II 

112TH CONGRESS 

2D SESSION S. 3562 

To reauthorize and improve the Older Americans Act of 1965, and for 

other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 19, 2012 

Mr. SANDERS (for himself, Mr. BLUMENTHAL, Mr. KERRY, Ms. MIKULSKI, 

Mr. BEGICH, Mr. AKAKA, Mr. DURBIN, Mrs. GILLIBRAND, Ms. KLOBUCHAR, Mr. LEAHY, Mr. WYDEN, Mr. FRANKEN, Mrs. BOXER, Mr. 

JOHNSON of South Dakota, Mr. MERKLEY, and Mr. MENENDEZ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To reauthorize and improve 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 Amendments of 2012’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) Older adults are the fastest growing seg2 ment of the Nation’s population, in the Nation’s his3 tory. 

4 (2) Every day, 10,000 Baby Boomers turn 65. 

5 (3) One in every 5 of those individuals age 65 

6 and older survives on an average of $7,500 a year. 

7 (4) Older adults haven’t seen a cost of living 

8 adjustment in Federal benefits, including assistance 

9 under the Social Security Act, in more than 2 years 

10 and will only see a very slight cost of living adjust11 ment in those benefits for fiscal year 2012. 

12 (5) Federal funding to support older adults and 

13 their caregivers has not kept pace with inflation. 

14 (6) Only 7 percent of individuals who are food 

15 insecure are getting a home-delivered meal. 

16 (7) The cost of staying in a nursing home is 

17 averaging over $77,000 per year. 

18 (8) The Medicaid program is paying for the 

19 majority of nursing home care. 

20 (9) States are cutting budgets for Medicaid pro21 grams, and the cuts sometimes result in nursing 

22 homes dropping older adults off at homeless shel23 ters. 

24 (10) In 2009, the Department of Justice esti25 mated that 14.1 percent of noninstitutionalized older 


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1 adults in the United States had experienced some 

2 form of elder abuse in the past year. 

3 (11) Only 1 in 23.5 cases of abuse of older 

4 adults is ever reported due to a lack of screening, 

5 awareness, and prevention efforts. 

6 (12) The mortality rate for older adults who are 

7 victims of abuse is 3 times higher than for older 

8 adults who are not victims of abuse. 

9 (13) The annual financial loss by older adults 

10 who are victims of financial abuse, due to that 

11 abuse, is estimated to be at least $2,900,000,000, 

12 and steadily increasing. 

13 (14) By making significant improvements 

14 through the Older Americans Act Amendments of 

15 2012, it is possible to improve the lives of millions 

16 of older adults, and ensure that they receive all of 

17 the supports and services that they need to stay 

18 healthy and active in their homes and communities. 

19 TITLE I—DECLARATION OF 

20 OBJECTIVES; DEFINITIONS 

21 SEC. 101. DECLARATION OF OBJECTIVES. 

22 Section 101 of the Older Americans Act of 1965 (42 

23 U.S.C. 3001) is amended— 

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

25 following: 


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1 ‘‘(1) An adequate income and economic security 

2 in later life in accordance with the American stand3 ard of living.’’; 

4 (2) in paragraph (4), by inserting ‘‘care coordi5 nation and’’ after ‘‘including’’; 

6 (3) in paragraph (8), by inserting ‘‘and sup7 ports, offered in a culturally and linguistically com8 petent manner’’ after ‘‘community services.’’; 

9 (4) by striking paragraphs (9) and (10) and in10 serting the following: 

11 ‘‘(9) Immediate benefit from proven research 

12 knowledge which can sustain and improve health, 

13 happiness, and economic security. 

14 ‘‘(10) Freedom, independence, economic secu15 rity, and the free exercise of individual initiative for 

16 older people in planning and managing their own 

17 lives, full participation in the planning and operation 

18 of community-based services and programs provided 

19 for their benefit, and protection against abuse, ne20 glect, and exploitation.’’; and 

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

22 ‘‘(11) Acquiring high-quality services in a man23 ner that is culturally and linguistically responsive to 

24 older individuals and family caregivers.’’. 


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1 SEC. 102. DEFINITIONS. 

2 (a) IN GENERAL.—Section 102 of the Older Ameri3 cans Act of 1965 (42 U.S.C. 3002) is amended— 

4 (1) by amending paragraph (1) to read as fol5 lows: 

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

8 knowing deprivation of goods or services that are 

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

11 (2) by redesignating paragraphs (4) through 

12 (14) and (15) through (54) as paragraphs (5) 

13 through (15) and (17) through (56), respectively; 

14 (3) by inserting after paragraph (3) the fol15 lowing: 

16 ‘‘(4) 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 case work 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 (4) by striking paragraph (5), as redesignated 

5 by paragraph (2) of this subsection, and inserting 

6 the following: 

7 ‘‘(5) The term ‘Aging and Disability Resource 

8 Center’ means an entity established by a State as 

9 part of the State system of long-term care, that pro10 vides a coordinated and integrated system that 

11 serves individuals with disabilities and older individ12 uals, including, at a minimum providing— 

13 ‘‘(A) comprehensive information on the full 

14 range of— 

15 ‘‘(i) available public and private long16 term care programs, options, service pro17 viders, and resources within a State, and 

18 within a community, including information 

19 on the availability of integrated long-term 

20 care; and 

21 ‘‘(ii) Federal or State programs that 

22 provide long-term care services and sup23 ports for individuals with disabilities and 

24 older individuals through home and com25 munity-based service programs; 


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1 ‘‘(B) personal and peer counseling to assist 

2 individuals with disabilities and older individ3 uals in— 

4 ‘‘(i) assessing their existing or antici5 pated long-term care needs and goals, in6 cluding needs and goals related to the 

7 availability of home and community-based 

8 services as an alternative to care in a nurs9 ing home or other institutional settings; 

10 and 

11 ‘‘(ii) developing and implementing a 

12 plan for long-term care, consistent with the 

13 desires of an individual and designed to 

14 meet the individual’s specific priorities, 

15 goals, needs, and circumstances; 

16 ‘‘(C) access for individuals with disabilities 

17 and older individuals to the full range of pub18 licly-supported long-term care programs and 

19 supports for which individuals described in this 

20 subparagraph may be eligible, including home 

21 and community-based options, by serving as a 

22 convenient point of entry for such programs 

23 and supports; 

24 ‘‘(D) if an individual with a disability or 

25 older individual wants to live or remain in the 


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1 community, efforts to work in cooperation with 

2 centers for independent living (as defined in 

3 section 702 of the Rehabilitation Act of 1973 

4 (29 U.S.C. 796a)) and other community-based 

5 entities— 

6 ‘‘(i) to facilitate the transition of an 

7 individual described in this subparagraph 

8 from a nursing home or other institutional 

9 setting to a home or community-based resi10 dence, with the requisite supports and 

11 services; or 

12 ‘‘(ii) to provide assistance to an indi13 vidual who is at risk for placement in a 

14 nursing home or other institutional setting, 

15 or of re-entering a nursing home or other 

16 institutional setting, so that an individual 

17 described in this subparagraph may remain 

18 in the individual’s own home, or in a home 

19 or community-based residence; 

20 ‘‘(E) initiatives that involve coordinating 

21 State and local partnerships, including those 

22 with disability advocacy organizations such as 

23 centers for independent living (as so defined) 

24 and aging networks such as area agencies on 

25 aging, to ensure that individuals with disabilVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ities and older individuals have access to the 

2 full array of needed services and opportunities; 

3 and 

4 ‘‘(F) initiatives that connect, to the great5 est extent practicable, individuals with disabil6 ities and older individuals with available long7 term care services and supports, including home 

8 and community-based services and supports, 

9 through the development of coordinated systems 

10 of information, referral, and access, regardless 

11 of an individual’s point of entry or initial in12 quiry, age, income, disability, or advance plan13 ning for long-term care services and supports.’’; 

14 (5) in subparagraph (B)(i) of paragraph (12), 

15 as redesignated by paragraph (2) of this subsection, 

16 by striking ‘‘comprehensive’’ and all that follows 

17 through ‘‘psychological’’ and inserting ‘‘comprehen18 sive person-centered assessment of the older indi19 vidual (including the physical, psychological, eco20 nomic,’’; 

21 (6) in paragraph (15), as redesignated by para22 graph (1) of this subsection— 

23 (A) in subparagraph (C), by inserting ‘‘, 

24 their family members,’’ before ‘‘and their pri25 mary’’; and 


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1 (B) by striking the last sentence; 

2 (7) by inserting after that paragraph (15) the 

3 following: 

4 ‘‘(16)(A) The term ‘economic security’ means 

5 access to the assets, income, and community-based 

6 services necessary to provide for adequate and un7 subsidized housing, health care, transportation, food, 

8 long-term care, and goods and services to meet other 

9 basic human needs. Such access shall be measured 

10 in a manner that shall be geographically based, and 

11 take into account an individual’s life circumstances. 

12 ‘‘(B) The term ‘economic security and benefits 

13 counseling’— 

14 ‘‘(i) means a supportive service that pro15 vides, to an older individual, a comprehensive 

16 assessment of the Federal, State, and commu17 nity benefits and services for which the indi18 vidual qualifies, along with assistance in apply19 ing for and obtaining the benefits and services; 

20 and 

21 ‘‘(ii) to the extent appropriate, includes an 

22 evaluation of the older individual’s— 

23 ‘‘(I) economic situation, including in24 come, assets, and access to pensions or 

25 other private benefits; 


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1 ‘‘(II) health care and housing needs; 

2 ‘‘(III) access to nutrition and nutri3 tion services; 

4 ‘‘(IV) ability to satisfy transportation 

5 needs; and 

6 ‘‘(V) long-term care planning.’’; 

7 (8) by amending paragraph (19), as redesig8 nated by paragraph (2) of this subsection, to read 

9 as follows: 

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

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

12 to— 

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

14 in, and prosecute elder abuse, neglect, and 

15 exploitation; and 

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

18 autonomy; and 

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

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

22 and exploitation.’’; 

23 (9) in paragraph (20), as redesignated by para24 graph (2) of this subsection, by striking ‘‘The term 


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1 ‘exploitation’ means’’ and inserting ‘‘The terms ‘ex2 ploitation’ and ‘financial exploitation’ mean’’; 

3 (10) in paragraph (25), as redesignated by 

4 paragraph (2) of this subsection, by striking ‘‘at or 

5 below the poverty line.’’ and inserting ‘‘that is not 

6 more than 200 percent of the poverty line.’’; 

7 (11) by striking paragraph (26), as redesig8 nated by paragraph (2) of this subsection, and in9 serting the following: 

10 ‘‘(26) The term ‘greatest social need’ means 

11 need caused by noneconomic factors— 

12 ‘‘(A) that— 

13 ‘‘(i) restrict the ability of an indi14 vidual to perform normal daily tasks; or 

15 ‘‘(ii) threaten the capacity of the indi16 vidual to live independently; and 

17 ‘‘(B) which include— 

18 ‘‘(i) physical and mental disabilities; 

19 ‘‘(ii) language barriers including lim20 ited English proficiency; 

21 ‘‘(iii) cultural, social, or geographic 

22 isolation (such as residence in a rural 

23 area), including isolation caused by racial, 

24 minority, or ethnic status, or status as an 

25 LGBT individual; 


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1 ‘‘(iv) HIV-positive health status or 

2 Alzheimer’s disease or a related disorder 

3 with neurological and organic brain dys4 function; 

5 ‘‘(v) greatest health service need, par6 ticularly a need posed by multiple chronic 

7 health conditions or a condition that places 

8 an individual at risk for falls; 

9 ‘‘(vi) abuse, neglect (including self-ne10 glect), or financial exploitation, including 

11 factors that are the basis of a referral to 

12 adult protective services; 

13 ‘‘(vii) status as a veteran; and 

14 ‘‘(viii) status as a Holocaust sur15 vivor.’’; 

16 (12) in paragraph (30), as redesignated by 

17 paragraph (2) of this subsection— 

18 (A) in subparagraph (C), by inserting ‘‘, 

19 including opportunities for work and volunteer 

20 service in the community’’ after ‘‘available’’; 

21 and 

22 (B) in subparagraph (E), by inserting ‘‘, in 

23 a culturally and linguistically competent man24 ner,’’ before ‘‘the entire community of older in25 dividuals’’; 


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1 (13) in paragraph (31), as redesignated by 

2 paragraph (2) of this subsection, by striking ‘‘infor3 mation and referral’’ and inserting ‘‘information and 

4 referral assistance’’; 

5 (14) in paragraph (35), as redesignated by 

6 paragraph (2) of this subsection— 

7 (A) by redesignating clauses (i) and (ii) of 

8 subparagraph (B) as subclauses (I) and (II), 

9 respectively, and aligning the margins of the 

10 subclauses with the margins of subclause (I) of 

11 subparagraph (A)(i) of paragraph (34), as so 

12 redesignated; 

13 (B) by redesignating subparagraphs (A) 

14 and (B) as clauses (i) and (ii), respectively, and 

15 aligning the margins of the clauses with the 

16 margins of clause (ii) of subparagraph (A) of 

17 that paragraph (34); 

18 (C) by inserting ‘‘(A)’’ before ‘‘The term’’; 

19 and 

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

21 ‘‘(B) The term ‘integrated legal assistance de22 livery system’ means a collaboratively run, statewide 

23 network that is established to provide direct legal as24 sistance, in the most efficient and impactful manner 

25 possible, targeted at older individuals with greatest 


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1 economic need and older individuals with greatest 

2 social need (with particular attention to individuals 

3 with factors listed in paragraph (26)(B)), in coordi4 nation with the legal assistance developer for the 

5 State and all State, regional, and local service pro6 viders engaged in promoting or supporting elder 

7 rights.’’; 

8 (15) in paragraph (36), as redesignated by 

9 paragraph (2) of this subsection— 

10 (A) in subparagraph (A), by adding ‘‘and’’ 

11 at the end; 

12 (B) in subparagraph (B), by striking ‘‘; 

13 and’’ at the end and inserting a period; and 

14 (C) by striking subparagraph (C); 

15 (16) in paragraph (37), as redesignated by 

16 paragraph (2) of this subsection, by striking ‘‘sec17 tions 307(a)(12) and’’ and inserting ‘‘the activities 

18 carried out under section 307(a)(9)’’; 

19 (17) in paragraph (38), as redesignated by 

20 paragraph (2) of this subsection, by inserting ‘‘(in21 cluding elder abuse and neglect screening)’’ after 

22 ‘‘educational services’’; 

23 (18) in paragraph (50)(B), as redesignated by 

24 paragraph (2) of this subsection, by striking ‘‘sub25 paragraphs (A) through (G) of paragraph (8)’’ and 


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1 inserting ‘‘subparagraphs (A) through (I) of para2 graph (14)’’; and 

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

4 ‘‘(57)(A) The term ‘care coordination’ means a 

5 person- and family-centered, assessment-based, and 

6 interdisciplinary approach to meet the needs and 

7 preferences of an older individual and a family care8 giver while enhancing the capabilities of the older in9 dividual (including the ability to self-direct services). 

10 ‘‘(B) The term ‘care coordination’ means co11 ordination that— 

12 ‘‘(i) integrates health care, long-term serv13 ices and supports, and social support services in 

14 a high-quality and cost-effective manner in 

15 which an individual’s needs, preferences, and 

16 capabilities are assessed, along with the needs 

17 and preferences of a family caregiver; 

18 ‘‘(ii) includes, as a core element, the active 

19 involvement of the older individual, the family, 

20 or a representative appointed by the older indi21 vidual or legally acting on the individual’s be22 half, community-based service professionals, 

23 and health care professionals providing care to 

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1 tered service and support plan, through which 

2 the services and supports will be provided in a 

3 manner free from conflicts of interest; 

4 ‘‘(iii) integrates services and interventions 

5 that are implemented, monitored, and evaluated 

6 for effectiveness using an evidence-based proc7 ess, which typically involves a designated lead 

8 care coordinator and involves feedback from the 

9 older individual; 

10 ‘‘(iv) includes activities that aim simulta11 neously at meeting individual and family needs 

12 and preferences, building on individual capabili13 ties, and improving outcomes and systems of 

14 care; 

15 ‘‘(v) includes provision of some or all of 

16 the services and activities described in clauses 

17 (i) through (iv) by trained professionals em18 ployed by or under a contract with— 

19 ‘‘(I) area agencies on aging; 

20 ‘‘(II) Aging and Disability Resource 

21 Centers; or 

22 ‘‘(III) other service providers, includ23 ing in-home service providers; and 

24 ‘‘(vi) is not furnished to directly diagnose, 

25 treat, or cure a medical disease or condition. 


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1 ‘‘(58) The term ‘cultural and linguistic com2 petence’ means competence in a set of behaviors, at3 titudes, and policies that is— 

4 ‘‘(A) used by an organization or among 

5 professionals; and 

6 ‘‘(B) enables effective work in cross-cul7 tural situations. 

8 ‘‘(59) The term ‘family caregiver’ means an 

9 adult family member, or another individual, who is 

10 an informal provider of in-home and community care 

11 to an older individual or to an individual with Alz12 heimer’s disease or a related disorder with neuro13 logical and organic brain dysfunction. 

14 ‘‘(60) The term ‘Holocaust survivor’ means an 

15 individual who— 

16 ‘‘(A)(i) lived in a country between 1933 

17 and 1945 under a Nazi regime, under Nazi oc18 cupation, or under the control of Nazi collabo19 rators; or 

20 ‘‘(ii) fled from a country between 1933 and 

21 1945 under a Nazi regime, under Nazi occupa22 tion, or under the control of Nazi collaborators; 

23 ‘‘(B) was persecuted between 1933 and 

24 1945 on the basis of race, religion, physical or 


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1 mental disability, sexual orientation, political 

2 affiliation, ethnicity, or other basis; and 

3 ‘‘(C) was a member of a group that was 

4 persecuted by the Nazis. 

5 ‘‘(61) The term ‘LGBT’, used with respect to 

6 an individual, means a lesbian, gay, bisexual, or 

7 transgender individual. 

8 ‘‘(62) The term ‘person-centered’, used with re9 spect to a service for an individual, means a service 

10 provided with an approach designed to ensure that 

11 an outcome reflects the needs, preferences, and situ12 ations of the individual. 

13 ‘‘(63) The term ‘veteran’ has the meaning given 

14 the term in section 101 of title 38, United States 

15 Code.’’. 

16 (b) CONFORMING AMENDMENTS.—Section 102 of the 

17 Older Americans Act of 1965 (42 U.S.C. 3002), as redes18 ignated by subsection (a)(2), is amended— 

19 (1) in paragraph (39)(A), by striking ‘‘as de20 fined in paragraph (5)’’ and inserting ‘‘as defined in 

21 paragraph (28)’’; 

22 (2) in paragraph (40), by striking ‘‘(as defined 

23 in paragraph (18)(B))’’ and inserting ‘‘(as defined 

24 in paragraph (20)(B))’’; and 


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1 (3) in paragraph (48)(D), by striking ‘‘(as de2 fined in paragraph (18)(B))’’ and inserting ‘‘(as de3 fined in paragraph (20)(B))’’. 

4 TITLE II—ADMINISTRATION ON 

5 AGING 

6 SEC. 201. ESTABLISHMENT OF ADMINISTRATION ON AGING. 

7 Section 201 of the Older Americans Act of 1965 (42 

8 U.S.C. 3011) is amended— 

9 (1) in subsection (d)(3)— 

10 (A) in subparagraph (C)— 

11 (i) in clause (i), by striking ‘‘; and’’ 

12 and inserting a semicolon; 

13 (ii) by redesignating clause (ii) as 

14 clause (iii); and 

15 (iii) by inserting after clause (i) the 

16 following: 

17 ‘‘(ii) resources needed by State Long18 Term Care Ombudsmen to collect and re19 port program data through the National 

20 Ombudsman Reporting System, including 

21 hardware and software that meet national 

22 standards; and’’; 

23 (B) in subparagraph (J), by inserting be24 fore the semicolon the following: ‘‘, including 


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1 the effectiveness of such services in meeting the 

2 needs of LGBT older individuals’’; and 

3 (C) in subparagraph (L)— 

4 (i) by striking ‘‘Older Americans Act 

5 Amendments of 1992’’ and inserting 

6 ‘‘Older Americans Act Amendments of 

7 2012’’; and 

8 (ii) by striking ‘‘712(h)(4)’’ and in9 serting ‘‘712(h)(5)’’; 

10 (2) in subsection (e)(2)— 

11 (A) in the matter preceding subparagraph 

12 (A), by inserting ‘‘, and in coordination with 

13 the heads of State adult protective services pro14 grams and the State Long-Term Care Ombuds15 men’’ after ‘‘and services’’; 

16 (B) in subparagraph (A), by striking 

17 ‘‘and’’ at the end; 

18 (C) in subparagraph (B), by striking the 

19 period and inserting a semicolon; and 

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

21 ‘‘(C) to establish best practices for State-based 

22 enforcement of a Home Care Consumer Bill of 

23 Rights through a Plan for Enforcement, as such Bill 

24 and Plan are outlined in section 705, not later than 

25 6 months after the date of enactment of the Older 


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1 Americans Act Amendments of 2012, and to make 

2 those best practices available to States, and to the 

3 public through the National Center on Elder Abuse; 

4 ‘‘(D) to assist States with the development of 

5 Home Care Consumer Bills of Rights and Plans for 

6 Enforcement, to support the shift from institutional 

7 care to home and community-based long-term serv8 ices and supports and ensure that home care con9 sumers, as defined in section 736, have basic protec10 tions as outlined in subsections (b) and (c) of section 

11 705; 

12 ‘‘(E) to develop a process for review and ap13 proval of States’ Home Care Consumer Bills of 

14 Rights and Plans for Enforcement, not later than 6 

15 months after the date of enactment of the Older 

16 Americans Act Amendments of 2012; and 

17 ‘‘(F) to review and approve States’ Home Care 

18 Consumer Bills of Rights and Plans for Enforce19 ment through that process.’’; and 

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

21 ‘‘(g) The Assistant Secretary is authorized to des22 ignate within the Administration a person to have respon23 sibility for addressing issues affecting LGBT older individ24 uals. 


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1 ‘‘(h) The Assistant Secretary is authorized to use 

2 funds appropriated to carry out this Act to implement ac3 tivities authorized under part I of subtitle B of title XX 

4 of the Social Security Act (42 U.S.C. 1397k et seq.), in5 cluding the establishment of the Advisory Board on Elder 

6 Abuse, Neglect, and Exploitation, and to convene the 

7 Elder Justice Coordinating Council. 

8 ‘‘(i)(1) The Assistant Secretary shall, by grant or 

9 contract with a national nonprofit entity, establish a Na10 tional Adult Protective Services Resource Center (referred 

11 to in this subsection as the ‘Center’). The purposes of the 

12 Center are to improve the capacity of State and local adult 

13 protective services programs to respond effectively to 

14 abuse, neglect, and exploitation of vulnerable adults, in15 cluding home care consumers and residents of long-term 

16 care facilities, and to coordinate with the Long-Term Care 

17 Ombudsman Program to protect home care consumers 

18 and residents most effectively. 

19 ‘‘(2) The nonprofit entity awarded a grant or con20 tract under this subsection shall have expertise in, and 

21 representation from, State and local adult protective serv22 ices programs. 

23 ‘‘(3) The Center shall— 

24 ‘‘(A) collect and disseminate information re25 garding, and increase public awareness of, the role 


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1 of adult protective services programs in investigating 

2 the abuse, neglect (including self-neglect), and ex3 ploitation of vulnerable adults, including home care 

4 consumers and residents of long-term care facilities, 

5 and in intervening to protect the consumers and 

6 residents from abuse; 

7 ‘‘(B) develop, distribute, and provide training 

8 and technical assistance for adult protective services 

9 program investigators and supervisors investigating 

10 the abuse, neglect (including self-neglect), and ex11 ploitation of vulnerable adults, including home care 

12 consumers and residents of long-term care facilities, 

13 and intervening to protect the consumers and resi14 dents from further abuse; 

15 ‘‘(C) develop, distribute, and provide training to 

16 home care and long-term care professionals and oth17 ers on recognizing, reporting (including regarding 

18 mandatory reporting requirements), and responding 

19 to the abuse, neglect (including self-neglect), and ex20 ploitation of vulnerable adults, including home care 

21 consumers and residents of long-term care facilities; 

22 ‘‘(D) compile and disseminate reports on re23 search and best practices for adult protective serv24 ices programs and other programs on effective re25 sponses to the abuse, neglect (including self-neglect), 


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1 and exploitation of vulnerable adults, including home 

2 care consumers and residents of long-term care fa3 cilities; 

4 ‘‘(E) work with the National Ombudsman Re5 source Center and State Long-Term Care Ombuds6 man programs to develop and disseminate training, 

7 practice standards, and policies regarding— 

8 ‘‘(i) the roles and responsibilities of adult 

9 protective services and ombudsman programs; 

10 ‘‘(ii) confidentiality and abuse reporting 

11 issues and protocols; and 

12 ‘‘(iii) effective ways to maximize the re13 sources of adult protective services programs 

14 for the benefit of home care consumers and 

15 residents of long-term care facilities; and 

16 ‘‘(F) establish a data system to collect informa17 tion on the abuse, neglect (including self-neglect), 

18 and exploitation of home care consumers and resi19 dents of long-term care facilities and to measure the 

20 effectiveness of the activities carried out by the Cen21 ter. 

22 ‘‘(4) Not later than 18 months after the date of en23 actment of the Older Americans Act Amendments of 2012, 

24 the Director shall— 


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1 ‘‘(A) collect and analyze, from leading national 

2 and State experts, the best practices related to 

3 screening for elder abuse; 

4 ‘‘(B) publish a report that describes rec5 ommendations regarding such best practices and dis6 seminate such report to all grantees under programs 

7 established under this Act and described under this 

8 section; and 

9 ‘‘(C) submit to Congress such report and a de10 scription of the dissemination activities under sub11 paragraph (B). 

12 ‘‘(5) In this subsection, the terms ‘home care con13 sumer’ and ‘home care ombudsman program’ have the 

14 meanings given the terms in section 736.’’. 

