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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4334 Engrossed in House (EH)]

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116th CONGRESS
  1st Session
                                H. R. 4334

_______________________________________________________________________

                                 AN ACT

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

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Dignity in Aging 
Act of 2019''.
    (b) Table of Contents.--The table of contents of this 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 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. Falls prevention and chronic disease self-management 
                            education.
Sec. 112. Extension of RAISE Family Caregivers Act.
Sec. 113. Support for socially-isolated older Americans.
Sec. 114. Increased focus of Assistant Secretary on health effects 
                            associated with social isolation.
Sec. 115. Advisory council on health effects associated with social 
                            isolation.
Sec. 116. Supportive services and senior centers.
Sec. 117. Demonstration projects.
Sec. 118. Younger onset Alzheimer's Disease.
Sec. 119. Priority for the senior community service employment program.
Sec. 120. Direct care workforce.
Sec. 121. National resource center for older individuals experiencing 
                            the long-term and adverse consequences of 
                            trauma.
Sec. 122. National Resource Center for Women and Retirement.
Sec. 123. Definition.
Sec. 124. Review of reports.
Sec. 125. Area plans.
Sec. 126. Addressing chronic pain management.
Sec. 127. Extension of the Supporting Grandparents Raising 
                            Grandchildren Act.
Sec. 128. Screening for suicide risk.
Sec. 129. Traumatic brain injury.
Sec. 130. Addressing public health emergencies and emerging health 
                            threats.
Sec. 131. Prevention of sexually transmitted diseases.
Sec. 132. Aging and Disability Resource Center.
   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.
Sec. 304. Report on legal hotlines.
Sec. 305. Community outreach.
Sec. 306. Principles for person-directed services and supports during 
                            serious illness.
         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. Hold harmless formula.

 TITLE I--ENSURING COLLABORATION AND PROMOTING INDEPENDENCE FOR OLDER 
                              INDIVIDUALS

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

    Section 101(2) of the Older Americans Act of 1965 (42 U.S.C. 
3001(2)) is amended by inserting ``(including access to person-
centered, trauma-informed care)'' after ``health''.

SEC. 102. VACCINATION.

    Section 102(14) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)) is amended--
            (1) in subparagraph (B) by inserting ``immunization 
        status,'' after ``oral health,''; and
            (2) in subparagraph (D) by inserting ``infectious disease, 
        and vaccine preventable disease,'' after ``disease),''.

SEC. 103. FUNCTIONS OF ASSISTANT SECRETARY.

    (a) Review of Applications.-- Section 202 of the Older Americans 
Act of 1965 (42 U.S.C. 3012) is amended--
            (1) by amending subsection (a)(4) to read as follows:
            ``(4) administer the grants provided by this Act but not 
        approve an application submitted by an applicant for a grant 
        for a program for which such applicant previously received a 
        grant unless the Assistant Secretary determines--
                    ``(A) the program for which such application was 
                submitted is operating effectively to achieve its 
                stated purpose; and
                    ``(B) such applicant complied with the assurances 
                provided to the Assistant Secretary with the 
                application for such previous grant; and''; and
            (2) by adding at the end the following:
    ``(h) The Assistant Secretary shall publish, on an annual basis, a 
list of centers and demonstration projects funded under each title of 
the Act. The Assistant Secretary shall ensure that this information is 
also directly provided to States and area agencies on aging.''.
    (b)  Addressing the Needs of Older Individuals in Disasters.--
Section 202(a) of the Older Americans Act of 1965 (42 U.S.C. 3012(a)) 
is amended--
            (1) in paragraph (30) by striking ``and'' at the end;
            (2) in paragraph (31) by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(32) provide technical assistance to and share best 
        practices with States and area agencies on aging on how to 
        collaborate and coordinate activities and develop long-range 
        emergency preparedness plans with local and State emergency 
        response agencies, relief organizations, local and State 
        governments, federal agencies as appropriate, and any other 
        institutions that have responsibility for disaster relief 
        service delivery.''.

SEC. 104. PROFESSIONAL STANDARDS FOR NUTRITION OFFICIAL UNDER ASSISTANT 
              SECRETARY.

    Section 205(a)(2)(C)(ii) of the Older Americans Act of 1965 (42 
U.S.C. 3016(a)(2)(C)(ii) is amended to read as follows:
            ``(ii) be a registered dietitian or registered dietitian 
        nutritionist.''.

SEC. 105. INTERAGENCY COORDINATING COMMITTEE ON AGE-FRIENDLY 
              COMMUNITIES.

