II 

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, and Mr. SANDERS) 

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

Committee on Health, Education, Labor, and Pensions 

A BILL 

To reauthorize the Older Americans Act of 1965, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

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

5 Reauthorization Act of 2015’’. 

6 SEC. 2. DEFINITIONS. 

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

8 U.S.C. 3002) is amended— 

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

10 following: 


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

3 knowing deprivation of goods or services that are 

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

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

7 following: 

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

9 such services provided to adults as the Secretary 

10 may specify and includes services such as— 

11 ‘‘(A) receiving reports of adult abuse, ne12 glect, or exploitation; 

13 ‘‘(B) investigating the reports described in 

14 subparagraph (A); 

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

16 and other casework and services; and 

17 ‘‘(D) providing, arranging for, or facili18 tating the provision of medical, social service, 

19 economic, legal, housing, law enforcement, or 

20 other protective, emergency, or support serv21 ices.’’; 

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

23 following: 

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

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1 tablished by a State as part of the State system of 

2 long-term care, to provide a coordinated and inte3 grated system for older individuals and individuals 

4 with disabilities (as defined in section 3 of the Amer5 icans with Disabilities Act of 1990 (42 U.S.C. 

6 12102)), and the caregivers of older individuals and 

7 individuals with disabilities, that provides— 

8 ‘‘(A) comprehensive information on the full 

9 range of available public and private long-term 

10 care programs, options, service providers, and 

11 resources within a community, including infor12 mation on the availability of integrated long13 term care services, and Federal or State pro14 grams that provide long-term care services and 

15 supports through home and community-based 

16 service programs; 

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

18 individuals in assessing their existing or antici19 pated long-term care needs and goals, and de20 veloping and implementing a person-centered 

21 plan for long-term care that is consistent with 

22 the desires of such an individual and designed 

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

24 and circumstances; 


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

2 range of publicly-supported long-term care serv3 ices and supports for which the individuals may 

4 be eligible, including home and community5 based service options, by serving as a conven6 ient point of entry for such programs and sup7 ports; and 

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

9 aging, centers for independent living described 

10 in part C of title VII of the Rehabilitation Act 

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

12 community-based entities, information and re13 ferrals regarding available home and commu14 nity-based services for individuals who are at 

15 risk for residing in, or who reside in, institu16 tional settings, so that the individuals have the 

17 choice to remain in or to return to the commu18 nity.’’; 

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

20 health,’’ after ‘‘bone density,’’; 

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

22 the following: 

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

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

25 to— 


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

2 in, and prosecute elder abuse, neglect, and 

3 exploitation; and 

4 ‘‘(ii) protect older individuals with di5 minished capacity while maximizing their 

6 autonomy; and 

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

8 recognition of an older individual’s rights, in9 cluding the right to be free of abuse, neglect, 

10 and exploitation.’’; and 

11 (6) in paragraph (18)(A), by striking ‘‘term ‘ex12 ploitation’ means’’ and inserting ‘‘terms ‘exploi13 tation’ and ‘financial exploitation’ mean’’. 

14 SEC. 3. ADMINISTRATION ON AGING. 

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

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

17 (1) in subsection (d)(3)— 

18 (A) in subparagraph (H), by striking 

19 ‘‘202(a)(21)’’ and inserting ‘‘202(a)(18)’’; 

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

21 ‘‘and’’ at the end; 

22 (C) 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 2015’’; and 

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

5 (D) 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;’’; 

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) REPORTS.—Section 207(a) of the Older Ameri24 cans Act of 1965 (42 U.S.C. 3018(a)) is amended— 


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

2 and inserting ‘‘202(a)(16)’’; and 

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

4 and inserting ‘‘202(a)(14)’’. 

5 (d) AUTHORIZATION OF APPROPRIATIONS.—Section 

6 216 of the Older Americans Act of 1965 (42 U.S.C. 