15 SEC. 202. FUNCTIONS OF ASSISTANT SECRETARY. 

16 Section 202 of the Older Americans Act of 1965 (42 

17 U.S.C. 3012) is amended— 

18 (1) in subsection (a)— 

19 (A) in paragraph (5), by inserting ‘‘eco20 nomic security,’’ after ‘‘nutrition,’’; 

21 (B) in paragraph (7), by inserting ‘‘, in22 cluding economic security trends among such 

23 individuals’’ after ‘‘older individuals’’; 


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1 (C) in paragraph (8), by striking ‘‘older in2 dividuals’’ and inserting ‘‘the health and eco3 nomic security of older individuals’’; 

4 (D) in paragraph (14), by inserting ‘‘for 

5 working with the Administrator of the Health 

6 Resources and Services Administration and the 

7 Secretary of Labor to identify and address 

8 workforce shortages involving such personnel,’’ 

9 after ‘‘field of aging,’’; 

10 (E) by striking paragraph (15) and insert11 ing the following: 

12 ‘‘(15)(A) as needed, provide technical assist13 ance, training through training packages, and other 

14 forms of instruction to entities consisting of State 

15 agencies, area agencies on aging, service providers, 

16 and community-based organizations, to ensure that 

17 the entities develop and implement, in a culturally 

18 and linguistically competent manner, programming, 

19 services, and outreach for older individuals with 

20 greatest economic need and older individuals with 

21 greatest social need (with particular attention to 

22 providing services to individuals with factors listed 

23 in section 102(26)(B) and providing services in 

24 areas identified by the Administrator of the Health 

25 Resources and Services Administration as having a 


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1 shortage of professionals trained to care for older in2 dividuals and with a focus on strategies that enable 

3 older adults to proceed on a path to economic secu4 rity); and 

5 ‘‘(B) consult with national and community6 based organizations representing minority individ7 uals to develop the capacity of the Administration to 

8 provide such technical assistance, training, and in9 struction.’’; 

10 (F) in paragraph (16)— 

11 (i) in subparagraph (A)(ii), by insert12 ing ‘‘, and separately specifying the num13 ber of such individuals who are LGBT in14 dividuals’’ before the semicolon; and 

15 (ii) in subparagraph (C), by striking 

16 ‘‘paragraphs (2) and (5)(A)’’ and inserting 

17 ‘‘paragraphs (2) and (4)(A)’’; 

18 (G) in paragraph (18), by amending sub19 paragraph (B) to read as follows: 

20 ‘‘(B) reserve and provide, for the funding 

21 of the Center (which may include enabling the 

22 Center to collaborate and participate with the 

23 Centers for Medicare & Medicaid Services in 

24 providing training for State survey agencies 

25 with an agreement in effect under section 1864 


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1 of the Social Security Act (42 U.S.C. 1395aa) 

2 or, in the case of States without such an agen3 cy, work with the Administrator for the Centers 

4 for Medicare & Medicaid Services to improve 

5 the investigative processes used by the Center 

6 to address complaints by residents of long-term 

7 care facilities)— 

8 ‘‘(i) for fiscal year 2013, not less than 

9 $2,000,000; and 

10 ‘‘(ii) for each subsequent fiscal year, 

11 not less than the sum of— 

12 ‘‘(I) $100,000; and 

13 ‘‘(II) the amount made available 

14 under this subparagraph for the fiscal 

15 year preceding the year for which the 

16 sum is determined;’’; 

17 (H) by striking paragraph (21) and insert18 ing the following: 

19 ‘‘(21)(A) establish information and assistance 

20 services as priority services for older individuals, and 

21 ensure that quality information and assistance serv22 ices are consistently provided to older individuals; 

23 ‘‘(B) ensure that there is full collaboration be24 tween all governmental information and assistance 

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1 ized, crisis intervention, disaster assistance, or other; 

2 and 

3 ‘‘(C) develop and operate, either directly or 

4 through contracts, grants, or cooperative agree5 ments, a National Eldercare Locator Service, pro6 viding information and assistance services through a 

7 nationwide toll free number to identify community 

8 resources, including certified, nonprofit financial 

9 services for older individuals;’’; 

10 (I) by striking paragraph (22) and insert11 ing the following: 

12 ‘‘(22) develop guidelines for area agencies on 

13 aging to follow in— 

14 ‘‘(A) choosing and evaluating providers of 

15 legal assistance with the capacity to work with16 in an integrated legal assistance delivery sys17 tem; and 

18 ‘‘(B) collecting data and reporting to the 

19 State agency;’’; 

20 (J) in paragraph (23), by striking all text 

21 following ‘‘developers’’ and inserting ‘‘referred 

22 to in section 307(a)(13) and section 731;’’; 

23 (K) by redesignating paragraphs (25) 

24 through (28) as paragraphs (26) through (29), 

25 respectively; 


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1 (L) by inserting after paragraph (24) the 

2 following: 

3 ‘‘(25)(A) conduct a planning and feasibility 

4 study— 

5 ‘‘(i) with the intent of establishing a na6 tional database of local service organizations or 

7 local senior community service employment pro8 grams authorized under title V that offer volun9 teer placements; and 

10 ‘‘(ii) on the capacity, as of the date of the 

11 study, of the aging network to manage such a 

12 database; and 

13 ‘‘(B) not later than 2 years after the date of 

14 enactment of the Older Americans Act Amendments 

15 of 2012, submit to Congress the results of the study 

16 conducted under subparagraph (A);’’; 

17 (M) in paragraph (28), as redesignated by 

18 subparagraph (K), by striking ‘‘and’’ at the 

19 end; 

20 (N) in paragraph (29), as redesignated by 

21 subparagraph (K), by striking the period and 

22 inserting a semicolon; and 

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


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1 ‘‘(30) conduct studies and collect data to deter2 mine the services that are needed by LGBT older in3 dividuals; 

4 ‘‘(31) collaborate and consult with the heads of 

5 Federal entities, including the Director of the Cen6 ters for Disease Control and Prevention and the As7 sistant Secretary for Preparedness and Response of 

8 the Department of the Health and Human Services, 

9 and the Secretary of Homeland Security, as appro10 priate, to provide technical assistance, training, and 

11 other assistance to States and area agencies on 

12 aging for the development and revision of emergency 

13 preparedness plans; and 

14 ‘‘(32)(A) encourage, provide technical assist15 ance to and share best practices with, States, area 

16 agencies on aging, Aging and Disability Resource 

17 Centers, and service providers to carry out outreach 

18 and coordinate activities with health care entities in 

19 order to assure better care coordination for individ20 uals with multiple chronic illnesses; and 

21 ‘‘(B) coordinate activities with other Federal 

22 agencies that are working to improve care coordina23 tion and developing new models and best practices 

24 for that coordination.’’; 

25 (2) in subsection (b)— 


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1 (A) in paragraph (8)— 

2 (i) in subparagraph (D)— 

3 (I) by inserting ‘‘, and with fu4 ture planning for eligible care recipi5 ents (as defined in section 372(a)) 

6 who are individuals with disabilities 

7 described in section 372(a)(2)(B) and 

8 who are living with older relative care9 givers (as so defined)’’ after ‘‘needs’’; 

10 and 

11 (II) by striking ‘‘and’’ at the end; 

12 and 

13 (ii) by adding at the end the fol14 lowing: 

15 ‘‘(F) to provide quality assurance informa16 tion, relating to the standards identified under 

17 paragraph (11)(A), using the methods described 

18 in paragraph (11)(B), about home and commu19 nity-based long-term care programs, service 

20 providers, and resources, when referring con21 sumers to those programs, providers, or re22 sources; and 

23 ‘‘(G) that may carry out the informal care24 giver assessment program described in sub25 section (i);’’; 


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1 (B) in paragraph (9)— 

2 (i) in the matter preceding subpara3 graph (A), by striking ‘‘and community4 based service providers’’ and inserting 

5 ‘‘community-based service providers, and, 

6 for purposes of subparagraph (C), Aging 

7 and Disability Resource Centers,’’; 

8 (ii) in subparagraph (A), by striking 

9 ‘‘and’’ at the end; 

10 (iii) subparagraph (B), by adding 

11 ‘‘and’’ at the end; and 

12 (iv) by adding at the end the fol13 lowing: 

14 ‘‘(C) methods, consistent with the methods 

15 described in paragraph (11)(B), to commu16 nicate to consumers quality assurance informa17 tion, relating to the standards identified under 

18 paragraph (11)(A), about home and commu19 nity-based long-term care programs, service 

20 providers, and resources;’’; 

21 (C) in paragraph (10), by striking ‘‘and’’ 

22 at the end; 

23 (D) by redesignating paragraph (11) as 

24 paragraph (12); and 


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1 (E) by inserting after paragraph (10) the 

2 following: 

3 ‘‘(11)(A) identify, in consultation with States 

4 (either directly or by entering into a contract under 

5 this subparagraph and considering the recommenda6 tion of the contract recipient) quality assurance 

7 standards for home and community-based long-term 

8 care programs, service providers, and resources 

9 that— 

10 ‘‘(i) shall be designed to ensure the health, 

11 safety, and welfare of consumers who are re12 ferred to such programs, service providers, and 

13 resources by area agencies on aging, Aging and 

14 Disability Resource Centers, and such other en15 tities as the Assistant Secretary determines to 

16 be appropriate; and 

17 ‘‘(ii) shall be identified after the Assistant 

18 Secretary takes into account, at a minimum, 

19 standards for— 

20 ‘‘(I) background checks of service pro21 viders; 

22 ‘‘(II) licensure of agencies and certifi23 cation and training of service providers; 

24 ‘‘(III) consumer satisfaction regarding 

25 programs, service providers, and resources, 


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1 in cases in which consumer satisfaction in2 formation is available; and 

3 ‘‘(IV) such additional matters as the 

4 Assistant Secretary determines to be ap5 propriate; and 

6 ‘‘(B) taking into account the variation in com7 munication infrastructure development among Aging 

8 and Disability Resource Centers, establish consumer9 friendly methods for communicating to consumers, 

10 consistently throughout a State— 

11 ‘‘(i) quality assurance information relating 

12 to the standards identified under subparagraph 

13 (A) about home and community-based long14 term care programs, service providers, and re15 sources to which such consumers are referred to 

16 by area agencies on aging, Aging and Disability 

17 Resource Centers, and such other entities as 

18 the Assistant Secretary determines to be appro19 priate; and 

20 ‘‘(ii)(I) the content of the State certifi21 cation or licensure requirements applicable to 

22 such home and community-based long-term care 

23 programs, service providers, or resources; or 

24 ‘‘(II) an explanation that the State does 

25 not have certification or licensure requirements 


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1 applicable to such home and community-based 

2 long-term care programs, service providers, or 

3 resources; and’’; 

4 (3) in subsection (e)(2)(B)— 

5 (A) in clause (viii), by striking ‘‘and’’; 

6 (B) by redesignating clause (ix) as clause 

7 (x); and 

8 (C) by inserting after clause (viii) the fol9 lowing: 

10 ‘‘(ix) organizations with expertise on eco11 nomic security, asset accumulation, and retire12 ment planning; and’’; and 

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

14 ‘‘(g) The Assistant Secretary shall— 

15 ‘‘(1) ensure, where appropriate, that all pro16 grams funded under this Act include appropriate 

17 training in the prevention of abuse, neglect, and ex18 ploitation and provision of services that address 

19 elder justice and exploitation; and 

20 ‘‘(2) periodically update determinations about 

21 the need for and benefit of such training related to 

22 prevention of abuse, neglect, and exploitation of 

23 older adults. 


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1 ‘‘(h)(1) The Assistant Secretary shall establish and 

2 operate the National Resource Center for Women and Re3 tirement (in this subsection referred to as the ‘Center’). 

4 ‘‘(2) In operating the Center, the Assistant Secretary 

5 shall— 

6 ‘‘(A) annually compile, publish, and disseminate 

7 a summary of recently conducted research on women 

8 and retirement security; 

9 ‘‘(B) develop and maintain an information 

10 clearinghouse on all programs (including private pro11 grams) showing promise of success for providing re12 tirement and financial information to women; 

13 ‘‘(C) develop, maintain, and disseminate con14 sumer information and public education materials 

15 regarding retirement and financial security for 

16 women; 

17 ‘‘(D) compile, publish, and disseminate training 

18 materials for personnel who are engaged or intend to 

19 engage in outreach to women, particularly to popu20 lations that are traditionally hard to reach with re21 tirement and financial information, such as care22 givers, ethnic minorities, and low-income women; 

23 ‘‘(E) provide technical assistance to State agen24 cies and to other public and nonprofit private agen25 cies and organizations to assist the agencies and orVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00038 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ganizations described in this subparagraph in plan2 ning, improving, developing, and carrying out pro3 grams and activities relating to providing women 

4 with the necessary financial management tools for 

5 secure retirement; 

6 ‘‘(F) work in collaboration with other national 

7 and local organizations serving older individuals to 

8 make efficient use of resources related to women and 

9 retirement; and 

10 ‘‘(G) conduct research and demonstration 

11 projects regarding the most effective methods and 

12 tools to assist women in preparing for secure retire13 ment. 

14 ‘‘(3)(A) The Assistant Secretary shall carry out para15 graph (2) through grants or contracts. 

16 ‘‘(B) The Assistant Secretary shall issue criteria ap17 plicable to the recipients of funds under this subsection, 

18 which shall include experience carrying out the activities 

19 described in paragraph (2). To be eligible to receive a 

20 grant or enter into a contract under subparagraph (A), 

21 an entity shall submit an application to the Assistant Sec22 retary at such time, in such manner, and containing such 

23 information as the Assistant Secretary may require. 

24 ‘‘(C) The Assistant Secretary shall make available to 

25 the Center such resources as are necessary for the Center 


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1 to carry out effectively the functions of the Center under 

2 this Act, which shall be an amount not less than $750,000 

3 for fiscal year 2013. In subsequent fiscal years, the Assist4 ant Secretary shall make available to the Center not less 

5 than the amount of resources made available to the Center 

6 under this subparagraph for fiscal year 2013. 

7 ‘‘(i)(1) Aging and Disability Resource Centers imple8 mented under subsection (b)(8) may carry out an assess9 ment program with respect to informal caregivers and care 

10 recipients. Such assessment program shall be modeled on 

11 the family caregiver assessment program established 

12 under section 373(b). 

13 ‘‘(2) For purposes of an informal caregiver assess14 ment carried out in accordance with paragraph (1), the 

15 following definitions shall apply: 

16 ‘‘(A) The term ‘care recipient’ means— 

17 ‘‘(i) an older individual; 

18 ‘‘(ii) an individual with a disability; or 

19 ‘‘(iii) an individual with a special need. 

20 ‘‘(B) The term ‘individual with a special need’ 

21 means an individual who requires care or supervision 

22 to— 

23 ‘‘(i) meet the individual’s basic needs; 

24 ‘‘(ii) prevent physical self-injury or injury 

25 to others; or 


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1 ‘‘(iii) avoid placement in an institutional 

2 facility. 

3 ‘‘(C)(i) Subject to clause (ii), the term ‘informal 

4 caregiver’ means an adult family member, or an5 other individual, who is an informal provider of in6 home and community care to a care recipient. 

7 ‘‘(ii) A State that has a State law with an alter8 nate definition of the term ‘informal caregiver’ for 

9 purposes of a program described in paragraph (1) 

10 may use that definition (with respect to caregivers 

11 for care recipients) for purposes of provisions of this 

12 Act that relate to that program, if such alternative 

13 definition is broader than the definition in clause (i), 

14 and subject to approval by the Assistant Secretary. 

15 ‘‘(j)(1) The Assistant Secretary shall, directly or by 

16 grant or contract, establish and operate the National Re17 source Center on Lesbian, Gay, Bisexual, and 

18 Transgender Aging (in this subsection referred to as the 

19 ‘Center’). 

20 ‘‘(2) To address the unique challenges faced by 

21 LGBT older adults, the Center shall provide national, 

22 State, and local organizations, including those with a pri23 mary mission of serving LGBT individuals, and those with 

24 a primary mission of serving older adults, with the inforVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 mation and technical assistance the organizations need to 

2 effectively serve LGBT older adults. 

3 ‘‘(3) The Center shall have 3 primary objectives, con4 sisting of— 

5 ‘‘(A) educating aging services organizations 

6 about the existence and special needs of LGBT older 

7 adults; 

8 ‘‘(B) sensitizing LGBT organizations about the 

9 existence and special needs of older adults; and 

10 ‘‘(C) providing educational resources to LGBT 

11 older adults and their caregivers. 

12 ‘‘(4)(A) To be eligible to receive funds under this sub13 section, an entity— 

14 ‘‘(i) shall have demonstrated expertise in work15 ing with organizations or individuals on issues af16 fecting LGBT individuals; 

17 ‘‘(ii) shall have documented experience in pro18 viding training and technical assistance on a na19 tional basis or a formal relationship with an organi20 zation that has that experience; and 

21 ‘‘(iii) shall meet such other criteria as the As22 sistant Secretary shall issue. 

23 ‘‘(B) To be eligible to receive funds under this sub24 section, an entity shall submit an application to the Assist25 ant Secretary at such time, in such manner, and conVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00042 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 taining such information as the Assistant Secretary may 

2 require. 

3 ‘‘(5) The Assistant Secretary shall make available to 

4 the Center on an annual basis such resources as are nec5 essary for the Center to carry out effectively the functions 

6 of the Center under this Act and not less than the amount 

7 of resources made available to the National Resource Cen8 ter on Lesbian, Gay, Bisexual, and Transgender Aging for 

9 fiscal year 2012. 

10 ‘‘(6) The Assistant Secretary shall develop and issue 

11 operating standards and reporting requirements for the 

12 Center.’’. 

13 SEC. 203. FEDERAL AGENCY CONSULTATION. 

14 Section 203 of the Older Americans Act of 1965 (42 

15 U.S.C. 3013) is amended— 

16 (1) in subsection (b)— 

17 (A) in paragraph (18), by striking ‘‘, and’’ 

18 and inserting a comma; 

19 (B) in paragraph (19), by striking the pe20 riod at the end and inserting a comma; and 

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

22 ‘‘(20) the Patient Protection and Affordable 

23 Care Act, including the amendments made by that 

24 Act (Public Law 111–148), including programs that 


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1 increase integration with community health centers, 

2 as practicable, and 

3 ‘‘(21) title XXIX of the Public Health Service 

4 Act (42 U.S.C. 300ii et seq.).’’; and 

5 (2) in subsection (c)(6)— 

6 (A) in subparagraph (A)— 

7 (i) in clause (iii)— 

8 (I) by inserting ‘‘and economic’’ 

9 after ‘‘demographic’’; and 

10 (II) by striking ‘‘and’’ at the end; 

11 (ii) in clause (iv), by adding ‘‘and’’ at 

12 the end; and 

13 (iii) by adding at the end the fol14 lowing: 

15 ‘‘(v) identifying and addressing workforce 

16 shortages related to services and supports for 

17 older individuals, and leveraging the resources 

18 of Federal programs that are related to the pro19 grams carried out under this Act, to address 

20 the shortages;’’; and 

21 (B) in subparagraph (B)— 

22 (i) in the matter preceding clause (i), 

23 by inserting ‘‘economic security,’’ after 

24 ‘‘housing,’’; and 


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1 (ii) in clause (i), by inserting ‘‘eco2 nomic security,’’ after ‘‘housing,’’; 

3 (C) in subparagraph (D), by inserting 

4 ‘‘economic security,’’ after ‘‘housing,’’; 

5 (D) in subparagraph (E), by inserting 

6 ‘‘and economic security’’ after ‘‘public health’’; 

7 (E) in subparagraph (F), by striking 

8 ‘‘and’’ at the end; 

9 (F) in subparagraph (G)— 

10 (i) in the matter preceding clause (i), 

11 by inserting ‘‘economic security,’’ after 

12 ‘‘health care,’’; and 

13 (ii) in clause (iii), by striking the pe14 riod at the end and inserting ‘‘; and’’; and 

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

16 ‘‘(H)(i) identify model Federal programs to as17 sist older individuals with achieving economic secu18 rity; and 

19 ‘‘(ii) propose greater coordination of efforts to 

20 provide such assistance, including by creating an in21 ventory of all Federal programs aimed at reducing 

22 poverty and increasing the economic security of older 

23 adults.’’. 


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1 SEC. 204. EVALUATION. 

2 Section 206 of the Older Americans Act of 1965 (42 

3 U.S.C. 3017) is amended— 

4 (1) in subsection (d), by striking ‘‘including, as 

5 appropriate, health and nutrition education dem6 onstration projects conducted under section 307(f) 

7 the full contents of which shall be’’ and inserting 

8 ‘‘and the full contents of those summaries and anal9 yses shall be’’; 

10 (2) by redesignating subsections (e) through (g) 

11 as subsections (f) through (h), respectively; 

12 (3) by inserting after paragraph (d) the fol13 lowing: 

14 ‘‘(e) The Secretary shall prepare and submit to Con15 gress an annual report evaluating the impact of area agen16 cies on aging on the economic security of older individ17 uals.’’; and 

18 (4) in subsection (h), as redesignated by paragraph (2), by striking ‘‘1 19 ⁄2 of’’. 

20 SEC. 205. REPORTS. 

21 Section 207 of the Older Americans Act of 1965 (42 

22 U.S.C. 3018) is amended— 

23 (1) in subsection (a)— 

24 (A) in paragraph (2), by striking ‘‘section 

25 202(a)(19)’’ and inserting ‘‘section 

26 202(a)(16)’’; 


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1 (B) in paragraph (3), by striking ‘‘, with 

2 particular attention’’ and all that follows 

3 through the semicolon and inserting ‘‘(with par4 ticular attention to individuals with factors list5 ed in section 102(26)(B));’’; and 

6 (C) in paragraph (4), by striking ‘‘section 

7 202(a)(17)’’ and inserting ‘‘section 

8 202(a)(14)’’; 

9 (2) in subsection (b)— 

10 (A) in paragraph (1)(C), by inserting ‘‘and 

11 the adult protection services programs of the 

12 States’’ after ‘‘of the States’’; and 

13 (B) in paragraph (3)(A), by striking 

14 ‘‘Health Care Finance Administration’’ and in15 serting ‘‘Centers for Medicare & Medicaid Serv16 ices’’; 

17 (3) in subsection (c)— 

18 (A) in paragraph (1), by inserting ‘‘, and 

19 separately specify the number of such individ20 uals who are LGBT individuals’’ before the 

21 semicolon; 

22 (B) by redesignating paragraphs (4) and 

23 (5) as paragraphs (5) and (6), respectively; and 

24 (C) by inserting after paragraph (3) the 

25 following: 


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1 ‘‘(4) the effectiveness of such activities in as2 sisting LGBT individuals;’’; and 

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

4 ‘‘(d) The Assistant Secretary shall ensure that— 

5 ‘‘(1) no individual will be required to provide in6 formation regarding the sexual orientation or gender 

7 identity of the individual as a condition of partici8 pating in activities or receiving services under this 

9 Act; and 

10 ‘‘(2) no agency or other entity providing activi11 ties or services under this Act, that receives, for the 

12 purposes of this Act, information regarding the sex13 ual orientation or gender identity of an individual 

14 will disclose the information in any form that would 

15 permit such individual to be identified. 

16 ‘‘(e) The Assistant Secretary shall develop appro17 priate protocols, demonstrations, tools, or guidance for use 

18 by State agencies and area agencies on aging, to ensure 

19 successful implementation of data collection requirements 

20 under section 201(d)(3)(J), paragraphs (16)(A)(ii) and 

21 (30) of section 202(a), subsections (a)(3), (c)(1), and 

22 (c)(4), and section 307(a)(6), relating to LGBT individ23 uals. 

24 ‘‘(f) The Assistant Secretary shall determine when 

25 such data collection requirements shall apply, taking into 


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1 consideration the complexity and importance of each re2 quirement, but each requirement shall apply not later than 

3 September 30, 2014.’’. 

4 SEC. 206. CONFORMING AMENDMENT. 

5 Section 215(j) of the Older Americans Act of 1965 

6 (42 U.S.C. 3020e–1(j)) is amended by striking ‘‘section 

7 216’’ and inserting ‘‘section 217’’. 

8 SEC. 207. AUTHORIZATION OF APPROPRIATIONS. 

9 Section 216 of the Older Americans Act of 1965 (42 

10 U.S.C. 3020f) is amended— 

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

12 2009, 2010, and 2011’’ and inserting ‘‘2013, 2014, 

13 2015, 2016, and 2017’’; 

14 (2) in subsection (b)— 

15 (A) by striking ‘‘section 202(a)(24)’’ and 

16 inserting ‘‘section 202(a)(21)’’; and 

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

18 and 2011’’ and inserting ‘‘2013, 2014, 2015, 

19 2016, and 2017’’; 

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

21 2009, 2010, and 2011’’ and inserting ‘‘2013, 2014, 

22 2015, 2016, and 2017’’; and 

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

24 ‘‘(d) NATIONAL ADULT PROTECTIVE SERVICES RE25 SOURCE CENTER.—There are authorized to be approVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 priated to carry out section 201(i) (relating to the Na2 tional Adult Protective Services Resource Center), such 

3 sums as may be necessary for fiscal years 2013, 2014, 

4 2015, 2016, and 2017. 

5 ‘‘(e) ADVISORY COMMITTEE TO ASSESS, COORDI6 NATE, AND IMPROVE LEGAL ASSISTANCE ACTIVITIES.— 

7 There is authorized to be appropriated to carry out section 

8 216, $300,000 for fiscal year 2013.’’. 

9 SEC. 208. ADVISORY COMMITTEE TO ASSESS, COORDINATE, 

10 AND IMPROVE LEGAL ASSISTANCE ACTIVI11 TIES. 

12 (a) IN GENERAL.—Title II of the Older Americans 

13 Act of 1965 is amended— 

14 (1) by redesignating section 216 (42 U.S.C. 

15 3020f) as section 217; and 

16 (2) by inserting after section 215 (42 U.S.C. 

17 3020e–1) the following: 

18 ‘‘SEC. 216. ADVISORY COMMITTEE TO ASSESS, COORDI19 NATE, AND IMPROVE LEGAL ASSISTANCE AC20 TIVITIES. 

21 ‘‘(a) ESTABLISHMENT.—There is established an Ad22 visory Committee to Assess, Coordinate, and Improve 

23 Legal Assistance Activities (referred to in this section as 

24 the ‘Committee’). 

25 ‘‘(b) MEMBERSHIP.— 


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1 ‘‘(1) COMPOSITION.—The Committee shall be 

2 composed of 9 members— 

3 ‘‘(A) with expertise with existing State 

4 legal assistance development programs carried 

5 out under section 731 and providers of State 

6 legal assistance under subtitle B of title III and 

7 title IV; and 

8 ‘‘(B) who shall be individuals appointed by 

9 the Assistant Secretary— 

10 ‘‘(i) 1 of whom shall be a consumer 

11 advocate; 

12 ‘‘(ii) 1 of whom shall be a professional 

13 advocate from a State agency or State 

14 legal assistance developer; 

15 ‘‘(iii) 4 of whom shall be representa16 tives from collaborating organizations 

17 under the National Legal Resource Center 

18 of the Administration; 

19 ‘‘(iv) 1 of whom shall be from a pro20 gram providing legal assistance under part 

21 B of title III; and 

22 ‘‘(v) 1 of whom shall be from an area 

23 agency on aging. 

24 ‘‘(2) DATE.—The appointments of the members 

25 of the Committee shall be made not later than 9 


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1 months after the date of enactment of the Older 

2 Americans Act Amendments of 2012. 

3 ‘‘(3) PERIOD OF APPOINTMENT; VACANCIES.— 

4 Members shall be appointed for the life of the Com5 mittee. Any vacancy in the Committee shall not af6 fect its powers, but shall be filled in the same man7 ner as the original appointment. 

8 ‘‘(4) CHAIRPERSON AND VICE CHAIRPERSON.— 

9 The Committee shall select a Chairperson and Vice 

10 Chairperson from among its members. 

11 ‘‘(c) INITIAL MEETING.—The Committee shall hold 

12 its first meeting not later than 9 months after the date 

13 of enactment of the Older Americans Act Amendments of 

14 2012. 

15 ‘‘(d) DUTIES OF THE COMMITTEE.— 

16 ‘‘(1) DEFINITION.—In this subsection, the term 

17 ‘legal assistance activities’ includes— 

18 ‘‘(A) legal assistance made available to 

19 older individuals with greatest economic need or 

20 with greatest social need; 

21 ‘‘(B) activities of the National Legal Re22 source Center carried out under section 420(a); 

23 ‘‘(C) State legal assistance developer ac24 tivities carried out under section 731; and 


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1 ‘‘(D) any other directly related activity or 

2 program as determined appropriate by the As3 sistant Secretary. 

4 ‘‘(2) STUDY.— 

5 ‘‘(A) IN GENERAL.—The Committee shall 

6 design, implement, and analyze results of a 

7 study of— 

8 ‘‘(i) the extent to which State leader9 ship is provided through the State legal as10 sistance developer in States to enhance the 

11 coordination and effectiveness of legal as12 sistance activities across the State; 

13 ‘‘(ii) the extent to which— 

14 ‘‘(I) there is data collection and 

15 reporting of information by legal as16 sistance providers in States; 

17 ‘‘(II) there is uniform statewide 

18 reporting among States; and 

19 ‘‘(III) the value and impact of 

20 services provided by the providers is 

21 being measured at the State or local 

22 level; and 

23 ‘‘(iii) the mechanisms to organize and 

24 promote legal assistance activities and de25 velopment to best meet the needs of older 


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1 individuals with greatest economic need 

2 and greatest social need, with particular 

3 attention to individuals with factors listed 

4 in section 102(26)(B). 

5 ‘‘(B) CONSIDERATIONS.—In carrying out 

6 subparagraph (A)(i), particular attention shall 

7 be given to— 

8 ‘‘(i) State leadership on targeting lim9 ited legal resources to older individuals 

10 with greatest economic need and greatest 

11 social need, with particular attention to in12 dividuals with factors listed in section 

13 102(26)(B); and 

14 ‘‘(ii) State leadership on establishing 

15 priority legal issue areas in accordance 

16 with section 307(a)(11)(E). 

17 ‘‘(3) RECOMMENDATIONS.—After completion of 

18 the study and analysis of study results under para19 graph (2), the Committee shall develop recommenda20 tions for the establishment of regulations or guid21 ance for— 

22 ‘‘(A) enhancing the leadership capacity of 

23 the State legal assistance developers to carry 

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1 tivities, with particular focus on enhancing lead2 ership capacity to— 

3 ‘‘(i) target limited legal resources to 

4 older individuals with greatest economic 

5 need and greatest social need, with par6 ticular attention to individuals with factors 

7 listed in section 102(26)(B); and 

8 ‘‘(ii) establish priority legal issue 

9 areas in accordance with section 

10 307(a)(11)(E); 

11 ‘‘(B) developing a uniform national data 

12 collection system to be implemented in all 

13 States on legal assistance activities and develop14 ment; 

15 ‘‘(C) State agencies in conducting an as16 sessment of the adequacy of the current fund17 ing (as of the date of the assessment) provided 

18 through the minimum proportion of the funds 

19 received by each area agency on aging in the 

20 State to carry out part B that must be ex21 pended on legal services (as specified in section 

22 306(a)(2)(C) and section 307(a)(2)(C)); and 

23 ‘‘(D) identifying mechanisms for orga24 nizing and promoting legal assistance activities 

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1 fectiveness to older individuals with greatest 

2 economic need and greatest social need, with 

3 particular attention to individuals with factors 

4 listed in section 102(26)(B). 

5 ‘‘(4) REPORT.—Not later than 1 year after the 

6 date of the establishment of the Committee, the 

7 Committee shall submit to the President, Congress, 

8 and the Assistant Secretary a report that contains 

9 a detailed statement of the findings and conclusions 

10 of the Committee, together with the recommenda11 tions described in paragraph (3). 

12 ‘‘(e) DUTIES OF THE ASSISTANT SECRETARY.—Not 

13 later than 180 days after receiving the report described 

14 in subsection (d)(4), the Assistant Secretary shall issue 

15 regulations or guidance on the topics described in sub16 section (d)(3), taking into consideration the recommenda17 tions described in subsection (d)(3). 

18 ‘‘(f) POWERS.— 

19 ‘‘(1) INFORMATION FROM FEDERAL AGEN20 CIES.—The Committee may secure directly from any 

21 Federal department or agency such information as 

22 the Committee considers necessary to carry out the 

23 provisions of this section. Upon request of the Com24 mittee, the head of such department or agency shall 

25 furnish such information to the Committee. 


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1 ‘‘(2) POSTAL SERVICES.—The Committee may 

2 use the United States mails in the same manner and 

3 under the same conditions as other departments and 

4 agencies of the Federal Government. 

