IB 

Union Calendar No. 206 

116TH CONGRESS 

1ST SESSION H. R. 4334 

[Report No. 116–258] 

To amend the Older Americans Act of 1965 to authorize appropriations 

for fiscal years 2020 through 2024, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 16, 2019 

Ms. BONAMICI (for herself, Ms. STEFANIK, Mrs. LEE of Nevada, Mr. COMER, 

Ms. WILD, and Mr. JOHNSON of South Dakota) introduced the following 

bill; which was referred to the Committee on Education and Labor 

OCTOBER 28, 2019 

Additional sponsors: Mr. SABLAN, Mr. GUTHRIE, Ms. STEVENS, Mr. THOMPSON of Pennsylvania, Mr. COURTNEY, Mr. ALLEN, Mr. TRONE, Mr. WATKINS, Mrs. HAYES, Mr. DEFAZIO, Mr. FITZPATRICK, Mr. WRIGHT, Mr. 

DAVID P. ROE of Tennessee, Mr. WALBERG, Mr. SMUCKER, Mr. 

MEUSER, Mr. MORELLE, Mr. KELLER, Mr. DAVID SCOTT of Georgia, 

and Ms. NORTON

OCTOBER 28, 2019 

Reported with an amendment, committed to the Committee of the Whole 

House on the State of the Union, and ordered to be printed 

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

[For text of introduced bill, see copy of bill as introduced on September 16, 2019] 


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A BILL 

To amend the Older Americans Act of 1965 to authorize 

appropriations for fiscal years 2020 through 2024, and 

for other purposes. 


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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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Dignity in Aging Act of 2019’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of this 

7 Act is the following: 

Sec. 1. Short title; table of contents. 

TITLE I—ENSURING COLLABORATION AND PROMOTING 

INDEPENDENCE FOR OLDER INDIVIDUALS 

Sec. 101. Person-centered, trauma-informed care. 

Sec. 102. Vaccination. 

Sec. 103. Functions of Assistant Secretary. 

Sec. 104. Professional standards for nutrition official under the Assistant Secretary. 

Sec. 105. Interagency Coordinating Committee on Age-Friendly Communities. 

Sec. 106. Technical assistance on age-friendly communities. 

Sec. 107. Malnutrition. 

Sec. 108. Coordination with resource centers. 

Sec. 109. Arts education. 

Sec. 110. Social determinants of health. 

Sec. 111. Federal coordination of supports and services for living independently 

and safely at home. 

Sec. 112. Falls prevention and chronic disease self-management education. 

Sec. 113. Extension of RAISE Family Caregivers Act. 

Sec. 114. Support for socially-isolated older Americans. 

Sec. 115. Increased focus of Assistant Secretary on social isolation. 

Sec. 116. Advisory council on social isolation. 

Sec. 117. Supportive services and senior centers. 

Sec. 118. Demonstration projects. 

Sec. 119. Younger onset Alzheimer’s Disease. 

Sec. 120. Priority for the senior community service employment program. 

Sec. 121. Direct care workforce. 

Sec. 122. National resource center for older individuals experiencing the longterm and adverse consequences of trauma. 

Sec. 123. National Resource Center for Women and Retirement. 

Sec. 124. Definition. 

Sec. 125. Review of reports. 

Sec. 126. Area plans. 

Sec. 127. Addressing chronic pain management. 

Sec. 128. Extension of the Supporting Grandparents Raising Grandchildren Act. 

Sec. 129. Screening for suicide risk. 

Sec. 130. Traumatic brain injury. 

Sec. 131. Addressing public health emergencies and emerging health threats. 


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TITLE II—EMPOWERING THE AGING NETWORK TO MEET THE 

NEEDS OF OLDER INDIVIDUALS 

Sec. 201. National family caregiver support program cap. 

Sec. 202. Minimum funding level for State administrative expenses. 

Sec. 203. Culturally-appropriate, medically-tailored meals. 

Sec. 204. Business acumen provisions and clarification regarding outside funding 

for area agencies on aging. 

Sec. 205. Other practices. 

Sec. 206. Caregiver assessments. 

Sec. 207. Research and evaluation. 

Sec. 208. Grant program for multigenerational collaboration. 

TITLE III—STRENGTHENING PROTECTIONS FOR OLDER 

INDIVIDUALS 

Sec. 301. State Long-Term Care Ombudsman Program minimum funding and 

maintenance of effort. 

Sec. 302. State long-term care volunteer ombudsman representatives. 

Sec. 303. Clarification regarding board and care facilities. 

TITLE IV—MEETING THE NEEDS OF OLDER NATIVE AMERICANS 

Sec. 401. Expanding supportive services for Native American aging programs. 

Sec. 402. Enhancing capacity to support Native American aging programs. 

TITLE V—MISCELLANEOUS 

Sec. 501. Technical corrections. 

Sec. 502. Authorization of appropriations; uses of funds. 

Sec. 503. Effective date. 

1 TITLE I—ENSURING COLLABORA2 TION AND PROMOTING INDE3 PENDENCE FOR OLDER INDI4 VIDUALS 

5 SEC. 101. PERSON-CENTERED, TRAUMA-INFORMED CARE. 

6 Section 101(2) of the Older Americans Act of 1965 (42 

7 U.S.C. 3001(2)) is amended by inserting ‘‘(including access 

8 to person-centered, trauma-informed care)’’ after ‘‘health’’. 

9 SEC. 102. VACCINATION. 

10 Section 102(14) of the Older Americans Act of 1965 

11 (42 U.S.C. 3002(14)) is amended— 


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1 (1) in subparagraph (B) by inserting ‘‘immuni2 zation status,’’ after ‘‘oral health,’’, and 

3 (2) in subparagraph (D) by inserting ‘‘infectious 

4 disease, and vaccine preventable disease,’’ after ‘‘dis5 ease),’’. 

6 SEC. 103. FUNCTIONS OF ASSISTANT SECRETARY. 

7 (a) REVIEW OF APPLICATIONS.— Section 202 of the 

8 Older Americans Act of 1965 (42 U.S.C. 3012) is amend9 ed— 

10 (1) by amending subsection (a)(4) to read as fol11 lows: 

12 ‘‘(4) administer the grants provided by this Act 

13 but not approve an application submitted by an ap14 plicant for a grant for a program for which such ap15 plicant previously received a grant unless the Assist16 ant Secretary determines— 

17 ‘‘(A) the program for which such applica18 tion was submitted is operating effectively to 

19 achieve its stated purpose; and 

20 ‘‘(B) such applicant— 

21 ‘‘(i) complied with the assurances pro22 vided to the Assistant Secretary with the 

23 application for such previous grant; and 


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1 ‘‘(ii) will comply with the assurances 

2 provided with the current submitted appli3 cation;’’, and 

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

5 ‘‘(h) The Assistant Secretary shall publish, on an an6 nual basis, a list of centers and demonstration projects 

7 funded under each title of the Act. The Assistant Secretary 

8 shall ensure that this information is also directly provided 

9 to States and area agencies on aging.’’. 

10 (b) ADDRESSING THE NEEDS OF OLDER INDIVIDUALS

11 IN DISASTERS.—Section 202(a) of the Older Americans Act 

12 of 1965 (42 U.S.C. 3012(a)) is amended— 

13 (1) in paragraph (30) by striking ‘‘and’’ at the 

14 end, 

15 (2) in paragraph (31) by striking the period at 

16 the end and inserting ‘‘; and’’, and 

17 (3) by adding at the following at the end the fol18 lowing: 

19 ‘‘(32) provide technical assistance to and share 

20 best practices with States and area agencies on aging 

21 on how to collaborate and coordinate activities and 

22 develop long-range emergency preparedness plans 

23 with local and State emergency response agencies, re24 lief organizations, local and State governments, fed25 eral agencies as appropriate, and any other instituVerDate Sep 11 2014 22:20 Oct 28, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6203 E:\BILLS\H4334.RH H4334

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1 tions that have responsibility for disaster relief service 

2 delivery.’’. 

3 SEC. 104. PROFESSIONAL STANDARDS FOR NUTRITION OF4 FICIAL UNDER THE ASSISTANT SECRETARY. 

5 Section 205(a)(2)(C)(ii) of the Older Americans Act 

6 of 1965 (42 U.S.C. 3016(a)(2)(C)(ii) is amended to read 

7 as follows: 

8 ‘‘(ii) be a registered dietitian or registered dieti9 tian nutritionist.’’. 