    Section 203 of the Older Americans Act of 1965 (42 U.S.C. 3013) is 
amended--
            (1) in subsection (b)--
                    (A) in paragraph (18) by striking ``and'' at the 
                end;
                    (B) in subparagraph (19) by striking the period at 
                the end, and inserting ``, and''; and
                    (C) by adding at the end the following:
            ``(20) section 393D of the Public Health Service Act (42 
        U.S.C. 280b-1f), relating to safety of seniors.''; and
            (2) in subsection (c)--
                    (A) in paragraph (1)--
                            (i) by striking ``Aging'' and inserting 
                        ``Age-Friendly Communities''; and
                            (ii) by inserting ``to support the ability 
                        of older individuals to age in place, including 
                        through the provision of homelessness 
                        prevention services, support the ability of 
                        older individuals to access preventive health 
                        care, promote age-friendly communities, and 
                        address the ability of older individuals to 
                        access long-term care supports, including 
                        access to caregivers and home- and community-
                        based services'' before the period at the end;
                    (B) in paragraph (4) by inserting ``, except that 
                the 1st term of a member appointed to the Interagency 
                Coordinating Committee on Age-Friendly Communities 
                shall begin not later than 1 year after the effective 
                date of this exception'' before the period at the end;
                    (C) in paragraph (5) by striking ``once each year'' 
                and inserting ``semiannually'';
                    (D) in paragraph (6)--
                            (i) in subparagraph (A)--
                                    (I) in clause (iii) by striking 
                                ``and'' at the end;
                                    (II) in clause (iv) by adding 
                                ``and'' at the end; and
                                    (III) by adding at the end the 
                                following:
                    ``(v) identifying best practices for connecting 
                older individuals to services for which they may be 
                eligible;'';
                            (ii) in subparagraph (B)--
                                    (I) by inserting 
                                ``transportation,'' after ``housing,'' 
                                the 1st place it appears;
                                    (II) in clause (i) by striking 
                                ``and'' at the end;
                                    (III) by amending clause (ii) to 
                                read as follows:
                    ``(ii) innovations in technology applications 
                (including assistive technology devices and assistive 
                technology services) that--
                            ``(I) promote safe and accessible 
                        independent living environments; and
                            ``(II) give older individuals access to 
                        information on available services or help in 
                        providing services to older individuals, 
                        including information on transportation 
                        services such as public transit, on-demand 
                        transportation services, volunteer-based 
                        transportation services, and other private 
                        transportation services; and''; and
                                    (IV) by adding at the end the 
                                following:
                    ``(iii) transportation models that reduce costs of 
                transportation for older individuals and provide the 
                ability to schedule trips in advance and on demand, as 
                appropriate;'';
                            (iii) in subparagraph (E)--
                                    (I) by striking ``nongovernmental 
                                experts and organizations, including 
                                public health interest and research 
                                groups and foundations'' and inserting 
                                ``nongovernmental organizations, 
                                academic or research institutions, 
                                community-based organizations, and 
                                philanthropic organizations''; and
                                    (II) by striking ``(F)'' and 
                                inserting ``(G)'';
                            (iv) by redesignating subparagraphs (E), 
                        (F), and (G) as subparagraphs (F), (G), and 
                        (H), respectively;
                            (v) by inserting after subparagraph (D) the 
                        following:
            ``(E) work with the Centers for Disease Control and 
        Prevention, the National Institute on Aging, Centers for 
        Medicare and Medicaid Services, the Housing and Urban 
        Development Office of Lead Hazard Control and Healthy Homes, 
        and other Federal agencies as appropriate, to develop 
        recommendations, in accordance with paragraph (1), to reduce 
        falls among older individuals that incorporate evidence-based 
        falls prevention programs and home modifications to reduce and 
        prevent falls;''; and
                            (vi) by adding at the end the following:
    ``(9) In this subsection, the term `age-friendly community' means a 
community that--
            ``(A) is taking steps--
                    ``(i) to include accessible housing, accessible 
                spaces and buildings, safe and secure paths, variable 
                route transportation services, and programs and 
                services designed to maintain health and well-being;
                    ``(ii) to respect and include older individuals in 
                social opportunities, civic participation, 
                volunteerism, and employment; and
                    ``(iii) to facilitate access to supportive services 
                for older individuals; and
            ``(B) has a plan in place to meet local needs for housing, 
        transportation, civic participation, social connectedness, and 
        accessible spaces.''; and
            (3) by adding at the end the following:
    ``(d) Not later than 2 years after the effective date of this 
subsection, the Comptroller General of the United States shall conduct 
a study and issue a report that includes--
            ``(1) an inventory of Federal programs, administered by the 
        Department of Health and Human Services, the Department of 
        Housing and Urban Development, or any other Federal agency 
        determined appropriate by the Comptroller General, that support 
        home assessments and home modifications for older individuals 
        and individuals with disabilities,
            ``(2) statistical data, for recent fiscal years, on the 
        number of older individuals and individuals with disabilities 
        served by each Federal program described in paragraph (1) and 
        the approximate amount of Federal funding invested in each such 
        program,
            ``(3) a demographic analysis of individuals served by each 
        such program for recent fiscal years,
            ``(4) an analysis of duplication and gaps in populations 
        supported by the Federal programs described in paragraph (1),
            ``(5) what is known about the impact of the Federal 
        programs described in paragraph (1) on health status and health 
        outcomes in populations supported by such programs,
            ``(6) a review of Federal efforts to coordinate Federal 
        programs existing prior to the effective date of this 
        subsection that support home assessments and home modifications 
        for older individuals and individuals with disabilities and any 
        considerations for improving coordination, which may include an 
        indication of the Federal agency or department that is best 
        suited to coordinate such Federal efforts, and
            ``(7) information on the extent to which consumer-friendly 
        resources, such as a brochure, are available through the 
        National Eldercare Locator Service established under section 
        202(a)(21), are accessible to all area agencies on aging, and 
        contain information on home assessments and home modifications 
        for older individuals attempting to live independently and 
        safely in their homes and for the caregivers of such 
        individuals.''.

SEC. 106. TECHNICAL ASSISTANCE ON AGE-FRIENDLY COMMUNITIES.

    Section 205(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 
3016(a)(2)) is amended--
            (1) by redesignating subparagraph (C) as subparagraph (D); 
        and
            (2) by inserting after subparagraph (B) the following:
    ``(C) The Assistant Secretary may provide technical assistance, 
including through the regional offices of the Administration, to State 
agencies, area agencies on aging, local government agencies, or leaders 
in age-friendly communities (as defined in section 203(c)(9)) 
regarding--
            ``(i) support for public and private entities in building 
        partnerships to promote such age-friendly communities;
            ``(ii) dissemination of, or consideration of ways to 
        implement, best practices and recommendations from the 
        Interagency Coordinating Committee on Age-Friendly Communities 
        established under section 203(c); and
            ``(iii) methods for managing and coordinating existing 
        programs to meet the needs of growing age-friendly 
        communities.''.

SEC. 107. MALNUTRITION.

    The Older Americans Act of 1965 (42 U.S.C. 2011 et seq.) is 
amended--
            (1) in section 102(14)(B) by inserting ``(including 
        screening for malnutrition)'' before the semicolon at the end; 
        and
            (2) in section 330(1) by striking ``and food insecurity'' 
        and inserting ``, food insecurity, and malnutrition''.

SEC. 108. COORDINATION WITH RESOURCE CENTERS.

    (a) Area Plans.--Section 306(a) of the Older Americans Act of 1965 
(42 U.S.C. 3026(a)) is amended--
            (1) in paragraph (16) by striking ``and'' at the end;
            (2) in paragraph (17) by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(18) provide assurances that the area agency on aging 
        will collect data to determine--
                    ``(A) the services that are needed by older 
                individuals whose needs were the focus of all centers 
                funded under title IV in fiscal year 2019; and
                    ``(B) the effectiveness of the programs, policies, 
                and services provided by such area agency on aging in 
                assisting such individuals; and
            ``(19) provide assurances that the area agency on aging 
        will use outreach efforts that will identify older individuals 
        eligible for assistance under this Act, with special emphasis 
        on those older individuals whose needs were the focus of all 
        centers funded under title IV in fiscal year 2019.''.
    (b) State Plans.--Section 307(a) of the Older Americans Act of 1965 
(42 U.S.C. 3027) is amended by adding at the end the following:
            ``(31) The plan shall contain an assurance that the State 
        shall prepare and submit to the Assistant Secretary annual 
        reports that describe--
                    ``(A) data collected to determine the services that 
                are needed by older individuals whose needs were the 
                focus of all centers funded under title IV in fiscal 
                year 2019;
                    ``(B) data collected to determine the effectiveness 
                of the programs, policies, and services provided by 
                area agencies on aging in assisting such individuals; 
                and
                    ``(C) outreach efforts and other activities carried 
                out to satisfy the assurances described in paragraphs 
                (18) and (19) of section 306(a).''.

SEC. 109. ARTS EDUCATION.

    (a) Program Design.--Section 202(a)(5) of the Older Americans Act 
of 1965 (42 U.S.C. 3012(a)(5)) is amended by inserting ``cultural 
experiences, activities and services, including the arts,'' after 
``education),''.
    (b) Supportive Services.--Section 321(a)(7) of the Older Americans 
Act of 1965 (42 U.S.C. 3030d(a)(7)) is amended by inserting ``cultural 
experiences (including the arts),'' after ``art therapy,''.

SEC. 110. SOCIAL DETERMINANTS OF HEALTH.

    Section 301(a)(1) of the Older Americans Act of 1965 (42 U.S.C. 
3021(a)(1)) is amended--
            (1) in subparagraph (C) by striking ``and'' at the end;
            (2) in subparagraph (D) by striking the period at the end 
        and inserting ``; and''; and
            (3) by adding at the end the following:
            ``(E) address the social determinants of health of older 
        individuals.''.

SEC. 111. FALLS PREVENTION AND CHRONIC DISEASE SELF-MANAGEMENT 
              EDUCATION.

    Section 411(a) of the Older Americans Act of 1965 (42 U.S.C. 
3032(a)) is amended--
            (1) by redesignating paragraphs (13) and (14) as paragraphs 
        (15) and (16), respectively; and
            (2) by inserting after paragraph (12) the following:
            ``(13) bringing to scale and sustaining evidence-based 
        falls prevention programs that will reduce the number of falls, 
        fear of falling, and fall-related injuries in older individuals 
        and older individuals with disabilities;
            ``(14) bringing to scale and sustaining evidence-based 
        chronic disease self-management programs that empower older 
        individuals and older individuals with disabilities to better 
        manage their chronic conditions;''.