5 ‘‘(g) PERSONNEL AND ADMINISTRATION.— 

6 ‘‘(1) TRAVEL EXPENSES.—The members of the 

7 Committee shall not receive compensation for the 

8 performance of services for the Committee, but shall 

9 be allowed travel expenses, including per diem in lieu 

10 of subsistence, at rates authorized for employees of 

11 agencies under subchapter I of chapter 57 of title 5, 

12 United States Code, while away from their homes or 

13 regular places of business in the performance of 

14 services for the Committee. Notwithstanding section 

15 1342 of title 31, United States Code, the Secretary 

16 may accept the voluntary and uncompensated serv17 ices of members of the Committee. 

18 ‘‘(2) DETAIL OF GOVERNMENT EMPLOYEES.— 

19 Any Federal Government employee may be detailed 

20 to the Committee without reimbursement, and such 

21 detail shall be without interruption or loss of civil 

22 service status or privilege. 

23 ‘‘(3) ADMINISTRATIVE AND SUPPORT SERV24 ICES.—The Assistant Secretary shall provide admin25 istrative and support services to the Committee. 


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1 ‘‘(4) PROCUREMENT OF TEMPORARY AND

2 INTERMITTENT SERVICES.—The Chairman of the 

3 Committee may procure temporary and intermittent 

4 services under section 3109(b) of title 5, United 

5 States Code, at rates for individuals that do not ex6 ceed the daily equivalent of the annual rate of basic 

7 pay prescribed for level V of the Executive Schedule 

8 under section 5316 of such title. 

9 ‘‘(h) EXEMPTION FROM TERMINATION REQUIRE10 MENTS.—Section 14 of the Federal Advisory Committee 

11 Act shall not apply to the Committee.’’. 

12 SEC. 209. CONSUMER PRICE INDEX. 

13 (a) IN GENERAL.—The Secretary of Labor, through 

14 the Bureau of Labor Statistics and in consultation with 

15 the Assistant Secretary for Aging, shall revise and improve 

16 the Experimental Price Index for the Elderly published by 

17 the Bureau of Labor Statistics (commonly referred to as 

18 the ‘‘CPI–E’’) in order for the CPI–E to be considered 

19 a reliable measure in determining future cost of living ad20 justments that impact Americans who are 62 years of age 

21 or older. 

22 (b) REVISION REQUIREMENTS.—In carrying out sub23 section (a), the Secretary of Labor shall— 

24 (1) increase the number of individuals in the 

25 United States who are 62 years of age and older (reVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00058 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ferred to in this section as ‘‘older adults’’) sampled 

2 in the consumer expenditure survey used to establish 

3 the CPI–E; 

4 (2) establish samples of market-based items, 

5 stores, and prices to represent the purchasing pat6 terns of older adults; and 

7 (3) examine the medical care component, in8 cluding the cost and usage of prescription drugs, of 

9 the CPI–E taking into account that older adults 

10 have different illnesses and medical expenses, includ11 ing oral health medical expenses, than individuals in 

12 the United States who are under 62 years of age. 

13 (c) REPORT TO CONGRESS.—Not later than 2 years 

14 after the date of enactment of this Act, the Secretary of 

15 Labor shall submit to Congress a report that describes the 

16 revised CPI–E and the activities carried out by the Sec17 retary under this section. 

18 SEC. 210. FUNCTIONS WITHIN THE ADMINISTRATION ON 

19 AGING TO ASSIST HOLOCAUST SURVIVORS. 

20 (a) DESIGNATION OF INDIVIDUAL WITHIN THE AD21 MINISTRATION.—The Assistant Secretary on Aging is au22 thorized to designate within the Administration on Aging 

23 a person who has specialized training, background, or ex24 perience with Holocaust survivor issues to have responsiVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00059 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 bility for implementing services for older individuals who 

2 are Holocaust survivors. 

3 (b) ANNUAL REPORT TO CONGRESS.—The Assistant 

4 Secretary on Aging, with assistance from the individual 

5 designated under subsection (a), shall prepare and submit 

6 to Congress an annual report on the status and needs, 

7 including the priority areas of concern, of older individuals 

8 who are Holocaust survivors. 

9 (c) DEFINITIONS.—In this section, the terms ‘‘older 

10 individual’’ and ‘‘Holocaust survivor’’ have the meanings 

11 given the terms in section 102 of the Older Americans Act 

12 of 1965 (42 U.S.C. 3002). 

13 TITLE III—GRANTS FOR STATE 

14 AND COMMUNITY PROGRAMS 

15 ON AGING 

16 SEC. 301. PURPOSE; ADMINISTRATION. 

17 Section 301(a)(2) of the Older Americans Act of 

18 1965 (42 U.S.C. 3021(a)(2)) is amended— 

19 (1) in subparagraph (E), by striking ‘‘and’’ at 

20 the end; 

21 (2) in subparagraph (F), by striking the period 

22 and inserting a semicolon; and 

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

24 ‘‘(G) Federally qualified health centers, as de25 fined in sections 1861(aa)(4) and 1905(l)(2)(B) of 


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1 the Social Security Act (42 U.S.C. 1395x(aa)(4), 

2 1396d(l)(2)(B)); and 

3 ‘‘(H) organizations that serve LGBT individ4 uals.’’. 

5 SEC. 302. DEFINITION. 

6 Section 302 of the Older Americans Act of 1965 (42 

7 U.S.C. 3022) is amended— 

8 (1) by striking paragraph (3); and 

9 (2) by redesignating paragraph (4) as para10 graph (3). 

11 SEC. 303. AUTHORIZATION OF APPROPRIATIONS. 

12 Section 303 of the Older Americans Act of 1965 (42 

13 U.S.C. 3023) is amended— 

14 (1) in subsection (a), by striking paragraph (1) 

15 and inserting the following: 

16 ‘‘(1) There are authorized to be appropriated to carry 

17 out part B (relating to supportive services) such sums as 

18 may be necessary for each of fiscal years 2013, 2014, 

19 2015, 2016, and 2017.’’; 

20 (2) by striking subsection (b) and inserting the 

21 following: 

22 ‘‘(b)(1) There are authorized to be appropriated to 

23 carry out subpart 1 of part C (relating to congregate nu24 trition services) such sums as may be necessary for each 

25 of fiscal years 2013, 2014, 2015, 2016, and 2017. 


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1 ‘‘(2) There are authorized to be appropriated to carry 

2 out subpart 2 of part C (relating to home delivered nutri3 tion services) such sums as may be necessary for fiscal 

4 years 2013, 2014, 2015, 2016, and 2017.’’; 

5 (3) by striking subsection (d) and inserting the 

6 following: 

7 ‘‘(d) There are authorized to be appropriated to carry 

8 out part D (relating to disease prevention and health pro9 motion services) such sums as may be necessary for each 

10 of fiscal years 2013, 2014, 2015, 2016, and 2017.’’; 

11 (4) by striking subsection (e) and inserting the 

12 following: 

13 ‘‘(e)(1) There are authorized to be appropriated to 

14 carry out part E (relating to family caregiver support) 

15 $250,000,000 for each of fiscal years 2013 through 2017. 

16 ‘‘(2) Of the funds appropriated under paragraph (1), 

17 not more than 1 percent of such funds may be reserved 

18 to carry out activities described in section 411(a)(11).’’; 

19 and 

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

21 ‘‘(f) It is the sense of Congress that— 

22 ‘‘(1) in order to carry out part B (relating to 

23 supportive services), the amount appropriated under 

24 subsection (a)(1) should be not less than 

25 $551,000,000 for fiscal year 2013; 


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1 ‘‘(2) in order to carry out subparts 1 and 2 of 

2 part C (relating to nutrition services), the amount 

3 appropriated under subsection (b) should be not less 

4 than $1,200,000,000 for fiscal year 2013; and 

5 ‘‘(3) in order to carry out part D (relating to 

6 disease prevention and health promotion services), 

7 the amount appropriated under subsection (d) 

8 should be not less than $32,000,000 for fiscal year 

9 2013.’’. 

10 SEC. 304. ALLOTMENTS. 

11 Section 304(b) of such Act (42 U.S.C. 3024(b)) is 

12 amended, in the first sentence, by striking ‘‘part B’’ and 

13 all that follows through ‘‘part E,’’ and inserting ‘‘part B, 

14 C, or E’’. 

15 SEC. 305. ORGANIZATION. 

16 Section 305 of the Older Americans Act of 1965 (42 

17 U.S.C. 3025) is amended— 

18 (1) in subsection (a)— 

19 (A) in paragraph (2)— 

20 (i) in subparagraph (C)— 

21 (I) in clause (i), by striking 

22 ‘‘and’’ at the end; 

23 (II) in clause (ii), by adding 

24 ‘‘and’’ at the end; and 


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1 (III) by adding at the end the 

2 following: 

3 ‘‘(iii) the distribution among planning 

4 and service areas of service providers who 

5 specialize in serving populations of older 

6 individuals with greatest social need;’’; and 

7 (ii) in subparagraph (G)— 

8 (I) by striking clause (ii) and in9 serting the following: 

10 ‘‘(ii) provide an assurance that the State 

11 agency will undertake specific program develop12 ment, advocacy, and outreach efforts focused on 

13 the needs of older individuals with greatest so14 cial need (with particular attention to individ15 uals with factors listed in section 102(26)(B)) 

16 and older individuals with greatest economic 

17 need; and’’; and 

18 (II) in clause (iii), by striking 

19 ‘‘and’’ at the end; 

20 (B) in paragraph (3)(E)— 

21 (i) in the matter before clause (i), by 

22 striking ‘‘information relating to’’; 

23 (ii) in clause (i)— 

24 (I) by inserting ‘‘information re25 lating to’’ after ‘‘(i)’’; and 


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1 (II) by striking ‘‘and’’ at the end; 

2 (iii) in clause (ii)— 

3 (I) by inserting ‘‘information re4 lating to’’ after ‘‘(ii)’’; and 

5 (II) by striking the period and 

6 inserting ‘‘; and’’; and 

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

9 ‘‘(iii) quality assurance information, 

10 relating to the standards identified under 

11 section 202(b)(11)(A), about home and 

12 community-based long-term care programs, 

13 service providers, and resources, provided 

14 through methods described in section 

15 202(b)(11)(B), when the Aging and Dis16 ability Resource Centers, area agencies on 

17 aging, and such other entities as the As18 sistant Secretary determines to be appro19 priate, refer consumers to those programs, 

20 providers, and resources in the State; 

21 and’’; and 

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

23 ‘‘(4) the State agency shall promote the devel24 opment and implementation of a State system to ad25 dress the care coordination needs of older individuals 


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1 with multiple chronic illnesses, and shall work with 

2 acute care providers, area agencies on aging, service 

3 providers, and Federal agencies to ensure that the 

4 system uses best practices and is evaluated on its 

5 provision of care coordination.’’; and 

6 (2) in subsection (b)(5)(C)(i)(III), by striking 

7 ‘‘planning and services areas’’ and inserting ‘‘plan8 ning and service areas’’. 

9 SEC. 306. AREA PLANS. 

10 Section 306 of the Older Americans Act of 1965 (42 

11 U.S.C. 3026) is amended— 

12 (1) in subsection (a)— 

13 (A) in paragraph (1), by striking ‘‘mainte14 nance, or construction of multipurpose senior 

15 centers’’ and inserting ‘‘maintenance, mod16 ernization, or construction of multipurpose sen17 ior centers (which system includes a plan to use 

18 the skills and services of older individuals in 

19 paid and unpaid work, including 

20 multigenerational work and older individual-to21 older individual service activities, relating to 

22 such maintenance, modernization, or construc23 tion, or activities at the centers)’’; 

24 (B) in paragraph (2)(A)— 


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1 (i) by striking ‘‘mental health serv2 ices’’ and inserting ‘‘evidence-based mental 

3 health services, evidence-based chronic con4 dition self-care management programs, and 

5 evidence-based falls prevention programs’’; 

6 and 

7 (ii) by striking ‘‘eligible)’’ and insert8 ing ‘‘eligible and shall include information 

9 on paid and unpaid work opportunities for 

10 older individuals)’’; 

11 (C) in paragraph (4)(B)(i)(VII) by insert12 ing ‘‘with multiple chronic illnesses or’’ after 

13 ‘‘older individuals’’; 

14 (D) in paragraph (6)— 

15 (i) in subparagraph (D), by inserting 

16 ‘‘(including acute care providers)’’ after 

17 ‘‘service providers’’; 

18 (ii) in subparagraph (E)(ii), by insert19 ing ‘‘and Federally qualified health cen20 ters, as defined in sections 1861(aa)(4) 

21 and 1905(l)(2)(B) of the Social Security 

22 Act (42 U.S.C. 1395x(aa)(4), 

23 1396d(l)(2)(B))’’ after ‘‘203(b)’’; and 

24 (iii) by adding at the end the fol25 lowing: 


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1 ‘‘(H)(i) in coordination with the State 

2 agency and with the State agency responsible 

3 for elder abuse prevention services, increase 

4 public awareness of elder abuse and exploi5 tation, and remove barriers to elder abuse edu6 cation, prevention, investigation, and treatment; 

7 ‘‘(ii) coordinate elder justice activities (in8 cluding screenings) provided by the area agency 

9 on aging, community health centers, other pub10 lic agencies, and nonprofit private organiza11 tions; 

12 ‘‘(iii) develop standardized, coordinated, 

13 and reporting protocols with respect to elder 

14 abuse; and 

15 ‘‘(iv) report any instances elder abuse in 

16 accordance with State law; and 

17 ‘‘(I) serve as an advocate in the cor18 responding planning and service area for evi19 dence-based falls prevention programs and poli20 cies for older individuals, and, if possible, enter 

21 into partnerships with State government agen22 cies (such as the State health agency and State 

23 transportation agency), local agencies, and com24 munity-based organizations that implement evi25 dence-based falls prevention programs and poliVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00068 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 cies, in order to increase public awareness of 

2 and access to in-home and community-based 

3 evidence-based falls prevention strategies, serv4 ices, and programs that aim to improve the 

5 health of older individuals and reduce health 

6 care costs;’’; 

7 (E) in paragraph (7)— 

8 (i) in subparagraph (B)(iii), by strik9 ing ‘‘placement, to permit such individ10 uals’’ and inserting ‘‘placement, with par11 ticular attention to individuals with factors 

12 listed in section 102(26)(B), to permit 

13 such at-risk individuals’’; 

14 (ii) in subparagraph (C)— 

15 (I) by inserting ‘‘(including 

16 falls)’’ after ‘‘injury’’; and 

17 (II) by striking ‘‘and’’ at the end; 

18 (iii) in subparagraph (D), by adding 

19 ‘‘and’’ at the end; and 

20 (iv) by adding at the end the fol21 lowing: 

22 ‘‘(E) implementing, through the agency or 

23 service providers, evidence-based health pro24 motion, chronic condition self-care management, 

25 and falls prevention programs, to assist older 


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1 individuals and their family caregivers in learn2 ing about and making behavioral changes in3 tended to improve health outcomes, reduce the 

4 impact of living with multiple chronic health 

5 conditions, and reduce health care spending;’’; 

6 (F) by striking paragraph (9) and insert7 ing the following: 

8 ‘‘(9) provide assurances that the area agency on 

9 aging, in carrying out the State Long-Term Care 

10 Ombudsman program described in section 307(a)(9), 

11 will— 

12 ‘‘(A) provide adequate funding to conduct 

13 an effective Ombudsman program in compliance 

14 with this Act; and 

15 ‘‘(B) expend not less than the total 

16 amount of funds appropriated under this Act or 

17 made available through other resources, and ex18 pended by the agency in fiscal year 2010, in 

19 carrying out such a program under this Act;’’; 

20 (G) in paragraph (16), by striking ‘‘and’’ 

21 at the end; 

22 (H) in paragraph (17)— 

23 (i) by inserting ‘‘and revise’’ after 

24 ‘‘develop’’; 


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1 (ii) by inserting ‘‘and health’’ after 

2 ‘‘State emergency response’’; and 

3 (iii) by striking the period and insert4 ing a semicolon; and 

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

6 ‘‘(18) include information describing— 

7 ‘‘(A) how the area agency on aging will en8 gage in outreach to veterans who are eligible for 

9 services under this Act; and 

10 ‘‘(B) effective and efficient procedures for 

11 the coordination of services provided under this 

12 Act with services provided to veterans by the 

13 Department of Veterans Affairs and other pro14 viders; 

15 ‘‘(19) describe how the area agency on aging 

16 will leverage its position as the primary community17 based provider of senior support services to— 

18 ‘‘(A) champion the cause of economic secu19 rity for older individuals among community 

20 members, political leaders, businesses, and fam21 ilies; 

22 ‘‘(B) concentrate resources of the area 

23 agency on aging toward promoting economic se24 curity for older individuals at both the indi25 vidual and community level; and 


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1 ‘‘(C) serve as a community resource for 

2 older individuals who lack the economic, social, 

3 or familial supports necessary to age with dig4 nity; 

5 ‘‘(20) provide assurances that the area agency 

6 on aging will— 

7 ‘‘(A) identify existing (as of the date of 

8 submission of the plan) care coordination pro9 grams and systems; 

10 ‘‘(B) identify unmet community need for 

11 care coordination; 

12 ‘‘(C) facilitate the development and imple13 mentation of an area-wide system to address 

14 the care coordination needs of older individuals 

15 with multiple chronic illnesses; and 

16 ‘‘(D) work with acute care providers, serv17 ice providers, and Federal and State agencies to 

18 ensure that the system uses best practices in its 

19 provision of care coordination; 

20 ‘‘(21) provide assurances that programming, 

21 services, and outreach will be developed and imple22 mented in a culturally and linguistically competent 

23 manner, for older individuals with greatest social 

24 need; 


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1 ‘‘(22) provide assurances that staff training in2 cludes instruction on cultural and linguistic com3 petence in the provision of services to older individ4 uals with greatest social need; 

5 ‘‘(23) provide assurances that the services of 

6 providers who are contractors will be provided in a 

7 culturally and linguistically competent manner; and 

8 ‘‘(24) provide assurances that, to the extent 

9 feasible, services provided in response to elder abuse 

10 will be provided in a culturally and linguistically 

11 competent manner.’’; and 

12 (2) in subsection (b)(3)— 

13 (A) in subparagraph (J), by striking 

14 ‘‘and’’; 

15 (B) by redesignating subparagraph (K) as 

16 subparagraph (L); and 

17 (C) by inserting after subparagraph (J) 

18 the following: 

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

20 and exploitation; and’’. 

21 SEC. 307. STATE PLANS. 

22 Section 307(a) of the Older Americans Act of 1965 

23 (42 U.S.C. 3027(a)) is amended— 

24 (1) in paragraph (2), by striking subparagraph 

25 (A) and inserting the following: 


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1 ‘‘(A) evaluate, using uniform procedures 

2 described in section 202(a)(27), the need for 

3 supportive services (including legal assistance 

4 pursuant to paragraph (11), information and 

5 assistance, care coordination, and transpor6 tation services), nutrition services, economic se7 curity and benefits counseling, and multipur8 pose senior centers within the State;’’; 

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

10 following: 

11 ‘‘(9) The plan shall provide assurances that the 

12 State agency will carry out, through the Office of 

13 the State Long-Term Care Ombudsman, a State 

14 Long-Term Care Ombudsman program in accord15 ance with section 712 and this title, and, in carrying 

16 out the program, will— 

17 ‘‘(A) provide adequate funding to conduct 

18 an effective Ombudsman program in compliance 

19 with this Act; and 

20 ‘‘(B) expend not less than the total 

21 amount of funds appropriated under this Act or 

22 made available through other resources, and ex23 pended by the agency in fiscal year 2010, in 

24 carrying out such a program under this Act.’’; 


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1 (3) in paragraph (11), in the matter preceding 

2 subparagraph (A), by striking ‘‘legal assistance—’’ 

3 and inserting ‘‘legal assistance, which shall be pro4 vided through an integrated legal assistance delivery 

5 system—’’; 

6 (4) in paragraph (12)— 

7 (A) by redesignating subparagraphs (B) 

8 and (C) as subparagraphs (C) and (D); and 

9 (B) by inserting after subparagraph (A) 

10 the following: 

11 ‘‘(B) that the State will develop and imple12 ment standardized protocols for screening and 

13 reporting with respect to elder abuse;’’; 

14 (5) by striking paragraph (15) and inserting 

15 the following: 

16 ‘‘(15)(A) The plan shall provide assurances that 

17 programming and services will be provided in a cul18 turally and linguistically competent manner to older 

19 individuals with greatest social need, and that the 

20 State will require the area agency on aging for each 

21 planning and service area in which a significant 

22 number of older individuals are limited English pro23 ficient— 

24 ‘‘(i) to utilize in the provision of such pro25 gramming and services, workers who are fluent 


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1 in the language spoken by a predominant num2 ber of such older individuals who are limited 

3 English proficient; and 

4 ‘‘(ii) to designate an individual employed 

5 by the area agency on aging, or available to 

6 such area agency on aging on a full-time basis, 

7 whose responsibilities will include— 

8 ‘‘(I) taking such action as may be ap9 propriate to assure that programming, 

10 services, and outreach are developed and 

11 implemented in a culturally and linguis12 tically competent manner for older individ13 uals with greatest social need; and 

14 ‘‘(II) providing guidance to individuals 

15 engaged in the delivery of services under 

16 the area plan involved to enable such indi17 viduals to deliver the services in a cul18 turally and linguistically competent man19 ner. 

20 ‘‘(B) The plan shall provide assurances that, if 

21 a substantial number of the older individuals resid22 ing in any planning and service area in the State are 

23 limited English proficient, then the State will require 

24 the area agency on aging for each such planning and 

25 service area to utilize, in the delivery of outreach 


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1 services under section 306(a)(2)(A) in a culturally 

2 and linguistically competent manner, the services of 

3 workers who are fluent in the language spoken by a 

4 predominant number of such older individuals who 

5 are limited English proficient.’’; 

6 (6) in paragraph (16)— 

7 (A) in subparagraph (A), by striking 

8 clauses (i) through (vi) and inserting the fol9 lowing: 

10 ‘‘(i) older individuals with greatest 

11 economic need; 

12 ‘‘(ii) older individuals with greatest 

13 social need (with particular attention to in14 dividuals with factors listed in section 

15 102(26)(B)); and 

16 ‘‘(iii) caregivers of individuals de17 scribed in clause (i) or (ii); and’’; and 

18 (B) in subparagraph (B)— 

19 (i) by striking ‘‘through (vi)’’ and in20 serting ‘‘and (ii)’’; and 

21 (ii) by striking ‘‘caretakers’’ and in22 serting ‘‘caregivers’’; 

23 (7) in paragraph (17), by striking ‘‘and develop 

24 collaborative programs, where appropriate,’’ and inVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00077 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 serting ‘‘, ensure care coordination, and (where ap2 propriate) develop collaborative programs,’’; 

3 (8) in paragraph (18), in the matter preceding 

4 subparagraph (A), by inserting ‘‘and ensure care co5 ordination that integrates long-term care services 

6 and other care services,’’ before ‘‘for older’’; 

7 (9) by striking paragraph (20) and inserting 

8 the following: 

9 ‘‘(20) The plan shall provide assurances that 

10 special efforts will be made to provide technical as11 sistance to minority providers of services and to pro12 viders who specialize in serving populations of older 

13 individuals with greatest social need.’’; 

14 (10) in paragraph (23)(A), by striking ‘‘with 

15 other State services’’ and inserting ‘‘with other Fed16 eral and State health care programs and services’’; 

17 (11) in paragraph (28)(B)— 

18 (A) by striking clause (i) and inserting the 

19 following: 

20 ‘‘(i) the projected change in the number of 

21 older individuals in the State, and the dispersal 

22 and growth in the number of older individuals 

23 with greatest social need in each planning and 

24 service area in the State;’’; and 


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1 (B) by striking clause (iii) and inserting 

2 the following: 

3 ‘‘(iii) an analysis of how the programs, 

4 policies, and services provided by the State can 

5 be improved, including by coordinating with 

6 area agencies on aging and by developing the 

7 cultural and linguistic competence of persons 

8 providing programming and services, and how 

9 resource levels can be adjusted to meet the 

10 needs of the changing population of older indi11 viduals in the State; and’’; 

12 (12) in paragraph (29)— 

13 (A) by inserting ‘‘and revise’’ after ‘‘de14 velop’’; and 

15 (B) by inserting ‘‘and health’’ after ‘‘local 

16 emergency response’’; and 

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

18 ‘‘(31) The plan shall provide assurances that 

19 the State agency will, if possible, enter into partner20 ships with other relevant State government agencies 

21 when collaborating with area agencies on aging, local 

22 agencies, or community-based organizations de23 scribed in section 306(a)(6)(I) in order to increase 

24 public awareness of and access to in-home and com25 munity-based evidence-based falls prevention strateVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00079 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 gies, services, and programs that aim to improve the 

2 health of older individuals and reduce health care 

3 costs. 

4 ‘‘(32) The plan shall include information de5 scribing— 

6 ‘‘(A) how the State agency will engage in 

7 outreach to veterans who are eligible for serv8 ices under this Act; and 

9 ‘‘(B) effective and efficient procedures for 

10 the coordination of services provided under this 

11 Act with services provided to veterans by the 

12 Department of Veterans Affairs and other pro13 viders. 

14 ‘‘(33) The plan shall provide assurances that 

15 the area agencies on aging in the State will facilitate 

16 the area-wide development and implementation of an 

17 area-wide system to address the care coordination 

18 needs of older individuals with multiple chronic ill19 nesses, and work with acute care providers, service 

20 providers, and other Federal and State agencies to 

21 ensure that the system uses best practices and is 

22 evaluated on its provision of care coordination.’’. 


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1 SEC. 308. PLANNING, COORDINATION, EVALUATION, AND 

2 ADMINISTRATION OF STATE PLANS. 

3 Section 308(a)(1) of the Older Americans Act of 

4 1965 (42 U.S.C. 3028(a)(1)) is amended— 

5 (1) by striking ‘‘, and the carrying out’’ and in6 serting ‘‘, the carrying out’’; and 

7 (2) by inserting before the period the following: 

8 ‘‘, and the modernization of such senior centers’’. 

9 SEC. 309. DISASTER RELIEF REIMBURSEMENTS. 

10 Section 310 of the Older Americans Act of 1965 (42 

11 U.S.C. 3030) is amended— 

12 (1) in the section heading, by inserting ‘‘AND

13 PLANNING’’ after ‘‘REIMBURSEMENTS’’; and 

14 (2) in subsection (b)(2), by inserting ‘‘section 

15 202(a)(29), emergency planning under this section, 

16 or’’ after ‘‘carry out’’. 

17 SEC. 310. CONSUMER CONTRIBUTIONS. 

18 Section 315 of the Older Americans Act of 1965 (42 

19 U.S.C. 3030c–2) is amended— 

20 (1) in subsection (b)— 

21 (A) in paragraph (1), by striking ‘‘185 

22 percent’’ and inserting ‘‘200 percent’’; and 

23 (B) in paragraph (3), by adding at the end 

24 the following: ‘‘Contributions under this section 

25 shall be used to supplement, and not to supVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00081 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 plant, any other funds expended for activities 

2 described in this Act.’’; and 

3 (2) in subsection (d)— 

4 (A) by striking ‘‘Not later’’ and all that 

5 follows through ‘‘shall conduct’’ and inserting 

6 ‘‘Not later than January 1, 2014, and annually 

7 thereafter, the Assistant Secretary shall con8 duct, and submit to the appropriate committees 

9 of Congress a report containing the results of,’’; 

10 and 

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

12 ‘‘The Assistant Secretary shall include in the 

13 report an evaluation of the methods used, by 

14 the area agencies on aging and service providers 

15 under this Act, to ensure that the consumer 

16 contributions are used to supplement the serv17 ices for which the contributions were col18 lected.’’. 

19 SEC. 311. STUDY OF NUTRITION PROJECTS. 

20 Section 317(a)(2) of the Older Americans Act 

21 Amendments of 2006 (Public Law 109–365) is amend22 ed— 

23 (1) in subparagraph (B), by striking ‘‘; and’’ 

24 and inserting a semicolon; 


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1 (2) in subparagraph (C), by striking the period 

2 at the end and inserting ‘‘; and’’; and 

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

4 ‘‘(D) an analysis of the ability of service 

5 providers to obtain viable contracts for special 

6 foods necessary to meet a religious requirement, 

7 required dietary need, or ethnic consideration.’’. 

8 SEC. 312. SUPPORTIVE SERVICES AND SENIOR CENTERS 

9 PROGRAM. 

10 Section 321 of the Older Americans Act of 1965 (42 

11 U.S.C. 3030d) is amended— 

12 (1) in subsection (a)— 

13 (A) in paragraph (5)(C), by striking ‘‘and 

14 letter writing services’’ and inserting ‘‘evidence15 based chronic condition self-care management, 

16 and letter writing services, and evidence-based 

17 falls prevention programs’’; 

18 (B) in paragraph (7)— 

19 (i) by inserting ‘‘evidence-based’’ after 

20 ‘‘through’’; and 

21 (ii) by striking ‘‘and dance-movement 

22 therapy’’ and inserting ‘‘dance-movement 

23 therapy, chronic condition self-care man24 agement, and falls prevention’’; 

25 (C) in paragraph (8)— 


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1 (i) by inserting ‘‘, screening for elder 

2 abuse and neglect, and falls prevention 

3 screening’’ after ‘‘mental health screen4 ing’’; and 

5 (ii) by striking ‘‘illness, or both,’’ and 

6 inserting ‘‘illnesses and injuries’’; 

7 (D) in paragraph (15), by inserting before 

8 the semicolon the following: ‘‘and elder abuse 

9 and neglect screening, chronic condition self10 care management, and falls prevention serv11 ices’’; and 

12 (E) in paragraph (23), by striking ‘‘mental 

13 health services’’ and inserting ‘‘evidence-based 

14 mental health, chronic condition self-care man15 agement, elder abuse, neglect, and exploitation 

16 prevention, and falls prevention services’’; and 

17 (2) in subsection (b)(1), by inserting ‘‘or mod18 ernization’’ after ‘‘construction’’. 