10 SEC. 105. INTERAGENCY COORDINATING COMMITTEE ON 

11 AGE-FRIENDLY COMMUNITIES. 

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

13 U.S.C. 3013) is amended— 

14 (1) in subsection (b)— 

15 (A) in paragraph (18) by striking ‘‘and’’ at 

16 the end, 

17 (B) in subparagraph (19) by striking the 

18 period at the end, and inserting ‘‘, and’’, and 

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

20 ‘‘(20) section 393D of the Public Health Service 

21 Act (42 U.S.C. 280b–1f), relating to safety of sen22 iors.’’, and 

23 (2) in subsection (c)— 

24 (A) in paragraph (1)— 


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1 (i) by striking ‘‘Aging’’ and inserting 

2 ‘‘Age-Friendly Communities’’, and 

3 (ii) by inserting ‘‘to support the ability 

4 of older individuals to age in place, includ5 ing through the provision of homelessness 

6 prevention services, support the ability of 

7 older individuals to access preventive health 

8 care, promote age-friendly communities, 

9 and address the ability of older individuals 

10 to access long-term care supports, including 

11 access to caregivers and home- and commu12 nity-based services’’ before the period at the 

13 end, 

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

15 that the 1st term of a member appointed to the 

16 Interagency Coordinating Committee on Age17 Friendly Communities shall begin not later than 

18 1 year after the date of the enactment of the ef19 fective date of this exception’’ before the period at 

20 the end, 

21 (C) in paragraph (5) by striking ‘‘once each 

22 year’’ and inserting ‘‘semiannually’’, 

23 (D) in paragraph (6)— 

24 (i) in subparagraph (A)— 


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1 (I) in clause (iii) by striking 

2 ‘‘and’’ at the end, 

3 (II) in clause (iv) by adding 

4 ‘‘and’’ at the end, and 

5 (III) by adding at the end the fol6 lowing: 

7 ‘‘(v) identifying best practices for con8 necting older individuals to services for which 

9 they may be eligible;’’, 

10 (ii) by amending subparagraph (B)(ii) 

11 to read as follows: 

12 ‘‘(ii) innovations in technology applications 

13 (including assistance technology devices and as14 sistance technology services) that— 

15 ‘‘(I) promote safe and accessible inde16 pendent living environments; and 

17 ‘‘(II) give older individuals access to 

18 information on available services or help in 

19 providing services to older individuals;’’, 

20 (iii) in subparagraph (E)— 

21 (I) by striking ‘‘nongovernmental 

22 experts and organizations, including 

23 public health interest and research 

24 groups and foundations’’ and inserting 

25 ‘‘nongovernmental organizations, acaVerDate Sep 11 2014 22:20 Oct 28, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6203 E:\BILLS\H4334.RH H4334

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1 demic or research institutions, commu2 nity-based organizations, and philan3 thropic organizations’’, and 

4 (II) by striking ‘‘(F)’’ and insert5 ing ‘‘(G)’’, 

6 (iv) by redesignating subparagraphs 

7 (E), (F), and (G) as subparagraphs (F), 

8 (G), and (H), respectively, 

9 (v) by inserting after subparagraph 

10 (D) the following: 

11 ‘‘(E) work with the Centers for Disease Control 

12 and Prevention, the National Institute on Aging, Cen13 ters for Medicare and Medicaid Services, the Housing 

14 and Urban Development Office of Lead Hazard Con15 trol and Healthy Homes, and other Federal agencies 

16 as appropriate, to develop recommendations, in ac17 cordance with paragraph (1), to reduce falls among 

18 older individuals that incorporate evidence-based falls 

19 prevention programs and home modifications to re20 duce and prevent falls;’’, and 

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

22 ‘‘(9) In this subsection, the term ‘age-friendly commu23 nity’ means a community that-— 

24 ‘‘(A) is taking steps— 


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1 ‘‘(i) to include accessible housing, accessible 

2 spaces and buildings, safe and secure paths, 

3 variable route transportation services, and pro4 grams and services designed to maintain health 

5 and well-being; 

6 ‘‘(ii) to respect and include older individ7 uals in social opportunities, civic participation, 

8 volunteerism, and employment; and 

9 ‘‘(iii) to facilitate access to supportive serv10 ices for older individuals; and 

11 ‘‘(B) has a plan in place to meet local needs for 

12 housing, transportation, civic participation, social 

13 connectedness, and accessible spaces.’’. 

14 SEC. 106. TECHNICAL ASSISTANCE ON AGE-FRIENDLY COM15 MUNITIES. 

16 Section 205(a)(2) of the Older Americans Act of 1965 

17 (42 U.S.C. 3016(a)(2)) is amended— 

18 (1) by redesignating subparagraph (C) as sub19 paragraph (D), and 

20 (2) by inserting after subparagraph (B) the fol21 lowing: 

22 ‘‘(C) The Assistant Secretary may provide technical 

23 assistance, including through the regional offices of the Ad24 ministration, to State agencies, area agencies on aging, 


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1 local government agencies, or leaders in age-friendly com2 munities (as defined in section 203(c)(9)) regarding— 

3 ‘‘(i) dissemination of, or consideration of ways 

4 to implement, best practices and recommendations 

5 from the Interagency Coordinating Committee on 

6 Age-Friendly Communities established under section 

7 203(c); and 

8 ‘‘(ii) methods for managing and coordinating ex9 isting programs to meet the needs of growing age10 friendly communities.’’. 

11 SEC. 107. MALNUTRITION. 

12 The Older Americans Act of 1965 (42 U.S.C. 2011 et 

13 seq.) is amended— 

14 (1) in section 102(14)(B) by inserting ‘‘(includ15 ing screening for malnutrition)’’ before the semicolon 

16 at the end, and 

17 (2) in section 330(1) by striking ‘‘and food inse18 curity’’ and inserting ‘‘, food insecurity, and mal19 nutrition’’. 

20 SEC. 108. COORDINATION WITH RESOURCE CENTERS. 

21 (a) AREA PLANS.—Section 306(a) of the Older Ameri22 cans Act of 1965 (42 U.S.C. 3026(a)) is amended— 

23 (1) in paragraph (16) by striking ‘‘and’’ at the 

24 end, 


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1 (2) in paragraph (17) by striking the period at 

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

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

4 ‘‘(18) provide assurances that the area agency on 

5 aging will collect data to determine the services that 

6 are needed by older individuals whose needs are the 

7 focus of all centers funded under title IV and the effec8 tiveness of the programs, policies, and services pro9 vided by such area agency on aging in assisting these 

10 individuals. Each agency plan shall provide assur11 ances that the area agency on aging will use outreach 

12 efforts that will identify individuals eligible for assist13 ance under this Act, with special emphasis on those 

14 individuals whose needs are the focus of all centers es15 tablished under title IV. This requirement applies to 

16 all centers funded on the day before the effective date 

17 of this paragraph.’’. 

18 (b) STATE PLANS.—Section 307(a) of the Older Ameri19 cans Act of 1965 (42 U.S.C. 3027) is amended by adding 

20 at the end the following: 

21 ‘‘(31) The State shall prepare and submit to the 

22 Assistant Secretary annual reports on the data col23 lected to determine the services that are needed by 

24 older individuals whose needs are the focus of all cen25 ters funded under title IV and the effectiveness of the 


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1 programs, policies, and services provided by area 

2 agencies on aging in assisting these individuals. The 

3 reports shall describe any outreach efforts and other 

4 activities described in section 306(a)(18). This re5 quirement applies to all centers funded on the day be6 fore the date of the enactment of the effective date of 

7 this paragraph.’’. 

8 SEC. 109. ARTS EDUCATION. 

9 (a) PROGRAM DESIGN.—Section 202(a)(5) of the Older 

10 Americans Act of 1965 (42 U.S.C. 3012(a)(5)) is amended 

11 by inserting ‘‘cultural experiences, activities and services, 

12 including the arts,’’ after ‘‘education),’’. 

13 (b) SUPPORTIVE SERVICES.—Section 321(a)(7) of the 

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

15 amended by inserting ‘‘cultural experiences (including the 

16 arts),’’ after ‘‘art therapy,’’. 

17 SEC. 110. SOCIAL DETERMINANTS OF HEALTH. 

18 Section 301(a)(1) of the Older Americans Act of 1965 

19 (42 U.S.C. 3021(a)(1)) is amended— 

20 (1) in subparagraph (C) by striking ‘‘and’’ at 

21 the end, 

22 (2) in subparagraph (D) by striking the period 

23 at the end and inserting ‘‘; and’’, and 

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


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1 ‘‘(E) address the social determinants of health of 

2 older individuals.’’. 