SEC. 112. EXTENSION OF RAISE FAMILY CAREGIVERS ACT.

    Section 6 of the RAISE Family Caregivers Act (Public Law 115-119; 
132 Stat. 27) is amended by striking ``3'' and inserting ``4''.

SEC. 113. SUPPORT FOR SOCIALLY-ISOLATED OLDER AMERICANS.

    Section 102(14) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)) is amended--
            (1) in subparagraph (K) by striking ``and'' at the end;
            (2) in subparagraph (L) by striking ``(K)'' and inserting 
        ``(L)'';
            (3) by redesignating subparagraph (L) as subparagraph (M); 
        and
            (4) by inserting after subparagraph (K) the following:
                    ``(L) screening for the prevention of negative 
                health effects associated with social isolation and 
                coordination of supportive services and health care to 
                address negative health effects associated with social 
                isolation; and''.

SEC. 114. INCREASED FOCUS OF ASSISTANT SECRETARY ON HEALTH EFFECTS 
              ASSOCIATED WITH SOCIAL ISOLATION.

    Section 202(a) of the Older Americans Act of 1965 (42 U.S.C. 
3012(a)), as amended by section 103, is amended--
            (1) in paragraph (31) by striking ``; and'' and inserting a 
        semicolon;
            (2) in paragraph (32) by striking the period at the end and 
        inserting ``; and''; and
            (3) by adding at the end the following:
            ``(33) develop objectives, priorities, and a long-term plan 
        for supporting State and local efforts involving education 
        about, prevention of, detection of, and response to negative 
        health effects associated with social isolation among older 
        individuals.''.

SEC. 115. ADVISORY COUNCIL ON HEALTH EFFECTS ASSOCIATED WITH SOCIAL 
              ISOLATION.

    Section 202 of the Older Americans Act of 1965 (42 U.S.C. 3012), as 
amended by section 103, is amended by adding at the end the following:
    ``(i)(1) The Assistant Secretary shall convene an advisory council 
on negative health effects associated with social isolation with aging 
network stakeholders, including caregivers, and select members in a 
manner that ensures geographic diversity of the members--
            ``(A) to review and evaluate efforts to address negative 
        health effects associated with social isolation among older 
        individuals; and
            ``(B) to identify challenges, solutions, and best practices 
        related to such efforts.
    ``(2) The advisory council convened under paragraph (1) shall--
            ``(A) ensure consideration of consumer-directed care 
        models; and
            ``(B) submit a report to Congress on its findings.
    ``(3) The Federal Advisory Committee Act (5 U.S.C. App.) shall not 
apply with respect to the advisory council convened under paragraph 
(1).''.

SEC. 116. SUPPORTIVE SERVICES AND SENIOR CENTERS.

    Section 321(a) of the Older Americans Act of 1965 (42 U.S.C. 
3030d(a)) is amended--
            (1) in paragraph (24) by striking ``and'' at the end;
            (2) by redesignating paragraph (25) as paragraph (26); and
            (3) by inserting after paragraph (24) the following:
            ``(25) services that promote or support social 
        connectedness and reduce negative health effects associated 
        with social isolation; and''.

SEC. 117. DEMONSTRATION PROJECTS.

    (a) Demonstrations.--Section 411(a) of the Older Americans Act of 
1965 (42 U.S.C. 3032(a)), as amended by section 111, is amended--
            (1) in paragraph (15) by striking ``and'' at the end;
            (2) by redesignating paragraph (16) as paragraph (17); and
            (3) by inserting after paragraph (15) the following:
            ``(16) projects that address negative health effects 
        associated with social isolation among older adults; and''.
    (b) Repeal.--Section 416 of the Older Americans Act of 1965 (42 
U.S.C. 3032e) is repealed.

SEC. 118. YOUNGER ONSET ALZHEIMER'S DISEASE.

    (a) Definition of ``Family Caregiver''.--Section 302(3) of the 
Older Americans Act of 1965 (42 U.S.C. 3022(3)) is amended by inserting 
``of any age'' after ``an individual''.
    (b) Definition of ``Resident''.--Section 711(6) of the Older 
Americans Act of 1965 (42 U.S.C. 3058(6)) is amended by inserting ``of 
any age'' after ``individual''.

SEC. 119. PRIORITY FOR THE SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM.

    (a) Priority.--The Older Americans Act of 1965 (42 U.S.C. 3001 et 
seq.) is amended--
            (1) in section 503(a)(4)(C)--
                    (A) in clause (iii) by striking ``and'' at the end;
                    (B) in clause (iv) by adding ``and'' at the end; 
                and
                    (C) by adding at the end the following:
                            ``(v) eligible individuals who have been 
                        incarcerated within the last 5 years or are 
                        under supervision following the release from 
                        prison or jail within the last 5 years;'';
            (2) in section 514(e)(1) by inserting ``older individuals 
        who have been incarcerated or are under supervision following 
        the release from prison or jail,'' after ``need,''; and
            (3) in section 518--
                    (A) in subsection (a)(3)(B)(ii)--
                            (i) in clause (IV) by striking ``or'' at 
                        the end;
                            (ii) in clause (V) by striking the period 
                        at the end and inserting ``; or''; and
                            (iii) by adding at the end the following:
                            ``(VI) have been incarcerated within the 
                        last 5 years or are under supervision following 
                        the release from prison or jail within the last 
                        5 years.''; and
                    (B) in subsection (b)(2)--
                            (i) in subparagraph (F) by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (G) by striking the 
                        period at the end and inserting ``; or''; and
                            (iii) by adding at the end the following:
            ``(H) has been incarcerated or is under supervision 
        following the release from prison or jail within the last 5 
        years.''.
    (b) Transition Period.--This section shall take effect 1 year after 
the date of the enactment of this Act.

SEC. 120. DIRECT CARE WORKFORCE.

    (a) Demonstrations.--Section 411(a) of the Older Americans Act of 
1965 (42 U.S.C. 3032(a)), as amended by sections 111 and 117, is 
amended--
            (1) by redesignating paragraphs (16) and (17) as paragraphs 
        (17) and (18), respectively; and
            (2) by inserting after paragraph (15) the following:
            ``(16) in coordination with the Secretary of Labor, the 
        demonstration of new strategies for the recruitment, retention, 
        or advancement of direct care workers, and to solicit, develop, 
        and implement strategies--
                    ``(A) to reduce barriers to entry for a diverse and 
                high-quality direct care workforce, including providing 
                wages, benefits, and advancement opportunities needed 
                to attract or retain direct care workers;
                    ``(B) to provide supportive services and career 
                planning for direct care workers; and
                    ``(C) to support the advancement of direct care 
                workers through education and workforce development 
                programs that include necessary credential or licensing 
                preparation, paid on-the-job training or work-based 
                learning, and appropriate safety training;''.
    (b) Older American Community Service Employment Program.--Section 
502(e)(2)(B) of the Older Americans Act of 1965 (42 U.S.C. 
3056(e)(2)(B)) is amended--
            (1) in clause (iii) by striking ``and'' at the end;
            (2) in clause (iv) by adding ``and'' at the end; and
            (3) by adding at the end the following:
                            ``(v) attract, retain, or advance the 
                        direct care workforce, in consultation with the 
                        Assistant Secretary, providing for wages and 
                        benefits needed to reduce barriers to entry for 
                        a diverse and high-quality direct care 
                        workforce, supportive services and career 
                        planning, and paid on-the-job training or work-
                        based learning, with appropriate safety 
                        training;''.