19 SEC. 313. NUTRITION SERVICES. 

20 (a) IN GENERAL.—Section 339(2) of the Older 

21 Americans Act of 1965 (42 U.S.C. 3030g–21(2)) is 

22 amended— 

23 (1) in subparagraph (A), by amending clause 

24 (iii) to read as follows: 


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1 ‘‘(iii) to the maximum extent prac2 ticable, are adjusted and appropriately 

3 funded to meet any special health-related 

4 or other dietary needs of program partici5 pants, including needs based on religious, 

6 cultural, or ethnic requirements,’’; 

7 (2) in subparagraph (J), by striking ‘‘, and’’ 

8 and inserting a comma; 

9 (3) in subparagraph (K), by striking the period 

10 and inserting a comma; and 

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

12 ‘‘(L) encourages individuals who distribute 

13 nutrition services under subpart 2 to engage in 

14 conversation with homebound older individuals 

15 and to be aware of the warning signs of medical 

16 emergencies, injury, or abuse in order to reduce 

17 isolation and promote well-being, 

18 ‘‘(M) encourages individuals who distribute 

19 nutrition services under subpart 2 to distribute 

20 information on diabetes, elder abuse, neglect, 

21 exploitation, and the annual Medicare wellness 

22 exam, and 

23 ‘‘(N) where feasible, encourages the use of 

24 locally grown foods in meal programs and iden25 tifies potential partnerships and contracts with 


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1 local producers and providers of locally grown 

2 foods.’’. 

3 (b) SPECIAL RULE.—Section 339 of the Older Ameri4 cans Act of 1965 (42 U.S.C. 3030g–21) is amended— 

5 (1) by inserting before ‘‘A State’’ the following: 

6 ‘‘(a) IN GENERAL.—’’; and 

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

8 ‘‘(b) TRANSPORTATION.—Funds appropriated to 

9 carry out this part may be used for transportation costs 

10 that can be demonstrated to be directly related to the pro11 vision of services specified in this part.’’. 

12 SEC. 314. DISEASE PREVENTION AND HEALTH PROMOTION 

13 SERVICES. 

14 (a) PROGRAM.—Section 361 of the Older Americans 

15 Act of 1965 (42 U.S.C. 3030m) is amended— 

16 (1) in subsection (a), in the first sentence— 

17 (A) by inserting ‘‘evidence-based’’ after ‘‘to 

18 provide’’; 

19 (B) by inserting ‘‘(through programs such 

20 as the programs coordinated through the Sick21 ness Prevention Achieved Through Regional 

22 Collaboration program)’’ after ‘‘promotion serv23 ices’’; and 

24 (C) by inserting before ‘‘or at’’ the fol25 lowing: ‘‘at Federally qualified health centers 


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1 (as defined in sections 1861(aa)(4) and 

2 1905(l)(2)(B) of the Social Security Act (42 

3 U.S.C. 1395x(aa)(4), 1396d(l)(2)(B))),’’; 

4 (2) by striking subsection (b); and 

5 (3) by redesignating subsection (c) as sub6 section (b). 

7 (b) CLINICAL PREVENTIVE SERVICES.—Part D of 

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

9 3030m et seq.) is amended by adding at the end the fol10 lowing: 

11 ‘‘SEC. 363. CLINICAL PREVENTIVE SERVICES. 

12 ‘‘(a) FINDING.—Congress finds that the clinical pre13 ventive services described in subsection (c) are covered 

14 under the Medicare program carried out under title XVIII 

15 of the Social Security Act (42 U.S.C. 1395 et seq.). 

16 ‘‘(b) PURPOSES.—The purpose of this section is to 

17 increase the number of older individuals receiving, at a 

18 minimum, the clinical preventive services. 

19 ‘‘(c) DEFINITION.—In this part, the term ‘disease 

20 prevention and health promotion services’ includes diabe21 tes screening and the clinical preventive services consisting 

22 of— 

23 ‘‘(1) provision of influenza vaccines; 

24 ‘‘(2) provision of pneumococcal vaccines; 

25 ‘‘(3) breast cancer screening; 


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1 ‘‘(4) cervical cancer screening; 

2 ‘‘(5) colorectal cancer screening; 

3 ‘‘(6) hypertension screening; and 

4 ‘‘(7) cholesterol screening.’’. 

5 SEC. 315. NATIONAL FAMILY CAREGIVER SUPPORT PRO6 GRAM. 

7 (a) OLDER RELATIVE CAREGIVER.—Section 372 of 

8 such Act (42 U.S.C. 3030s) is amended— 

9 (1) in subsection (a)— 

10 (A) by striking paragraphs (1) and (2) and 

11 inserting the following: 

12 ‘‘(1) CHILD.—The term ‘child’ means an indi13 vidual who is not more than 18 years of age. 

14 ‘‘(2) ELIGIBLE CARE RECIPIENT.—The term 

15 ‘eligible care recipient’ means a relative, of a care16 giver, who is— 

17 ‘‘(A) a child; or 

18 ‘‘(B) an individual with a disability who is 

19 not less than 19 and not more than 59 years 

20 of age. 

21 ‘‘(3) OLDER RELATIVE CAREGIVER.— 

22 ‘‘(A) IN GENERAL.—The term ‘older rel23 ative caregiver’ means a caregiver, as defined in 

24 subparagraph (B) or (C), who— 

25 ‘‘(i) is 55 years of age or older; 


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1 ‘‘(ii) lives with, is the informal pro2 vider of in-home and community care to, 

3 and is the primary caregiver for, an eligible 

4 care recipient who is described in subpara5 graph (B) or (C), respectively; and 

6 ‘‘(iii) is not a family caregiver. 

7 ‘‘(B) CAREGIVER FOR CHILD.—For pur8 poses of subparagraph (A), the term ‘caregiver’, 

9 used with respect to an eligible care recipient 

10 who is a child, means an individual who— 

11 ‘‘(i) is the grandparent, stepgrand12 parent, or other relative (other than the 

13 parent) by blood, marriage, or adoption, of 

14 the eligible care recipient; 

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

16 eligible care recipient because the biological 

17 or adoptive parents are unable or unwilling 

18 to serve as the primary caregiver of the eli19 gible care recipient; and 

20 ‘‘(iii) has a legal relationship to the el21 igible care recipient, such as legal custody 

22 or guardianship, or is raising the eligible 

23 care recipient informally. 

24 ‘‘(C) CAREGIVER OF INDIVIDUAL WITH A

25 DISABILITY.—For purposes of subparagraph 


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1 (A), the term ‘caregiver’, used with respect to 

2 an eligible care recipient who is an individual 

3 with a disability described in paragraph (2)(B) 

4 means an individual who is the parent, grand5 parent, or other relative by blood, marriage, or 

6 adoption, of the eligible care recipient.’’; 

7 (2) by striking subsection (b); 

8 (3) by striking ‘‘(a) IN GENERAL.—’’; and 

9 (4) by striking ‘‘this subpart:’’ and inserting 

10 ‘‘this part:’’. 

11 (b) PROGRAM.—Section 373 of the Older Americans 

12 Act of 1965 (42 U.S.C. 3030s–1) is amended— 

13 (1) in subsection (a)(2), by striking ‘‘grand14 parents or older individuals who are relative care15 givers.’’ and inserting ‘‘older relative caregivers.’’; 

16 (2) by redesignating subsections (b) through (g) 

17 as subsections (c) through (h), respectively; 

18 (3) by inserting after subsection (a) the fol19 lowing: 

20 ‘‘(b) ASSESSMENT PROGRAM OF NEEDS OF FAMILY

21 CAREGIVERS.— 

22 ‘‘(1) IN GENERAL.—The Assistant Secretary 

23 may make grants to States to establish a program, 

24 in accordance with the program requirements de25 scribed in paragraph (5), to assess the needs of famVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00090 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ily caregivers for targeted support services described 

2 in paragraph (5)(C). 

3 ‘‘(2) APPLICATION BY STATES.—Each State 

4 seeking a grant under this subsection shall submit 

5 an application to the Assistant Secretary at such 

6 time, in such manner, and containing such informa7 tion and assurances as the Assistant Secretary de8 termines appropriate. 

9 ‘‘(3) GRANT AMOUNT.—The amount of a grant 

10 to a State under this subsection shall be determined 

11 according to such methodology as the Assistant Sec12 retary determines appropriate. 

13 ‘‘(4) PROGRAM ADMINISTRATION.—A State re14 ceiving a grant under this subsection may enter into 

15 an agreement with area agencies on aging in the 

16 State, or an Aging and Disability Resource Center 

17 in the State, to administer the program, using such 

18 grant funds. 

19 ‘‘(5) PROGRAM REQUIREMENTS.— 

20 ‘‘(A) STANDARDIZED ASSESSMENT.—As21 sessments under a program established under 

22 paragraph (1)— 

23 ‘‘(i) shall be conducted by social work24 ers, care managers, nurses, or other appro25 priate professionals; and 


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1 ‘‘(ii)(I) shall be conducted with a 

2 standardized instrument to identify family 

3 caregiver needs; and 

4 ‘‘(II) in a State in which an area 

5 agency on aging or an Aging and Dis6 ability Resource Center is using such an 

7 instrument on the date of enactment of the 

8 Older Americans Act Amendments of 

9 2012, may continue to be conducted with 

10 that instrument. 

11 ‘‘(B) QUESTIONNAIRE.— 

12 ‘‘(i) IN GENERAL.—Subject to clause 

13 (ii), assessments under a program estab14 lished as described in paragraph (1) shall 

15 include asking the family caregiver relevant 

16 questions in order to determine whether 

17 the family caregiver would benefit from 

18 any targeted support services described in 

19 subparagraph (C). 

20 ‘‘(ii) COMPLETION ON A VOLUNTARY

21 BASIS.—The answering of questions under 

22 clause (i) by a family caregiver shall be on 

23 a voluntary basis. 

24 ‘‘(iii) ADDRESSING DIVERSE CARE25 GIVER NEEDS AND PREFERENCES.—The 


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1 questionnaire administered under this sub2 paragraph shall be designed in a manner 

3 that accounts for, and aims to ascertain, 

4 the varying needs and preferences of fam5 ily caregivers, based on the range of their 

6 capabilities, caregiving experience, and 

7 other relevant personal characteristics and 

8 circumstances. 

9 ‘‘(C) TARGETED SUPPORT SERVICES DE10 SCRIBED.—The following targeted support serv11 ices are described in this subparagraph: 

12 ‘‘(i) Information and assistance (in13 cluding brochures and online resources for 

14 researching a disease or disability or for 

15 learning and managing a regular 

16 caregiving role, new technologies that can 

17 assist family caregivers, and practical as18 sistance for locating services). 

19 ‘‘(ii) Individual counseling (including 

20 advice and consultation sessions to bolster 

21 emotional support for the family caregiver 

22 to make well-informed decisions about how 

23 to cope with caregiver strain). 


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1 ‘‘(iii) Support groups, including 

2 groups that provide help for family care3 givers to— 

4 ‘‘(I) locate a support group either 

5 locally or online to share experiences 

6 and reduce isolation; 

7 ‘‘(II) make well-informed 

8 caregiving decisions; and 

9 ‘‘(III) reduce isolation. 

10 ‘‘(iv) Education and training (includ11 ing workshops and other resources avail12 able with information about stress manage13 ment, self-care to maintain good physical 

14 and mental health, understanding and 

15 communicating with individuals with de16 mentia, medication management, normal 

17 aging processes, change in disease and dis18 ability, the role of assistive technologies, 

19 and other relevant topics). 

20 ‘‘(v) Respite care and emergency 

21 back-up services (including, on a short22 term basis, in-home care services that give 

23 the family caregiver a break from pro24 viding such care). 


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1 ‘‘(vi) Chore services (such as house 

2 cleaning) to assist the individual receiving 

3 care. 

4 ‘‘(vii) Personal care (including outside 

5 help) to assist the individual receiving care. 

6 ‘‘(viii) Legal and financial planning 

7 and consultation (including advice and 

8 counseling regarding long-term care plan9 ning, estate planning, powers of attorney, 

10 community property laws, tax advice, em11 ployment leave advice, advance directives, 

12 and end-of-life care). 

13 ‘‘(ix) Transportation (including trans14 portation to medical appointments) to as15 sist the individual receiving care. 

16 ‘‘(x) Other targeted support services, 

17 as determined appropriate by the State 

18 agency and approved by the Assistant Sec19 retary. 

20 ‘‘(D) REFERRALS.—In the case where a 

21 questionnaire completed by a family caregiver 

22 under subparagraph (B) indicates that the fam23 ily caregiver would benefit from 1 or more of 

24 the targeted support services described in sub25 paragraph (C), the agency administering the 


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1 program established under paragraph (1) shall 

2 provide referrals to the family caregiver for 

3 State, local, and private-sector caregiver pro4 grams and other resources that provide such 

5 targeted support services to such caregivers. 

6 ‘‘(E) TARGETING AND TIMING OF ASSESS7 MENTS.—Assessments under the program es8 tablished under paragraph (1) may be con9 ducted— 

10 ‘‘(i) when an individual who is being 

11 assisted by a family caregiver transitions 

12 from one care setting to another; 

13 ‘‘(ii) upon referral from a social work14 er, care manager, nurse, physician, or 

15 other appropriate professional; or 

16 ‘‘(iii) according to circumstances de17 termined by the State and approved by the 

18 Assistant Secretary. 

19 ‘‘(F) COORDINATION WITH OTHER ASSESS20 MENT.—Assessments under the program estab21 lished under paragraph (1) may be conducted 

22 separately or as part of, or in conjunction with, 

23 eligibility or other routine assessments of an in24 dividual who is being (or is going to be) as25 sisted by a family caregiver. 


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1 ‘‘(G) FOLLOWUP SERVICES.—As the As2 sistant Secretary determines appropriate, a 

3 State with a program described in paragraph 

4 (1) shall conduct followup activities with care5 givers who have participated in an assessment 

6 under the program to determine the status of 

7 the caregivers and whether services were pro8 vided. 

9 ‘‘(H) REPORTING REQUIREMENT.—Each 

10 State with a program described in paragraph 

11 (1) shall periodically submit to the Assistant 

12 Secretary a report containing information on 

13 the number of caregivers assessed under the 

14 program, information on the number of refer15 rals made for targeted support services under 

16 the program (disaggregated by type of service), 

17 demographic information on caregivers assessed 

18 under the program, and other information re19 quired by the Assistant Secretary.’’; 

20 (4) in subsection (c), as redesignated by para21 graph (2)— 

22 (A) in paragraph (4), by striking ‘‘and’’ at 

23 the end; 

24 (B) in paragraph (5), by striking the pe25 riod and inserting ‘‘; and’’; and 


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

2 ‘‘(6) the efforts of the Ombudsman to facilitate 

3 the activities of, and support, the State Long-Term 

4 Care Ombudsman program under title VII and this 

5 title, and the efforts of the Ombudsman to facilitate 

6 the activities of, and support, family and caregiver 

7 councils in long-term care facilities.’’; 

8 (5) in subsection (d), as redesignated by para9 graph (2)— 

10 (A) in paragraph (1)— 

11 (i) in the matter preceding subpara12 graph (A), by striking ‘‘and grandparents 

13 and older individuals who are relative care14 givers,’’ and inserting ‘‘and older relative 

15 caregivers,’’; 

16 (ii) in subparagraph (A), by striking 

17 ‘‘paragraph (1) or (2) of’’; and 

18 (iii) in subparagraph (B)— 

19 (I) by striking ‘‘subsection (b), in 

20 the case of a caregiver described in 

21 paragraph (1)’’ and inserting ‘‘sub22 section (c), in the case of a caregiver 

23 described in subsection (a)(1)’’; and 


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1 (II) by striking ‘‘section 

2 102(22).’’ and inserting ‘‘section 

3 102(24).’’; and 

4 (B) by striking paragraph (2) and insert5 ing the following: 

6 ‘‘(2) PRIORITY.—In providing services under 

7 this part, the State shall give— 

8 ‘‘(A) with respect to family caregivers who 

9 provide care for individuals with Alzheimer’s 

10 disease and related disorders with neurological 

11 and organic brain dysfunction, priority to care12 givers who provide care for older individuals 

13 with such disease or disorder; 

14 ‘‘(B) with respect to older relative care15 givers, priority to caregivers— 

16 ‘‘(i) who provide care for eligible care 

17 recipients described in section 

18 372(a)(2)(B) who have severe disabilities; 

19 but 

20 ‘‘(ii) who are not the parents of the 

21 recipients; and 

22 ‘‘(C) priority to caregivers who are older 

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1 ed in section 102(26)(B)), or are older individ2 uals with greatest economic need.’’; 

3 (6) in subsection (e), as redesignated by para4 graph (2), by striking ‘‘subsection (b)’’ and inserting 

5 ‘‘subsection (c)’’; 

6 (7) in subsection (f)(3), as redesignated by 

7 paragraph (2), in the second sentence, by striking 

8 ‘‘or grandparents or older individuals who are rel9 ative caregivers,’’ and inserting ‘‘older relative care10 givers,’’; 

11 (8) in subsection (g)(1), as redesignated by 

12 paragraph (2)— 

13 (A) in subparagraph (A), by striking ‘‘for 

14 fiscal years 2007, 2008, 2009, 2010, and 

15 2011’’ and inserting ‘‘for each of fiscal years 

16 2013 through 2017 and remaining after the 

17 reservation described in section 303(e)(2) (if 

18 elected) is made’’; and 

19 (B) in subparagraph (B), by striking 

20 ‘‘sums appropriated under section 303’’ and in21 serting ‘‘remaining sums described in subpara22 graph (A)’’; and 

23 (9) in subsection (h), as redesignated by para24 graph (2)— 


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1 (A) in paragraph (2), by striking subpara2 graph (C) and inserting the following: 

3 ‘‘(C) LIMITATION.—A State may use not 

4 more than 10 percent of the total Federal and 

5 non-Federal share available to the State under 

6 this part to provide support services to— 

7 ‘‘(i) older relative caregivers who pro8 vide care for children; and 

9 ‘‘(ii) older relative caregivers— 

10 ‘‘(I) who provide care for individ11 uals described in section 

12 372(a)(2)(B); and 

13 ‘‘(II) who are the parents of the 

14 individuals.’’; and 

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

16 ‘‘(3) USE OF FUNDS FOR OMBUDSMAN PRO17 GRAM.—Amounts made available to a State to carry 

18 out the State program under this part may be used 

19 to support the Office of the State Long-Term Care 

20 Ombudsman, including supporting the development 

21 of resident and family councils.’’. 

22 (c) ELIMINATION OF SUPERFLUOUS SUBPART DES23 IGNATION.— 


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1 (1) HEADING.—Part E of title III of such Act 

2 (42 U.S.C. 3021 et seq.) is amended by striking the 

3 subpart heading for subpart 1. 

4 (2) CONFORMING AMENDMENTS.—Sections 373 

5 (as amended by subsection (b)) and 374 of such Act 

6 (42 U.S.C. 3030s–1, 3030s–2) are further amended 

7 by striking ‘‘this subpart’’ in each place it appears 

8 and inserting ‘‘this part’’. 

9 TITLE IV—ACTIVITIES FOR 

10 HEALTH, INDEPENDENCE, 

11 AND LONGEVITY 

12 SEC. 401. GRANT PROGRAMS. 

13 Section 411 of the Older Americans Act of 1965 (42 

14 U.S.C. 3032) is amended— 

15 (1) in subsection (a)— 

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

17 by inserting ‘‘(including the highest court of 

18 each State)’’ after ‘‘with States’’; 

19 (B) in paragraph (9)(C), by adding at the 

20 end the following: ‘‘, and technical assistance 

21 and training to States and area agencies on 

22 aging for preparedness for and response to all 

23 hazards and emergencies;’’; 

24 (C) by striking paragraph (11) and insert25 ing the following: 


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1 ‘‘(11) conducting activities of national signifi2 cance to promote quality and continuous improve3 ment in the support and services provided to individ4 uals with the greatest social need, through activities 

5 that include needs assessment, program development 

6 and evaluation, training, technical assistance, and 

7 research, concerning— 

8 ‘‘(A) addressing physical and mental 

9 health, disabilities, and health disparities; 

10 ‘‘(B) providing long-term care, including 

11 in-home and community-based care; 

12 ‘‘(C) providing informal care, and formal 

13 care in a facility setting; 

14 ‘‘(D) providing access to culturally respon15 sive health and human services; and 

16 ‘‘(E) addressing other gaps in assistance 

17 and issues that the Assistant Secretary deter18 mines are of particular importance to older in19 dividuals with the greatest social need;’’; 

20 (D) in paragraph (12), by striking ‘‘; and’’ 

21 and inserting a semicolon; 

22 (E) by redesignating paragraph (13) as 

23 paragraph (14); and 

24 (F) by inserting after paragraph (12) the 

25 following: 


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1 ‘‘(13) in accordance with subsection (c), assess2 ing the fairness, effectiveness, timeliness, safety, in3 tegrity, and accessibility of adult guardianship and 

4 conservatorship proceedings, including the appoint5 ment and the monitoring of the performance of 

6 guardians and conservators, and implementing 

7 changes deemed necessary as a result of the assess8 ments; and’’; 

9 (2) in subsection (b), by striking ‘‘2007’’ and 

10 all that follows through ‘‘2011’’ and inserting 

11 ‘‘2013, 2014, 2015, 2016, and 2017’’; and 

12 (3) by inserting at the end the following: 

13 ‘‘(c) ADULT GUARDIANSHIPS AND

14 CONSERVATORSHIPS.— 

15 ‘‘(1) GRANTS.— 

16 ‘‘(A) IN GENERAL.—In awarding grants or 

17 contracts under subsection (a)(13), the Assist18 ant Secretary shall obtain feedback from the 

19 State Justice Institute in accordance with sub20 paragraph (B) and may consult with the Attor21 ney General, and such grants or contracts shall 

22 otherwise comply with this subsection. 

23 ‘‘(B) STATE JUSTICE INSTITUTE.—The 

24 Assistant Secretary shall submit to the State 

25 Justice Institute recommendations for the 


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1 awarding of grants or contracts under sub2 section (a)(13). The Institute shall have 60 

3 days in which to submit to the Assistant Sec4 retary the response of the Institute to such rec5 ommendations. The Assistant Secretary shall 

6 consider such response prior to awarding such 

7 grants or contracts. 

8 ‘‘(2) GRANTEES AND ACTIVITIES.—Grants may 

9 be awarded under subsection (a)(13) to the highest 

10 court of each State for the purpose of enabling such 

11 court, in collaboration with the State agency and 

12 State adult protective services program— 

13 ‘‘(A) to conduct assessments of the prac14 tices and procedures used to— 

15 ‘‘(i) determine whether to impose a 

16 full, limited, or temporary adult guardian17 ship or conservatorship; 

18 ‘‘(ii) select a guardian of a person or 

19 conservator of an estate; 

20 ‘‘(iii) review the continued need for a 

21 full, limited, or temporary guardianship or 

22 conservatorship of an adult; and 

23 ‘‘(iv) review the performance of 

24 guardians or conservators; 


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1 ‘‘(B) to implement changes deemed nec2 essary as a result of the assessments; and 

3 ‘‘(C) to collect data regarding those prac4 tices and procedures and the impact of the nec5 essary changes. 

6 ‘‘(3) ALLOTMENTS.—The amount of a grant 

7 under subsection (a)(13) shall be determined by the 

8 Assistant Secretary, in consultation with the State 

9 Justice Institute and the Attorney General (if the 

10 Assistant Secretary determines appropriate). 

11 ‘‘(4) BACKGROUND CHECKS.—The Assistant 

12 Secretary shall set aside 25 percent of amounts 

13 made available for grants under this subsection for 

14 each fiscal year to enable courts to implement or im15 prove systems to conduct background checks on pro16 spective guardians and conservators. Such systems 

17 shall comply with the following requirements: 

18 ‘‘(A) At minimum, the background checks 

19 shall include national and State criminal back20 ground checks, a search of child abuse and 

21 adult abuse registries, and a search as to 

22 whether the individual has been suspended or 

23 disbarred from law, accounting, or other profes24 sional licensing for misconduct. 


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1 ‘‘(B) The court shall consider all of the in2 formation obtained from the background check 

3 to determine whether such an individual is suf4 ficiently trustworthy to be a guardian or conser5 vator and that the appointment of such indi6 vidual is in the best interest of the protected 

7 person. 

8 ‘‘(C) The information obtained from the 

9 background check shall only be used for the 

10 purpose of determining the suitability of the 

11 prospective guardian or conservator for appoint12 ment. 

13 ‘‘(5) ELECTRONIC FILING.—Funds received 

14 pursuant to subsection (a)(13) may be used to im15 plement systems enabling the annual accountings 

16 and other required conservatorship and guardianship 

17 filings to be completed, filed, and reviewed electroni18 cally in order to simplify the filing process for con19 servators and guardians, and better enable the 

20 courts to identify discrepancies and detect fraud and 

21 the exploitation of protected persons. 

22 ‘‘(6) EVALUATION AND REPORT.—The Assist23 ant Secretary, in consultation with the Attorney 

24 General and the State Justice Institute, shall con25 duct an evaluation of the improvements made by 


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1 courts to which this subsection applies, and prepare 

2 and submit a report concerning such evaluation to 

3 Congress within 18 months of the date on which the 

4 first grant is awarded under subsection (a)(13), and 

5 a second report 18 months later, and shall use and 

6 distribute the reports and evaluations as the Assist7 ant Secretary, in consultation with the Attorney 

8 General and the State Justice Institute, determines 

9 appropriate in order to improve guardianships and 

10 conservatorships nationwide.’’. 

11 SEC. 402. PROTECTION FORM VIOLENCE PROJECTS. 

12 Section 413(b) of the Older Americans Act of 1965 

13 (42 U.S.C. 3032b(b)) is amended— 

14 (1) in paragraph (3), by striking ‘‘or’’ after the 

15 semicolon at the end; 

16 (2) in paragraph (4), by striking the period at 

17 the end and inserting ‘‘; or’’; and 

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

19 ‘‘(5) research and replicate successful models of 

20 elder abuse, neglect, and exploitation prevention and 

21 training.’’. 

22 SEC. 403. DEMONSTRATION, SUPPORT, AND RESEARCH 

23 PROJECTS. 

24 Section 417(a)(1) of the Older Americans Act of 

25 1965 (42 U.S.C. 3032(a)(1)) is amended— 


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1 (1) in subparagraph (A)— 

2 (A) by striking ‘‘grandparents and other 

3 older individuals who are relative caregivers’’ 

4 and inserting ‘‘older relative caregivers who 

5 are’’; and 

6 (B) by striking ‘‘or’’ after the semicolon; 

7 (2) in subparagraph (B), by striking ‘‘and’’ 

8 after the semicolon and inserting ‘‘or’’; and 

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

10 ‘‘(C) engage volunteers in providing sup11 port and information to older individuals (and 

12 their families or caretakers) who have experi13 enced or are at risk of elder abuse, including 

14 physical or emotional abuse, neglect, or exploi15 tation; and’’. 

16 SEC. 404. COMMUNITY INNOVATIONS FOR AGING IN PLACE. 

17 Section 422 of the Older Americans Act of 1965 (42 

18 U.S.C. 3032k) is amended by adding at the end the fol19 lowing: 

20 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

21 is authorized to be appropriated to carry out this section 

22 $5,000,000 for each of fiscal years 2013 through 2017.’’. 


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1 SEC. 405. MULTIPURPOSE SENIOR CENTER MODERNIZA2 TION, TRAINING, AND SUPPORT. 

3 Part A of title IV of the Older Americans Act of 1965 

4 (42 U.S.C. 3032 et seq.) is amended by adding at the end 

5 the following: 

6 ‘‘SEC. 423. MULTIPURPOSE SENIOR CENTER MODERNIZA7 TION, TRAINING, AND SUPPORT. 

8 ‘‘(a) PROGRAM AUTHORIZED.—The Assistant Sec9 retary shall award grants and enter into contracts with 

10 eligible entities to carry out projects to— 

11 ‘‘(1) support and promote modern multipurpose 

12 senior center models which yield vibrant, multi13 service, multigenerational centers for older individ14 uals, families of older individuals, and others in the 

15 community to gain skills, resources, and connections 

16 needed to meet the challenges that occur with con17 tinuum of care and quality of life; 

18 ‘‘(2) build an evidence base of modern, 

19 replicable practices that allow senior centers to serve 

20 a diverse array of older individuals, as well as their 

21 families and other caregivers, leveraging innovative 

22 partnerships and public and private resources to de23 velop and expand programs; and 

24 ‘‘(3) mobilize services and leverage resources to 

25 support the role of multipurpose senior centers as 

26 community focal points, as provided in section 


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1 306(a)(3), and for the establishment, construction, 

2 maintenance, and operation of centers, as described 

3 in sections 303(c)(2) and 306(a)(1), including devel4 opment of intergenerational shared site models, con5 sistent with the purposes of this Act. 