3 SEC. 111. FEDERAL COORDINATION OF SUPPORTS AND 

4 SERVICES FOR LIVING INDEPENDENTLY AND 

5 SAFELY AT HOME. 

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

7 3011–3020) is amended by inserting after section 203A the 

8 following: 

9 ‘‘SEC. 203B. FEDERAL COORDINATION OF SUPPORTS AND 

10 SERVICES FOR LIVING INDEPENDENTLY AND 

11 SAFELY AT HOME. 

12 ‘‘(a) INITIATIVE.—The Assistant Secretary shall carry 

13 out an initiative under this section to identify and dissemi14 nate information about Federal resources to promote falls 

15 prevention, home assessments, and home modifications, 

16 which may include in-home assistive technology, to enable 

17 older individuals to live independently and safely in a home 

18 environment. 

19 ‘‘(b) COORDINATION OF FEDERAL EFFORTS.—In car20 rying out the initiative under this section, the Assistant 

21 Secretary shall coordinate, through memoranda of under22 standing, agreements, or other appropriate means of coordi23 nation, with all Federal efforts and Federal programs in 

24 effect on the effective date of this section that support evi25 dence-based falls prevention, home assessments, and home 


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1 modifications, which may include in-home assistive tech2 nology, for older individuals, including older individuals 

3 with disabilities. 

4 ‘‘(c) REPORTS.—Not later than 1 year after the effec5 tive date of this section, and triennially thereafter as need6 ed, the Assistant Secretary shall publish a report that in7 cludes— 

8 ‘‘(1) an inventory of the then current Federal 

9 programs that support evidence-based falls preven10 tion, home assessments, and home modifications, 

11 which may include in-home assistive technology, for 

12 older individuals and older individuals with disabil13 ities; 

14 ‘‘(2) for the fiscal year of the report, statistical 

15 data on the number of older individuals and older in16 dividuals with disabilities served by each Federal pro17 gram described in paragraph (1), including a demo18 graphic analysis and the approximate amount of 

19 Federal funding invested in each such program; 

20 ‘‘(3) an evaluation of the impact of Federal pro21 grams that support falls prevention and home modi22 fications, which may include in-home assistive tech23 nology, on health status and health outcomes in popu24 lations supported by such efforts and programs; and 


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1 ‘‘(4) information on the extent to which con2 sumer-friendly resources, such as a brochure— 

3 ‘‘(A) are available through the National 

4 Eldercare Locator Service established under sec5 tion 202(a)(21); 

6 ‘‘(B) are accessible to all area agencies on 

7 aging; and 

8 ‘‘(C) contain information on home assess9 ments and home modifications for older individ10 uals attempting to live independently and safely 

11 in their homes and for the caregivers of such in12 dividuals.’’. 

13 SEC. 112. FALLS PREVENTION AND CHRONIC DISEASE SELF14 MANAGEMENT EDUCATION. 

15 Section 411(a) of the Older Americans Act of 1965 (42 

16 U.S.C. 3032(a)) is amended— 

17 (1) by redesignating paragraphs (13) and (14) 

18 as paragraphs (15) and (16), respectively, and 

19 (2) by inserting after paragraph (12) the fol20 lowing: 

21 ‘‘(13) bringing to scale and sustaining evidence22 based falls prevention programs that will reduce the 

23 number of falls, fear of falling, and fall-related inju24 ries in older individuals and older individuals with 

25 disabilities; 


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1 ‘‘(14) bringing to scale and sustaining evidence2 based chronic disease self-management programs that 

3 empower older individuals and older individuals with 

4 disabilities to better manage their chronic condi5 tions;’’. 

6 SEC. 113. EXTENSION OF RAISE FAMILY CAREGIVERS ACT. 

7 Section 6 of the RAISE Family Caregivers Act (Public 

8 Law 115–119; 132 Stat. 27) is amended by striking ‘‘3’’ 

9 and inserting ‘‘4’’. 

10 SEC. 114. SUPPORT FOR SOCIALLY-ISOLATED OLDER AMER11 ICANS. 

12 Section 102(14) of the Older Americans Act of 1965 

13 (42 U.S.C. 3002(14)) is amended— 

14 (1) in subparagraph (K) by striking ‘‘and’’ at 

15 the end, 

16 (2) in subparagraph (L) by striking ‘‘(K)’’ and 

17 inserting ‘‘(L)’’, 

18 (3) by redesignating subparagraph (L) as sub19 paragraph (M), and 

20 (4) by inserting after subparagraph (K) the fol21 lowing: 

22 ‘‘(L) screening for the prevention of social 

23 isolation and coordination of supportive services 

24 and health care to address social isolation and 

25 loneliness; and’’. 


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1 SEC. 115. INCREASED FOCUS OF ASSISTANT SECRETARY ON 

2 SOCIAL ISOLATION. 

3 Section 202(a) of the Older Americans Act of 1965 (42 

4 U.S.C. 3012(a)), as amended by section 103, is amended— 

5 (1) in paragraph (31) by striking ‘‘; and’’ and 

6 inserting a semicolon, 

7 (2) in paragraph (32) by striking the period at 

8 the end and inserting ‘‘; and’’, and 

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

10 ‘‘(33) develop objectives, priorities, and a long11 term plan for supporting State and local efforts in12 volving education about, prevention of, detection of, 

13 and response to social isolation among older individ14 uals.’’. 

15 SEC. 116. ADVISORY COUNCIL ON SOCIAL ISOLATION. 

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

17 U.S.C. 3012), as amended by section 103, is amended by 

18 adding at the end the following: 

19 ‘‘(i)(1) The Assistant Secretary shall convene an advi20 sory council on social isolation with aging network stake21 holders, including caregivers, and select members in a man22 ner that ensures geographic diversity of the members— 

23 ‘‘(A) to review and evaluate efforts to address so24 cial isolation and loneliness among older individuals; 

25 and 


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1 ‘‘(B) to identify challenges, solutions, and best 

2 practices related to such efforts. 

3 ‘‘(2) The advisory council convened under paragraph 

4 (1) shall— 

5 ‘‘(A) ensure consideration of consumer-directed 

6 care models; and 

7 ‘‘(B) submit a report to Congress on its findings. 

8 ‘‘(3) The Federal Advisory Committee Act (5 U.S.C. 

9 App.) shall not apply with respect to the advisory council 

10 convened under paragraph (1).’’. 

11 SEC. 117. SUPPORTIVE SERVICES AND SENIOR CENTERS. 

12 Section 321(a) of the Older Americans Act of 1965 (42 

13 U.S.C. 3030d(a)) is amended— 

14 (1) in paragraph (24) by striking ‘‘and’’ at the 

15 end, 

16 (2) by redesignating paragraph (25) as para17 graph (26), and 

18 (3) by inserting after paragraph (24) the fol19 lowing: 

20 ‘‘(25) services that promote or support social 

21 connectedness and reduce social isolation; and’’. 

22 SEC. 118. DEMONSTRATION PROJECTS. 

23 (a) DEMONSTRATIONS.—Section 411(a) of the Older 

24 Americans Act of 1965 (42 U.S.C. 3032(a)), as amended 

25 by section 112, is amended— 


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1 (1) in paragraph (15) by striking ‘‘and’’ at the 

2 end, 

3 (2) by redesignating paragraph (16) as para4 graph (17), and 

5 (3) by inserting after paragraph (15) the fol6 lowing: 

7 ‘‘(16) projects that address social isolation and 

8 loneliness among older adults; and’’. 

9 (b) REPEAL.—Section 416 of the Older Americans Act 

10 of 1965 (42 U.S.C. 3032e) is repealed. 

11 SEC. 119. YOUNGER ONSET ALZHEIMER’S DISEASE. 

12 (a) DEFINITION OF ‘‘FAMILY CAREGIVER’’.—Section 

13 302(3) of the Older Americans Act of 1965 (42 U.S.C. 

14 3022(3)) is amended by inserting ‘‘of any age’’ after ‘‘an 

15 individual’’. 

16 (b) DEFINITION OF ‘‘RESIDENT’’.—Section 711(6) of 

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

18 amended by inserting ‘‘of any age’’ after ‘‘individual’’. 

19 SEC. 120. PRIORITY FOR THE SENIOR COMMUNITY SERVICE 

20 EMPLOYMENT PROGRAM. 

21 The Older Americans Act of 1965 (42 U.S.C. 3001 et 

22 seq.) is amended— 

23 (1) in section 503(a)(4)(C)— 

24 (A) in clause (iii) by striking ‘‘and’’ at the 

25 end, 


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1 (B) in clause (iv) by adding ‘‘and’’ at the 

2 end, and 

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

4 ‘‘(v) eligible individuals who have been 

5 incarcerated or are under supervision fol6 lowing the release from prison or jail with7 in the last 5 years;’’, 

8 (2) in section 514(e)(1) by inserting ‘‘older indi9 viduals who have been incarcerated or are under su10 pervision following the release from prison or jail,’’ 

11 after ‘‘need,’’, and 

12 (3) in section 518— 

13 (A) in subsection (a)(3)(B)(ii)— 

14 (i) in clause (IV) by striking ‘‘or’’ at 

15 the end, 

16 (ii) in clause (V) by striking the period 

17 at the end and inserting ‘‘; or’’, and 

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

20 ‘‘(VI) have been incarcerated or are 

21 under supervision following the release from 

22 prison or jail within the last 5 years.’’, and 

23 (B) in subsection (b)(2)— 

24 (i) in subparagraph (F) by striking 

25 ‘‘or’’ at the end, 


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1 (ii) in subparagraph (G) by striking 

2 the period at the end and inserting ‘‘; or’’, 

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

5 ‘‘(H) has been incarcerated or is under super6 vision following the release from prison or jail within 

7 the last 5 years.’’. 