7 3020f) is amended— 

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

9 2009, 2010, and 2011’’ and inserting ‘‘2016, 2017, 

10 and 2018’’; 

11 (2) in subsection (b)— 

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

13 ‘‘202(a)(21)’’; and 

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

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

16 2018’’; and 

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

18 2009, 2010, and 2011’’ and inserting ‘‘2016, 2017, 

19 and 2018’’. 

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

21 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 

22 303 of the Older Americans Act of 1965 (42 U.S.C. 3023) 

23 is amended— 


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

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

3 of fiscal years 2016 through 2018.’’; 

4 (2) in subsection (b)— 

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

6 years 2007’’ and all that follows and inserting 

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

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

9 years 2007’’ and all that follows and inserting 

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

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

12 2007’’ and all that follows and inserting ‘‘each of 

13 fiscal years 2016 through 2018.’’; and 

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

15 inserting ‘‘2011 and each of fiscal years 2016 

16 through 2018’’. 

17 (b) ALLOTMENT.—Section 304 of the Older Ameri18 cans Act of 1965 (42 U.S.C. 3024) is amended— 

19 (1) in subsection (a)(3), by striking subpara20 graph (D) and inserting the following: 

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

22 no State shall be allotted an amount that is less than 99 

23 percent of the amount allotted to such State for the pre24 vious fiscal year. 


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

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

3 100 percent of the amount allotted to such State for fiscal 

4 year 2018.’’; and 

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

6 of’’. 

7 (c) PLANNING AND SERVICE AREAS.—Section 

8 305(b)(5)(C)(i)(III) of the Older Americans Act of 1965 

9 (42 U.S.C. 3025(b)(5)(C)(i)(III)) is amended by striking 

10 ‘‘planning and services areas’’ and inserting ‘‘planning 

11 and service areas’’. 

12 (d) AREA PLANS.—Section 306 of the Older Ameri13 cans Act of 1965 (42 U.S.C. 3026) is amended— 

14 (1) in subsection (a)— 

15 (A) in paragraph (1), by striking ‘‘estab16 lishment, maintenance, or construction of multi17 purpose senior centers,’’ and inserting ‘‘estab18 lishment, maintenance, modernization, or con19 struction of multipurpose senior centers (includ20 ing a plan to use the skills and services of older 

21 individuals in paid and unpaid work, including 

22 multigenerational and older individual to older 

23 individual work),’’; and 

24 (B) in paragraph (6)— 


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

2 ‘‘and’’ at the end; and 

3 (ii) by adding at the end the fol4 lowing: 

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

6 and with the State agency responsible for elder 

7 abuse prevention services, increase public 

8 awareness of elder abuse, neglect, and exploi9 tation, and remove barriers to education, pre10 vention, investigation, and treatment of elder 

11 abuse, neglect, and exploitation, as appro12 priate;’’; and 

13 (2) in subsection (b)(3)— 

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

15 at the end; 

16 (B) by redesignating subparagraph (K) as 

17 subparagraph (L); and 

18 (C) by inserting after subparagraph (J) 

19 the following: 

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

21 and exploitation; and’’. 

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

23 Older Americans Act of 1965 (42 U.S.C. 3027(a)(2)(A)) 

24 is amended by striking ‘‘202(a)(29)’’ and inserting 

25 ‘‘202(a)(26)’’. 


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1 (f) NUTRITION SERVICES INCENTIVE PROGRAM.— 

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

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

4 2007’’ and all that follows and inserting ‘‘each of fiscal 

5 years 2016 through 2018.’’. 

6 (g) SUPPORTIVE SERVICES.—Section 321 of the 

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

8 amended— 

9 (1) in subsection (a)— 

10 (A) in paragraph (1), by striking ‘‘or refer11 ral services’’ and inserting ‘‘referral, chronic 

12 condition self-care management, or falls preven13 tion services’’; 

14 (B) in paragraph (8), by striking ‘‘(includ15 ing’’ and all that follows and inserting the fol16 lowing: ‘‘(including mental and behavioral 

17 health screening and falls prevention services 

18 screening) to detect or prevent (or both) ill19 nesses and injuries that occur most frequently 