6 ‘‘(b) USE OF FUNDS.—An eligible entity shall use 

7 funds made available under a grant awarded, or a contract 

8 entered into, under subsection (a) to— 

9 ‘‘(1) carry out a project described in subsection 

10 (a); and 

11 ‘‘(2) evaluate the project in accordance with 

12 subsection (f). 

13 ‘‘(c) APPLICATION.—To be eligible to receive a grant 

14 or enter into a contract under subsection (a), an eligible 

15 entity shall submit an application to the Assistant Sec16 retary at such time, in such manner, and accompanied by 

17 such information as the Assistant Secretary may reason18 ably require. 

19 ‘‘(d) ELIGIBLE ENTITY.—For purposes of this sec20 tion, the term ‘eligible entity’ means— 

21 ‘‘(1) a multipurpose senior center that has met 

22 national accreditation and fiduciary standards; and 

23 ‘‘(2) a regional partnership or collaboration of 

24 multipurpose senior centers or State association of 


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1 senior centers in which not less than 2 centers are 

2 accredited. 

3 ‘‘(e) COMPETITIVE GRANTS FOR TECHNICAL ASSIST4 ANCE.— 

5 ‘‘(1) GRANTS.—The Assistant Secretary shall 

6 make a grant, on a competitive basis, to an eligible 

7 nonprofit organization described in paragraph (2), to 

8 enable the organization to— 

9 ‘‘(A) provide training and technical assist10 ance to recipients of grants under this section 

11 and other multipurpose senior centers to adopt 

12 and tailor evidence-based modernization strate13 gies and practices to respond to the economic 

14 and health needs of the diverse and growing 

15 aging populations in their own communities; 

16 and 

17 ‘‘(B) carry out other duties, as determined 

18 by the Assistant Secretary. 

19 ‘‘(2) ELIGIBLE NONPROFIT ORGANIZATION.— 

20 To be eligible to receive a grant under this sub21 section, an organization shall be a nonprofit organi22 zation (including a partnership of nonprofit organi23 zations), that— 

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1 purpose senior centers and experience evalu2 ating and reporting on programs; and 

3 ‘‘(B) has demonstrated knowledge of and 

4 expertise in multipurpose senior center accredi5 tation or other standards of excellence. 

6 ‘‘(3) APPLICATION.—To be eligible to receive a 

7 grant under this subsection, an organization (includ8 ing a partnership of nonprofit organizations) shall 

9 submit an application to the Assistant Secretary at 

10 such time, in such manner, and containing such in11 formation as the Assistant Secretary may require, 

12 including an assurance that the organization will 

13 submit to the Assistant Secretary such evaluations 

14 and reports as the Assistant Secretary may require. 

15 ‘‘(f) LOCAL EVALUATION AND REPORT.— 

16 ‘‘(1) EVALUATION.—Each entity receiving a 

17 grant or a contract under subsection (a) to carry out 

18 a project described in subsection (a) shall evaluate 

19 the project, leadership, and resources for the mod20 ernization of multipurpose senior centers to deter21 mine— 

22 ‘‘(A) the effectiveness of the project in pro23 ducing innovations and mobilizing resources; 


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1 ‘‘(B) the impact on older individuals, fami2 lies of older individuals, and the community 

3 being served; and 

4 ‘‘(C) the potential for the project to be rep5 licated by other multipurpose senior centers, 

6 noting the necessary resources and partnerships 

7 and the types of populations and communities 

8 best suited for the model. 

9 ‘‘(2) REPORT.—The entity described in para10 graph (1) shall submit a report to the Assistant Sec11 retary containing the evaluation not later than 6 

12 months after the expiration of the period for which 

13 the grant or contract is in effect. 

14 ‘‘(g) REPORT TO CONGRESS.—Not later than 6 

15 months after the Assistant Secretary receives the reports 

16 described in subsection (f)(2), the Assistant Secretary 

17 shall prepare and submit to Congress a report that as18 sesses the evaluations and includes, at a minimum— 

19 ‘‘(1) a description of the nature and operation 

20 of the projects funded under this section and other 

21 activities conducted in support of such projects; 

22 ‘‘(2) the findings resulting from the evaluations 

23 of the model projects conducted under this section; 

24 ‘‘(3) a description of recommended best prac25 tices of modern multipurpose senior centers; 


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1 ‘‘(4) a strategy for disseminating the findings 

2 resulting from the projects described in paragraph 

3 (1); and 

4 ‘‘(5) recommendations for legislative or admin5 istrative action, as the Assistant Secretary deter6 mines appropriate.’’. 

7 SEC. 406. DEMONSTRATION PROGRAM ON CARE COORDINA8 TION AND SERVICE DELIVERY. 

9 (a) FINDINGS.—Congress finds the following: 

10 (1) As of 2011, more than 35,000,000 Ameri11 cans are aged 65 or older. Sixty-two percent of them 

12 suffer from multiple chronic conditions which require 

13 person-centered, coordinated care that helps them to 

14 live in a home- or community-based setting. In 

15 2007, 42 percent of Americans age 65 or older re16 ported needing assistance performing instrumental 

17 activities of daily living or activities of daily living. 

18 (2) Direct-care workers (referred to in this sub19 section as ‘‘DCWs’’) provide an estimated 70 to 80 

20 percent of the paid hands-on long-term care and per21 sonal assistance received by elders and people with 

22 disabilities or other chronic conditions in the United 

23 States. These workers help their clients bathe, dress, 

24 and negotiate a host of other daily tasks. DCWs are 


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1 a lifeline for those they serve, as well as for families 

2 and friends struggling to provide quality care. 

3 (3) Eldercare and disability services positions 

4 account for nearly one-third of the 15,000,000 

5 health care jobs in the United States. The direct6 care workforce alone accounts for more than 

7 3,000,000 jobs, expected to grow to more than 

8 4,000,000 by 2018. 

9 (4) The majority of DCWs are now employed in 

10 home and community-based settings, and not in in11 stitutional settings such as nursing care facilities or 

12 hospitals. By 2018, home and community-based 

13 DCWs are likely to outnumber facility workers by 

14 nearly 2 to 1. 

15 (5) A 2008 Institute of Medicine report, enti16 tled ‘‘Re-tooling for an Aging America: Building the 

17 Health Care Workforce’’, called for new models of 

18 care delivery and coordination, and dedicated a 

19 chapter to the central importance of the direct-care 

20 workforce in a ‘‘re-tooled’’ eldercare delivery system. 

21 (6) An Institute of Medicine report on the fu22 ture of nursing, released in October of 2010, rec23 ommended nurses should practice to the full extent 

24 of their education and training. The report also 

25 states that all health care professionals should work 


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1 collaboratively in team-based models, and that the 

2 goal should be to encourage care models that use 

3 every member of the team to the full capacity of his 

4 or her training and skills. 

5 (7) The Patient Protection and Affordable Care 

6 Act (Public Law 111–148) emphasizes the need for 

7 improving care and lowering costs by better coordi8 nation of care and integration of services, particu9 larly for consumers with multiple chronic conditions. 

10 This will require developing new models of care for 

11 those receiving long-term services and supports. 

12 (8) A November 2010 focus group of DCWs ex13 amined the concept of an advanced role for this 

14 workforce. About half of the participants shared that 

15 they care for consumers who do not have any family 

16 or other unpaid caregivers present, which often re17 quires them to assume an additional role as an advo18 cate, with those consumers often turning to them as 

19 a source of trusted information and emotional sup20 port. All participants agreed that consumers and 

21 family members frequently ask them to undertake 

22 tasks that they would like to provide, but for which 

23 they have not received proper training. 

24 (b) PROGRAM.—Part A of title IV of the Older Amer25 icans Act of 1965 (42 U.S.C. 3032 et seq.), as amended 


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1 by section 405, is further amended by adding at the end 

2 the following: 

3 ‘‘SEC. 424. DEMONSTRATION PROGRAM ON CARE COORDI4 NATION AND SERVICE DELIVERY. 

5 ‘‘(a) ESTABLISHMENT OF DEMONSTRATION PRO6 GRAM.— 

7 ‘‘(1) IN GENERAL.—The Assistant Secretary 

8 shall carry out a demonstration program in accord9 ance with this section. Under such program, the As10 sistant Secretary shall award grants to eligible enti11 ties to carry out demonstration projects that focus 

12 on care coordination and service delivery redesign 

13 for older individuals with chronic illness or at risk 

14 of institutional placement by— 

15 ‘‘(A) designing and testing new models of 

16 care coordination and service delivery that 

17 thoughtfully and effectively deploy advanced 

18 aides to improve efficiency and quality of care 

19 for frail older individuals; and 

20 ‘‘(B) giving direct-care workers opportuni21 ties for career advancement through additional 

22 training, an expanded role, and increased com23 pensation. 

24 ‘‘(2) DIRECT-CARE WORKER.—In this section, 

25 the term ‘direct-care worker’ has the meaning given 


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1 that term in the 2010 Standard Occupational Classi2 fications of the Department of Labor for Home 

3 Health Aides [31–1011], Psychiatric Aides [31– 

4 1013], Nursing Assistants [31–1014], and Personal 

5 Care Aides [39–9021]. 

6 ‘‘(b) DEMONSTRATION PROJECTS.—The demonstra7 tion program shall be composed of 6 demonstration 

8 projects, as follows: 

9 ‘‘(1) Two demonstration projects shall focus on 

10 using the abilities of direct-care workers to promote 

11 smooth transitions in care and help to prevent un12 necessary hospital readmissions. Under these 

13 projects, direct-care workers shall be incorporated as 

14 essential members of interdisciplinary care coordina15 tion teams. 

16 ‘‘(2) Two demonstration projects shall focus on 

17 maintaining the health and improving the health sta18 tus of those with multiple chronic conditions and 

19 long-term care needs. Under these projects, direct20 care workers shall assist in monitoring health status, 

21 ensuring compliance with prescribed care, and edu22 cating and coaching the older individual involved and 

23 any family caregivers. 

24 ‘‘(3) Two demonstration projects shall focus on 

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1 ical responsibilities related to specific diseases, in2 cluding Alzheimer’s and dementia, congestive heart 

3 failure, and diabetes. 

4 ‘‘(c) ELIGIBLE ENTITY.—In this section, the term 

5 ‘eligible entity’ means a consortium that consists of— 

6 ‘‘(1) not less than 1— 

7 ‘‘(A) home personal care service provider; 

8 or 

9 ‘‘(B) area agency on aging; and 

10 ‘‘(2) not less than 1— 

11 ‘‘(A) hospital or health system; 

12 ‘‘(B) long-term care and rehabilitation fa13 cility; 

14 ‘‘(C) labor organization or labor-manage15 ment partnership; 

16 ‘‘(D) community-based aging service pro17 vider; 

18 ‘‘(E) patient-centered medical home; 

19 ‘‘(F) Federally qualified health center; 

20 ‘‘(G) managed care entity, including a 

21 managed health and long-term care program; 

22 ‘‘(H) entity that provides health services 

23 training; 


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1 ‘‘(I) State-based public entity engaged in 

2 building new roles and related curricula for di3 rect-care workers; or 

4 ‘‘(J) any other entity that the Assistant 

5 Secretary deems eligible based on integrated 

6 care criteria. 

7 ‘‘(d) APPLICATION.—To be eligible to receive a grant 

8 under this section, an eligible entity shall submit to the 

9 Assistant Secretary an application at such time, in such 

10 manner, and containing such information as the Secretary 

11 may require, which shall include— 

12 ‘‘(1) a description of the care coordination and 

13 service delivery models of the entity, detailed on a 

14 general, organizational, and staff level; 

15 ‘‘(2) a description of how the demonstration 

16 project carried out by the entity will improve care 

17 quality, including specific objectives and anticipated 

18 outcomes that will be used to measure success; and 

19 ‘‘(3) a description of how the coordinated care 

20 team approach with an enhanced role for the direct21 care worker under the demonstration project will in22 crease efficiency and cost effectiveness compared to 

23 past practice. 

24 ‘‘(e) PLANNING AWARDS UNDER DEMONSTRATION

25 PROGRAM.— 


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1 ‘‘(1) IN GENERAL.—Each eligible entity that re2 ceives a grant under this section shall receive a 

3 grant for planning activities related to the dem4 onstration project to be carried out by the entity, in5 cluding— 

6 ‘‘(A) designing the implementation of the 

7 project; 

8 ‘‘(B) identifying competencies and devel9 oping curricula for the training of participating 

10 direct-care workers; 

11 ‘‘(C) developing training materials and 

12 processes for other members of the interdiscipli13 nary care team; 

14 ‘‘(D) articulating a plan for identifying 

15 and tracking cost savings gained from imple16 mentation of the project and for achieving long17 term financial sustainability; and 

18 ‘‘(E) articulating a plan for evaluating the 

19 project. 

20 ‘‘(2) AMOUNT AND TERM.— 

21 ‘‘(A) TOTAL AMOUNT.—The amount 

22 awarded under paragraph (1) for all grants 

23 shall not exceed $600,000. 

24 ‘‘(B) TERM.—Activities carried out under 

25 a grant awarded under paragraph (1) shall be 


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1 completed not later than 1 year after the grant 

2 is awarded. 

3 ‘‘(f) IMPLEMENTATION AWARDS UNDER DEM4 ONSTRATION PROGRAM.— 

5 ‘‘(1) IN GENERAL.—Each eligible entity may re6 ceive a grant for implementation activities related to 

7 the demonstration project to be carried out by the 

8 entity, if the Assistant Secretary determines the en9 tity— 

10 ‘‘(A) has successfully carried out the ac11 tivities under the grant awarded under sub12 section (e); 

13 ‘‘(B) offers a feasible plan for long-term fi14 nancial sustainability; 

15 ‘‘(C) has constructed a meaningful model 

16 of advancement for direct-care workers; and 

17 ‘‘(D) aims to provide training to a sizeable 

18 number of direct-care workers and to serve a 

19 sizeable number of older individuals. 

20 ‘‘(2) USE OF FUNDS.—The implementation ac21 tivities described under paragraph (1) shall in22 clude— 

23 ‘‘(A) training of all care team members in 

24 accordance with the design of the demonstra25 tion project; and 


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1 ‘‘(B) evaluating the competency of all staff 

2 based on project design. 

3 ‘‘(3) EVALUATION AND REPORT.— 

4 ‘‘(A) EVALUATION.—Each recipient of a 

5 grant under paragraph (1), in consultation with 

6 an independent evaluation contractor, shall— 

7 ‘‘(i) evaluate the impact of training 

8 and deployment of direct-care workers in 

9 advanced roles, as described in this section, 

10 within each participating entity on out11 comes, such as direct-care worker job satis12 faction and turnover, beneficiary and fam13 ily caregiver satisfaction with services, rate 

14 of hospitalization of beneficiaries, and ad15 ditional measures determined by the Sec16 retary; 

17 ‘‘(ii) evaluate the impact of such 

18 training and deployment on the long-term 

19 services and supports delivery system and 

20 resources; 

21 ‘‘(iii) issue a statement of the poten22 tial of the use of direct-care workers in ad23 vanced roles to lower cost and improve 

24 quality of care in the Medicaid program; 

25 and 


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1 ‘‘(iv) evaluate the long-term financial 

2 sustainability of the model used under the 

3 grant and the impact of such model on 

4 quality of care. 

5 ‘‘(B) REPORTS.—Not later than 180 days 

6 after completion of the demonstration program 

7 under this section, each recipient of a grant 

8 under paragraph (1) shall submit to the Sec9 retary a report on the implementation of activi10 ties conducted under the demonstration project, 

11 including— 

12 ‘‘(i) the outcomes, performance bench13 marks, and lessons learned from the 

14 project; 

15 ‘‘(ii) a statement of cost savings 

16 gained from implementation of the project 

17 and how the cost savings have been rein18 vested to improve direct-care job quality 

19 and quality of care; and 

20 ‘‘(iii) results of the evaluation con21 ducted under subparagraph (A), and the 

22 statement of potential issued under sub23 paragraph (A)(iii), with respect to such ac24 tivities, together with such recommenda25 tions for legislation or administrative acVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00125 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 tion for expansion of the demonstration 

2 program on a broader scale as the Sec3 retary determines appropriate. 

4 ‘‘(4) AMOUNT AND TERM.— 

5 ‘‘(A) TOTAL AMOUNT.—The amount 

6 awarded under paragraph (1) for all grants 

7 shall not exceed $2,900,000. 

8 ‘‘(B) TERM.—Activities carried out under 

9 a grant awarded under paragraph (1) shall be 

10 completed not later than 2 years after the grant 

11 is awarded.’’. 

12 SEC. 407. LIVABLE COMMUNITIES GRANT PROGRAM. 

13 Part A of title IV of the Older Americans Act of 1965 

14 (42 U.S.C. 3032 et seq.), as amended by section 406, is 

15 further amended by adding at the end the following: 

16 ‘‘SEC. 425. LIVABLE COMMUNITIES GRANT PROGRAM. 

17 ‘‘(a) DEFINITIONS.—In this section: 

18 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en19 tity’ means— 

20 ‘‘(A) a State; 

21 ‘‘(B) an area agency on aging; or 

22 ‘‘(C) a tribal or Native Hawaiian organiza23 tion. 


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1 ‘‘(2) LIVABLE COMMUNITY.—The term ‘livable 

2 community’ means a metropolitan, urban, suburban, 

3 or rural community in which— 

4 ‘‘(A) safe, reliable, and accessible transpor5 tation choices exist; 

6 ‘‘(B) long-term, affordable, accessible, en7 ergy-efficient, and conveniently located housing 

8 choices exist for people of all ages, incomes, 

9 races, and ethnicities; 

10 ‘‘(C) the growth of neighborhoods is sup11 ported, revitalized, and encouraged, and the 

12 cost-effectiveness of infrastructure is maxi13 mized; 

14 ‘‘(D) economic development and economic 

15 competitiveness are promoted; 

16 ‘‘(E) the environment and natural re17 sources are preserved; 

18 ‘‘(F) agricultural land, rural land, and 

19 green space are protected; and 

20 ‘‘(G) public health is supported, improving 

21 the quality of life for residents of, and workers 

22 in, the community. 

23 ‘‘(3) TRIBAL OR NATIVE HAWAIIAN ORGANIZA24 TION.—The term ‘tribal or Native Hawaiian organiVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00127 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 zation’ means an organization that is eligible to re2 ceive a grant under title VI. 

3 ‘‘(b) IN GENERAL.—The Assistant Secretary shall 

4 award grants, from allotments made under subsection 

5 (c)(1) and as described in subsection (c)(2), to eligible en6 tities to pay for the Federal share of the cost of assisting 

7 communities in preparing for the aging of the population, 

8 through activities described in subsection (e). 

9 ‘‘(c) AVAILABILITY OF FUNDS.— 

10 ‘‘(1) STATES AND AREA AGENCIES ON AGING.— 

11 Subject to paragraph (4), from the sums appro12 priated under subsection (h) for each of fiscal years 

13 2013, 2014, 2015, 2016, and 2017, the Assistant 

14 Secretary shall allot funds under this section in the 

15 amount of— 

16 ‘‘(A) $30,000 to each State; and 

17 ‘‘(B) $30,000 to each area agency on 

18 aging. 

19 ‘‘(2) TRIBAL OR NATIVE HAWAIIAN ORGANIZA20 TIONS.—Subject to paragraph (4), from the sums 

21 appropriated under subsection (h) for each of fiscal 

22 years 2013, 2014, 2015, 2016, and 2017, the As23 sistant Secretary shall reserve $1,500,000, and use 

24 the reserved funds for grants to tribal or Native Ha25 waiian organizations. 


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1 ‘‘(3) NATIONAL RESOURCE CENTER.—Subject 

2 to paragraph (4), from the sums appropriated under 

3 subsection (h) for each of fiscal years 2013, 2014, 

4 2015, 2016, and 2017, the Assistant Secretary shall 

5 reserve $3,000,000, and use the reserved funds for 

6 a grant to the national organization selected under 

7 subsection (f)(1). 

8 ‘‘(4) INSUFFICIENT APPROPRIATIONS.—Not9 withstanding paragraphs (1), (2), and (3), if the 

10 amount appropriated under subsection (h) for a fis11 cal year is insufficient for the Assistant Secretary to 

12 provide all the allotments described in paragraph 

13 (1), and to reserve the amounts described in para14 graphs (2) and (3), for that fiscal year, the Sec15 retary shall proportionately reduce the number of al16 lotments made under paragraph (1), and the amount 

17 of each reservation described in paragraph (2) or (3) 

18 for that fiscal year. 

19 ‘‘(d) APPLICATION.—An eligible entity desiring a 

20 grant under this section shall submit an application to the 

21 Assistant Secretary at such time, in such manner, and ac22 companied by such information as the Assistant Secretary 

23 may require. 

24 ‘‘(e) USE OF GRANT FUNDS.—An eligible entity may 

25 use the funds made available through a grant— 


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1 ‘‘(1) to hire a professional planner to help State 

2 agencies, local elected officials, local government 

3 agencies, tribal or Native Hawaiian organizations, 

4 and private and nonprofit organizations to develop 

5 policies, programs, and services to foster livable com6 munities for people of all ages; 

7 ‘‘(2) to assess the aging population; and 

8 ‘‘(3) to coordinate the activities of State and 

9 local agencies in order to meet the needs of older in10 dividuals. 

11 ‘‘(f) NATIONAL RESOURCE CENTER.— 

12 ‘‘(1) IN GENERAL.—The Assistant Secretary 

13 shall make a grant to a national organization, as de14 scribed in subsection (c)(3), to establish a National 

15 Resource Center on Livable Communities for All 

16 Ages to provide technical assistance to eligible enti17 ties awarded grants under subsection (b). 

18 ‘‘(2) CRITERIA FOR SELECTION.—The national 

19 organization selected under paragraph (1) shall have 

20 a proven capacity to provide training and technical 

21 assistance to support States, area agencies on aging, 

22 and tribal or Native Hawaiian organizations, in en23 gaging in community planning activities. 

24 ‘‘(3) APPLICATION.—A national organization 

25 desiring the grant under this subsection shall submit 


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1 an application to the Assistant Secretary at such 

2 time, in such manner, and accompanied by such in3 formation as the Assistant Secretary may require. 

4 ‘‘(g) FEDERAL SHARE.— 

5 ‘‘(1) IN GENERAL.—Except as provided in para6 graph (2), the Federal share of the cost described in 

7 subsection (b) shall be 75 percent. 

8 ‘‘(2) EXCEPTIONS.— 

9 ‘‘(A) SMALL AND RURAL COMMUNITIES.— 

10 In the case of an eligible entity that is an area 

11 agency on aging that serves an area with less 

12 than 200,000 in population, the Federal share 

13 of the cost described in subsection (b) may be 

14 80 percent. 

15 ‘‘(B) TRIBAL OR NATIVE HAWAIIAN ORGA16 NIZATIONS.—In the case of an eligible entity 

17 that is a tribal or Native Hawaiian organiza18 tion, the Federal share of the cost described in 

19 subsection (b) shall be 100 percent. 

20 ‘‘(3) NON-FEDERAL SHARE.— 

21 ‘‘(A) IN-KIND CONTRIBUTIONS.—For the 

22 purpose of this section, the non-Federal share 

23 of the cost may be provided in cash or in-kind, 

24 fairly evaluated. 


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1 ‘‘(B) OTHER FEDERAL FUNDING.—An eli2 gible entity may use Federal funds appropriated 

3 under this Act and available to carry out sec4 tion 306, 307, 614, or 624, as the case may be, 

5 towards providing the non-Federal share of the 

6 cost. 

7 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

8 ‘‘(1) IN GENERAL.—There are authorized to be 

9 appropriated to carry out this section such sums as 

10 may be necessary for fiscal years 2013, 2014, 2015, 

11 2016, and 2017. 

12 ‘‘(2) SENSE OF THE SENATE.—It is the sense 

13 of the Senate that the amount appropriated under 

14 paragraph (1) should be not less than $25,000,000 

15 for fiscal year 2013.’’. 

16 SEC. 408. INNOVATION TO IMPROVE TRANSPORTATION FOR 

17 OLDER INDIVIDUALS WHO ARE HOLOCAUST 

18 SURVIVORS. 

19 Part A of title IV of the Older Americans Act of 1965 

20 (42 U.S.C. 3032 et seq.), as amended by section 407, is 

21 further amended by adding at the end the following: 


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1 ‘‘SEC. 426. INNOVATION TO IMPROVE TRANSPORTATION 

2 FOR OLDER INDIVIDUALS WHO ARE HOLO3 CAUST SURVIVORS. 

4 ‘‘(a) IN GENERAL.—The Assistant Secretary shall 

5 award grants or contracts to eligible entities to increase 

6 and improve transportation services, including affordable 

7 non-emergency transportation to medical appointments 

8 and shopping for food and other essential items, to enable 

9 older individuals to remain in the community, with a pref10 erence for those older individuals who are Holocaust sur11 vivors. The Assistant Secretary shall make grants or enter 

12 into such contracts for a period of not less than 5 years. 

13 ‘‘(b) USE OF FUNDS.— 

14 ‘‘(1) IN GENERAL.—An eligible entity receiving 

15 a grant or contract under subsection (a)— 

16 ‘‘(A) shall use funds received through such 

17 grant or contract to carry out a demonstration 

18 project, or to provide technical assistance to as19 sist local transit providers, area agencies on 

20 aging, senior centers, and local senior support 

21 groups, to encourage and facilitate coordination 

22 of Federal, State, and local transportation serv23 ices and resources for older individuals who are 

24 Holocaust survivors; and 

25 ‘‘(B) may use funds received through such 

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1 sistance on behalf of, or carry out such a dem2 onstration project for, older individuals. 

3 ‘‘(2) SPECIFIC ACTIVITIES.—In carrying out a 

4 demonstration project or providing technical assist5 ance under paragraph (1) the eligible entity may 

6 carry out activities that include— 

7 ‘‘(A) developing innovative approaches for 

8 improving access by older individuals to trans9 portation services, including volunteer driver 

10 programs, economically sustainable transpor11 tation programs, and programs that allow older 

12 individuals to transfer their automobiles to a 

13 provider of transportation services in exchange 

14 for the services; 

15 ‘‘(B) preparing information on transpor16 tation options and resources for older individ17 uals and organizations serving such individuals, 

18 and disseminating the information by estab19 lishing and operating a toll-free telephone num20 ber; 

21 ‘‘(C) developing models and best practices 

22 for providing comprehensive integrated trans23 portation services for older individuals, includ24 ing services administered by the Secretary of 

25 Transportation, by providing ongoing technical 


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1 assistance to agencies providing services under 

2 title III and by assisting in coordination of pub3 lic and community transportation services; and 

4 ‘‘(D) providing special services to link 

5 older individuals to transportation services not 

6 provided under title III. 

7 ‘‘(c) PREFERENCE.—In awarding grants and enter8 ing into contracts under subsection (a), the Assistant Sec9 retary shall give preference to eligible entities that have 

10 previous extensive experience working with and conducting 

11 assessments of the needs of Holocaust survivors who are 

12 older individuals. 

13 ‘‘(d) CONSULTATION.—In selecting grantees under 

14 this section, the Assistant Secretary shall consult with the 

15 individual designated under section 210(a) of the Older 

16 Americans Act Amendments of 2012 and with national or17 ganizations with special expertise in serving Holocaust 

18 survivors who are older individuals. 

19 ‘‘(e) ELIGIBLE ENTITY.—In this section, the term 

20 ‘eligible entity’ means an entity that has previous exten21 sive experience working with and conducting assessments 

22 of the needs of older individuals.’’. 


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1 SEC. 409. GRANTS OR CONTRACTS TO FACILITATE LOW-IN2 COME ACCESS TO DENTAL CARE. 

3 Part A of title IV of the Older Americans Act of 

4 1965, as amended by section 408, is further amended by 

5 adding at the end the following: 

6 ‘‘SEC. 427. GRANTS OR CONTRACTS TO FACILITATE LOW-IN7 COME ACCESS TO DENTAL CARE. 

8 ‘‘(a) DEFINITION.—In this section, the term ‘medi9 cally recommended dental care’ means treatment of an 

10 oral disease or other oral condition, on the referral of a 

11 physician or other health care professional, to sustain or 

12 improve overall health, prevent exacerbation of a co-mor13 bid condition, or as a prerequisite to a required medical 

14 therapy. 

15 ‘‘(b) GRANTS.—The Secretary shall award competi16 tive grants to, or enter into contracts with, eligible entities 

17 to fund the employment costs of professionals who will use 

18 grant or contract funds to— 

19 ‘‘(1) coordinate the provision of medically rec20 ommended dental care to eligible individuals by vol21 unteer dentists in a manner consistent with State li22 censing laws; and 

23 ‘‘(2) verify the medical, dental, and financial 

24 needs of eligible individuals who may be eligible for 

25 free medically recommended dental care. 

26 ‘‘(c) ELIGIBILITY.— 


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1 ‘‘(1) ELIGIBLE ENTITY.—To be eligible to re2 ceive a grant or contract under subsection (b), an 

3 entity shall— 

4 ‘‘(A) be an entity that is exempt from tax 

5 under section 501(c) of the Internal Revenue 

6 Code of 1986; 

7 ‘‘(B) provide for the participation of eligi8 ble individuals in a free dental services program 

9 on a national basis; and 

10 ‘‘(C) submit to the Secretary an applica11 tion at such time, in such manner, and con12 taining such information as the Secretary may 

13 require. 