8 SEC. 121. DIRECT CARE WORKFORCE. 

9 (a) DEMONSTRATIONS.—Section 411(a) of the Older 

10 Americans Act of 1965 (42 U.S.C. 3032(a)), as amended 

11 by sections 112 and 118, is amended— 

12 (1) by redesignating paragraphs (16) and (17) 

13 as paragraphs (17) and (18), respectively, and 

14 (2) by inserting after paragraph (15) the fol15 lowing: 

16 ‘‘(16) in coordination with the Secretary of 

17 Labor, the demonstration of new strategies for the re18 cruitment, retention, or advancement of direct care 

19 workers, and to solicit, develop, and implement strate20 gies— 

21 ‘‘(A) to reduce barriers to entry for a di22 verse and high-quality direct care workforce, in23 cluding providing wages, benefits, and advance24 ment opportunities needed to attract and retain 

25 direct care workers; 


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1 ‘‘(B) to provide supportive services and ca2 reer planning for direct care workers; and 

3 ‘‘(C) to support the advancement of direct 

4 care workers through education and workforce 

5 development programs that include necessary 

6 credential or licensing preparation, paid on-the7 job training or work-based learning, and appro8 priate safety training;’’. 

9 (b) OLDER AMERICAN COMMUNITY SERVICE EMPLOY10 MENT PROGRAM.—Section 502(e)(2)(B) of the Older Ameri11 cans Act of 1965 (42 U.S.C. 3056(e)(2)(B)) is amended— 

12 (1) in clause (iii) by striking ‘‘and’’ at the end, 

13 (2) in clause (iv) by adding ‘‘and’’ at the end, 

14 and 

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

16 ‘‘(v) attract, retain, and advance the 

17 direct care workforce, in consultation with 

18 the Assistant Secretary, providing for wages 

19 and benefits needed to reduce barriers to 

20 entry for a diverse and high-quality direct 

21 care workforce, supportive services and ca22 reer planning, and paid on-the-job training 

23 or work-based learning, with appropriate 

24 safety training;’’. 


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1 SEC. 122. NATIONAL RESOURCE CENTER FOR OLDER INDI2 VIDUALS EXPERIENCING THE LONG-TERM 

3 AND ADVERSE CONSEQUENCES OF TRAUMA. 

4 Section 411(a) of the Older Americans Act of 1965 (42 

5 U.S.C. 3032(a)), as amended by sections 112, 118, and 121, 

6 is amended— 

7 (1) by redesignating paragraphs (17) and (18) 

8 as paragraphs (18) and (19), respectively, and 

9 (2) by inserting after paragraph (16) the fol10 lowing: 

11 ‘‘(17) the implementation of a national resource 

12 center that shall— 

13 ‘‘(A) provide training and technical assist14 ance to agencies in the aging network delivering 

15 services to older individuals experiencing the 

16 long-term and adverse consequences of trauma; 

17 ‘‘(B) share best practices with the aging net18 work; and 

19 ‘‘(C) make subgrants to the agencies best po20 sitioned to advance and improve the delivery of 

21 person-centered, trauma-informed services for 

22 older individuals experiencing the long-term and 

23 adverse consequences of trauma;’’. 


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1 SEC. 123. NATIONAL RESOURCE CENTER FOR WOMEN AND 

2 RETIREMENT. 

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

4 U.S.C. 3012), as amended by sections 103 and 116, is 

5 amended by adding at the end the following: 

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

7 grant or contract, operate the National Resource Center for 

8 Women and Retirement (in this subsection referred to as 

9 the ‘Center’). 

10 ‘‘(2) The Center shall— 

11 ‘‘(A) provide basic financial management, retire12 ment planning, and other educational tools that pro13 mote financial wellness and help to identify and pre14 vent fraud and elder exploitation, and integrate these 

15 with information on health and long-term care; 

16 ‘‘(B) annually disseminate a summary of out17 reach provided, including work to provide user-friend18 ly consumer information and public education mate19 rials; 

20 ‘‘(C) develop targeted outreach strategies; 

21 ‘‘(D) provide technical assistance to State agen22 cies and to other public and nonprofit private agen23 cies and organizations; and 

24 ‘‘(E) develop partnerships and collaborations to 

25 address program objectives.’’. 


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1 SEC. 124. DEFINITION. 

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

3 U.S.C. 3002) is amended— 

4 (1) by redesignating paragraphs (41) through 

5 (54) as paragraphs (42) through (55), and 

6 (2) by inserting after paragraph (40) the fol7 lowing: 

8 ‘‘(41) The term ‘person-centered, trauma-in9 formed’ when used with respect to services means 

10 services provided through an aging program that— 

11 ‘‘(A) use a holistic approach to providing 

12 services; 

13 ‘‘(B) promote the dignity, strength and em14 powerment of victims of trauma; and 

15 ‘‘(C) incorporate research-based practices 

16 based on knowledge about the role of trauma in 

17 trauma victims’ lives.’’. 

18 SEC. 125. REVIEW OF REPORTS. 

19 Sec. 308(b) of the Older Americans Act of 1965 (42 

20 U.S.C. 3028(b)) is amended by inserting at the end the fol21 lowing: 

22 ‘‘(8) The Assistant Secretary shall review the reports 

23 submitted under section 307(a)(31), and include in the re24 port required by section 207(a), aggregated data, including 

25 the effectiveness and outreach efforts included in 307(a)(31), 

26 on services that are needed by older individuals whose needs 


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1 are the focus of all centers funded under title IV. This re2 quirement applies to all centers funded on the day before 

3 the date of the effective date of this paragraph.’’. 

4 SEC. 126. AREA PLANS. 

5 Section 306(a)(4) of the Older Americans Act of 1965 

6 (42 U.S.C. 3026(a)(4)) is amended in subparagraph 

7 (B)(i)(VII) by inserting ‘‘, specifically including survivors 

8 of the Holocaust’’ after ‘‘placement’’. 

9 SEC. 127. ADDRESSING CHRONIC PAIN MANAGEMENT. 

10 Section 102(14)(D) of the Older Americans Act of 1965 

11 (42 U.S.C. 3002(14)) is amended by inserting ‘‘chronic 

12 pain management,’’ after ‘‘substance abuse reduction,’’. 

13 SEC. 128. EXTENSION OF THE SUPPORTING GRAND14 PARENTS RAISING GRANDCHILDREN ACT. 

15 Section 3(f) of the Supporting Grandparents Raising 

16 Grandchildren Act (Public Law 115-196) is amended by 

17 striking ‘‘3’’ and inserting ‘‘4’’. 

18 SEC. 129. SCREENING FOR SUICIDE RISK. 

19 Section 102(14)(G) of the Older Americans Act of 1965 

20 (42 U.S.C. 3002(14)(G)) is amended by inserting ‘‘and 

21 screening for suicide risk’’ after ‘‘depression’’. 

22 SEC. 130. TRAUMATIC BRAIN INJURY. 

23 (a) DEFINITIONS.—Section 102 of the Older Ameri24 cans Act of 1965 (42 U.S.C. 3002), as amended by section 

25 114, is amended— 


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1 (1) in paragraph (14)— 

2 (A) in paragraph (M) by striking ‘‘(L)’’ 

3 and inserting ‘‘(M)’’, 

4 (B) by redesignating subparagraphs (H) 

5 through (M) as subparagraphs (I) through (N), 

6 respectively, 

7 (C) by inserting after subparagraph (G) the 

8 following: 

9 ‘‘(H) screening for fall-related traumatic 

10 brain injury, coordination of treatment, rehabili11 tation and related services, and referral serv12 ices;’’, and 

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

14 ‘‘(56) The term ‘traumatic brain injury’ has the 

15 meaning given to it in section 339B(d) of the Public 

16 Health Service Act.’’. 

17 (b) HEALTH SCREENING.—Section 321(a)(8) of the 

18 Older Americans Act of 1965 (42 U.S.C.3030d(a)(8)) is 

19 amended to read as follows: 

20 ‘‘(8) services designed to provide health screening 

21 (including mental and behavioral health screening, 

22 screening for social isolation and loneliness, falls pre23 vention services screening and traumatic brain injury 

24 screening) to detect or prevent (or both) illnesses and 


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1 injuries that occur most frequently in older individ2 uals;’’. 

