportation needs of Holo10 caust survivors. 

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

12 address the unique needs of residents of long-term 

13 care facilities for whom institutional settings may 

14 produce sights, sounds, smells, emotions, and rou15 tines, that can induce panic, anxiety, and retrauma16 tization as a result of experiences from the Holo17 caust. 

18 (4) How supportive services providers may con19 sider the unique needs of Holocaust survivors. 

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

21 as determined by the Assistant Secretary for Aging, 

22 may serve Holocaust survivors. 
39 

†S 192 ES

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

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

3 the date of enactment of this Act. 

Passed the Senate July 16, 2015. 

Attest: 

Secretary. 
114TH CONGRESS 

1ST SESSION S. 192 

AN ACT 

To reauthorize the Older Americans Act of 1965, 

and for other purposes.