20 in older individuals;’’ and 

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

22 the semicolon the following: ‘‘, and screening 

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

24 (2) in subsection (b)(1), by inserting ‘‘or mod25 ernization’’ after ‘‘construction’’; 


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1 (3) in subsection (c), by inserting before the pe2 riod the following: ‘‘, and pursue opportunities for 

3 the development of intergenerational shared site 

4 models for programs or projects, consistent with the 

5 purposes of this Act’’; and 

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

7 ‘‘(e) In this section, the term ‘adult child with a dis8 ability’ means a child who— 

9 ‘‘(1) is age 18 or older; 

10 ‘‘(2) is financially dependent on an older indi11 vidual who is a parent of the child; and 

12 ‘‘(3) has a disability.’’. 

13 (h) HOME DELIVERED NUTRITION SERVICES PRO14 GRAM.—Section 336(1) of the Older Americans Act of 

15 1965 (42 U.S.C. 3030f(1)) is amended by striking 

16 ‘‘canned’’ and all that follows through ‘‘meals’’ and insert17 ing ‘‘canned, or fresh foods and, as appropriate, supple18 mental foods, and any additional meals’’. 

19 (i) NUTRITION SERVICES.—Section 339 of the Older 

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

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

22 inserting ‘‘utilize’’; and 

23 (2) in paragraph (2)— 

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

25 at the end; 


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

2 period and inserting ‘‘, and’’; and 

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

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

5 locally grown foods in meal programs and iden6 tifies potential partnerships and contracts with 

7 local producers and providers of locally grown 

8 foods.’’. 

9 (j) EVIDENCE-BASED DISEASE PREVENTION AND

10 HEALTH PROMOTION SERVICES PROGRAM.—Part D of 

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

12 3030m et seq.) is amended— 

13 (1) in the part heading, by inserting ‘‘EVI14 DENCE-BASED’’ before ‘‘DISEASE’’; and 

15 (2) in section 361(a), by inserting ‘‘evidence16 based’’ after ‘‘to provide’’. 

17 (k) OLDER RELATIVE CAREGIVERS.— 

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

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

20 3030s et seq.) is amended by striking the subpart 

21 heading for subpart 1. 

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

23 U.S.C. 3030s) is amended— 

24 (A) in subsection (a)— 


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

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

3 (ii) by striking paragraph (2) and in4 serting the following: 

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

6 term ‘individual with a disability’ means an indi7 vidual with a disability, as defined in section 3 of the 

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

9 12102), who is not less than age 18 and not more 

10 than age 59. 

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

12 ‘older relative caregiver’ means a caregiver who— 

13 ‘‘(A)(i) is age 55 or older; and 

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

15 in-home and community care to, and is the pri16 mary caregiver for, a child or an individual with 

17 a disability; 

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

19 child— 

20 ‘‘(i) is the grandparent, 

21 stepgrandparent, or other relative (other 

22 than the parent) by blood, marriage, or 

23 adoption, of the child; 

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

25 child because the biological or adoptive 


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1 parents are unable or unwilling to serve as 

2 the primary caregivers of the child; and 

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

4 child, such as legal custody, adoption, or 

5 guardianship, or is raising the child infor6 mally; and 

7 ‘‘(C) in the case of a caregiver for an indi8 vidual with a disability, is the parent, grand9 parent, or other relative by blood, marriage, or 

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

11 and 

12 (B) in subsection (b)— 

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

14 follows through ‘‘family caregivers’’ and in15 serting ‘‘part, for family caregivers’’; 

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

17 a period; and 

18 (iii) by striking paragraph (2). 