14 ‘‘(2) ELIGIBLE INDIVIDUAL.—To be eligible to 

15 participate in a program described in paragraph 

16 (1)(B), an individual shall be— 

17 ‘‘(A) an older individual with greatest eco18 nomic need; 

19 ‘‘(B) an older individual or adult individual 

20 entitled to benefits under part A, or an indi21 vidual enrolled in part B, of title XVIII of the 

22 Social Security Act (42 U.S.C. 1395 et seq.); or 

23 ‘‘(C) an individual enrolled in a State plan 

24 under title XIX, or a health plan under title 

25 XXI, of such Act (42 U.S.C. 1396 et seq., 


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1 1397aa et seq.), or under an approved waiver of 

2 either such plan. 

3 ‘‘(d) USE OF FUNDS.—An entity shall use amounts 

4 received under a grant or contract under this section to 

5 establish, expand, or operate a program to coordinate the 

6 provision of free medically recommended dental care 

7 through volunteer dentists to eligible individuals. 

8 ‘‘(e) EVALUATION AND REPORT.— 

9 ‘‘(1) EVALUATION.—Each entity that receives a 

10 grant or contract under this section shall evaluate 

11 the number of patients served under the grant or 

12 contract, and the effectiveness of the program de13 scribed in subsection (d) in reducing medical ex14 penses associated with the disease or condition for 

15 which care described in subsection (d) was provided. 

16 ‘‘(2) REPORT.—The entity shall submit a re17 port containing the results of the evaluation to the 

18 Assistant Secretary, not later than 6 months after 

19 the end of the period of the grant or contract. 

20 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

21 is authorized to be appropriated to carry out this section, 

22 $2,000,000 for each of fiscal years 2013 through 2017.’’. 


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1 SEC. 410. NATIONAL RESOURCE CENTER ON FAMILY 

2 CAREGIVING. 

3 (a) IN GENERAL.—Part A of title IV of the Older 

4 Americans Act of 1965 (42 U.S.C. 3032 et seq.), as 

5 amended by section 409, is further amended by adding 

6 at the end the following: 

7 ‘‘SEC. 428. NATIONAL RESOURCE CENTER ON FAMILY 

8 CAREGIVING. 

9 ‘‘(a) DEFINITIONS.—In this section: 

10 ‘‘(1) PUBLIC OR PRIVATE NONPROFIT ENTI11 TY.—The term ‘public or private nonprofit entity’ 

12 means— 

13 ‘‘(A) a State, a political subdivision of a 

14 State, or an agency or instrumentality of such 

15 a State or political subdivision; or 

16 ‘‘(B) a nonprofit entity that is described in 

17 section 501(c)(3) of the Internal Revenue Code 

18 of 1986 and exempt from taxation under sec19 tion 501(a) of such Code. 

20 ‘‘(2) STATE.—The term ‘State’ means 1 of the 

21 50 States. 

22 ‘‘(b) ESTABLISHMENT.—The Secretary of Health 

23 and Human Services shall award a grant to or enter into 

24 a cooperative agreement with a public or private nonprofit 

25 entity to establish a National Resource Center on Family 

26 Caregiving (referred to in this section as the ‘Center’). 


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1 ‘‘(c) PURPOSES OF NATIONAL RESOURCE CENTER.— 

2 The Center shall— 

3 ‘‘(1) identify, develop, and disseminate informa4 tion on best practices for and evidence-based models 

5 of family caregiver support programs; 

6 ‘‘(2) provide timely information on policy and 

7 program updates relating to family caregivers; 

8 ‘‘(3) partner with related organizations to dis9 seminate practical strategies and tools to support 

10 families in their caregiving roles; 

11 ‘‘(4) convene educational programs and web12 based seminars on family caregiver issues and pro13 gram development; and 

14 ‘‘(5) provide a comprehensive Internet website 

15 with a national searchable database on family care16 giver programs and resources in the States. 

17 ‘‘(d) AUTHORIZATION.—There is authorized to be ap18 propriated to carry out this section $12,000,000 for the 

19 period of fiscal years 2013 through 2017.’’. 

20 (b) TECHNICAL AMENDMENTS.— 

21 (1) Section 431(a) of such Act (42 U.S.C. 

22 3033(a)) is amended by striking ‘‘or contract’’ the 

23 first place it appears and inserting ‘‘or contract (in24 cluding a cooperative agreement)’’. 


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1 (2) Section 432(a) of such Act (42 U.S.C. 

2 3033a(a)) is amended by striking ‘‘and contracts’’ 

3 and inserting ‘‘and contracts (including cooperative 

4 agreements)’’. 

5 TITLE V—COMMUNITY SERVICE 

6 SENIOR OPPORTUNITIES 

7 SEC. 501. OLDER AMERICAN COMMUNITY SERVICE EM8 PLOYMENT PROGRAM. 

9 Section 502 of the Older Americans Act of 1965 (42 

10 U.S.C. 3056) is amended— 

11 (1) in subsection (a)(1)— 

12 (A) by striking ‘‘To foster individual eco13 nomic self-sufficiency and’’ and inserting ‘‘To 

14 further the goal of economic security, foster in15 dividual economic self-sufficiency, grow local 

16 economies, improve the quality of life in local 

17 communities, and’’; and 

18 (B) by striking ‘‘persons who are age 55’’ 

19 and inserting ‘‘persons who are not economi20 cally secure and who are age 55’’; 

21 (2) in subsection (b)— 

22 (A) in paragraph (1)— 

23 (i) in the matter preceding subpara24 graph (A), in the first sentence, by insert25 ing after ‘‘nonprofit private agencies and 


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1 organizations’’ the following: ‘‘(which non2 profit organizations may include eligible 

3 technology organizations)’’; 

4 (ii) in subparagraph (E)— 

5 (I) by striking ‘‘support for chil6 dren,’’ and inserting ‘‘support for 

7 adults, children,’’; and 

8 (II) by inserting ‘‘, and which 

9 may include support for the health 

10 and safety of older adults and the pre11 vention and detection of elder abuse’’ 

12 after ‘‘families’’; 

13 (iii) in subparagraph (Q), by striking 

14 ‘‘and’’ at the end; 

15 (iv) in subparagraph (R), by striking 

16 the period and inserting ‘‘; and’’; and 

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

18 ‘‘(S) will, to the maximum extent prac19 ticable, achieve the goal described in paragraph 

20 (4).’’; and 

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

22 ‘‘(4) PLACEMENT GOAL.— 

23 ‘‘(A) GOAL.—In order to maximize the 

24 number of older individuals being served, each 

25 grantee under this title shall, to the maximum 


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1 extent practicable, achieve a goal, referred to 

2 paragraph (1)(S), of placing not less than 50 

3 percent of the participants in the grantee’s 

4 project in positions with organizations that as5 sist older adults or in positions with duties that 

6 positively impact the lives of older adults. 

7 ‘‘(B) CONTRACTS WITH SERVICE PRO8 VIDERS.—In order to achieve the goal described 

9 in subparagraph (A), each such grantee shall 

10 enter into a contract or memorandum of under11 standing with— 

12 ‘‘(i) entities from 2 or more categories 

13 of entities, which categories shall consist 

14 of— 

15 ‘‘(I) the State Long-Term Care 

16 Ombudsman selected in accordance in 

17 section 712; 

18 ‘‘(II) an area agency on aging; 

19 ‘‘(III) a multipurpose senior cen20 ter; 

21 ‘‘(IV) a contractor providing sup22 port services under part B, C, D, or 

23 E of title III; and 

24 ‘‘(V) a transportation service pro25 vider; or 


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1 ‘‘(ii) an entity approved by the Assist2 ant Secretary, and the Secretary of 

3 Labor.’’; and 

4 (3) in subsection (e)(2)— 

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

6 ‘‘and’’ at the end; 

7 (B) in subparagraph (F), by striking the 

8 period and inserting ‘‘; and’’; and 

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

10 ‘‘(G) a project carried, out by an eligible 

11 technology organization, that will focus on the 

12 provision to eligible individuals of— 

13 ‘‘(i) basic and intermediate computer 

14 skills; 

15 ‘‘(ii) Internet skills; 

16 ‘‘(iii) e-mail skills; 

17 ‘‘(iv) word processing and spreadsheet 

18 skills; 

19 ‘‘(v) presentation software skills; and 

20 ‘‘(vi) any other key skills appropriate 

21 for assisting eligible individuals in entering 

22 or re-entering the workforce.’’. 


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1 SEC. 502. STATE PLAN. 

2 Section 503(a)(4)(C) of the Older Americans Act of 

3 1965 (42 U.S.C. 3056a(a)(4)(C)) is amended by striking 

4 clauses (i) through (iv) and inserting the following: 

5 ‘‘(i) minority and Indian eligible indi6 viduals; 

7 ‘‘(ii) eligible individuals with limited 

8 English proficiency; 

9 ‘‘(iii) eligible individuals with disabil10 ities; 

11 ‘‘(iv) eligible individuals with greatest 

12 economic need; and 

13 ‘‘(v) eligible individuals with greatest 

14 social need;’’. 

15 SEC. 503. AUTHORIZATION OF APPROPRIATIONS. 

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

17 (42 U.S.C. 3056o(a)) is amended to read as follows: 

18 ‘‘(a) AUTHORIZATION.— 

19 ‘‘(1) IN GENERAL.—There are authorized to be 

20 appropriated to carry out this title such sums as 

21 may be necessary for fiscal years 2013, 2014, 2015, 

22 2016, and 2017. 

23 ‘‘(2) SENSE OF CONGRESS.—It is the sense of 

24 Congress that the amount appropriated under para25 graph (1) should not be less than $660,000,000 for 

26 fiscal year 2013.’’. 


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1 SEC. 504. DEFINITIONS. 

2 Section 518(a) of the Older Americans Act of 1965 

3 (42 U.S.C. 3056p(a)) is amended— 

4 (1) by redesignating paragraphs (4) through 

5 (8) as paragraphs (5) through (9), respectively; and 

6 (2) by inserting after paragraph (3) the fol7 lowing: 

8 ‘‘(4) ELIGIBLE TECHNOLOGY ORGANIZATION.— 

9 The term ‘eligible technology organization’ includes 

10 a nonprofit organization that— 

11 ‘‘(A) has developed a research-based cur12 riculum specifically designated to help older 

13 adults improve their technology skills, such as 

14 a curriculum developed through a Broadband 

15 Technology Opportunities Program or a Tech16 nology Opportunities Program of the Depart17 ment of Commerce; or 

18 ‘‘(B) is an eligible provider of training 

19 services identified under section 122 of the 

20 Workforce Investment Act of 1998 (29 U.S.C. 

21 2842).’’. 

22 SEC. 505. STUDY ON FEASIBILITY OF TRANSFER OF PRO23 GRAM. 

24 (a) STUDY.—The Assistant Secretary for Aging of 

25 the Department of Health and Human Services, and the 

26 Secretary of Labor, shall study the feasibility of transferVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00146 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ring the program carried out under title V of the Older 

2 Americans Act of 1965 (42 U.S.C. 3056 et seq.) to the 

3 Administration on Aging. 

4 (b) REPORT.—Not later than 2 years after the date 

5 of enactment of this Act, the Assistant Secretary and the 

6 Secretary shall submit a report containing the results of 

7 the study to the appropriate committees of Congress. 

8 TITLE VI—GRANTS FOR NATIVE 

9 AMERICANS 

10 SEC. 601. TECHNICAL AMENDMENT. 

11 Section 611 of such Act (42 U.S.C. 3057b) is amend12 ed by striking ‘‘(a)’’ in the matter preceding paragraph 

13 (1). 

14 SEC. 602. CONFORMING AMENDMENT. 

15 Section 631(b) of the Older Americans Act of 1965 

16 (42 U.S.C. 3057k–11(b)) is amended by striking ‘‘sub17 sections (c), (d), and (e)’’ and inserting ‘‘subsections (d), 

18 (e), and (f)’’. 

19 SEC. 603. REAUTHORIZATION OF FUNDING FOR GRANTS 

20 FOR NATIVE AMERICANS. 

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

22 (42 U.S.C. 3057n(2)) is amended by striking ‘‘part C,’’ 

23 and all that follows and inserting ‘‘part C, $11,000,000 

24 for each of fiscal years 2013 through 2017.’’. 


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1 TITLE VII—VULNERABLE ELDER 

2 RIGHTS PROTECTION ACTIVI3 TIES 

4 SEC. 701. ESTABLISHMENT. 

5 Section 701 of the Older Americans Act of 1965 (42 

6 U.S.C. 3058) is amended— 

7 (1) by inserting ‘‘and grants’’ after ‘‘allot8 ments’’; and 

9 (2) by adding at the end the following: ‘‘The 

10 Assistant Secretary, to the maximum extent prac11 ticable, shall ensure that education and public 

12 awareness activities under this title are fully inte13 grated with all service programs under title III (with 

14 special emphasis on the nutrition programs, legal 

15 services, and information and referral assistance ac16 tivities), the work of Aging and Disability Resource 

17 Centers, and the long-term care ombudsman pro18 grams, including programs carried out under title 

19 VI.’’. 

20 SEC. 702. AUTHORIZATION OF APPROPRIATIONS FOR OM21 BUDSMAN PROGRAM. 

22 (a) STATE LONG-TERM CARE OMBUDSMAN PRO23 GRAM.—Section 702 of the Older Americans Act of 1965 

24 (42 U.S.C. 3058a) is amended— 


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1 (1) in subsection (a), by striking ‘‘, such sums’’ 

2 and all that follows and inserting ‘‘, such sums as 

3 may be necessary for fiscal years 2013, 2014, 2015, 

4 2016, and 2017.’’; and 

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

6 ‘‘(d) SENSE OF CONGRESS.—It is the sense of Con7 gress that, in order to carry out chapter 2 (relating to 

8 State Long-Term Care Ombudsman programs), the 

9 amount appropriated under subsection (a) should be not 

10 less than $25,500,000 for fiscal year 2013.’’. 

11 (b) STATE HOME CARE OMBUDSMAN PROGRAMS.— 

12 Chapter 1 of subtitle A of title VII of the Older Americans 

13 Act of 1965 is amended by inserting after section 702 (42 

14 U.S.C. 3058a) the following: 

15 ‘‘SEC. 702A. AUTHORIZATION OF APPROPRIATIONS FOR 

16 STATE HOME CARE OMBUDSMAN PROGRAM. 

17 ‘‘There are authorized to be appropriated to carry out 

18 chapter 5 such sums as may be necessary for fiscal year 

19 2013 and each subsequent fiscal year.’’. 

20 SEC. 703. GRANTS. 

21 Section 703 of the Older Americans Act of 1965 (42 

22 U.S.C. 3058b) is amended by adding at the end the fol23 lowing: 

24 ‘‘(d) GRANTS FOR STATE HOME CARE OMBUDSMAN

25 PROGRAMS.— 


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1 ‘‘(1) IN GENERAL.—The Assistant Secretary 

2 shall use funds made available under section 702A 

3 to award grants, on a competitive basis, to States 

4 for State Home Care Ombudsman Programs. 

5 ‘‘(2) CONSIDERATIONS.—In selecting States to 

6 receive the grants, the Assistant Secretary shall con7 sider— 

8 ‘‘(A) a State’s current financial support 

9 (as of the date of consideration) for home care 

10 ombudsman services; 

11 ‘‘(B) a State’s commitment to preventing 

12 conflict of interest between providers of home 

13 care services and providers of home care om14 budsman services; and 

15 ‘‘(C) other criteria determined by the As16 sistant Secretary. 

17 ‘‘(3) PRIORITIES.—In selecting States to receive 

18 the grants, the Assistant Secretary may give first 

19 priority to States that are providing home care om20 budsman services to home care consumers on the 

21 date of enactment of section 737, and seek to en22 hance the home care ombudsman programs through 

23 which the States provide those services.’’. 


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1 SEC. 704. ELIGIBILITY. 

2 Section 704 of the Older Americans Act of 1965 (42 

3 U.S.C. 3058c) is amended, in the matter preceding para4 graph (1), by inserting ‘‘or grants’’ after ‘‘allotments’’. 

5 SEC. 705. ADDITIONAL STATE PLAN REQUIREMENTS. 

6 (a) IN GENERAL.—Section 705 of the Older Ameri7 cans Act of 1965 (42 U.S.C. 3058d) is amended— 

8 (1) in subsection (a)— 

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

10 by inserting ‘‘or grant’’ after ‘‘allotment’’; 

11 (B) in paragraph (1), by striking ‘‘require12 ments of the chapter and this chapter’’ and in13 serting ‘‘requirements of this chapter and this 

14 subtitle’’; 

15 (C) in paragraph (2), by inserting ‘‘family 

16 caregivers,’’ after ‘‘title VI,’’; 

17 (D) in paragraph (4), by striking ‘‘enact18 ment of this subtitle’’ and inserting ‘‘enactment 

19 of the chapter’’; 

20 (E) in paragraph (6), by striking ‘‘and’’ at 

21 the end; 

22 (F) in paragraph (7), by striking the pe23 riod and inserting ‘‘; and’’; and 

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


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1 ‘‘(8) subject to section 705(b) of the Older 

2 Americans Act Amendments of 2012, an assur3 ance— 

4 ‘‘(A) that the State has a Home Care Con5 sumer Bill of Rights and a Plan for Enforce6 ment of such a Bill, developed in accordance 

7 with the procedures described under paragraph 

8 (2) and as approved by the Assistant Secretary, 

9 and the State shall include a copy of the Bill 

10 and Plan; or 

11 ‘‘(B) at the discretion of the Assistant Sec12 retary, in the event the State does not have an 

13 approved Home Care Consumer Bill of Rights 

14 and Plan for Enforcement, that the State has 

15 an alternative such as a proposal for developing 

16 and submitting for approval a Home Care Con17 sumer Bill of Rights and Plan for Enforce18 ment.’’; 

19 (2) by redesignating subsection (b) as sub20 section (d); 

21 (3) by inserting after subsection (a) the fol22 lowing: 

23 ‘‘(b) HOME CARE CONSUMER BILL OF RIGHTS.— 

24 The Home Care Consumer Bill of Rights referred to in 

25 subsection (a)(8) shall, at a minimum— 


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1 ‘‘(1) address a home care consumer’s right to 

2 basic safety by— 

3 ‘‘(A) affirming that home care consumers 

4 are protected from physical, sexual, mental, and 

5 verbal abuse, neglect, and exploitation; 

6 ‘‘(B) affirming that home care consumers 

7 are served by providers who are properly 

8 trained and are providing home care services 

9 within their scope of practice and the scope of 

10 their certification or licensure (if such a certifi11 cation or licensure is required by the applicable 

12 State); 

13 ‘‘(C) affirming that such providers main14 tain the confidentiality of all personal, financial, 

15 and medical information of home care con16 sumers; and 

17 ‘‘(D) affirming that providers respect the 

18 personal property of home care consumers, and 

19 in the event of consumer reports of theft or 

20 loss, that providers will investigate and report 

21 back to the consumer the results of the inves22 tigation; 

23 ‘‘(2) address a home care consumer’s right to 

24 access information by— 


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1 ‘‘(A) affirming that home care consumers 

2 are informed of their rights under this sub3 section and subsection (c) within 2 weeks after 

4 the start of home care services, and about the 

5 entities the consumers may contact if their 

6 rights are violated, including the name and con7 tact information for State and local agencies re8 sponsible for enforcing the Home Care Con9 sumer Bill of Rights; 

10 ‘‘(B) affirming that home care con11 sumers— 

12 ‘‘(i) are informed of the cost of home 

13 care services prior to receiving those serv14 ices, whether the cost of those services are 

15 covered under health insurance, long-term 

16 care insurance, or other private and public 

17 programs, and any charges the consumer 

18 will be expected to pay; and 

19 ‘‘(ii) are given advance notice of any 

20 changes to those costs or services; and 

21 ‘‘(C) affirming that home care consumers 

22 have access to information about the availability 

23 of the home care services provided in the com24 munity involved and have the ability to choose 


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1 among home care services and providers of 

2 home care services available in the community; 

3 ‘‘(3) address a home care consumer’s right to 

4 choice, participation, and self-determination by— 

5 ‘‘(A) affirming that home care consumers 

6 can participate in the planning of their home 

7 care services, including making choices about 

8 aspects of their care and services that are im9 portant to them, choosing providers and sched10 ules to the extent practicable, receiving reason11 able accommodation of their needs and pref12 erences, and involving anyone they chose to par13 ticipate with them in that planning; 

14 ‘‘(B) affirming that home care consumers 

15 are provided with sufficient information to 

16 make informed decisions, are fully informed in 

17 advance about any proposed changes in care 

18 and services, and are involved in the decision19 making process regarding those changes; and 

20 ‘‘(C) affirming that home care consumers 

21 can refuse services and receive an explanation 

22 of the consequences of doing so; 

23 ‘‘(4) address a home care consumer’s right to 

24 receive care and services provided in a way that pro25 motes each consumer’s dignity and individuality; 


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1 ‘‘(5) address a home care consumer’s right to 

2 redress grievances by— 

3 ‘‘(A) affirming that home care consumers 

4 are able to voice grievances about the quality of 

5 their home care services, the number of hours 

6 of service, and violations of their rights, receive 

7 prompt responses to those concerns, and are in8 formed about the entities the consumers may 

9 contact to state those grievances in order to 

10 have the grievances addressed in an appropriate 

11 and timely manner, and without retaliation; and 

12 ‘‘(B) affirming that home care consumers 

13 are able to assert their rights under this sub14 section and subsection (c) without retaliation; 

15 ‘‘(6) address the role and responsibilities that 

16 fiduciaries may have in securing the rights of home 

17 care consumers affirmed under the Home Care Con18 sumer Bill of Rights; and 

19 ‘‘(7) meet any other guidelines determined to be 

20 appropriate by the Assistant Secretary. 

21 ‘‘(c) PLAN FOR ENFORCEMENT.—In developing the 

22 Plan for Enforcement referred to in subsection (a)(8), the 

23 State shall take into account the best practices established 

24 under section 201(e)(2)(C). The Plan shall include a de25 scription of how State entities with a role in protecting 


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1 older individuals, such as home care services licensing 

2 agencies, adult protective services agencies, the Office of 

3 the State Long-Term Care Ombudsman (if the office has 

4 jurisdiction over home and community-based long-term 

5 care), local law enforcement agencies, and other entities 

6 determined to be appropriate by the Assistant Secretary, 

7 will coordinate activities to enforce the Home Care Con8 sumer Bill of Rights.’’; and 

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

10 ‘‘(e) DEFINITION.—In this section, the term ‘home 

11 care consumer’ and ‘home care services’ have the mean12 ings given the terms in section 736.’’. 

13 (b) APPLICATION OF REQUIREMENT TO SUBMIT

14 STATE HOME CARE CONSUMER BILL OF RIGHTS AND

15 PLAN FOR ENFORCEMENT.— 

16 (1) IN GENERAL.—The requirement for a State 

17 to provide an assurance, and either a Home Care 

18 Consumer Bill of Rights and a Plan for Enforce19 ment of such Bill or an alternative, under paragraph 

20 (8) of section 705(a) of the Older Americans Act of 

21 1965 (as added by subsection (a)) shall apply to 

22 States beginning on the date (referred to in this sub23 section as the ‘‘application date’’) that is 1 year 

24 after the date of the establishment of best practices 


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1 under section 201(e)(2)(C) of such Act (as added by 

2 section 201). 

3 (2) FIRST SUBMISSION AFTER APPLICATION

4 DATE.—A State shall comply with paragraph (8) of 

5 section 705(a) of the Older Americans Act of 1965 

6 (as added by subsection (a)) in whichever of the fol7 lowing 2 submissions occurs first with respect to 

8 such State after the application date described under 

9 paragraph (1): 

10 (A) The submission of a new State plan 

11 under section 307 of the Older Americans Act 

12 of 1965 (42 U.S.C. 3027). 

13 (B) The submission of an annual revision 

14 to a State plan submitted under such section 

15 307. 

16 (3) ONGOING SUBMISSIONS.—After complying 

17 with paragraph (8) of section 705(a) of the Older 

18 Americans Act of 1965 (as added by subsection (a)) 

19 in a submission in accordance with paragraph (2) of 

20 this subsection, a State shall comply with such para21 graph (8) in each new State plan submitted under 

22 section 307 of the Older Americans Act of 1965 (42 

23 U.S.C. 3027). 


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1 SEC. 706. DEFINITIONS. 

2 Section 711(6) of the Older Americans Act of 1965 

3 (42 U.S.C. 3058f(6)) is amended by striking ‘‘older indi4 vidual’’ and inserting ‘‘individual’’. 

5 SEC. 707. STATE LONG-TERM CARE OMBUDSMAN PROGRAM. 

6 Section 712 of the Older Americans Act of 1965 (42 

7 U.S.C. 3058g) is amended— 

8 (1) in subsection (a)— 

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

10 the following: ‘‘The Ombudsman shall be re11 sponsible for the management, including the fis12 cal management, of the Office.’’; 

13 (B) in paragraph (3)— 

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

15 clause (i) and inserting the following: 

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

18 no decisionmaking capacity and who have 

19 no known legal representative, and if such 

20 a resident is unable to provide or refuses 

21 consent for an Ombudsman to work on a 

22 complaint directly involving the resident, 

23 the Ombudsman shall seek evidence to in24 dicate what outcome the resident would 

25 have desired and, in a case in which such 

26 evidence is reliable, shall assume that the 


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1 resident wishes to have the resident’s 

2 health, safety, welfare, and rights pro3 tected and shall work to accomplish the de4 sired outcome;’’; 

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

6 ‘‘regular and timely’’ and inserting ‘‘reg7 ular, timely, private, and unimpeded’’; 

8 (iii) by redesignating subparagraphs 

9 (F) through (I) as subparagraphs (G) 

10 through (J); 

11 (iv) by inserting after subparagraph 

12 (E) the following: 

13 ‘‘(F) collect and analyze data, relating to 

14 discrimination against LGBT older individuals 

15 on the basis of actual or perceived sexual ori16 entation or gender identity in the admission to, 

17 transfer or discharge from, or lack of adequate 

18 care provided in long term care settings, and 

19 shall include the analyses in the reports;’’; and 

20 (v) in subparagraph (I), as redesig21 nated by clause (iii) of this subpara22 graph— 

23 (I) in clauses (ii) and (iii), by 

24 striking ‘‘and’’ at the end; 


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

2 ‘‘provide technical support for’’ and 

3 inserting ‘‘actively encourage and as4 sist in’’; and 

5 (III) by adding at the end the 

6 following: 

7 ‘‘(iv) identify interventions or devices 

8 that affect the rights and safety of resi9 dents, including the use of chemical and 

10 physical restraints; and 

11 ‘‘(v) educate providers, residents, and 

12 families about the danger of those inter13 ventions and devices; and’’; 

14 (C) in paragraph (4)— 

15 (i) in the paragraph header, by strik16 ing ‘‘CONTRACTS AND ARRANGEMENTS’’ 

17 and inserting ‘‘ORGANIZATIONAL PLACE18 MENT’’; and 

19 (ii) by striking subparagraph (B) and 

20 inserting the following: 

21 ‘‘(B) IDENTIFYING, REMOVING, AND REM22 EDYING ORGANIZATIONAL CONFLICT.— 

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

24 may not operate the Office or carry out the 

25 program, directly, or by contract or other 


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1 arrangement with any public agency or 

2 nonprofit private organization, in a case in 

3 which there is an organizational conflict of 

4 interest unless such conflict has been— 

5 ‘‘(I) identified by the State agen6 cy; 

7 ‘‘(II) disclosed by the State agen8 cy to the Assistant Secretary in writ9 ing; and 

10 ‘‘(III) remedied in accordance 

11 with this subparagraph. 

12 ‘‘(ii) REPORTING BY ANY PERSON OR

13 ENTITY.—Any person or entity may iden14 tify any potential or actual organizational 

15 conflict of interest involving the Office and 

16 report the conflict to the Assistant Sec17 retary for review and action under clause 

18 (iii). 

19 ‘‘(iii) ACTION BY ADMINISTRATION.— 

20 In a case in which a potential or actual or21 ganizational conflict of interest involving 

22 the Office is disclosed or reported to the 

23 Assistant Secretary, the Assistant Sec24 retary shall require that the State agen25 cy— 


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1 ‘‘(I) remove the conflict; or 

2 ‘‘(II) submit, and obtain the ap3 proval of the Assistant Secretary for, 

4 an adequate remedial plan that indi5 cates how the Ombudsman will be 

6 unencumbered in fulfilling all of the 

7 functions specified in paragraph (3). 

8 ‘‘(C) ORGANIZATIONAL CONFLICT OF IN9 TEREST.—In this paragraph, the term ‘organi10 zational conflict of interest’ includes a situation 

11 in which the Office is placed in an organization 

12 that— 

13 ‘‘(i) is responsible for licensing or cer14 tifying long-term care services in the State; 

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

16 of such an association) of long-term care 

17 facilities, or of any other residential facili18 ties for older individuals; 

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

20 including programs carried out under a 

21 Medicaid waiver approved under section 

22 1115 of the Social Security Act (42 U.S.C. 

23 1315) or under subsection (c) or (b) of 

24 1915 of the Social Security Act (42 U.S.C. 

25 1396n), or under a Medicaid State plan 


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1 amendment under subsection (i) of section 

2 1915 of the Social Security Act (42 U.S.C. 