3 (c) ACTIVITIES FOR HEALTH.—Section 411(a)(12) of 

4 the Older Americans Act of 1965 (42 U.S.C. 3032(a)(12)) 

5 is amended to read as follows: 

6 ‘‘(12) building public awareness of cognitive im7 pairments such as Alzheimer’s disease and related 

8 disorders with neurological and organic brain dys9 function, depression, mental health disorders, and 

10 traumatic brain injury;’’. 

11 SEC. 131. ADDRESSING PUBLIC HEALTH EMERGENCIES AND 

12 EMERGING HEALTH THREATS. 

13 Section 102(14) of the Older Americans Act of 1965 

14 (42 U.S.C. 3002(14)), as amended by sections 114 and 130, 

15 is amended— 

16 (1) in subparagraph (M) by striking ‘‘and’’ at 

17 the end, 

18 (2) in subparagraph (N) by striking ‘‘(M)’’ and 

19 inserting ‘‘(N)’’, 

20 (3) by redesignating subparagraphs (K), (L), 

21 (M), and (N) as subparagraphs (L), (M), (N), and 

22 (O) respectively, and 

23 (4) by inserting after subparagraph (J) the fol24 lowing: 


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1 ‘‘(K) responses to public health emergencies 

2 and emerging health threats;’’. 

3 TITLE II—EMPOWERING THE 

4 AGING NETWORK TO MEET 

5 THE NEEDS OF OLDER INDI6 VIDUALS 

7 SEC. 201. NATIONAL FAMILY CAREGIVER SUPPORT PRO8 GRAM CAP. 

9 (a) FEDERAL SHARE.—Section 373(g)(2) of the Older 

10 Americans Act of 1965 (42 U.S.C. 3030s–1(g)(2)) is amend11 ed by striking subparagraph (C). 

12 (b) MONITORING THE IMPACT OF THE ELIMINATION OF

13 THE CAP ON FUNDS FOR OLDER RELATIVE CAREGIVERS.— 

14 (1) REPORT.—Not later than 18 months after the 

15 date of the enactment of this Act, and annually there16 after, the Assistant Secretary shall submit to the 

17 Committee on Education and Labor of the House of 

18 Representatives and the Committee on Health, Edu19 cation, Labor, and Pensions of the Senate a report on 

20 the impact of the amendment made by subsection (a) 

21 to eliminate the limitation on funds that States may 

22 allocate to provide support services to older relative 

23 caregivers in the National Family Caregiver Support 

24 Program established under part E of title III of the 

25 Older Americans Act of 1965 (42 U.S.C. 3030s– 


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1 3030s–2). Each such report shall also be made avail2 able to the public. 

3 (2) CONTENTS.—For purposes of reports required 

4 by paragraph (1), each State that receives an allot5 ment under such National Family Caregiver Support 

6 Program for fiscal year 2020 or a subsequent fiscal 

7 year shall report to the Assistant Secretary for the fis8 cal year involved the amount of funds of the total 

9 Federal and non-Federal share allotment used by the 

10 State to provide support services for caregiver support 

11 for older relative caregivers and family caregivers. 

12 SEC. 202. MINIMUM FUNDING LEVEL FOR STATE ADMINIS13 TRATIVE EXPENSES. 

14 Section 308(b)(2)(A) of the Older Americans Act of 

15 1965 (42 U.S.C. 3028(b)(2)(B)) is amended by striking 

16 ‘‘$500,000’’ and inserting ‘‘$750,000’’. 

17 SEC. 203. CULTURALLY-APPROPRIATE, MEDICALLY-TAI18 LORED MEALS. 

19 Section 339(2)(A) of the Older Americans Act of 1965 

20 (42 U.S.C. 3939h(2)(A)) is amended by inserting ‘‘, includ21 ing cultural considerations and preferences (including 

22 needs based on religious, cultural, or ethnic requirements) 

23 and medically tailored meals’’ before the comma at the end. 


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1 SEC. 204. BUSINESS ACUMEN PROVISIONS AND CLARIFICA2 TION REGARDING OUTSIDE FUNDING FOR 

3 AREA AGENCIES ON AGING. 

4 (a) ASSISTANCE RELATING TO GROWING AND SUS5 TAINING CAPACITY.—Section 202(b)(9) of the Older Ameri6 cans Act of 1965 (42 U.S.C. 3012(b)(9)) is amended— 

7 (1) in subparagraph (A) by striking ‘‘and’’ after 

8 the semicolon at the end, 

9 (2) in subparagraph (B) by inserting ‘‘and’’ 

10 after the semicolon at the end, and 

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

12 ‘‘(C) business acumen, capacity building, 

13 organizational development, innovation, and 

14 other methods of growing and sustaining the ca15 pacity of the aging network to serve older indi16 viduals and caregivers most effectively;’’. 

17 (b) CLARIFYING PARTNERSHIPS FOR AREA AGENCIES

18 ON AGING.—Section 306 of the Older Americans Act of 1965 

19 (42 U.S.C. 3026) is amended by adding at the end the fol20 lowing: 

21 ‘‘(g) Nothing in this Act shall restrict an area agency 

22 on aging from providing services not provided or authorized 

23 by this Act, including through— 

24 ‘‘(1) contracts with health care payers; 

25 ‘‘(2) consumer private pay programs; or 


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1 ‘‘(3) other arrangements with entities or individ2 uals that increase the availability of home and com3 munity-based services and supports in the planning 

4 and service area supported by the area agency on 

5 aging.’’. 

6 SEC. 205. OTHER PRACTICES. 

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

8 U.S.C. 3030c-2) is amended by adding at the end the fol9 lowing: 

10 ‘‘(e) RESPONSE TO AREA AGENCIES ON AGING.—Upon 

11 request from an area agency on aging, the State shall make 

12 available any policies or guidance pertaining to policies 

13 under this section.’’. 

14 SEC. 206. CAREGIVER ASSESSMENTS. 

15 (a) DEFINITION OF CAREGIVER ASSESSMENT.—Sec16 tion 372(a) of the Older Americans Act of 1965 (42 U.S.C. 

17 3030s(a)) is amended by adding at the end the following: 

18 ‘‘(4) CAREGIVER ASSESSMENT.—The term ‘care19 giver assessment’ means a systematic process of gath20 ering information about the situation of a caregiver 

21 who voluntarily participates in such process to iden22 tify the caregiver’s specific needs, barriers, and exist23 ing supports as identified by the caregiver that— 

24 ‘‘(A) provides the opportunity for the recog25 nized caregiver to participate in such process; 


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1 ‘‘(B) requires direct contact with the care2 giver and is used to appropriately target and 

3 tailor support services to the caregiver’s unique 

4 needs; and 

5 ‘‘(C) includes reassessment of such specific 

6 needs, barriers, and existing supports, including 

7 to accommodate a significant change in the 

8 caregiving situation, which shall occur on a vol9 untary basis with the consent of the caregiver.’’. 

10 (b) USE OF CAREGIVER ASSESSMENTS.—Section 

11 373(b) of the Older Americans Act of 1965 (42 U.S.C. 

12 3030s–1(b)) is amended by inserting ‘‘may be informed 

13 through the use of caregiver assessments and’’ after ‘‘with,’’. 

14 (c) TECHNICAL ASSISTANCE FOR CAREGIVER ASSESS15 MENTS.—Section 373 of the Older Americans Act of 1965 

16 (42 U.S.C. 3030s–1) is amended by adding at the end the 

17 following: 

18 ‘‘(h) TECHNICAL ASSISTANCE FOR CAREGIVER AS19 SESSMENTS.—Not later than 1 year after the effective date 

20 of this subsection, the Assistant Secretary, in consultation 

21 with caregivers, older individuals, individuals with a dis22 ability who receive care from an older relative caregiver, 

23 the aging network, and other experts and stakeholders, shall 

24 provide technical assistance to promote and implement the 

25 use of caregiver assessments. Such technical assistance shall 


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1 include sharing available tools and templates, comprehen2 sive assessment protocols, and best practices concerning— 

3 ‘‘(1) conducting caregiver assessments and reas4 sessments; 

5 ‘‘(2) implementing such assessments that are 

6 consistent across a planning and service area; and 

7 ‘‘(3) implementing caregiver support service 

8 plans, including referrals to and coordination of ac9 tivities with relevant State and local services.’’. 