SEC. 121. NATIONAL RESOURCE CENTER FOR OLDER INDIVIDUALS EXPERIENCING 
              THE LONG-TERM AND ADVERSE CONSEQUENCES OF TRAUMA.

    Section 411(a) of the Older Americans Act of 1965 (42 U.S.C. 
3032(a), as amended by sections 111, 117, and 120, is amended--
            (1) in paragraph (17) by striking ``and'' at the end;
            (2) in paragraph (18) by striking the period at the end; 
        and
            (3) by adding at the end the following:
            ``(19) the establishment and operation of a national 
        resource center that shall--
                    ``(A) provide training and technical assistance to 
                agencies in the aging network delivering services to 
                older individuals experiencing the long-term and 
                adverse consequences of trauma;
                    ``(B) share best practices with the aging network; 
                and
                    ``(C) make subgrants to the agencies best 
                positioned to advance and improve the delivery of 
                person-centered, trauma-informed services for older 
                individuals experiencing the long-term and adverse 
                consequences of trauma.''.

SEC. 122. NATIONAL RESOURCE CENTER FOR WOMEN AND RETIREMENT.

    Section 202 of the Older Americans Act of 1965 (42 U.S.C. 3012), as 
amended by sections 103 and 115, is amended by adding at the end the 
following:
    ``(j)(1) The Assistant Secretary shall, directly or by grant or 
contract, operate the National Resource Center for Women and Retirement 
(in this subsection referred to as the `Center').
    ``(2) The Center shall--
            ``(A) provide basic financial management, retirement 
        planning, and other educational tools that promote financial 
        wellness and help to identify and prevent fraud and elder 
        exploitation, and integrate these with information on health 
        and long-term care;
            ``(B) annually disseminate a summary of outreach provided, 
        including work to provide user-friendly consumer information 
        and public education materials;
            ``(C) develop targeted outreach strategies;
            ``(D) provide technical assistance to State agencies and to 
        other public and nonprofit private agencies and organizations; 
        and
            ``(E) develop partnerships and collaborations to address 
        program objectives.''.

SEC. 123. DEFINITION.

    Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is 
amended--
            (1) by redesignating paragraphs (41) through (54) as 
        paragraphs (42) through (55); and
            (2) by inserting after paragraph (40) the following:
            ``(41) The term `person-centered, trauma-informed' when 
        used with respect to services means services provided through 
        an aging program that--
                    ``(A) use a holistic approach to providing 
                services;
                    ``(B) promote the dignity, strength and empowerment 
                of victims of trauma; and
                    ``(C) incorporate research-based practices based on 
                knowledge about the role of trauma in trauma victims' 
                lives.''.

SEC. 124. REVIEW OF REPORTS.

    Section 308(b) of the Older Americans Act of 1965 (42 U.S.C. 
3028(b)) is amended by inserting at the end the following:
            ``(8) The Assistant Secretary shall review the reports 
        submitted under section 307(a)(31) and include aggregate data 
        in the report required by section 207(a), including data on--
                    ``(A) the effectiveness of the programs, policies, 
                and services provided by area agencies on aging in 
                assisting individuals whose needs were the focus of all 
                centers funded under title IV in fiscal year 2019; and
                    ``(B) outreach efforts and other activities carried 
                out to satisfy the assurances described in paragraphs 
                (18) and (19) of section 306(a), to identify such older 
                individuals and their service needs.''.

SEC. 125. AREA PLANS.

    Section 306(a)(4) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)(4)) is amended in subparagraph (B)(i)(VII) by inserting ``, 
specifically including survivors of the Holocaust'' after 
``placement''.

SEC. 126. ADDRESSING CHRONIC PAIN MANAGEMENT.

    Section 102(14)(D) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)) is amended by inserting ``chronic pain management,'' after 
``substance abuse reduction,''.

SEC. 127. EXTENSION OF THE SUPPORTING GRANDPARENTS RAISING 
              GRANDCHILDREN ACT.

     Section 3(f) of the Supporting Grandparents Raising Grandchildren 
Act (Public Law 115-196) is amended by striking ``3'' and inserting 
``4''.

SEC. 128. SCREENING FOR SUICIDE RISK.

    Section 102(14)(G) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)(G)) is amended by inserting ``and screening for suicide risk'' 
after ``depression''.

SEC. 129. TRAUMATIC BRAIN INJURY.

    (a) Section 102 of the Older Americans Act of 1965 (42 U.S.C. 
3002), as amended by section 113, is amended--
            (1) in paragraph (14)--
                    (A) in paragraph (M) by striking ``(L)'' and 
                inserting ``(M)'';
                    (B) by redesignating subparagraphs (H) through (M) 
                as subparagraphs (I) through (N), respectively; and
                    (C) by inserting after subparagraph (G) the 
                following:
                    ``(H) screening for fall-related traumatic brain 
                injury; coordination of treatment, rehabilitation, and 
                related services; and referral services;''; and
            (2) by adding at the end the following:
            ``(56) The term `traumatic brain injury' has the meaning 
        given to it in section 339B(d) of the Public Health Service 
        Act.''.
    (b) Section 321(a)(8) of the Older Americans Act of 1965 (42 
U.S.C.3030d(a)(8)) is amended--
            (1) by striking ``screening and'' and inserting 
        ``screening, screening for negative health effects associated 
        with social isolation,''; and
            (2) by striking ``screening)'' and inserting ``screening, 
        and traumatic brain injury screening)''.
    (c) Section 411(a)(12) of the Older Americans Act of 1965 (42 
U.S.C. 3032(a)(12)) is amended--
            (1) by inserting ``dementia,'' after ``dysfunction,'';
            (2) by striking ``and'' the 2d place it appears; and
            (3) by inserting ``and traumatic brain injury'' before the 
        semicolon at the end.

SEC. 130. ADDRESSING PUBLIC HEALTH EMERGENCIES AND EMERGING HEALTH 
              THREATS.

    Section 102(14) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)), as amended by sections 113 and 129, is amended--
            (1) in subparagraph (M) by striking ``and'' at the end;
            (2) in subparagraph (N) by striking ``(M)'' and inserting 
        ``(N)'';
            (3) by redesignating subparagraphs (K), (L), (M), and (N) 
        as subparagraphs (L), (M), (N), and (O) respectively; and
            (4) by inserting after subparagraph (J) the following:
                    ``(K) responses to public health emergencies and 
                emerging health threats;''.

SEC. 131. PREVENTION OF SEXUALLY TRANSMITTED DISEASES.

    Section 102(14)(D) of the Older Americans Act of 1965 (42 U.S.C. 
3002(14)(D)), as amended by section 102, is amended by inserting 
``prevention of sexually transmitted disease,'' after ``disease)''.

SEC. 132. AGING AND DISABILITY RESOURCE CENTER.

    Section 102(4) of the Older Americans Act of 1965 (42 U.S.C. 
3002(4)) is amended--
            (1) in the matter preceding subparagraph (A), by inserting 
        ``, in collaboration with (as appropriate) area agencies on 
        aging, centers for independent living (as described in part C 
        of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f 
        et seq.)), and other aging or disability entities'' after 
        ``provides'';
            (2) in subparagraph (B)--
                    (A) by inserting ``services, supports, and'' after 
                ``plan for long-term''; and
                    (B) by inserting ``and choices'' after ``desires''; 
                and
            (3) in subparagraph (D) by striking ``(29 U.S.C. 796f et 
        seq.), and other community-based entities,'' and inserting ``, 
        and other community-based entities, including other aging or 
        disability entities''.