3 1396n(i)); 

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

5 management; 

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

7 services; 

8 ‘‘(vi) provides adult protective serv9 ices; 

10 ‘‘(vii) is responsible for eligibility de11 terminations for the Medicare program 

12 carried out under title XVIII, or the Med13 icaid program carried out under title XIX, 

14 of the Social Security Act (42 U.S.C. 1395 

15 et seq., 1396 et seq.); 

16 ‘‘(viii) conducts preadmission screen17 ing for placements in facilities described in 

18 clause (ii); or 

19 ‘‘(ix) makes decisions regarding ad20 mission of individuals to such facilities.’’; 

21 and 

22 (D) in paragraph (5)— 

23 (i) in subparagraph (A)— 

24 (I) by striking ‘‘In carrying’’ and 

25 inserting the following: 


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1 ‘‘(i) IN GENERAL.—In carrying’’; and 

2 (II) by adding at the end the fol3 lowing: 

4 ‘‘(ii) RELATIONSHIP WITH THE OF5 FICE.—The program shall be a unified 

6 program under the Office. Local Ombuds7 man entities and representatives shall re8 port to the Ombudsman on all functions, 

9 duties, and programmatic issues related to 

10 the program that are carried out or ad11 dressed by the entities or representatives. 

12 Case and other programmatic records 

13 maintained by representatives, employees, 

14 or volunteers of the local Ombudsman enti15 ty shall be considered to be the property of 

16 the Ombudsman.’’; and 

17 (ii) in subparagraph (B)(vi), by strik18 ing ‘‘support’’ and inserting ‘‘actively en19 courage and assist in’’; 

20 (2) in subsection (b)— 

21 (A) in paragraph (1)— 

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

23 ‘‘access’’ and inserting ‘‘private and 

24 unimpeded access’’; 


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1 (ii) in subparagraph (B)(i), by strik2 ing ‘‘the medical and social records of a’’ 

3 and inserting ‘‘all records concerning a’’; 

4 (iii) by redesignating subparagraphs 

5 (C) and (D) as subparagraphs (E) and 

6 (F), respectively; and 

7 (iv) by inserting after subparagraph 

8 (B) the following: 

9 ‘‘(C) such access as is necessary to advo10 cate for a resident’s desired outcome to the ex11 tent that the resident can express the outcome 

12 desired, even if the resident has limited deci13 sionmaking capacity; 

14 ‘‘(D) access to the records of a resident 

15 with limited decisionmaking capacity in a case 

16 in which— 

17 ‘‘(i) the access is necessary to inves18 tigate and resolve a complaint described in 

19 subsection (a)(3); 

20 ‘‘(ii) a legal guardian of the resident 

21 refuses to give permission for the access; 

22 ‘‘(iii) such a representative of the Of23 fice has reasonable cause to believe that 

24 the guardian is not acting in the best in25 terests of the resident by refusing; 


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1 ‘‘(iv) the resident has no other known 

2 legal representative; and 

3 ‘‘(v) the representative of the Office 

4 obtains the approval of the Ombudsman;’’; 

5 and 

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

7 ‘‘(3) HEALTH OVERSIGHT AGENCY.—For pur8 poses of section 264(c) of the Health Insurance 

9 Portability and Accountability Act of 1996 (includ10 ing regulations issued under that section) (42 U.S.C. 

11 1320d–2 note), the Ombudsman and a representa12 tive of the Office shall be considered a ‘health over13 sight agency,’ so that release of residents’ individ14 ually identifiable health information to the Ombuds15 man or representative is not precluded in cases in 

16 which the requirements of clause (i) or (ii) of para17 graph (1)(B) are otherwise met.’’; 

18 (3) in subsection (c)(2)(D), by striking ‘‘section 

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

20 (4) in subsection (d)— 

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

22 and inserting ‘‘information’’; and 

23 (B) in paragraph (2)— 


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1 (i) in the paragraph heading, by strik2 ing ‘‘IDENTITY OF COMPLAINANT OR RESI3 DENT’’ and inserting ‘‘PROCEDURES’’; 

4 (ii) in subparagraph (A)— 

5 (I) by striking ‘‘files and 

6 records’’ the first place it appears and 

7 inserting ‘‘information (including files 

8 or records)’’; 

9 (II) by striking ‘‘disclose’’ and all 

10 that follows and inserting ‘‘disclose 

11 such information);’’; and 

12 (III) by striking ‘‘and’’ at the 

13 end; 

14 (iii) in subparagraph (B)— 

15 (I) in the matter preceding clause 

16 (i), by striking ‘‘files or records’’ and 

17 inserting ‘‘information’’; 

18 (II) in clause (ii), by striking 

19 ‘‘or’’ at the end; 

20 (III) by redesignating clause (iii) 

21 as clause (iv); 

22 (IV) by inserting after clause (ii) 

23 the following: 

24 ‘‘(iii) in a case in which a resident has 

25 limited decisionmaking capacity— 


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1 ‘‘(I) disclosure of the identity of 

2 the resident is necessary to investigate 

3 and resolve a complaint described in 

4 subsection (a)(3); 

5 ‘‘(II) a legal guardian of the resi6 dent refuses to give permission for the 

7 disclosure; 

8 ‘‘(III) a representative of the Of9 fice has reasonable cause to believe 

10 that the guardian is not acting in the 

11 best interests of the resident by refus12 ing; 

13 ‘‘(IV) the resident has no other 

14 known legal representative; and 

15 ‘‘(V) the representative of the Of16 fice obtains the approval of the Om17 budsman; or’’; and 

18 (V) in clause (iv), as redesignated 

19 by subclause (III), by striking the pe20 riod and inserting ‘‘; and’’; and 

21 (iv) by adding at the end the fol22 lowing: 

23 ‘‘(C) require that the Ombudsman and 

24 representatives of the Office hold all commu25 nications with a complainant or resident who is 


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•S 3562 IS

1 seeking assistance in strict confidence and take 

2 all reasonable steps to safeguard the confiden3 tiality of information provided by the complain4 ant or resident.’’; 

5 (5) in subsection (f)(3)— 

6 (A) in subparagraph (C), by striking ‘‘fa7 cility; and’’ and inserting ‘‘facility or a related 

8 organization, and has not been employed by 

9 such a facility or organization within 2 years 

10 before the date of the determination involved;’’; 

11 (B) in subparagraph (D), by striking 

12 ‘‘and’’ at the end; and 

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

14 ‘‘(E) does not have management responsi15 bility for, nor operate under the supervision of, 

16 an agency with responsibility for adult protec17 tive services; and 

18 ‘‘(F) does not serve as a guardian or in 

19 another fiduciary capacity for residents of long20 term care facilities in an official capacity (as 

21 opposed to serving as a guardian or fiduciary, 

22 for a family member, in a personal capacity); 

23 and’’; 

24 (6) in subsection (h)— 


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

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

4 ‘‘(4) strengthen and update’’; 

5 (B) by redesignating paragraphs (4) 

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

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

9 following: 

10 ‘‘(4) ensure that the Ombudsman attends train11 ing provided by the Administration through the Na12 tional Ombudsman Resource Center established in 

13 section 202(a)(18);’’; 

14 (D) in paragraph (7)(A), as redesignated 

15 by subparagraph (B) of this paragraph, by 

16 striking ‘‘subtitle C of the’’ and inserting ‘‘sub17 title C of title I of the’’; and 

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

19 subparagraph (B) of this paragraph, by striking 

20 ‘‘(6), or (7)’’ and inserting ‘‘(7), or (8)’’; and 

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

22 ‘‘(k) ENSURING EFFECTIVE PROGRAMS AND RESI23 DENTS’ RIGHTS.—The State agency shall ensure the Of24 fice— 


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1 ‘‘(1) provides facility residents with private and 

2 unimpeded access to the Office, including access to 

3 all records concerning the resident; and 

4 ‘‘(2) allows all facility residents to receive serv5 ices from the Office.’’. 

6 SEC. 708. PREVENTION OF ELDER ABUSE, NEGLECT, AND 

7 EXPLOITATION. 

8 Section 721 of the Older Americans Act of 1965 (42 

9 U.S.C. 3058i(b)) is amended— 

10 (1) in subsection (b)— 

11 (A) in paragraph (2), by striking the semi12 colon and inserting the following: ‘‘, including 

13 education and outreach to professionals includ14 ing postal carriers, employees of financial insti15 tutions, firefighters, meter readers, and other 

16 community professionals who are in a position 

17 to observe an older individual on a daily or reg18 ular basis;’’; 

19 (B) in paragraph (4), by inserting before 

20 the semicolon the following: ‘‘and submit data 

21 on the prevalence of elder abuse, neglect, and 

22 exploitation for the appropriate database of the 

23 Administration or another database specified by 

24 the Assistant Secretary’’; 


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1 (C) by redesignating paragraphs (7), (8), 

2 (9), (10), (11), and (12), as paragraphs (8), 

3 (10), (11), (12), (13), and (14), respectively; 

4 (D) by striking paragraph (6) and insert5 ing the following: 

6 ‘‘(6) conducting specialized abuse sensitivity 

7 training for caregivers described in part E of title 

8 III; 

9 ‘‘(7) conducting training for professionals and 

10 paraprofessionals, including trainers, in relevant 

11 fields on the identification, prevention, and treat12 ment of elder abuse, neglect, and exploitation, with 

13 particular focus on prevention and enhancement of 

14 self-determination and autonomy;’’; 

15 (E) in paragraph (8), as redesignated by 

16 subparagraph (C) of this paragraph, by insert17 ing before the semicolon the following: ‘‘, in18 cluding providing intake workers or hotlines 

19 that are able to take information or calls di20 rectly from older individuals, their family mem21 bers, and community professionals in the plan22 ning and service areas of the older individuals, 

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


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1 (F) by inserting after paragraph (8), as re2 designated by subparagraph (C) of this para3 graph, the following: 

4 ‘‘(9) conducting appropriate training to ensure 

5 cultural sensitivity in the provision of elder rights 

6 services, including training in cultural issues associ7 ated with abuse;’’; 

8 (G) in subparagraph (C) of paragraph 

9 (11), as redesignated by subparagraph (C) of 

10 this paragraph— 

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

12 as forensic accountants,’’ after ‘‘such per13 sonnel’’; and 

14 (ii) in clause (v), by striking the 

15 comma at the end and inserting ‘‘, includ16 ing programs and arrangements that will 

17 safeguard victims’ or potential victims’ fi18 nances, such as daily money management 

19 programs and conservatorships,’’; 

20 (H) in paragraph (13), as redesignated by 

21 subparagraph (C) of this paragraph— 

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

23 ‘‘and’’ at the end; and 

24 (ii) by adding at the end the fol25 lowing: 


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1 ‘‘(F) supporting and studying innovative 

2 practices in local communities, to develop part3 nerships across disciplines for the prevention, 

4 investigation, and prosecution of exploitation;’’; 

5 (I) in paragraph (14), as redesignated by 

6 subparagraph (C) of this paragraph— 

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

8 ‘‘or’’ at the end; 

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

10 the period at the end and inserting ‘‘; or’’; 

11 and 

12 (iii) by adding at the end the fol13 lowing: 

14 ‘‘(D) older individuals who are Holocaust 

15 survivors; and’’; and 

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

17 ‘‘(15) developing a State Home Care Consumer 

18 Bill of Rights and Plan for Enforcement (as de19 scribed in section 705) to protect home care con20 sumers (as defined in section 736) from abuse, ne21 glect, and exploitation.’’. 

22 SEC. 709. STATE LEGAL ASSISTANCE DEVELOPMENT. 

23 Section 731 of the Older Americans Act of 1965 (42 

24 U.S.C. 3058j) is amended by striking ‘‘A State agency’’ 


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1 and all that follows through ‘‘to ensure—’’ and inserting 

2 the following: 

3 ‘‘(a) STATE LEGAL SERVICES DEVELOPER.—A State 

4 agency shall provide the services of an individual who shall 

5 be known as a State legal services developer, who shall 

6 promote, and may facilitate, the development and oper7 ation of an integrated legal assistance delivery system for 

8 the State. To the maximum extent practicable, the indi9 vidual selected to serve as the developer shall— 

10 ‘‘(1) agree to serve as the developer on a full11 time basis; 

12 ‘‘(2) have a law degree from an accredited law 

13 school or have been admitted to practice law in any 

14 jurisdiction in the United States; and 

15 ‘‘(3) possess other knowledge, skills, training, 

16 and education that reflect a comprehensive under17 standing of legal services for older individuals. 

18 ‘‘(b) OTHER PERSONNEL.—In addition to the State 

19 legal services developer, the State agency shall provide the 

20 services of other personnel, sufficient to ensure—’’. 

21 SEC. 710. STATE HOME CARE OMBUDSMAN PROGRAMS. 

22 Subtitle A of title VII of the Older Americans Act 

23 of 1965 (42 U.S.C. 3058 et seq.) is amended by adding 

24 at the end the following: 


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1 ‘‘CHAPTER 5—STATE HOME CARE 

2 OMBUDSMAN PROGRAMS 

3 ‘‘SEC. 736. DEFINITIONS. 

4 ‘‘In this chapter: 

5 ‘‘(1) HOME CARE CONSUMER.—The term ‘home 

6 care consumer’ means a person who receives services 

7 in the person’s home or community to promote inde8 pendence and reduce the necessity for residence in 

9 a long-term care facility, which may include— 

10 ‘‘(A) home care services provided through 

11 this Act, the Medicare program under title 

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

13 1395 et seq.), the Medicaid program under title 

14 XIX of the Social Security Act (42 U.S.C. 1396 

15 et seq.), or another public or private funding 

16 source; or 

17 ‘‘(B) home care services determined to be 

18 appropriate by a State operating a State Home 

19 Care Ombudsman Program. 

20 ‘‘(2) HOME CARE OMBUDSMAN PROGRAM.—The 

21 term ‘home care ombudsman program’ means a 

22 State Home Care Ombudsman Program described in 

23 section 737(a)(1). 

24 ‘‘(3) HOME CARE OMBUDSMAN REPRESENTA25 TIVE.—The term ‘home care ombudsman representVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00177 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ative’ includes an employee or volunteer who rep2 resents an entity designated under section 

3 737(a)(5)(A) and who is individually designated by 

4 the Ombudsman. 

5 ‘‘(4) HOME CARE SERVICES.—The term ‘home 

6 care services’ means home and community-based 

7 services to promote independence and reduce the ne8 cessity for residence in a long-term care facility, in9 cluding personal care services designed to assist an 

10 individual in the activities of daily living such as 

11 bathing, exercising, personal grooming, and getting 

12 in and out of bed. 

13 ‘‘(5) LOCAL HOME CARE OMBUDSMAN ENTI14 TY.—The term ‘local home care Ombudsman entity’ 

15 means an entity designated under section 

16 737(a)(5)(A) to carry out the duties described in 

17 section 737(a)(5)(B) with respect to a planning and 

18 service area or other substate area. 

19 ‘‘(6) OFFICE; OMBUDSMAN.—The terms ‘Office’ 

20 and ‘Ombudsman’, used without further modifica21 tion, have the meanings given the terms in section 

22 711. 

23 ‘‘SEC. 737. PROGRAM. 

24 ‘‘(a) ESTABLISHMENT.— 


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1 ‘‘(1) IN GENERAL.—In order to be eligible to 

2 receive a grant under section 703(d) from funds ap3 propriated under section 702A and made available to 

4 carry out this chapter, a State agency shall, in ac5 cordance with this section, agree to carry out a 

6 State Home Care Ombudsman Program within the 

7 Office of the State Long-Term Care Ombudsman. 

8 ‘‘(2) HOME CARE OMBUDSMAN PROGRAM.—The 

9 home care ombudsman program shall be carried out 

10 by the Ombudsman. 

11 ‘‘(3) FUNCTIONS.—In carrying out the home 

12 care ombudsman program, the Ombudsman, person13 ally or through representatives of the home care om14 budsman program— 

15 ‘‘(A) shall identify, investigate, and resolve 

16 complaints that— 

17 ‘‘(i) are made by, or on behalf of, 

18 home care consumers; 

19 ‘‘(ii) relate to action, inaction, or deci20 sions, that may adversely affect the health, 

21 safety, welfare, or rights of home care con22 sumers (including the welfare and rights of 

23 home care consumers with respect to the 

24 appointment and activities of guardians 

25 and representative payees), of— 


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1 ‘‘(I) entities responsible for de2 termining eligibility for home care 

3 services, such as State and local gov4 ernments; and 

5 ‘‘(II) entities responsible for de6 termining availability of home care 

7 services, such as managed care orga8 nizations; or 

9 ‘‘(iii) relate to action, inaction, or de10 cisions, regarding informing home care 

11 consumers about their eligibility for, or the 

12 availability of, home care services, of— 

13 ‘‘(I) providers, or representatives 

14 of providers, of home care services; 

15 ‘‘(II) public agencies; 

16 ‘‘(III) health and social service 

17 agencies; and 

18 ‘‘(IV) entities providing con19 sumer-directed services under a con20 sumer-directed program; 

21 ‘‘(B) shall provide services to protect the 

22 health, safety, welfare, and rights of home care 

23 consumers; 

24 ‘‘(C) shall inform home care consumers 

25 about means of obtaining services provided by 


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1 providers or agencies described in subparagraph 

2 (A)(ii) or services described in subparagraph 

3 (B); 

4 ‘‘(D) shall, in conjunction with other enti5 ties, such as area agencies on aging, conduct 

6 public education about the home care ombuds7 man program and its services, including the 

8 rights of home care workers to report concerns 

9 to the Ombudsman in order to protect the 

10 health, safety, welfare, and rights of home care 

11 consumers; 

12 ‘‘(E) shall ensure that home care con13 sumers and complainants receive timely re14 sponses from representatives of the home care 

15 ombudsman program to complaints; 

16 ‘‘(F) shall represent the interests of home 

17 care consumers before governmental agencies 

18 and seek administrative, legal, and other rem19 edies to protect the health, safety, welfare, and 

20 rights of the home care consumers, including 

21 issues related to the sufficiency of the home 

22 care workforce and its availability to meet the 

23 needs of home care consumers; 

24 ‘‘(G) shall provide administrative and tech25 nical assistance to entities designated under 


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1 paragraph (5) to assist the entities in partici2 pating in the home care ombudsman program; 

3 ‘‘(H) shall provide for training representa4 tives of the home care ombudsman program; 

5 ‘‘(I) shall— 

6 ‘‘(i) promote the development of cit7 izen organizations, to participate in the 

8 home care ombudsman program; 

9 ‘‘(ii) analyze, comment on, and mon10 itor the development and implementation 

11 of Federal, State, and local laws, regula12 tions, and other governmental policies and 

13 actions, that pertain to the health, safety, 

14 welfare, and rights of home care con15 sumers, with respect to the adequacy of 

16 home care services in the State, including 

17 issues related to the sufficiency of the 

18 home care workforce and its availability to 

19 meet the needs of home care consumers; 

20 ‘‘(iii) recommend any changes in such 

21 laws, regulations, policies, and actions as 

22 the Ombudsman determines to be appro23 priate; and 

24 ‘‘(iv) facilitate public comment on the 

25 laws, regulations, policies, and actions; and 


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1 ‘‘(J) shall carry out other activities as the 

2 Assistant Secretary determines to be appro3 priate. 

4 ‘‘(4) CONTRACTS AND ARRANGEMENTS.— 

5 ‘‘(A) IN GENERAL.— 

6 ‘‘(i) AGENCIES AND ORGANIZA7 TIONS.—Except as provided in subpara8 graph (B), the State agency shall carry out 

9 the home care ombudsman program, di10 rectly, or by contract or other arrangement 

11 with any public agency or nonprofit private 

12 organization. 

13 ‘‘(ii) AREA AGENCIES ON AGING.—The 

14 State agency shall determine whether to 

15 enter into contracts or arrangements with 

16 area agencies on aging to carry out the 

17 home care ombudsman program, based on 

18 the structure of the State’s existing (as of 

19 the date of the determination) long-term 

20 care ombudsman program and the poten21 tial for conflicts of interest in the home 

22 and community-based services system in 

23 the State. A State agency may carry out a 

24 home care ombudsman program through 


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1 area agencies on aging in the State, if the 

2 area agencies on aging— 

3 ‘‘(I) have existing (as of the date 

4 of the determination) consumer pro5 tection systems in place to prevent 

6 such conflicts of interest; or 

7 ‘‘(II) establish adequate proce8 dures to prevent conflicts of interest 

9 under the program. 

10 ‘‘(B) LICENSING AND CERTIFICATION OR11 GANIZATIONS; ASSOCIATIONS.—The State agen12 cy may not enter into the contract or other ar13 rangement described in subparagraph (A) 

14 with— 

15 ‘‘(i) an agency or organization that is 

16 responsible for licensing or certifying home 

17 care services in the State; or 

18 ‘‘(ii) an association (or an affiliate of 

19 such an association) of providers of home 

20 care services. 

21 ‘‘(5) DESIGNATION OF LOCAL HOME CARE OM22 BUDSMAN ENTITIES AND HOME CARE OMBUDSMAN

23 REPRESENTATIVES.— 

24 ‘‘(A) DESIGNATION.—In carrying out the 

25 duties of the Office, the Ombudsman may desVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00184 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 ignate an entity as a local home care Ombuds2 man entity (and, in doing so, the Ombudsman 

3 shall, if a local Ombudsman entity has already 

4 been designated, designate such local Ombuds5 man entity as the local home care Ombudsman 

6 entity), and may designate an employee or vol7 unteer to represent the entity. 

8 ‘‘(B) DUTIES.—An individual so des9 ignated, in accordance with the policies and 

10 procedures established by the Ombudsman and 

11 the State agency— 

12 ‘‘(i) shall provide services to protect 

13 the health, safety, welfare, and rights of 

14 home care consumers; 

15 ‘‘(ii) shall ensure that home care con16 sumers in the service area of the entity 

17 have timely responses to complaints and 

18 requests for assistance; 

19 ‘‘(iii) shall identify, investigate, and 

20 resolve complaints made by or on behalf of 

21 home care consumers that relate to action, 

22 inaction, or decisions, that may adversely 

23 affect the health, safety, welfare, or rights 

24 of home care consumers; 


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1 ‘‘(iv) shall represent the interests of 

2 home care consumers before government 

3 agencies and seek administrative, legal, 

4 and other remedies to protect the health, 

5 safety, welfare, and rights of home care 

6 consumers; 

7 ‘‘(v) shall— 

8 ‘‘(I) review, and if necessary, 

9 comment on any existing and pro10 posed laws, regulations, and other 

11 government policies and actions, that 

12 pertain to the rights and well-being of 

13 home care consumers; and 

14 ‘‘(II) facilitate the ability of the 

15 public to comment on the laws, regu16 lations, policies, and actions; 

17 ‘‘(vi) shall make referrals for services 

18 to protect and provide for the health, safe19 ty, educational needs, welfare, and rights 

20 of family or household members (including 

21 children) of home care consumers; and 

22 ‘‘(vii) shall carry out other activities 

23 that the Ombudsman determines to be ap24 propriate. 


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1 ‘‘(C) ELIGIBILITY FOR DESIGNATION.— 

2 Entities eligible to be designated as local home 

3 care Ombudsman entities, and individuals eligi4 ble to be designated as home care ombudsman 

5 representatives of such entities, shall— 

6 ‘‘(i) have demonstrated capability to 

7 carry out the duties established in section 

8 712(a)(5)(B); 

9 ‘‘(ii) be free of conflicts of interest 

10 and not stand to gain financially through 

11 an action or potential action brought on 

12 behalf of individuals the Ombudsman 

13 serves; and 

14 ‘‘(iii) meet such additional require15 ments as the Ombudsman may specify. 

16 ‘‘(D) POLICIES AND PROCEDURES.— 

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

18 shall establish, in accordance with the Om19 budsman, policies and procedures for moni20 toring local home care Ombudsman entities 

21 designated to carry out the duties estab22 lished in section 712(a)(5)(B). 

23 ‘‘(ii) POLICIES.—In a case in which 

24 the entities are grantees or the home care 

25 ombudsman representatives are employees, 


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1 of area agencies on aging, the State agency 

2 shall develop the policies in consultation 

3 with the area agencies on aging. The poli4 cies shall provide for participation and 

5 comment by the agencies and for resolu6 tion of concerns with respect to case activ7 ity. 

8 ‘‘(iii) CONFIDENTIALITY AND DISCLO9 SURE.—The State agency shall develop the 

10 policies and procedures in accordance with 

11 all provisions of this subtitle regarding 

12 confidentiality and conflict of interest for 

13 providers of home care services. 

14 ‘‘(b) PROCEDURES FOR ACCESS.— 

15 ‘‘(1) IN GENERAL.—The State shall ensure that 

16 representatives of the home care ombudsman pro17 gram shall have— 

18 ‘‘(A) access to home care consumers and 

19 their homes with permission of the home care 

20 consumer involved or a legal representative; 

21 ‘‘(B)(i) appropriate access to review all 

22 records of a home care consumer, if— 

23 ‘‘(I) the representative of the home 

24 care ombudsman program has the permis25 sion of the home care consumer, or the 


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1 legal representative of the home care con2 sumer; or 

3 ‘‘(II) the home care consumer is un4 able to consent to the review and has no 

5 legal representative; or 

6 ‘‘(ii) such access to the records as is nec7 essary to investigate a complaint if— 

8 ‘‘(I) a legal guardian of the home care 

9 consumer refuses to give the permission; 

10 ‘‘(II) a representative of the home 

11 care ombudsman program has reasonable 

12 cause to believe that the guardian is not 

13 acting in the best interests of the home 

14 care consumer; and 

15 ‘‘(III) the representative obtains the 

16 approval of the Ombudsman; 

17 ‘‘(C) access to the administrative records, 

18 policies, and documents, to which home care 

19 consumers have, or the general public has ac20 cess, of the provider of home care services; and 

21 ‘‘(D) access to and, on request, copies of 

22 all licensing and certification records main23 tained by the State with respect to the provider 

24 of home care services. 


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1 ‘‘(2) PROCEDURES.—The State agency shall es2 tablish procedures to ensure the access described in 

3 paragraph (1). 

4 ‘‘(c) REPORTING SYSTEM.—The State agency shall 

5 ensure that the reporting system established in section 

6 712(c) is equipped to— 

7 ‘‘(1) collect and analyze data relating to com8 plaints and conditions concerning home care services 

9 and to home care consumers for the purpose of iden10 tifying and resolving significant problems, including 

11 complaints concerning— 

12 ‘‘(A) quality of services; 

13 ‘‘(B) quantity of services; 

14 ‘‘(C) availability of services; and 

15 ‘‘(D) denial, reduction, and termination of 

16 services; and 

17 ‘‘(2) submit the data, on a regular basis, to— 

18 ‘‘(A) the agency of the State responsible 

19 for licensing or certifying providers of home 

20 care services in the State; 

21 ‘‘(B) other State and Federal entities that 

22 the Ombudsman determines to be appropriate; 

23 ‘‘(C) the Assistant Secretary; and 

24 ‘‘(D) the National Ombudsman Resource 

25 Center established in section 202(a)(18)(A). 


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1 ‘‘(d) DISCLOSURE.— 

2 ‘‘(1) IN GENERAL.—The State agency shall es3 tablish procedures for the disclosure by the Ombuds4 man or local home care Ombudsman entities of in5 formation maintained by the home care ombudsman 

6 program, including records described in subsection 

7 (b)(1) or (c). 

8 ‘‘(2) IDENTITY OF COMPLAINANT OR HOME

9 CARE CONSUMER.—The procedures described in 

10 paragraph (1) shall— 

11 ‘‘(A) provide that, subject to subparagraph 

12 (B), the information (including files or records) 

13 described in paragraph (1) may be disclosed 

14 only at the discretion of the Ombudsman (or 

15 the person designated by the Ombudsman to 

16 disclose such information); and 

17 ‘‘(B) prohibit the disclosure of the identity 

18 of any complainant or home care consumer with 

19 respect to whom the Office maintains such in20 formation unless— 

21 ‘‘(i) the complainant or home care 

22 consumer, or the legal representative of the 

23 complainant or home care consumer, con24 sents to the disclosure and the consent is 

25 given in writing; 


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1 ‘‘(ii)(I) the complainant or home care 

2 consumer gives consent orally; and 

3 ‘‘(II) the consent is documented con4 temporaneously in a writing made by a 

5 representative of the home care ombuds6 man program in accordance with such re7 quirements as the State agency shall estab8 lish; or 

9 ‘‘(iii) the disclosure is required by 

10 court order. 

11 ‘‘(e) CONSULTATION.—In planning and carrying out 

12 the home care ombudsman program, the State agency 

13 shall consider the views of area agencies on aging, older 

14 individuals, and providers of home care services and dem15 onstrate how the State agency has taken their views into 

16 consideration. 