10 (d) REPORTING ON CAREGIVER ASSESSMENT.—Sec11 tion 373(e) of the Older Americans Act of 1965 (42 U.S.C. 

12 3030s–1(e)) is amended— 

13 (1) in paragraph (3) by inserting ‘‘, including 

14 caregiver assessments used in the State,’’ after ‘‘mech15 anisms’’ the 1st place it appears, and 

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

17 ‘‘(4) REPORT ON CAREGIVER ASSESSMENTS.— 

18 ‘‘(A) IN GENERAL.—Not later than 3 years 

19 after the effective date of this paragraph, the As20 sistant Secretary shall issue a report on the use 

21 of caregiver assessments by area agencies on 

22 aging, entities contracting with such agencies, 

23 and organizations. Such report shall include— 

24 ‘‘(i) an analysis of the current use of 

25 caregiver assessments, including a reposiVerDate Sep 11 2014 22:20 Oct 28, 2019 Jkt 099200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6203 E:\BILLS\H4334.RH H4334

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1 tory of caregiver assessment tools or tem2 plates and comprehensive assessment proto3 cols; 

4 ‘‘(ii) using objective data, an analysis 

5 of the impact of caregiver assessments on— 

6 ‘‘(I) family caregivers and older 

7 relative caregivers; and 

8 ‘‘(II) the individuals to whom the 

9 caregivers described in subclause (I) 

10 provide care; 

11 ‘‘(iii) an analysis of the impact of 

12 using caregiver assessments on the aging 

13 network; 

14 ‘‘(iv) an analysis of how caregiver as15 sessments are being used to identify the spe16 cific needs, barriers, and existing supports 

17 of family caregivers and older relative care18 givers; 

19 ‘‘(v) recommendations for using care20 giver assessments, including in rural or un21 derserved areas; and 

22 ‘‘(vi) feedback from State agencies and 

23 area agencies on aging, particularly in 

24 rural or underserved areas, on the imple25 mentation of caregiver assessments. 


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1 ‘‘(B) SUBMISSION.—Not later than 6 

2 months after the issuance of the report under 

3 subparagraph (A), the Assistant Secretary shall 

4 submit the report to the Committee on Education 

5 and Labor of the House of Representatives, the 

6 Committee on Health, Education, Labor, and 

7 Pensions of the Senate, and the Special Com8 mittee on Aging of the Senate.’’. 

9 SEC. 207. RESEARCH AND EVALUATION. 

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

11 U.S.C. 3011) is amended by adding at the end the following: 

12 ‘‘(g)(1) The Assistant Secretary shall coordinate the re13 search and evaluation functions of this Act under a Na14 tional Research, Demonstration, and Evaluation Center for 

15 the Aging Network (in this subsection referred to as the 

16 ‘Center’), which shall be headed by a director designated 

17 by the Assistant Secretary from individuals described in 

18 paragraph (4). 

19 ‘‘(2) The purpose of the Center shall be— 

20 ‘‘(A) to coordinate research, research dissemina21 tion, evaluation, demonstration projects, and related 

22 activities carried out under this Act; 

23 ‘‘(B) to provide assessment of the programs au24 thorized under this Act; and 


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1 ‘‘(C) to increase the repository of information on 

2 evidence-based programs and interventions available 

3 to the aging network. Such information shall be ap4 plicable to existing programs and help in the develop5 ment of new evidence-based programs and interven6 tions. 

7 ‘‘(3) Activities of the Center shall include conducting, 

8 promoting, coordinating, and providing support for— 

9 ‘‘(A) research and evaluation activities that sup10 port the objectives of this Act, including— 

11 ‘‘(i) evaluation of new and existing pro12 grams and interventions authorized by this Act; 

13 and 

14 ‘‘(ii) research on and assessment of the im15 pacts that programs and interventions under 

16 this Act have on the health outcomes, social de17 terminants of health, quality of life, and inde18 pendence of individuals served under this Act; 

19 ‘‘(B) demonstration projects that support the ob20 jectives of the Act and activities to bring effective 

21 demonstration projects to scale with a prioritization 

22 of projects that address the needs of underserved popu23 lations; 

24 ‘‘(C) outreach and dissemination of research 

25 findings; and 


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1 ‘‘(D) technical assistance related to the activities 

2 described in this subparagraph. 

3 ‘‘(4) The director shall be an individual with substan4 tial knowledge of and experience in aging and health policy, 

5 and research administration. 

6 ‘‘(5) Not later than October 1, 2020, and at 5-year in7 tervals thereafter, the director shall prepare and publish in 

8 the Federal Register for public comment a draft of a 5-year 

9 plan that— 

10 ‘‘(A) outlines priorities for research, research dis11 semination, evaluation, and related activities; 

12 ‘‘(B) explains the basis for such priorities; and 

13 ‘‘(C) describes how the plan will meet the needs 

14 of underserved populations. 

15 ‘‘(6) The director shall, as appropriate, coordinate 

16 with other Federal departments and agencies involved in 

17 research in the field of aging. 

18 ‘‘(7) Not later than December 31, 2020, and annually 

19 thereafter, the director shall prepare, and submit to the Sec20 retary, the Committee on Health, Education, Labor, and 

21 Pensions of the Senate, the Special Committee on Aging of 

22 the Senate, and the Committee on Education and Labor 

23 of the House of Representatives, a report on the activities 

24 funded under this section and title IV. 


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1 ‘‘(8) The director shall, as appropriate, consult with 

2 experts on aging research and evaluation and aging net3 work stakeholders on the implementation of the activities 

4 described under paragraph (3) of this subsection. 

5 ‘‘(9) The director shall coordinate all research and 

6 evaluation authorities under this Act.’’. 

7 SEC. 208. GRANT PROGRAM FOR MULTIGENERATIONAL 

8 COLLABORATION. 

9 Section 417 of the Older Americans Act of 1965 (42 

10 U.S.C. 3032f) is amended— 

11 (1) by amending subsection (a) to read as fol12 lows: 

13 ‘‘(a) GRANTS AND CONTRACTS.—The Assistant Sec14 retary shall award grants to, and enter into contracts with, 

15 eligible organizations to carry out projects— 

16 ‘‘(1) to provide opportunities for older individ17 uals to participate in multigenerational activities 

18 and civic engagement activities that contribute to the 

19 health and wellness of older individuals and individ20 uals in younger generations by developing— 

21 ‘‘(A) meaningful roles for participants; 

22 ‘‘(B) reciprocity in relationship building; 

23 ‘‘(C) reduced social isolation and improved 

24 participant social connectedness; 


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1 ‘‘(D) improved economic well-being for older 

2 individuals; 

3 ‘‘(E) increased lifelong learning; or 

4 ‘‘(F) support for family caregivers by— 

5 ‘‘(i) providing support for older rel6 ative caregivers (as defined in section 372) 

7 raising children (such as kinship navigator 

8 programs); or 

9 ‘‘(ii) involving volunteers who are 

10 older individuals who provide support and 

11 information to families who have a child 

12 with a disability or chronic illness, or other 

13 families in need of such family support; 

14 ‘‘(2) to coordinate multigenerational activities 

15 and civic engagement activities, including 

16 multigenerational nutrition and meal service pro17 grams; 

18 ‘‘(3) to promote volunteerism, including becom19 ing a mentor to young people; and 

20 ‘‘(4) to facilitate development of and participa21 tion in multigenerational activities and civic engage22 ment activities.’’, 

23 (2) by amending subsection (b) to read as fol24 lows: 

25 ‘‘(b) USE OF FUNDS.— 


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1 ‘‘(1) IN GENERAL.—An eligible organization 

2 shall use funds made available under a grant award3 ed, or a contract entered into, under this section to 

4 carry out a project described in subsection (a). 