   TITLE II--EMPOWERING THE AGING NETWORK TO MEET THE NEEDS OF OLDER 
                              INDIVIDUALS

SEC. 201. NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM CAP.

    (a) Federal Share.--Section 373(g)(2) of the Older Americans Act of 
1965 (42 U.S.C. 3030s-1(g)(2)) is amended by striking subparagraph (C).
    (b) Monitoring the Impact of the Elimination of the Cap on Funds 
for Older Relative Caregivers.--
            (1) Report.--Not later than 18 months after the date of the 
        enactment of this Act, and annually thereafter, the Assistant 
        Secretary shall submit to the Committee on Education and Labor 
        of the House of Representatives and the Committee on Health, 
        Education, Labor, and Pensions of the Senate a report on the 
        impact of the amendment made by subsection (a) to eliminate the 
        limitation on funds that States may allocate to provide support 
        services to older relative caregivers in the National Family 
        Caregiver Support Program established under part E of title III 
        of the Older Americans Act of 1965 (42 U.S.C. 3030s--3030s-2). 
        Each such report shall also be made available to the public.
            (2) Contents.--For purposes of reports required by 
        paragraph (1), each State that receives an allotment under such 
        National Family Caregiver Support Program for fiscal year 2020 
        or a subsequent fiscal year shall report to the Assistant 
        Secretary for the fiscal year involved the amount of funds of 
        the total Federal and non-Federal share allotment used by the 
        State to provide support services for caregiver support for 
        older relative caregivers and family caregivers.

SEC. 202. MINIMUM FUNDING LEVEL FOR STATE ADMINISTRATIVE EXPENSES.

    Section 308(b)(2)(A) of the Older Americans Act of 1965 (42 U.S.C. 
3028(b)(2)(B)) is amended by striking ``$500,000'' and inserting 
``$750,000''.

SEC. 203. CULTURALLY-APPROPRIATE, MEDICALLY-TAILORED MEALS.

    Section 339(2)(A) of the Older Americans Act of 1965 (42 U.S.C. 
3939h(2)(A)) is amended by inserting ``, including cultural 
considerations and preferences (including needs based on religious, 
cultural, or ethnic requirements) and medically tailored meals'' before 
the comma at the end.

SEC. 204. BUSINESS ACUMEN PROVISIONS AND CLARIFICATION REGARDING 
              OUTSIDE FUNDING FOR AREA AGENCIES ON AGING.

    (a) Assistance Relating to Growing and Sustaining Capacity.--
Section 202(b)(9) of the Older Americans Act of 1965 (42 U.S.C. 
3012(b)(9)) is amended--
            (1) in subparagraph (A) by striking ``and'' after the 
        semicolon at the end;
            (2) in subparagraph (B) by inserting ``and'' after the 
        semicolon at the end; and
            (3) by adding at the end the following:
                    ``(C) business acumen, capacity building, 
                organizational development, innovation, and other 
                methods of growing and sustaining the capacity of the 
                aging network to serve older individuals and caregivers 
                most effectively;''.
    (b) Clarifying Partnerships for Area Agencies on Aging.--Section 
306 of the Older Americans Act of 1965 (42 U.S.C. 3026) is amended by 
adding at the end the following:
    ``(g) Nothing in this Act shall restrict an area agency on aging 
from providing services not provided or authorized by this Act, 
including through--
            ``(1) contracts with health care payers;
            ``(2) consumer private pay programs; or
            ``(3) other arrangements with entities or individuals that 
        increase the availability of home and community-based services 
        and supports in the planning and service area supported by the 
        area agency on aging.''.

SEC. 205. OTHER PRACTICES.

    Section 315 of the Older Americans Act of 1965 (42 U.S.C. 3030c-2) 
is amended by adding at the end the following:
    ``(e) Response to Area Agencies on Aging.--Upon request from an 
area agency on aging, the State shall make available any policies or 
guidance pertaining to policies under this section.''.

SEC. 206. CAREGIVER ASSESSMENTS.

    (a) Definition of Caregiver Assessment.--Section 372(a) of the 
Older Americans Act of 1965 (42 U.S.C. 3030s(a)) is amended by adding 
at the end the following:
            ``(4) Caregiver assessment.--The term `caregiver 
        assessment' means a systematic process of gathering information 
        about the situation of a caregiver who voluntarily participates 
        in such process, which may include contact through a home 
        visit, the Internet, telephone or teleconference, or in-person 
        interaction, to identify the caregiver's specific needs, 
        barriers, and existing supports as identified by the caregiver 
        that--
                    ``(A) provides the opportunity for the recognized 
                caregiver to participate in such process;
                    ``(B) requires direct contact with the caregiver 
                and is used to appropriately target and tailor support 
                services to the caregiver's unique needs; and
                    ``(C) includes reassessment of such specific needs, 
                barriers, and existing supports, including to 
                accommodate a significant change in the caregiving 
                situation, which shall occur on a voluntary basis with 
                the consent of the caregiver.''.
    (b) Use of Caregiver Assessments.--Section 373(b) of the Older 
Americans Act of 1965 (42 U.S.C. 3030s-1(b)) is amended by inserting 
``may be informed through the use of caregiver assessments and'' after 
``with,''.
    (c) Technical Assistance for Caregiver Assessments.--Section 373 of 
the Older Americans Act of 1965 (42 U.S.C. 3030s-1) is amended by 
adding at the end the following:
    ``(h) Technical Assistance for Caregiver Assessments.--Not later 
than 1 year after the effective date of this subsection, the Assistant 
Secretary, in consultation with caregivers, older individuals, 
individuals with a disability who receive care from an older relative 
caregiver, the aging network, and other experts and stakeholders, shall 
provide technical assistance to promote and implement the use of 
caregiver assessments. Such technical assistance shall include sharing 
available tools and templates, comprehensive assessment protocols, and 
best practices concerning--
            ``(1) conducting caregiver assessments and reassessments;
            ``(2) implementing such assessments that are consistent 
        across a planning and service area; and
            ``(3) implementing caregiver support service plans, 
        including referrals to and coordination of activities with 
        relevant State and local services.''.
    (d) Reporting on Caregiver Assessment.--Section 373(e) of the Older 
Americans Act of 1965 (42 U.S.C. 3030s-1(e)) is amended--
            (1) in paragraph (3) by inserting ``, including caregiver 
        assessments used in the State,'' after ``mechanisms'' the 1st 
        place it appears; and
            (2) by adding at the end the following:
            ``(4) Report on caregiver assessments.--
                    ``(A) In general.--Not later than 3 years after the 
                effective date of this paragraph, the Assistant 
                Secretary shall issue a report on the use of caregiver 
                assessments by area agencies on aging, entities 
                contracting with such agencies, and organizations. Such 
                report shall include--
                            ``(i) an analysis of the current use of 
                        caregiver assessments, including a repository 
                        of caregiver assessment tools or templates and 
                        comprehensive assessment protocols;
                            ``(ii) using objective data, an analysis of 
                        the impact of caregiver assessments on--
                                    ``(I) family caregivers and older 
                                relative caregivers; and
                                    ``(II) the individuals to whom the 
                                caregivers described in subclause (I) 
                                provide care;
                            ``(iii) an analysis of the impact of using 
                        caregiver assessments on the aging network;
                            ``(iv) an analysis of how caregiver 
                        assessments are being used to identify the 
                        specific needs, barriers, and existing supports 
                        of family caregivers and older relative 
                        caregivers;
                            ``(v) recommendations for using caregiver 
                        assessments, including in rural or underserved 
                        areas; and
                            ``(vi) feedback from State agencies and 
                        area agencies on aging, particularly in rural 
                        or underserved areas, on the implementation of 
                        caregiver assessments.
                    ``(B) Submission.--Not later than 6 months after 
                the issuance of the report under subparagraph (A), the 
                Assistant Secretary shall submit the report to the 
                Committee on Education and Labor of the House of 
                Representatives, the Committee on Health, Education, 
                Labor, and Pensions of the Senate, and the Special 
                Committee on Aging of the Senate.''.