19 (l) NATIONAL FAMILY CAREGIVER SUPPORT PRO20 GRAM.—Section 373 of the Older Americans Act of 1965 

21 (42 U.S.C. 3030s–1) is amended— 

22 (1) in subsection (a)(2), by striking ‘‘grand23 parents or older individuals who are relative care24 givers.’’ and inserting ‘‘older relative caregivers.’’; 

25 (2) in subsection (c)— 


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1 (A) in paragraph (1), in the matter pre2 ceding subparagraph (A), by striking ‘‘grand3 parents and older individuals who are relative 

4 caregivers, and who’’ and inserting ‘‘older rel5 ative caregivers, who’’; and 

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

7 older individuals providing care to individuals 

8 with severe disabilities, including children with 

9 severe disabilities’’ and inserting ‘‘to older rel10 ative caregivers of children with severe disabil11 ities, or individuals with disabilities who have 

12 severe disabilities’’; 

13 (3) in subsection (e)(3), by striking ‘‘grand14 parents or older individuals who are relative care15 givers’’ and inserting ‘‘older relative caregivers’’; 

16 (4) in subsection (f)(1)(A), by striking ‘‘for fis17 cal years 2007, 2008, 2009, 2010, and 2011’’ and 

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

19 (5) in subsection (g)(2)(C), by striking ‘‘grand20 parents and older individuals who are relative care21 givers of a child who is not more than 18 years of 

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

23 (m) CONFORMING AMENDMENT.—Part E of title III 

24 is amended by striking ‘‘this subpart’’ each place it ap25 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’’; 

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 2016 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) are repealed. 

7 (e) CONFORMING AMENDMENT.—Section 

8 417(a)(1)(A) of the Older Americans Act of 1965 (42 

9 U.S.C. 3032f(a)(1)(A)) is amended by striking ‘‘grand10 parents and other older individuals who are relative care11 givers’’ and inserting ‘‘older relative caregivers (as defined 

12 in section 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 2016 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 2016 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 decisionmaking 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’’; 

23 (C) in paragraph (5)(B)— 

24 (i) in clause (vi)— 


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•S 192 IS

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 decisionmaking 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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•S 192 IS

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 

25 Portability and Accountability Act of 1996 (includVerDate Sep 11 2014 20:21 Jan 24, 2015 Jkt 049200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S192.IS S192

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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 (c)(2)(D), by striking 

11 ‘‘202(a)(21)’’ and inserting ‘‘202(a)(18)’’; 

12 (4) in subsection (d)— 

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

14 and inserting ‘‘files, records, and other informa15 tion’’; and 

16 (B) in paragraph (2)— 

17 (i) in subparagraph (A)— 

18 (I) by striking ‘‘files and 

19 records’’ each place such term appears 

20 and inserting ‘‘files, records, and 

21 other information’’; and 

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

23 semicolon; 

24 (ii) in subparagraph (B)— 


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

2 and inserting ‘‘files, records, or other 

3 information’’; and 

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

5 period at the end and inserting ‘‘; 

6 and’’; and 

7 (iii) by adding at the end the fol8 lowing: 

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

10 ensure that the Ombudsman may disclose infor11 mation as needed in order to best serve resi12 dents with limited or no decisionmaking capac13 ity who have no known legal representative and 

14 are unable to communicate consent, in order for 

15 the Ombudsman to carry out the functions and 

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

17 (5)(B) of subsection (a).’’; and 

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

19 following: 

20 ‘‘(f) CONFLICT OF INTEREST.— 

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

22 The State agency shall— 

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

24 of the immediate family of an individual, in25 volved in the designation of the Ombudsman 


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•S 192 IS

1 (whether by appointment or otherwise) or the 

2 designation of an entity designated under sub3 section (a)(5), is subject to a conflict of inter4 est; 

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

6 the Office, representative of a local Ombudsman 

7 entity, or member of the immediate family of 

8 the officer, employee, or representative, is sub9 ject to a conflict of interest; and 

10 ‘‘(C) ensure that the Ombudsman— 

11 ‘‘(i) does not have a direct involve12 ment in the licensing or certification of a 

13 long-term care facility or of a provider of 

14 a long-term care service; 

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

16 investment interest (represented by equity, 

17 debt, or other financial relationship) in a 

18 long-term care facility or a long-term care 

19 service; 

20 ‘‘(iii) is not employed by, or partici21 pating in the management of, a long-term 

22 care facility or a related organization, and 

23 has not been employed by such a facility or 

24 organization within 1 year before the date 

25 of the determination involved; 


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

2 right to receive, directly or indirectly, re3 muneration (in cash or in kind) under a 

4 compensation arrangement with an owner 

5 or operator of a long-term care facility; 

6 ‘‘(v) does not have management re7 sponsibility for, or operate under the su8 pervision of an individual with manage9 ment responsibility for, adult protective 

10 services; and 

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

12 in another fiduciary capacity for residents 

13 of long-term care facilities in an official ca14 pacity (as opposed to serving as a guardian 

15 or fiduciary for a family member, in a per16 sonal capacity). 