5 ‘‘(2) PROVISION OF PROJECTS THROUGH GRANT6 EES.—In making grants under this section, the As7 sistant Secretary shall ensure that awards are made 

8 for the activities and projects described in each of 

9 paragraphs (1) and (2) of subsection (a).’’; 

10 (3) in subsection (c)— 

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

12 by inserting ‘‘that serves individuals in younger 

13 generations and older individuals’’ after ‘‘to 

14 carry out a project’’; 

15 (B) in paragraph (1) by inserting ‘‘, intent 

16 to carry out, or intent to partner with local or17 ganizations or multiservice organizations to 

18 carry out,’’ after ‘‘record of carrying out’’, 

19 (C) in paragraph (3) by striking ‘‘; and’’ 

20 and inserting a semicolon, 

21 (D) in paragraph (4) by striking the period 

22 at the end and inserting ‘‘; and’’, and 

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

24 ‘‘(5) eligible organizations proposing 

25 multigenerational activity projects that utilize shared 


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1 site programs, such as collocated child care and long2 term care facilities.’’, 

3 (4) by amending subsection (e) to read as fol4 lows: 

5 ‘‘(e) ELIGIBLE ORGANIZATIONS.—Organizations eligi6 ble to receive a grant or enter into a contract under sub7 section (a) shall— 

8 ‘‘(1) be a State, an area agency on aging, or an 

9 organization that provides opportunities for older in10 dividuals to participate in activities described in such 

11 subsection; and 

12 ‘‘(2) have the capacity to conduct the coordina13 tion, promotion, and facilitation described in such 

14 subsection through the use of multigenerational coor15 dinators.’’, 

16 (5) by striking subsection (g), 

17 (6) in subsection (h)(2)(B)(i) by striking ‘‘indi18 viduals from the generations with older individuals’’ 

19 and inserting ‘‘older individuals’’, 

20 (7) by redesignating subsections (b) through (f) 

21 as subsections (c) through (g), respectively, and 

22 (8) by inserting after subsection (a) the fol23 lowing: 


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1 ‘‘(b) GRANT PERIOD.—Each grant awarded or con2 tract made under subsection (a) shall be to carry out 

3 projects for a period of not less than 36 months.’’. 

4 TITLE III—STRENGTHENING 

5 PROTECTIONS FOR OLDER IN6 DIVIDUALS 

7 SEC. 301. STATE LONG-TERM CARE OMBUDSMAN PROGRAM 

8 MINIMUM FUNDING AND MAINTENANCE OF 

9 EFFORT. 

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

11 seq.) is amended— 

12 (1) in section 306(a)(9)— 

13 (A) by inserting ‘‘together with any other 

14 funds’’ after ‘‘Act’’, and 

15 (B) by striking ‘‘2000’’ and inserting 

16 ‘‘2019’’, and 

17 (2) in section 307(a)(9)— 

18 (A) by striking ‘‘an amount’’ the 1st place 

19 it appears and inserting ‘‘the total amount’’, 

20 (B) by striking ‘‘2000’’ and inserting 

21 ‘‘2019’’ each place it appears, and 

22 (C) by inserting ‘‘from all sources includ23 ing’’ after ‘‘received’’ each place it appears. 


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1 SEC. 302. STATE LONG-TERM CARE VOLUNTEER OMBUDS2 MAN REPRESENTATIVES. 

3 Section 712(a)(5) of the Older Americans Act of 1965 

4 (42 U.S.C. 3058g(a)(5)) is amended— 

5 (1) by redesignating subparagraph (D) as sub6 paragraph (E), and 

7 (2) by inserting after subparagraph (C) the fol8 lowing: 

9 ‘‘(D) VOLUNTEER OMBUDSMAN REPRESENT10 ATIVES.—An individual designated as a volun11 teer ombudsman representative may receive fi12 nancial support and recognition from the Office 

13 of the State Long-Term Care Ombudsman Pro14 gram for expenses incurred during service.’’. 

15 SEC. 303. CLARIFICATION REGARDING BOARD AND CARE 

16 FACILITIES. 

17 Section 102(35)(C) of the Older Americans Act of 1965 

18 (42 U.S.C. 3002(35)(C)) is amended by striking ‘‘for pur19 poses of sections 307(a)(12) and 712,’’. 

20 TITLE IV—MEETING THE NEEDS 

21 OF OLDER NATIVE AMERICANS 

22 SEC. 401. EXPANDING SUPPORTIVE SERVICES FOR NATIVE 

23 AMERICAN AGING PROGRAMS. 

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

25 3057 et seq.) is amended— 

26 (1) in part D— 


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1 (A) by amending section 643 to read as fol2 lows: 

3 ‘‘SEC. 643. AUTHORIZATION OF APPROPRIATIONS. 

4 ‘‘There are authorized to be appropriated to carry out 

5 this title— 

6 ‘‘(1) for parts A and B, $38,524,324 for fiscal 

7 year 2020, $40,835,783 for fiscal year 2021, 

8 $43,285,930 for fiscal year 2022, $45,883,086 for fis9 cal year 2023, and $48,636,071 for fiscal year 2024; 

10 and 

11 ‘‘(2) for part C subject to section 644, 

12 $10,785,575 for fiscal year 2020, $11,432,710 for fis13 cal year 2021, $12,118,672 for fiscal year 2022, 

14 $12,845,792 for fiscal year 2023, and $13,616,540 for 

15 fiscal year 2024.’’, and 

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

17 ‘‘SEC. 644. FUNDING SET ASIDE. 

18 ‘‘Of the funds appropriated under section 643(1) for 

19 a fiscal year, 5 percent shall be made available to carry 

20 out part D for such fiscal year.’’, 

21 (2) by redesignating part D as part E, and 

22 (3) by inserting after part C the following: 


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1 ‘‘PART D—SUPPORTIVE SERVICES FOR HEALTHY 

2 AGING AND INDEPENDENCE 

3 ‘‘SEC. 636. PROGRAM. 

4 ‘‘(a) IN GENERAL.—The Assistant Secretary shall 

5 carry out a demonstration program for making grants to 

6 tribal or Native Hawaiian organizations with applications 

7 approved under parts A and B, to pay for the Federal share 

8 of carrying out programs, to enable the organizations to 

9 provide a wider range of in-home and community sup10 portive services to enable older individuals to maintain 

11 their health and independence and to avoid long-term care 

12 facility placement. 

13 ‘‘(b) SUPPORTIVE SERVICES.— 

14 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

15 supportive services described in subsection (a) may 

16 include any of the activities described in section 

17 321(a). 

18 ‘‘(2) PRIORITY.—The Assistant Secretary, in 

19 making grants under this section, shall give priority 

20 to organizations that will use the grant funds for sup21 portive services described in subsection (a) that are 

22 for in-home assistance, transportation, information 

23 and referral, case management, health and wellness 

24 programs, legal services, family caregiver support 

25 services, and other services that directly support the 

26 independence of the older individuals served.’’. 


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1 SEC. 402. ENHANCING CAPACITY TO SUPPORT NATIVE 

2 AMERICAN AGING PROGRAMS. 

3 Title II of the Older Americans Act of 1965 (42 U.S.C. 

4 3011 et seq.) is amended— 

5 (1) in section 201(c)(3)(H) by inserting ‘‘to en6 sure adequate capacity to deliver the services under 

7 such title, which technical assistance programs may 

8 include program management, data development and 

9 use, basic business skills, grant development, program 

10 and service innovations, and staff professional devel11 opment and certification’’ before the semicolon at the 

12 end, and 

13 (2) section 216 is amended to read as follows: 

14 ‘‘SEC. 216. AUTHORIZATION OF APPROPRIATIONS. 

15 ‘‘(a) IN GENERAL.—For purposes of carrying out this 

16 Act, there are authorized to be appropriated for administra17 tion, salaries, and expenses of the Administration 

18 $44,042,171 for fiscal year 2020, $46,684,701 for fiscal year 

19 2021, $49,485,783 for fiscal year 2022, $52,454,930 for fis20 cal year 2023, and $55,602,226 for fiscal year 2024. 

21 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS FOR PRO22 GRAMS.—There are authorized to be appropriated— 

23 ‘‘(1) to carry out section 201(g), $20,000,000 for 

24 each of the fiscal years 2020 through 2024; 

25 ‘‘(2) to carry out section 202(a)(21) (relating to 

26 the National Eldercare Locator Service), $2,186,227 


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1 for fiscal year 2020, $2,317,401 for fiscal year 2021, 

2 $2,456,445 for fiscal year 2022, $2,603,832 for fiscal 

3 year 2023, and $2,760,062 for fiscal year 2024; 

4 ‘‘(3) to carry out section 215, $1,992,460 for fis5 cal year 2020, $2,112,008 for fiscal year 2021, 

6 $2,238,728 for fiscal year 2022, $2,373,052 for fiscal 

7 year 2023, and $2,515,435 for fiscal year 2024; 

8 ‘‘(4) to carry out section 202 (relating to Elder 

9 Rights Support Activities under this title), $1,375,011 

10 for fiscal year 2020, $1,457,511 for fiscal year 2021, 

11 $1,544,962 for fiscal year 2022, $1,637,660 for fiscal 

12 year 2023, and $1,735,919 for fiscal year 2024; 

13 ‘‘(5) to carry out section 202(b) (relating to the 

14 Aging and Disability Resource Centers), $8,708,043 

15 for fiscal year 2020, $9,230,526 for fiscal year 2021, 

16 $9,784,357 for fiscal year 2022, $10,371,419 for fiscal 

17 year 2023, and $10,993,704 for fiscal year 2024; and 

18 ‘‘(6) to carry out section 201(c)(3)(H) (relating 

19 to professional development and technical assistance 

20 for programs under title VI), $500,000 for fiscal year 

21 2020.’’. 