SEC. 207. RESEARCH AND EVALUATION.

    Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is 
amended by adding at the end the following:
    ``(g)(1) The Assistant Secretary shall coordinate the research and 
evaluation functions of this Act under a National Research, 
Demonstration, and Evaluation Center for the Aging Network (in this 
subsection referred to as the `Center'), which shall be headed by a 
director designated by the Assistant Secretary from individuals 
described in paragraph (4).
    ``(2) The purpose of the Center shall be--
            ``(A) to coordinate research, research dissemination, 
        evaluation, demonstration projects, and related activities 
        carried out under this Act;
            ``(B) to provide assessment of the programs authorized 
        under this Act; and
            ``(C) to increase the repository of information on 
        evidence-based programs and interventions available to the 
        aging network. Such information shall be applicable to existing 
        programs and help in the development of new evidence-based 
        programs and interventions.
    ``(3) Activities of the Center shall include conducting, promoting, 
coordinating, and providing support for--
            ``(A) research and evaluation activities that support the 
        objectives of this Act, including--
                    ``(i) evaluation of new and existing programs and 
                interventions authorized by this Act; and
                    ``(ii) research on and assessment of the 
                relationship between programs and interventions under 
                this Act and the health outcomes, social determinants 
                of health, quality of life, health care savings 
                (including to the Medicare program under title XVIII of 
                the Social Security Act and the Medicaid program under 
                title XIX of such Act as practicable), and independence 
                of individuals served under this Act;
            ``(B) demonstration projects that support the objectives of 
        the Act and activities to bring effective demonstration 
        projects to scale with a prioritization of projects that 
        address the needs of underserved populations;
            ``(C) outreach and dissemination of research findings; and
            ``(D) technical assistance related to the activities 
        described in this subparagraph.
    ``(4) The director shall be an individual with substantial 
knowledge of and experience in aging and health policy, and research 
administration.
    ``(5) Not later than October 1, 2020, and at 5-year intervals 
thereafter, the director shall prepare and publish in the Federal 
Register for public comment a draft of a 5-year plan that--
            ``(A) outlines priorities for research, research 
        dissemination, evaluation, and related activities;
            ``(B) explains the basis for such priorities; and
            ``(C) describes how the plan will meet the needs of 
        underserved populations.
    ``(6) The director shall coordinate research, research 
dissemination, evaluation, and demonstration projects, and related 
activities with appropriate agency program staff, and, as appropriate, 
coordinate with other Federal departments and agencies involved in 
research in the field of aging.
    ``(7) Not later than December 31, 2020, and annually thereafter, 
the director shall prepare, and submit to the Secretary, the Committee 
on Health, Education, Labor, and Pensions of the Senate, the Special 
Committee on Aging of the Senate, and the Committee on Education and 
Labor of the House of Representatives, a report on the activities 
funded under this section and title IV.
    ``(8) The director shall, as appropriate, consult with experts on 
aging research and evaluation and aging network stakeholders on the 
implementation of the activities described under paragraph (3) of this 
subsection.
    ``(9) The director shall coordinate all research and evaluation 
authorities under this Act.''.

SEC. 208. GRANT PROGRAM FOR MULTIGENERATIONAL COLLABORATION.

    Section 417 of the Older Americans Act of 1965 (42 U.S.C. 3032f) is 
amended--
            (1) by amending subsection (a) to read as follows:
    ``(a) Grants and Contracts.--The Assistant Secretary shall award 
grants to, and enter into contracts with, eligible organizations to 
carry out projects--
            ``(1) to provide opportunities for older individuals to 
        participate in multigenerational activities and civic 
        engagement activities that contribute to the health and 
        wellness of older individuals and individuals in younger 
        generations by developing--
                    ``(A) meaningful roles for participants;
                    ``(B) reciprocity in relationship building;
                    ``(C) reduced social isolation and improved 
                participant social connectedness;
                    ``(D) improved economic well-being for older 
                individuals;
                    ``(E) increased lifelong learning; or
                    ``(F) support for older relative caregivers by--
                            ``(i) providing support for older relative 
                        caregivers (as defined in section 372) raising 
                        children (such as kinship navigator programs); 
                        or
                            ``(ii) involving volunteers who are older 
                        individuals who provide support and information 
                        to families who have a child with a disability 
                        or chronic illness, or other families in need 
                        of such family support;
            ``(2) to coordinate multigenerational activities and civic 
        engagement activities, including multigenerational nutrition 
        and meal service programs;
            ``(3) to promote volunteerism, including becoming a mentor 
        to young people; and
            ``(4) to facilitate development of and participation in 
        multigenerational activities and civic engagement 
        activities.'';
            (2) by amending subsection (b) to read as follows:
    ``(b) Use of Funds.--
            ``(1) In general.--An eligible organization shall use funds 
        made available under a grant awarded, or a contract entered 
        into, under this section to carry out a project described in 
        subsection (a).
            ``(2) Provision of projects through grantees.--In making 
        grants under this section, the Assistant Secretary shall ensure 
        that awards are made for the activities and projects described 
        in each of paragraphs (1) and (2) of subsection (a).'';
            (3) in subsection (c)--
                    (A) in the matter preceding paragraph (1), by 
                inserting ``that serves individuals in younger 
                generations and older individuals'' after ``to carry 
                out a project'';
                    (B) in paragraph (1) by inserting ``, intent to 
                carry out, or intent to partner with local 
                organizations or multiservice organizations to carry 
                out,'' after ``record of carrying out'';
                    (C) in paragraph (3) by striking ``; and'' and 
                inserting a semicolon;
                    (D) in paragraph (4) by striking the period at the 
                end and inserting ``; and''; and
                    (E) by adding at the end the following:
            ``(5) eligible organizations proposing multigenerational 
        activity projects that utilize shared site programs, such as 
        collocated child care and long-term care facilities.'';
            (4) by amending subsection (e) to read as follows:
    ``(e) Eligible Organizations.--Organizations eligible to receive a 
grant or enter into a contract under subsection (a) shall--
            ``(1) be a State, an area agency on aging, or an 
        organization that provides opportunities for older individuals 
        to participate in activities described in such subsection; and
            ``(2) have the capacity to conduct the coordination, 
        promotion, and facilitation described in such subsection 
        through the use of multigenerational coordinators.'';
            (5) by striking subsection (g);
            (6) in subsection (h)(2)(B)(i) by striking ``individuals 
        from the generations with older individuals'' and inserting 
        ``older individuals'';
            (7) by redesignating subsections (b) through (f) as 
        subsections (c) through (g), respectively; and
            (8) by inserting after subsection (a) the following:
    ``(b) Grant Period.--Each grant awarded or contract made under 
subsection (a) shall be to carry out projects for a period of not less 
than 36 months.''.