17 ‘‘(2) ORGANIZATIONAL CONFLICT OF INTER18 EST.— 

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

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

21 in which the Office poses an organizational con22 flict of interest, including a situation in which 

23 the Office is placed in an organization that— 


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1 ‘‘(i) is responsible for licensing, certi2 fying, or surveying long-term care services 

3 in the State; 

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

5 of such an association) of long-term care 

6 facilities, or of any other residential facili7 ties for older individuals; 

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

9 including programs carried out under a 

10 Medicaid waiver approved under section 

11 1115 of the Social Security Act (42 U.S.C. 

12 1315) or under subsection (b) or (c) of 

13 section 1915 of the Social Security Act (42 

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

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

16 or (k) of section 1915 of the Social Secu17 rity Act (42 U.S.C. 1396n); 

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

19 management; 

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

21 services; 

22 ‘‘(vi) provides adult protective serv23 ices; 

24 ‘‘(vii) is responsible for eligibility de25 terminations for the Medicaid program 


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1 carried out under title XIX of the Social 

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

3 ‘‘(viii) conducts preadmission screen4 ing for placements in facilities described in 

5 clause (ii); or 

6 ‘‘(ix) makes decisions regarding ad7 mission or discharge of individuals to or 

8 from such facilities. 

9 ‘‘(B) IDENTIFYING, REMOVING, AND REM10 EDYING ORGANIZATIONAL CONFLICT.— 

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

12 may not operate the Office or carry out the 

13 program, directly, or by contract or other 

14 arrangement with any public agency or 

15 nonprofit private organization, in a case in 

16 which there is an organizational conflict of 

17 interest (within the meaning of subpara18 graph (A)) unless such conflict of interest 

19 has been— 

20 ‘‘(I) identified by the State agen21 cy; 

22 ‘‘(II) disclosed by the State agen23 cy to the Assistant Secretary in writ24 ing; and 


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1 ‘‘(III) remedied in accordance 

2 with this subparagraph. 

3 ‘‘(ii) ACTION BY ASSISTANT SEC4 RETARY.—In a case in which a potential or 

5 actual organizational conflict of interest 

6 (within the meaning of subparagraph (A)) 

7 involving the Office is disclosed or reported 

8 to the Assistant Secretary by any person 

9 or entity, the Assistant Secretary shall re10 quire that the State agency, in accordance 

11 with the policies and procedures estab12 lished by the State agency under sub13 section (a)(5)(D)(iii)— 

14 ‘‘(I) remove the conflict; or 

15 ‘‘(II) submit, and obtain the ap16 proval of the Assistant Secretary for, 

17 an adequate remedial plan that indi18 cates how the Ombudsman will be 

19 unencumbered in fulfilling all of the 

20 functions specified in subsection 

21 (a)(3).’’; and 

22 (6) in subsection (h)— 

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

24 ‘‘older’’; 


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

2 precedes ‘‘procedures’’ and inserting the fol3 lowing: 

4 ‘‘(4) strengthen and update’’; 

5 (C) by redesignating paragraphs (4) 

6 through (9) as paragraphs (5) through (10), re7 spectively; 

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

9 following: 

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

11 participates in training provided by the National 

12 Ombudsman Resource Center established in section 

13 202(a)(18);’’; 

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

15 by subparagraph (C) of this paragraph, by 

16 striking ‘‘paragraph (4)’’ and inserting ‘‘para17 graph (5)’’; 

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

19 by subparagraph (C) of this paragraph, by 

20 striking ‘‘subtitle C of the’’ and inserting ‘‘sub21 title C of title I of the’’; and 

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

23 subparagraph (C) of this paragraph, by striking 

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


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•S 192 IS

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

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

3 amended— 

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

5 (1) and (2) of section 712(f)’’ and inserting ‘‘sub6 paragraphs (A) and (B) of section 712(f)(1)’’; and 

7 (2) in paragraph (2), by striking ‘‘subpara8 graphs (A) through (D) of section 712(f)(3)’’ and 

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

10 712(f)(1)(C)’’. 