17 ‘‘(f) CONFLICT OF INTEREST.—The State agency 

18 shall— 

19 ‘‘(1) ensure that no individual, or member of 

20 the immediate family of an individual, involved in 

21 the designation of the Ombudsman (whether by ap22 pointment or otherwise) or the designation of an en23 tity designated under subsection (a)(5), is subject to 

24 a conflict of interest; 


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1 ‘‘(2) ensure that no officer or employee of the 

2 Office, home care ombudsman representative of a 

3 local home care Ombudsman entity, or member of 

4 the immediate family of the officer, employee, or 

5 home care ombudsman representative, is subject to 

6 a conflict of interest; 

7 ‘‘(3) ensure that the Ombudsman— 

8 ‘‘(A) does not have a direct involvement in 

9 the licensing or certification of a provider of 

10 home care services; 

11 ‘‘(B) does not have an ownership or invest12 ment interest (represented by equity, debt, con13 tract, or other financial relationship) in a pro14 vider of home care services; 

15 ‘‘(C) is not employed by, or participating 

16 in the management of, a provider of home care 

17 services; and 

18 ‘‘(D) does not receive, or have the right to 

19 receive, directly or indirectly, remuneration (in 

20 cash or in-kind) under a compensation arrange21 ment with an owner or operator of a provider 

22 of home care services; and 

23 ‘‘(4) establish, and specify in writing, mecha24 nisms to identify and remove conflicts of interest re25 ferred to in paragraphs (1) and (2), and to identify 


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1 and eliminate the relationships described in subpara2 graphs (A) through (D) of paragraph (3), including 

3 such mechanisms as— 

4 ‘‘(A) the methods by which the State agen5 cy will examine individuals, and immediate fam6 ily members, to identify the conflicts; and 

7 ‘‘(B) the actions that the State agency will 

8 require the individuals and such family mem9 bers to take to remove such conflicts. 

10 ‘‘(g) LEGAL COUNSEL.—The State agency shall en11 sure that— 

12 ‘‘(1)(A) adequate legal counsel is available, and 

13 is able, without conflict of interest, to— 

14 ‘‘(i) provide advice and consultation needed 

15 to protect the health, safety, welfare, and rights 

16 of home care consumers; and 

17 ‘‘(ii) assist the Ombudsman and represent18 atives of the home care ombudsman program in 

19 the performance of the official duties of the 

20 Ombudsman and representatives; and 

21 ‘‘(B) legal representation is provided to any 

22 representative of the home care ombudsman pro23 gram against whom suit or other legal action is 

24 brought or threatened to be brought in connection 


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1 with the performance of the official duties of the 

2 Ombudsman or such a representative; and 

3 ‘‘(2) the Ombudsman pursues administrative, 

4 legal, and other appropriate remedies on behalf of 

5 home care consumers. 

6 ‘‘(h) ADMINISTRATION.— 

7 ‘‘(1) REQUIREMENTS.—The State agency shall 

8 require the Office to— 

9 ‘‘(A) include in its annual report required 

10 in section 712(h)(1)— 

11 ‘‘(i) a description of the activities car12 ried out by the Office as they related to 

13 the home care ombudsman program in the 

14 year for which the report is prepared; 

15 ‘‘(ii) the data and an analysis of the 

16 data collected under subsection (c); 

17 ‘‘(iii) an evaluation of the problems 

18 experienced by, and the complaints made 

19 by or on behalf of, home care consumers; 

20 ‘‘(iv) recommendations for— 

21 ‘‘(I) improving quality of the care 

22 and life of the home care consumers; 

23 and 


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1 ‘‘(II) protecting the health, safe2 ty, welfare, and rights of the home 

3 care consumers; 

4 ‘‘(v)(I) an analysis of the success of 

5 the home care ombudsman program includ6 ing success in providing services to home 

7 care consumers in communities with high 

8 percentages of racial or ethnic minorities; 

9 and 

10 ‘‘(II) identification of barriers that 

11 prevent the optimal operation of the home 

12 care ombudsman program; and 

13 ‘‘(vi) policy, regulatory, and legislative 

14 recommendations to solve identified prob15 lems, to resolve the complaints, to improve 

16 the quality of care and life of home care 

17 consumers, to protect the health, safety, 

18 welfare, and rights of home care con19 sumers, and to remove the barriers; 

20 ‘‘(B) not later than 2 years after the date 

21 of the enactment of this chapter, establish pro22 cedures for the training of the representatives 

23 of the home care ombudsman program, includ24 ing unpaid volunteers, based on best practices 

25 outlined by the Assistant Secretary in the most 


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1 recent report submitted under subsection 

2 (m)(1), in consultation with representatives of 

3 citizen groups, providers of home care services, 

4 and the home care ombudsman program, that— 

5 ‘‘(i) specify a minimum number of 

6 hours of initial training; 

7 ‘‘(ii) specify the content of the train8 ing, including training relating to— 

9 ‘‘(I) Federal, State, and local 

10 laws, regulations, and policies, with 

11 respect to providers of home care 

12 services in the State; 

13 ‘‘(II) investigative techniques; 

14 and 

15 ‘‘(III) such other matters as the 

16 State determines to be appropriate; 

17 and 

18 ‘‘(iii) specify an annual number of 

19 hours of in-service training for all des20 ignated representatives; 

21 ‘‘(C) prohibit any representative of the 

22 home care ombudsman program (other than the 

23 Ombudsman) from carrying out any activity de24 scribed in subparagraphs (A) through (H) of 

25 subsection (a)(3) unless the representative— 


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1 ‘‘(i) has received the training required 

2 under subparagraph (B); and 

3 ‘‘(ii) has been approved by the Om4 budsman as qualified to carry out the ac5 tivity on behalf of the Office; 

6 ‘‘(D) coordinate home care ombudsman 

7 services with the protection and advocacy sys8 tems for individuals with developmental disabil9 ities and mental illnesses established under— 

10 ‘‘(i) subtitle C of the Developmental 

11 Disabilities Assistance and Bill of Rights 

12 Act of 2000 (42 U.S.C. 15041 et seq.); 

13 and 

14 ‘‘(ii) the Protection and Advocacy for 

15 Individuals with Mental Illness Act (42 

16 U.S.C. 10801 et seq.); 

17 ‘‘(E) coordinate, to the greatest extent pos18 sible, home care ombudsman services with legal 

19 assistance provided under section 306(a)(2)(C), 

20 through adoption of memoranda of under21 standing and other means; 

22 ‘‘(F) coordinate services with State and 

23 local law enforcement agencies and courts of 

24 competent jurisdiction; and 


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1 ‘‘(G) permit any local home care Ombuds2 man entity to carry out the responsibilities de3 scribed in subparagraph (A), (D), or (E). 

4 ‘‘(2) AUTHORITIES.—The State agency shall re5 quire the Office to— 

6 ‘‘(A) analyze, comment on, and monitor 

7 the development and implementation of Fed8 eral, State, and local laws, regulations, and 

9 other government policies and actions that per10 tain to providers of home care services and 

11 those services, and to the health, safety, wel12 fare, and rights of home care consumers, in the 

13 State, and recommend any changes in such 

14 laws, regulations, and policies as the Ombuds15 man determines to be appropriate; 

16 ‘‘(B)(i) provide such information as the 

17 Ombudsman determines to be necessary to pub18 lic and private agencies, legislators, and other 

19 persons, regarding— 

20 ‘‘(I) the problems and concerns of 

21 older individuals receiving home care serv22 ices; and 

23 ‘‘(II) recommendations related to the 

24 problems and concerns; and 


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1 ‘‘(ii) make available to the public, and sub2 mit to the Assistant Secretary, the chief execu3 tive officer of the State, the State legislature, 

4 the State agency responsible for licensing or 

5 certifying providers of home care services, and 

6 other appropriate governmental entities, each 

7 report prepared under paragraph (1)(A); and 

8 ‘‘(C) permit any local home care Ombuds9 man entity to carry out the responsibilities de10 scribed in subparagraph (A) or (B). 

11 ‘‘(i) LIABILITY.—The State shall ensure that no rep12 resentative of the home care ombudsman program will be 

13 liable under State law for the good faith performance of 

14 official duties. 

15 ‘‘(j) NONINTERFERENCE.—The State shall— 

16 ‘‘(1) ensure that willful interference with rep17 resentatives of the home care ombudsman program 

18 in the performance of the official duties of the rep19 resentatives (as defined by the Assistant Secretary) 

20 shall be unlawful; 

21 ‘‘(2) prohibit retaliation and reprisals by a pro22 vider of home care services or other entity with re23 spect to any recipient of home and community-based 

24 services, employee, exclusive representative of an em25 ployee, or other person for filing a complaint with, 


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1 providing information to, or otherwise cooperating 

2 with any representative of, the home care ombuds3 man program; and 

4 ‘‘(3) provide for appropriate sanctions with re5 spect to the interference, retaliation, and reprisals. 

6 ‘‘(k) COORDINATION WITH ADULT PROTECTIVE

7 SERVICES.— 

8 ‘‘(1) IN GENERAL.—The Ombudsman, in car9 rying out the State Home Care Ombudsman Pro10 gram, shall coordinate activities with the National 

11 Adult Protective Services Resource Center and the 

12 head of the State’s adult protective services program 

13 in a manner that is consistent with the State’s exist14 ing (as of the date of the coordination) protocols for 

15 coordination of activities between the Ombudsman, 

16 in carrying out the State Long-Term Care Ombuds17 man Program. 

18 ‘‘(2) ESTABLISHMENT OF PROTOCOLS.—If the 

19 protocols described in paragraph (1) do not exist in 

20 the State, the Ombudsman, in conjunction with the 

21 head of the State’s adult protective services pro22 gram, shall establish protocols to coordinate activi23 ties with the intent of better serving vulnerable 

24 adults, which protocols shall— 

25 ‘‘(A) clarify the roles of each program; 


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1 ‘‘(B) establish procedures for maintaining 

2 a working relationship; 

3 ‘‘(C) outline mutual expectations; and 

4 ‘‘(D) establish procedures for coordinating 

5 activities with law enforcement. 

6 ‘‘(l) MAINTENANCE OF EFFORT.—A State, in using 

7 the funds made available for a fiscal year through a grant 

8 received under section 703(d), shall maintain the expendi9 tures of the State for home care ombudsman services at 

10 a level that is not less than the level of such expenditures 

11 maintained by the State for the preceding fiscal year. 

12 ‘‘(m) EVALUATION.—The Assistant Secretary shall— 

13 ‘‘(1) in conjunction with the Director of the Of14 fice of Long-Term Care Ombudsman Programs and 

15 the heads of other entities determined to be nec16 essary by the Assistant Secretary, collect and ana17 lyze the data required to be submitted under sub18 section (c) by the States and within 1 year after re19 ceipt of the data, submit a report to Congress out20 lining best practices for carrying out a home care 

21 ombudsman program; and 

22 ‘‘(2) make the report available to States.’’. 


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1 SEC. 711. ESTABLISHMENT OF SENIOR MEDICARE PATROL 

2 PROGRAM AS PERMANENT PROGRAM. 

3 Title VII of the Older Americans Act of 1965 is 

4 amended— 

5 (1) by redesignating subtitle C as subtitle D; 

6 (2) by redesignating sections 761 through 765 

7 as sections 771 through 775, respectively; and 

8 (3) by adding after subtitle B the following: 

9 ‘‘Subtitle C—Senior Medicare 

10 Patrol Program 

11 ‘‘SEC. 761. FINDINGS. 

12 ‘‘Congress finds the following: 

13 ‘‘(1) At least 3 percent of all health care spend14 ing is lost to fraud each year. 

15 ‘‘(2) The Medicare Fraud Strike Forces have 

16 charged with fraud over 1,000 individuals, who col17 lectively have falsely billed the Centers for Medicare 

18 & Medicaid Services for over $2,300,000,000 in 

19 Medicare benefits. 

20 ‘‘(3) Approximately $1.55 is saved for every 1 

21 dollar the government spends on fraud prevention in 

22 the Medicare program and Medicaid program. 

23 ‘‘(4) Due to the SMP program, between the in24 ception of the SMP program in 1996, and 2010— 


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1 ‘‘(A) 25,300,000 Medicare and Medicaid 

2 beneficiaries have been reached through com3 munity education programs; 

4 ‘‘(B) a total of 72 SMP projects have edu5 cated Medicare and Medicaid beneficiaries in 

6 82,968 group sessions and 1,112,887 individual 

7 sessions; 

8 ‘‘(C) 1,321,222 media airings have oc9 curred and 75,062 community outreach edu10 cation events have been conducted; 

11 ‘‘(D) savings to and costs avoided by Medi12 care, Medicaid, and other programs, and bene13 ficiaries, total over $114,000,000; and 

14 ‘‘(E) over 24,000 volunteers have been ac15 tive in educating Medicare and Medicaid bene16 ficiaries. 

17 ‘‘(5) Many Medicare and Medicaid beneficiaries 

18 who receive help from the SMP program to avoid 

19 fraud cannot be tracked by the Office of the Inspec20 tor General of the Department of Health and 

21 Human Services, so the figures described in para22 graphs (1) through (4) are most likely much higher. 

23 ‘‘SEC. 762. DEFINITIONS. 

24 ‘‘In this subtitle: 


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1 ‘‘(1) BENEFICIARY.—Except as provided in sec2 tion 761, the term ‘beneficiary’ means an individual 

3 entitled to, or enrolled for, benefits under part A of 

4 the Medicare program or enrolled for benefits under 

5 part B of the Medicare program, including such an 

6 individual who is also eligible for medical assistance 

7 under the Medicaid program. 

8 ‘‘(2) FRAUD.—The term ‘fraud’ means fraud, 

9 waste, and abuse within the meaning of section 

10 1128J of the Social Security Act (42 U.S.C. 1320a– 

11 7k). 

12 ‘‘(3) MEDICARE PROGRAM; MEDICAID PRO13 GRAM.—The terms ‘Medicare program’ and ‘Med14 icaid program’ mean the programs carried out under 

15 titles XVIII and XIX, respectively, of the Social Se16 curity Act (42 U.S.C. 1395 et seq., 1396 et seq.). 

17 ‘‘(4) SMP.—The term ‘SMP’ means Senior 

18 Medicare Patrol. 

19 ‘‘SEC. 763. PROGRAM AUTHORIZED. 

20 ‘‘(a) IN GENERAL.—The Assistant Secretary shall 

21 carry out a program for making grants to States with 

22 State plans approved under section 307. The grants shall 

23 enable the States to establish and operate State SMP pro24 grams, in accordance with this section, to assist partici25 pants in the SMP programs in empowering and assisting 


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1 beneficiaries, and their families and caregivers, through 

2 outreach, counseling, and education, to prevent, detect, 

3 and report health care fraud, errors, and abuse. 

4 ‘‘(b) GRANT AMOUNTS.— 

5 ‘‘(1) IN GENERAL.—Except as provided in para6 graph (2), each grant made under subsection (a) 

7 shall be for an amount equal to $180,000. 

8 ‘‘(2) TERRITORIES.—In the case of the Virgin 

9 Islands of the United States, Guam, American 

10 Samoa, and the Commonwealth of the Northern 

11 Mariana Islands, each such grant shall be for an 

12 amount equal to the amount the State received for 

13 fiscal year 2012 under the SMP program carried out 

14 under titles II and IV. 

15 ‘‘(3) STUDY.—The Assistant Secretary shall 

16 conduct a study on the benefits and drawbacks of al17 lotting funds to States under a formula, for grants 

18 made under subsection (a). The study shall address 

19 a formula under which the Assistant Secretary 

20 would allot funds to a State based on the number 

21 of beneficiaries in the State, or based on the per22 centage of individuals in the State who are bene23 ficiaries. The Assistant Secretary shall submit to the 

24 appropriate committees of Congress a report con25 taining the results of the study. 


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1 ‘‘(c) USE OF FUNDS.— 

2 ‘‘(1) IN GENERAL.—Each State that receives 

3 such a grant shall use the grant funds to establish 

4 and operate a State SMP program. 

5 ‘‘(2) ACTIVITIES.—In establishing and oper6 ating the program, the State shall— 

7 ‘‘(A) provide, directly or by grant or con8 tract, for the services of a State SMP Director 

9 and staff sufficient to— 

10 ‘‘(i) play a leadership role in State ef11 forts to prevent, detect, and report fraud 

12 under the Medicare program and Medicaid 

13 program; 

14 ‘‘(ii) report to the Assistant Secretary 

15 on State SMP activities described in clause 

16 (i), in such manner as the Assistant Sec17 retary determines to be appropriate to fa18 cilitate evaluation of the effectiveness of 

19 such activities in achieving such SMP pro20 gram goals and standards as the Assistant 

21 Secretary shall issue; and 

22 ‘‘(iii) coordinate with the Secretary, 

23 the State Attorney General, State Medicaid 

24 fraud control unit, law enforcement, and 

25 consumer protection entities with respect 


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1 to efforts to prevent fraud under the Medi2 care program and Medicaid program; 

3 ‘‘(B) empower older individuals, through 

4 increased awareness and understanding of 

5 health care programs, to protect themselves 

6 from the economic and health-related con7 sequences of fraud under the Medicare program 

8 and Medicaid program; 

9 ‘‘(C) work to resolve complaints by bene10 ficiaries of potential fraud in partnership with 

11 national and State fraud control or consumer 

12 protection entities, including Medicare program 

13 contractors, State Medicaid fraud control units, 

14 State Attorneys General, the Inspector General 

15 of the Department of Health and Human Serv16 ices, and the Administrator of the Centers for 

17 Medicare & Medicaid Services; 

18 ‘‘(D) undertake the training of older indi19 viduals and other volunteers, so that the train20 ees are able to conduct outreach to bene21 ficiaries— 

22 ‘‘(i) in their communities through con23 ducting group presentations, exhibiting at 

24 community events, answering calls to SMP 


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1 help lines, and providing one-on-one coun2 seling; and 

3 ‘‘(ii) in order to teach beneficiaries 

4 how to protect their personal identities, 

5 identify and report errors on their health 

6 care bills, and identify deceptive health 

7 care practices, such as illegal marketing, 

8 providing unnecessary or inappropriate 

9 services, and charging for services that 

10 were never provided; and 

11 ‘‘(E) provide any additional activities the 

12 State wishes to provide through the State SMP 

13 program that will contribute to the overall pur14 pose of empowering and assisting beneficiaries 

15 and their families and caregivers, to prevent, 

16 detect, and report health care fraud, errors, and 

17 abuse. 

18 ‘‘(3) ELIGIBLE ENTITIES; PRIORITY IN SELEC19 TION.— 

20 ‘‘(A) IN GENERAL.—Subject to subpara21 graph (B), to be eligible to receive a grant or 

22 contract under paragraph (2)(A), an entity 

23 shall be a State or local government agency, an 

24 area agency on aging, a private nonprofit orga25 nization, a faith-based organization, or such 


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1 other entity as the Assistant Secretary deter2 mines to be appropriate. 

3 ‘‘(B) PRIORITY.—In selecting eligible enti4 ties to receive such grants or contracts, a State 

5 shall give priority to those entities with dem6 onstrated experience in conducting health care 

7 fraud prevention programs. 

8 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

9 is authorized to be appropriated to carry out this subtitle, 

10 such sums as may be necessary for each of fiscal years 

11 2013 through 2017.’’. 

12 TITLE VIII—GERIATRICS AND 

13 GERONTOLOGY 

14 SEC. 801. PRIMARY HEALTH SERVICES. 

15 Section 331(a)(3)(D) of the Public Health Service 

16 Act (42 U.S.C. 254d(a)(3)(D)) is amended by inserting 

17 ‘‘geriatrics, gerontology,’’ after ‘‘pediatrics,’’. 

18 TITLE IX—CONFORMING 

19 AMENDMENTS 

20 SEC. 901. GREATEST ECONOMIC NEED; GREATEST SOCIAL 

21 NEED. 

22 (a) DEFINITIONS.—Section 102 of the Older Ameri23 cans Act of 1965 (42 U.S.C. 3002) is amended in sub24 paragraph (E)(i) of paragraph (30), as redesignated by 

25 section 102(a)(2), by inserting after ‘‘social need’’ the folVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00210 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 lowing: ‘‘(with particular attention to individuals with fac2 tors listed in paragraph (26)(B))’’. 

3 (b) FEDERAL AGENCY CONSULTATION.—Section 

4 203(a)(3)(A) of the Older Americans Act of 1965 (42 

5 U.S.C. 3013(a)(3)(A)) is amended by striking ‘‘older indi6 viduals (with particular attention to low-income older indi7 viduals, including low-income minority older individuals, 

8 older individuals with limited English proficiency, and 

9 older individuals residing in rural areas)’’ and inserting 

10 ‘‘older individuals, older individuals with greatest eco11 nomic need, older individuals with greatest social need 

12 (with particular attention to individuals with factors listed 

13 in section 102(26)(B)),’’. 

14 (c) EVALUATION.—Section 206(a) of the Older 

15 Americans Act of 1965 (42 U.S.C. 3017(a)) is amended 

16 by striking ‘‘greatest economic need’’ and all that follows 

17 through ‘‘areas),’’ and inserting ‘‘greatest economic need 

18 and unserved older individuals with greatest social need 

19 (with particular attention to individuals with factors listed 

20 in section 102(26)(B)),’’. 

21 (d) REPORTS.—Section 207(c) of the Older Ameri22 cans Act of 1965 (42 U.S.C. 3018(c)) is amended in para23 graph (6), as redesignated by section 205(3)(B)— 

24 (1) by striking ‘‘economic need (including low25 income minority individuals and older individuals reVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00211 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 siding in rural areas)’’ and inserting ‘‘economic 

2 need’’; and 

3 (2) by striking ‘‘social need (including low-in4 come minority individuals and older individuals re5 siding in rural areas)’’ and inserting ‘‘social need 

6 (with particular attention to individuals with factors 

7 listed in section 102(26)(B))’’. 

8 (e) APPROPRIATE USE OF FUNDS.—Section 

9 212(b)(3) of the Older Americans Act of 1965 (42 U.S.C. 

10 3020c(b)(3)) is amended— 

11 (1) by striking ‘‘social need,’’ and inserting ‘‘so12 cial need (with particular attention to individuals 

13 with factors listed in section 102(26)(B)) or’’; and 

14 (2) by striking ‘‘, or an older’’ and all that fol15 lows through ‘‘placement’’. 

16 (f) ORGANIZATION.—Section 305 of the Older Ameri17 cans Act of 1965 (42 U.S.C. 3025) is amended— 

18 (1) in subsection (a)— 

19 (A) in paragraph (1)(E)— 

20 (i) by striking ‘‘greatest economic 

21 need’’ and all that follows through ‘‘rural 

22 areas)’’ the first place it appears and in23 serting ‘‘greatest economic need’’; and 

24 (ii) by striking ‘‘greatest social need’’ 

25 and all that follows through ‘‘rural areas)’’ 


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1 and inserting ‘‘greatest social need (with 

2 particular attention to individuals with fac3 tors listed in section 102(26)(B))’’; and 

4 (B) in paragraph (2)— 

5 (i) in subparagraph (C)(ii), as amend6 ed by section 305(1)(A)(i) of this Act, by 

7 striking ‘‘areas’’ and all that follows and 

8 inserting ‘‘areas of older individuals with 

9 greatest economic need and older individ10 uals with greatest social need (with par11 ticular attention to individuals with factors 

12 listed in section 102(26)(B)); and’’; and 

13 (ii) in subparagraph (E), by striking 

14 ‘‘services to’’ and all that follows through 

15 ‘‘rural areas)’’ and inserting ‘‘services to 

16 older individuals with greatest economic 

17 need and older individuals with greatest 

18 social need (with particular attention to in19 dividuals with factors listed in section 

20 102(26)(B), including such individuals who 

21 are or are alleged victims of elder abuse, 

22 neglect, or exploitation)’’; and 

23 (2) in subsection (d)(1), by striking ‘‘greatest 

24 economic or social need’’ and inserting ‘‘greatest 

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1 ticular attention to individuals with factors listed in 

2 section 102(26)(B))’’. 

3 (g) AREA PLANS.—Section 306 of the Older Ameri4 cans Act of 1965 (42 U.S.C. 3026) is amended— 

5 (1) in subsection (a)— 

6 (A) in paragraph (1)— 

7 (i) by striking ‘‘greatest economic 

8 need’’ and all that follows through ‘‘rural 

9 areas)’’ the first place it appears and in10 serting ‘‘greatest economic need’’; and 

11 (ii) by striking ‘‘greatest social need’’ 

12 and all that follows through ‘‘rural areas) 

13 residing in such area,’’ and inserting 

14 ‘‘greatest social need (with particular at15 tention to individuals with factors listed in 

16 section 102(26)(B)) residing in such 

17 area,’’; and 

18 (B) in paragraph (4)— 

19 (i) in subparagraph (A)— 

20 (I) in clause (i)(I), by striking 

21 ‘‘will—’’ and all that follows and in22 serting ‘‘will set specific objectives, 

23 consistent with State policy, for pro24 viding services to older individuals 

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1 dividuals with greatest social need 

2 (with particular attention to individ3 uals with factors listed in section 

4 102(26)(B)), and older individuals at 

5 risk for institutional placement; and’’; 

6 (II) in clause (i)(II), by striking 

7 ‘‘items (aa) and (bb) of’’; and 

8 (III) in subclauses (I), (II), and 

9 (III) of clause (ii), by striking ‘‘low10 income’’ and all that follows through 

11 ‘‘rural areas’’ and inserting ‘‘individ12 uals with greatest economic need and 

13 individuals with greatest social need 

14 (with particular attention to individ15 uals with factors listed in section 

16 102(26)(B))’’; and 

17 (ii) in subparagraph (B)(i)— 

18 (I) in subclause (II), by striking 

19 ‘‘economic need’’ and all that follows 

20 through ‘‘rural areas)’’ and inserting 

21 ‘‘economic need’’; and 

22 (II) in subclause (III), by strik23 ing ‘‘social need’’ and all that follows 

24 through ‘‘rural areas)’’ and inserting 

25 ‘‘social need (with particular attention 


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1 to individuals with factors listed in 

2 section 102(26)(B))’’; and 

3 (2) in subsection (b)(2)(B), by striking ‘‘includ4 ing individuals’’ and all that follows and inserting 

5 ‘‘including older individuals with greatest economic 

6 need and older individuals with greatest social need 

7 (with particular attention to individuals with factors 

8 listed in section 102(26)(B));’’. 

9 (h) STATE PLANS.—Section 307(a) of the Older 

10 Americans Act of 1965 (42 U.S.C. 3027(a)) is amended— 

11 (1) in paragraph (4), by striking ‘‘provided to 

12 individuals’’ and all that follows and inserting ‘‘pro13 vided to individuals with greatest economic need and 

14 individuals with greatest social need (with particular 

15 attention to individuals with factors listed in section 

16 102(26)(B)).’’; 

17 (2) in paragraph (11)(B), by striking ‘‘individ18 uals with the greatest such need;’’ and inserting ‘‘in19 dividuals with greatest economic need and individ20 uals with greatest social need (with particular atten21 tion to individuals with factors listed in section 

22 102(26)(B)),’’; and 

23 (3) in paragraph (28)(B)(ii), by striking ‘‘in24 cluding individuals’’ and all that follows and insert25 ing ‘‘including older individuals with greatest ecoVerDate Mar 15 2010 00:49 Sep 22, 2012 Jkt 099200 PO 00000 Frm 00216 Fmt 6652 Sfmt 6201 E:\BILLS\S3562.IS S3562

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1 nomic need and older individuals with greatest social 

2 need (with particular attention to individuals with 

3 factors listed in section 102(26)(B));’’. 

4 (i) CONSUMER CONTRIBUTIONS.—Section 315 of the 

5 Older Americans Act of 1965 (42 U.S.C. 3030c–2) is 

6 amended— 

7 (1) in subsection (c)(2), by striking ‘‘participa8 tion of’’ and all that follows through ‘‘rural areas)’’ 

9 and inserting ‘‘participation of older individuals with 

10 greatest economic need and older individuals with 

11 greatest social need (with particular attention to in12 dividuals with factors listed in section 102(26)(B))’’; 

13 and 

14 (2) in subsection (d), by striking ‘‘(with par15 ticular’’ and all that follows through ‘‘rural areas)’’ 

16 and inserting ‘‘, including participation rates for in17 dividuals with greatest economic need and individ18 uals with greatest social need (with particular atten19 tion to individuals with factors listed in section 

20 102(26)(B))’’. 

21 (j) DEMONSTRATION, SUPPORT, AND RESEARCH

22 PROJECTS.—Section 417(c)(2) of the Older Americans 

23 Act of 1965 (42 U.S.C. 3032f(c)(2)) is amended by strik24 ing ‘‘older individuals and communities’’ and all that fol25 lows and inserting ‘‘communities with greatest need, older 


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1 individuals with greatest economic need, and older individ2 uals with greatest social need (with particular attention 

3 to individuals with factors listed in section 102(26)(B));’’. 

4 (k) OLDER AMERICAN COMMUNITY SERVICE EM5 PLOYMENT PROGRAM.—Section 502(b)(1)(M) of the 

6 Older Americans Act of 1965 (42 U.S.C. 3056(b)(1)(M)) 

7 is amended by striking ‘‘and eligible individuals with 

8 greatest economic need’’ and inserting ‘‘eligible individuals 

9 with disabilities, eligible individuals with greatest eco10 nomic need, and eligible individuals with greatest social 

11 need’’. 

12 (l) INTERAGENCY COOPERATION.—Section 514 of the 

13 Older Americans Act of 1965 (42 U.S.C. 3056l) is amend14 ed— 

15 (1) in subsection (c)(1), by striking ‘‘individuals 

16 with greatest economic need, individuals with great17 est social need,’’ and inserting ‘‘individuals with 

18 greatest economic need, individuals with greatest so19 cial need (with particular attention to individuals 

20 with factors listed in section 102(26)(B)),’’; and 

21 (2) in subsection (e)(1), by striking ‘‘minority’’ 

22 and all that follows through ‘‘economic need,’’ and 

23 inserting ‘‘individuals with greatest economic need, 

24 individuals with greatest social need,’’. 

Æ 


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