       TITLE III--STRENGTHENING PROTECTIONS FOR OLDER INDIVIDUALS

SEC. 301. STATE LONG-TERM CARE OMBUDSMAN PROGRAM MINIMUM FUNDING AND 
              MAINTENANCE OF EFFORT.

    The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is 
amended--
            (1) by amending section 306(a)(9) to read as follows:
            ``(9) provide assurances that--
                    ``(A) the area agency on aging, in carrying out the 
                State Long-Term Care Ombudsman program under section 
                307(a)(9), will expend not less than the total amount 
                of funds appropriated under this Act and expended by 
                the agency in fiscal year 2019 in carrying out such a 
                program under this title; and
                    ``(B) funds made available to area agencies on 
                aging pursuant to section 712 shall be used to 
                supplement and not supplant other Federal, State, and 
                local funds expended to support activities described in 
                section 712.''; and
            (2) by amending section 307(a)(9) to read as follows:
            ``(9) The plan shall provide assurances that--
                    ``(A) the State agency will carry out, through the 
                Office of the State Long-Term Care Ombudsman, a State 
                Long-Term Care Ombudsman program in accordance with 
                section 712 and this title, and will expend for such 
                purpose an amount that is not less than an amount 
                expended by the State agency with funds received under 
                this title for fiscal year 2019, and an amount that is 
                not less than the amount expended by the State agency 
                with funds received under title VII for fiscal year 
                2019; and
                    ``(B) funds made available to state agencies 
                pursuant to section 712 shall be used to supplement and 
                not supplant other Federal, State, and local funds 
                expended to support activities described in section 
                712.''.

SEC. 302. STATE LONG-TERM CARE VOLUNTEER OMBUDSMAN REPRESENTATIVES.

    Section 712(a)(5) of the Older Americans Act of 1965 (42 U.S.C. 
3058g(a)(5)) is amended--
            (1) by redesignating subparagraph (D) as subparagraph (E); 
        and
            (2) by inserting after subparagraph (C) the following:
                    ``(D) Volunteer ombudsman representatives.--An 
                individual designated as a volunteer ombudsman 
                representative may receive financial support and 
                recognition from the Office of the State Long-Term Care 
                Ombudsman Program for expenses incurred during 
                service.''.

SEC. 303. CLARIFICATION REGARDING BOARD AND CARE FACILITIES.

    Section 102(35)(C) of the Older Americans Act of 1965 (42 U.S.C. 
3002(35)(C)) is amended by striking ``for purposes of sections 
307(a)(12) and 712,''.

SEC. 304. REPORT ON LEGAL HOTLINES.

    Not later than 3 years after the date of the enactment of this Act, 
the Assistant Secretary on Aging shall prepare and submit to the 
Congress a report containing--
            (1) information on which States or localities operate 
        senior legal hotlines;
            (2) information on how such hotlines operated by States or 
        localities are funded;
            (3) information on the usefulness of senior legal hotlines 
        in the coordination and provision of legal assistance; and
            (4) recommendations on additional actions that should be 
        taken related to senior legal hotlines.

SEC. 305. COMMUNITY OUTREACH.

    Section 721(b)(12) of the Older Americans Act of 1965 (42 U.S.C. 
3058i(b)(12)) is amended--
            (1) in subparagraph (C) by inserting ``community outreach 
        and education,'' after ``technical assistance''; and
            (2) in subparagraph (F)--
                    (A) by striking ``studying'' and inserting 
                ``implementing''; and
                    (B) by inserting ``, programs, and materials'' 
                after ``practices''.

SEC. 306. PRINCIPLES FOR PERSON-DIRECTED SERVICES AND SUPPORTS DURING 
              SERIOUS ILLNESS.

    (a) Definitions.--
            (1) Administrator.--The term ``Administrator'' means the 
        Administrator of the Administration for Community Living.
            (2) Area agency on aging; assistant secretary; state 
        agency.--The terms ``area agency on aging'', ``Assistant 
        Secretary'', and ``State agency'' have the meanings given the 
        terms in section 102 of the Older Americans Act of 1965 (42 
        U.S.C. 3002).
            (3) Covered agency.--The term ``covered agency'' means--
                    (A) a State agency or area agency on aging; and
                    (B) a Federal agency other than the Department of 
                Health and Human Services, and a unit of that 
                Department other than the Administration on Aging, that 
                the Assistant Secretary determines performs functions 
                for which the principles are relevant, and the Centers 
                for Medicare & Medicaid Services.
            (4) Principles.--The term ``principles'' means the 
        Principles for Person-directed Services and Supports during 
        Serious Illness, issued by the Administration on September 1, 
        2017, or an updated set of such Principles.
    (b) Dissemination.--The Administrator shall disseminate the 
principles to appropriate stakeholders within the aging network, as 
determined by the Assistant Secretary, and to covered agencies. The 
covered agencies may use the principles in setting priorities for 
service delivery and care plans in programs carried out by the 
agencies.
    (c) Feedback.--The Administrator shall solicit, on an ongoing 
basis, feedback on the principles from covered agencies, experts in the 
fields of aging and dementia, and stakeholders who provide or receive 
disability services.
    (d) Report.--Not less often than once, but not more often than 
annually, during the 3 years after the date of the enactment of this 
Act, the Administrator shall prepare and submit to Congress a report 
describing the feedback received under subsection (c) and indicating if 
any changes or updates are needed to the principles.

         TITLE IV--MEETING THE NEEDS OF OLDER NATIVE AMERICANS

SEC. 401. EXPANDING SUPPORTIVE SERVICES FOR NATIVE AMERICAN AGING 
              PROGRAMS.

    Title VI of the Older Americans Act of 1965 (42 U.S.C. 3057 et 
seq.) is amended--
            (1) in part D--
                    (A) by amending section 643 to read as follows:

``SEC. 643. AUTHORIZATION OF APPROPRIATIONS.

    ``There are authorized to be appropriated to carry out this title--
            ``(1) for parts A and B, $38,524,324 for fiscal year 2020, 
        $40,835,783 for fiscal year 2021, $43,285,930 for fiscal year 
        2022, $45,883,086 for fiscal year 2023, and $48,636,071 for 
        fiscal year 2024; and
            ``(2) for part C subject to section 644, $10,785,575 for 
        fiscal year 2020, $11,432,710 for fiscal year 2021, $12,118,672 
        for fiscal year 2022, $12,845,792 for fiscal year 2023, and 
        $13,616,540 for fiscal year 2024.''; and
                    (B) by adding at the end the following:

``SEC. 644. FUNDING SET ASIDE.

    ``Of the funds appropriated under section 643(1) for a fiscal year, 
not more than 5 percent shall be made available to carry out part D for 
such fiscal year if for such fiscal year--
            ``(1) the funds appropriated for parts A and B are greater 
        than the funds appropriated for such parts for fiscal year 
        2019; and
            ``(2) the Assistant Secretary makes available for parts A 
        and B not less than the amount of resources made available for 
        fiscal year 2019.'';
            (2) by redesignating part D as part E; and
            (3) by inserting after part C the following:

    ``PART D--SUPPORTIVE SERVICES FOR HEALTHY AGING AND INDEPENDENCE

``SEC. 636. PROGRAM.