22 TITLE V—MISCELLANEOUS 

23 SEC. 501. TECHNICAL CORRECTIONS. 

24 The Older Americans Act of 1965 (42 U.S.C. 3001 et 

25 seq.) is amended— 


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1 (1) in section 102(37)(A) by striking ‘‘paragraph 

2 (5)’’ and inserting ‘‘paragraph (26)’’, 

3 (2) in section 202(a)(23) by striking ‘‘sections 

4 307(a)(18) and 731(b)(2)’’ and inserting ‘‘sections 

5 307(a)(13) and 731’’, 

6 (3) in section 202(e)(1)(A) by moving the left 

7 margin of clause (i) 2 ems to the left, 

8 (4) in sections 203(c)(7), 207(b)(2)(B), and 

9 215(i) by striking ‘‘Committee on Education and the 

10 Workforce’’ and inserting ‘‘Committee on Education 

11 and Labor’’, 

12 (5) in section 207(b)(3)(A) by striking ‘‘Admin13 istrator of the Health Care Finance Administration’’ 

14 and inserting ‘‘Administrator of the Centers for Medi15 care and Medicaid Services’’, 

16 (6) in section 304(a)(3)(C) by striking ‘‘term’’ 

17 and all that follows through ‘‘does’’, and inserting 

18 ‘‘term ‘State’ does’’, 

19 (7) in section 306(a)— 

20 (A) by inserting ‘‘the number of older indi21 viduals at risk for institutional placement resid22 ing in such area,’’ after ‘‘areas) residing in such 

23 area,’’ the last place it appears, and 

24 (B) in paragraph (2) by striking ‘‘who are 

25 victims of’’ and inserting ‘‘with’’, 


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1 (8) in section 339 by striking ‘‘Institute of Medi2 cine of the National Academy of Sciences’’ and insert3 ing ‘‘National Academies of Sciences, Engineering, 

4 and Medicine’’, 

5 (9) in section 611 by striking ‘‘(a)’’, and 

6 (10) in section 614(c)(4) by striking ‘‘(a)(12)’’ 

7 and inserting ‘‘(a)(11)’’. 

8 SEC. 502. AUTHORIZATION OF APPROPRIATIONS; USES OF 

9 FUNDS. 

10 (a) AUTHORIZATION OF APPROPRIATIONS; USES OF

11 FUNDS.—Section 303 of the Older Americans Act of 1965 

12 (42 U.S.C. 3023) is amended to read as follows: 

13 ‘‘SEC. 303. AUTHORIZATION OF APPROPRIATIONS; USES OF 

14 FUNDS. 

15 ‘‘(a)(1) There are authorized to be appropriated to 

16 carry out part B (relating to supportive services) 

17 $413,011,586 for fiscal year 2020, $437,792,281 for fiscal 

18 year 2021, $464,059,818 for fiscal year 2022, $491,903,407 

19 for fiscal year 2023, and $521,417,612 for fiscal year 2024. 

20 ‘‘(2) Funds appropriated under paragraph (1) shall 

21 be available to carry out section 712. 

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

23 carry out subpart 1 of part C (relating to congregate nutri24 tion services) $531,279,663 for fiscal year 2020, 

25 $563,156,443 for fiscal year 2021, $596,945,830 for fiscal 


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1 year 2022, $632,762,580 for fiscal year 2023, and 

2 $670,728,334 for fiscal year 2024. 

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

4 out subpart 2 of part C (relating to home delivered nutri5 tion services) $269,577,167 for fiscal year 2020, 

6 $285,751,797 for fiscal year 2021, $302,896,905 for fiscal 

7 year 2022, $321,070,719 for fiscal year 2023, and 

8 $340,334,963 for fiscal year 2024. 

9 ‘‘(c) Grants made under part B, and subparts 1 and 

10 2 of part C, of this title may be used for paying part of 

11 the cost of— 

12 ‘‘(1) the administration of area plans by area 

13 agencies on aging designated under section 

14 305(a)(2)(A), including the preparation of area plans 

15 on aging consistent with section 306 and the evalua16 tion of activities carried out under such plans; and 

17 ‘‘(2) the development of comprehensive and co18 ordinated systems for supportive services, congregate 

19 and home delivered nutrition services under subparts 

20 1 and 2 of part C, the development and operation of 

21 multipurpose senior centers, and the delivery of legal 

22 assistance. 

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

24 out part D (relating to disease prevention and health pro25 motion services) $26,650,753 for fiscal year 2020, 


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1 $28,249,798 for fiscal year 2021, $29,944,786 for fiscal year 

2 2022, $31,741,473 for fiscal year 2023, and $33,645,961 for 

3 fiscal year 2024. 

4 ‘‘(e) There are authorized to be appropriated to carry 

5 out part E (relating to family caregiver support) 

6 $194,331,264 for fiscal year 2020, $205,991,140 for fiscal 

7 year 2021, $218,350,609 for fiscal year 2022, $231,451,645 

8 for fiscal year 2023, and $245,338,744 for fiscal year 

9 2024.’’. 

10 (b) Section 304(a)(3)(D) of the Older Americans Act 

11 of 1965 (42 U.S.C. 3024(a)(3)(D)) is amended— 

12 (1) in clause (i) by striking ‘‘2017 through 

13 2019’’ and inserting ‘‘2020 through 2024’’, and 

14 (2) in clause (ii) by striking ‘‘2020’’ and insert15 ing ‘‘2025’’. 

16 (c) Section 311(e) of the Older Americans Act of 1965 

17 (42 U.S.C. 3030a(e)) is amended to read as follows: 

18 ‘‘(e) There are authorized to be appropriated to carry 

19 out this section (other than subsection (c)(1)) $171,682,200 

20 for fiscal year 2020, $181,983,132 for fiscal year 2021, 

21 $192,902,120 for fiscal year 2022, $204,476,247 for fiscal 

22 year 2023, and $216,744,822 for fiscal year 2024.’’. 

23 (d) Section 411(b) of the Older Americans Act of 1965 

24 (42 U.S.C. 3032(b)) is amended to read as follows: 


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1 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out— 

3 ‘‘(1) aging network support activities under this 

4 section, $14,549,157 for fiscal year 2020, $15,422,107 

5 for fiscal year 2021, $16,347,433 for fiscal year 2022, 

6 $17,328,279 for fiscal year 2023, and $18,367,976 for 

7 fiscal year 2024; and 

8 ‘‘(2) elder rights support activities under this 

9 section, $15,650,667 for fiscal year 2020, $16,589,707 

10 for fiscal year 2021, $17,585,090 for fiscal year 2022, 

11 $18,640,195 for fiscal year 2023, and $19,758,607 for 

12 fiscal year 2024.’’. 

13 (e) Section 517(a) of the Older Americans Act of 1965 

14 (42 U.S.C. 3056o(a)) is amended to read as follows: 

15 ‘‘(a) IN GENERAL.—There are authorized to be appro16 priated to carry out this title $429,020,486 for fiscal year 

17 2020, $454,761,715 for fiscal year 2021, $482,047,418 for 

18 fiscal year 2022, $510,970,263 for fiscal year 2023, and 

19 $541,628,478 for fiscal year 2024.’’. 

20 (f) Section 702 of the Older Americans Act of 1965 

21 (42 U.S.C.3058a) is amended to read as follows: 

22 ‘‘SEC. 702. AUTHORIZATION OF APPROPRIATIONS. 

23 ‘‘(a) OMBUDSMAN PROGRAM.—There are authorized to 

24 be appropriated to carry out chapter 2, $18,110,027 for fis25 cal year 2020, $19,196,629 for fiscal year 2021, 


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1 $20,348,427 for fiscal year 2022, $21,569,332 for fiscal year 

2 2023, and $22,863,492 for fiscal year 2024. 

3 ‘‘(b) OTHER PROGRAMS.—There are authorized to be 

4 appropriated to carry out chapters 3 and 4, $5,119,287 for 

5 fiscal year 2020, $5,426,444 for fiscal year 2021, $5,752,031 

6 for fiscal year 2022, $6,097,153 for fiscal year 2023, and 

7 $6,462,982 for fiscal year 2024.’’. 

8 SEC. 503. EFFECTIVE DATE. 

9 This Act shall take effect on October 1, 2019. 


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Union Calendar No. 206 

116TH CONGRESS 

1ST SESSION H. R. 4334 

[Report No. 116–258] 

A BILL 

To amend the Older Americans Act of 1965 to authrough 2024, and for other purposes. thorize appropriations for fiscal years 2020 

OCTOBER 28, 2019 

Reported with an amendment, committed to the Comand ordered to be printed mittee of the Whole House on the State of the Union, 


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