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

12 EXPLOITATION.—Section 721 of the Older Americans Act 

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

14 (1) in subsection (b)— 

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

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

17 (B) by redesignating paragraphs (5) 

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

19 respectively; 

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

21 following: 

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

23 abuse, neglect, and exploitation for the appropriate 

24 database of the Administration or another database 

25 specified by the Assistant Secretary;’’; 


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

2 by subparagraph (B) of this paragraph— 

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

4 as forensic specialists,’’ after ‘‘such per5 sonnel’’; and 

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

7 the comma the following: ‘‘, including pro8 grams and arrangements that protect 

9 against financial exploitation’’; and 

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

11 subparagraph (B) of this paragraph— 

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

13 ‘‘and’’ at the end; and 

14 (ii) by adding at the end the fol15 lowing: 

16 ‘‘(F) supporting and studying innovative 

17 practices in communities to develop partner18 ships across disciplines for the prevention, in19 vestigation, and prosecution of abuse, neglect, 

20 and exploitation; and’’; and 

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

22 subparagraph (A)— 

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

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


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

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

3 SEC. 9. BEHAVIORAL HEALTH. 

4 The Older Americans Act of 1965 is amended— 

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

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

7 ‘‘and behavioral’’ after ‘‘mental’’; 

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

9 behavioral’’ after ‘‘mental’’; and 

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

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

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

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

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

15 3012(a)(5)), by inserting ‘‘and behavioral’’ after 

16 ‘‘mental’’; 

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

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

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

20 (B) in paragraph (6)(F), by striking ‘‘men21 tal health services’’ each place such term ap22 pears and inserting ‘‘mental and behavioral 

23 health services’’; and 

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


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•S 192 IS

1 (A) in paragraph (1), as amended by sec2 tion 4(g), by inserting ‘‘and behavioral’’ after 

3 ‘‘mental’’; 

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

5 ‘‘and behavioral’’ after ‘‘mental’’; and 

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

7 behavioral’’ after ‘‘mental’’. 

8 SEC. 10. GUIDANCE ON SERVING HOLOCAUST SURVIVORS. 

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

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

11 are critical to meeting the urgent needs of Holocaust sur12 vivors to age in place with dignity, comfort, security, and 

13 quality of life, the Assistant Secretary for Aging shall 

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

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

16 individuals, with respect to serving Holocaust survivors, 

17 including guidance on promising practices for conducting 

18 outreach to that population. In developing the guidance, 

19 the Assistant Secretary for Aging shall consult with ex20 perts and organizations serving Holocaust survivors, and 

21 shall take into account the possibility that the needs of 

22 Holocaust survivors may differ based on geography. 

23 (b) CONTENTS.—The guidance shall include the fol24 lowing: 


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1 (1) How nutrition service providers may meet 

2 the special health-related or other dietary needs of 

3 participants in programs under the Older Americans 

4 Act of 1965, including needs based on religious, cul5 tural, or ethnic requirements. 

6 (2) How transportation service providers may 

7 address the urgent transportation needs of Holo8 caust survivors. 

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

10 address the unique needs of residents of long-term 

11 care facilities for whom institutional settings may 

12 produce sights, sounds, smells, emotions, and rou13 tines, that can induce panic, anxiety, and retrauma14 tization as a result of experiences from the Holo15 caust. 

16 (4) How supportive services providers may con17 sider the unique needs of Holocaust survivors. 

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

19 as determined by the Assistant Secretary for Aging, 

20 may serve Holocaust survivors. 

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

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

23 the date of enactment of this Act. 

Æ 


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