    ``(a) In General.--The Assistant Secretary shall carry out a 
competitive demonstration program for making grants to tribal or Native 
Hawaiian organizations with applications approved under parts A and B, 
to pay for the Federal share of carrying out programs, to enable the 
organizations to build their capacity to provide a wider range of in-
home and community supportive services to enable older individuals to 
maintain their health and independence and to avoid long-term care 
facility placement.
    ``(b) Supportive Services.--
            ``(1) In general.--Subject to paragraph (2), supportive 
        services described in subsection (a) may include any of the 
        activities described in section 321(a).
            ``(2) Priority.--The Assistant Secretary, in making grants 
        under this section, shall give priority to organizations that 
        will use the grant funds for supportive services described in 
        subsection (a) that are for in-home assistance, transportation, 
        information and referral, case management, health and wellness 
        programs, legal services, family caregiver support services, 
        and other services that directly support the independence of 
        the older individuals served.
    ``(c) Rule of Construction.--Nothing in this section shall be 
construed or interpreted to prohibit the provision of supportive 
services under part A or B.''.

SEC. 402. ENHANCING CAPACITY TO SUPPORT NATIVE AMERICAN AGING PROGRAMS.

    Title II of the Older Americans Act of 1965 (42 U.S.C. 3011 et 
seq.) is amended--
            (1) in section 201(c)(3)(H) by inserting ``to ensure 
        adequate capacity to deliver the services under such title, 
        which technical assistance programs may include program 
        management, data development and use, basic business skills, 
        grant development, program and service innovations, and staff 
        professional development and certification'' before the 
        semicolon at the end; and
            (2) section 216 is amended to read as follows:

``SEC. 216. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) In General.--For purposes of carrying out this Act, there are 
authorized to be appropriated for administration, salaries, and 
expenses of the Administration $44,042,171 for fiscal year 2020, 
$46,684,701 for fiscal year 2021, $49,485,783 for fiscal year 2022, 
$52,454,930 for fiscal year 2023, and $55,602,226 for fiscal year 2024.
    ``(b) Authorization of Appropriations for Programs.--There are 
authorized to be appropriated--
            ``(1) to carry out section 201(g), $20,000,000 for each of 
        the fiscal years 2020 through 2024;
            ``(2) to carry out section 202(a)(21) (relating to the 
        National Eldercare Locator Service), $2,186,227 for fiscal year 
        2020, $2,317,401 for fiscal year 2021, $2,456,445 for fiscal 
        year 2022, $2,603,832 for fiscal year 2023, and $2,760,062 for 
        fiscal year 2024;
            ``(3) to carry out sections 215 and 202(j), $1,992,460 for 
        fiscal year 2020, $2,112,008 for fiscal year 2021, $2,238,728 
        for fiscal year 2022, $2,373,052 for fiscal year 2023, and 
        $2,515,435 for fiscal year 2024;
            ``(4) to carry out section 202 (relating to Elder Rights 
        Support Activities under this title), $1,375,011 for fiscal 
        year 2020, $1,457,511 for fiscal year 2021, $1,544,962 for 
        fiscal year 2022, $1,637,660 for fiscal year 2023, and 
        $1,735,919 for fiscal year 2024;
            ``(5) to carry out section 202(b) (relating to the Aging 
        and Disability Resource Centers), $8,708,043 for fiscal year 
        2020, $9,230,526 for fiscal year 2021, $9,784,357 for fiscal 
        year 2022, $10,371,419 for fiscal year 2023, and $10,993,704 
        for fiscal year 2024; and
            ``(6) to carry out section 201(c)(3)(H) (relating to 
        professional development and technical assistance for programs 
        under title VI), $500,000 for fiscal year 2021.''.

                         TITLE V--MISCELLANEOUS

SEC. 501. TECHNICAL CORRECTIONS.

    The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is 
amended--
            (1) in section 102(37)(A) by striking ``paragraph (5)'' and 
        inserting ``paragraph (26)'';
            (2) in section 202(a)(23) by striking ``sections 307(a)(18) 
        and 731(b)(2)'' and inserting ``sections 307(a)(13) and 731'';
            (3) in section 202(e)(1)(A) by moving the left margin of 
        clause (i) 2 ems to the left;
            (4) in sections 203(c)(7), 207(b)(2)(B), and 215(i) by 
        striking ``Committee on Education and the Workforce'' and 
        inserting ``Committee on Education and Labor'';
            (5) in section 207(b)(3)(A) by striking ``Administrator of 
        the Health Care Finance Administration'' and inserting 
        ``Administrator of the Centers for Medicare and Medicaid 
        Services'';
            (6) in section 304(a)(3)(C) by striking ``term'' and all 
        that follows through ``does'', and inserting ``term `State' 
        does'';
            (7) in section 304(d)(1)(B) by striking ``(excluding'' and 
        all that follows through ``303(a)(3))'';
            (8) in section 306(a)--
                    (A) by inserting ``the number of older individuals 
                at risk for institutional placement residing in such 
                area,'' after ``areas) residing in such area,'' the 
                last place it appears; and
                    (B) in paragraph (2) by striking ``who are victims 
                of'' and inserting ``with'';
            (9) in section 339 by striking ``Institute of Medicine of 
        the National Academy of Sciences'' and inserting ``National 
        Academies of Sciences, Engineering, and Medicine'';
            (10) in section 611 by striking ``(a)''; and
            (11) in section 614(c)(4) by striking ``(a)(12)'' and 
        inserting ``(a)(11)''.

SEC. 502. AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS.

    (a) Authorization of Appropriations; Uses of Funds.--Section 303 of 
the Older Americans Act of 1965 (42 U.S.C. 3023) is amended to read as 
follows:

``SEC. 303. AUTHORIZATION OF APPROPRIATIONS; USES OF FUNDS.

    ``(a)(1) There are authorized to be appropriated to carry out part 
B (relating to supportive services) $413,011,586 for fiscal year 2020, 
$437,792,281 for fiscal year 2021, $464,059,818 for fiscal year 2022, 
$491,903,407 for fiscal year 2023, and $521,417,612 for fiscal year 
2024.
    ``(2) Funds appropriated under paragraph (1) shall be available to 
carry out section 712.
    ``(b)(1) There are authorized to be appropriated to carry out 
subpart 1 of part C (relating to congregate nutrition services) 
$531,279,663 for fiscal year 2020, $563,156,443 for fiscal year 2021, 
$596,945,830 for fiscal year 2022, $632,762,580 for fiscal year 2023, 
and $670,728,334 for fiscal year 2024.
    ``(2) There are authorized to be appropriated to carry out subpart 
2 of part C (relating to home delivered nutrition services) 
$269,577,167 for fiscal year 2020, $285,751,797 for fiscal year 2021, 
$302,896,905 for fiscal year 2022, $321,070,719 for fiscal year 2023, 
and $340,334,963 for fiscal year 2024.
    ``(c) Grants made under part B, and subparts 1 and 2 of part C, of 
this title may be used for paying part of the cost of--
            ``(1) the administration of area plans by area agencies on 
        aging designated under section 305(a)(2)(A), including the 
        preparation of area plans on aging consistent with section 306 
        and the evaluation of activities carried out under such plans; 
        and
            ``(2) the development of comprehensive and coordinated 
        systems for supportive services, congregate and home delivered 
        nutrition services under subparts 1 and 2 of part C, the 
        development and operation of multipurpose senior centers, and 
        the delivery of legal assistance.
    ``(d) There are authorized to be appropriated to carry out part D 
(relating to disease prevention and health promotion services) 
$26,650,753 for fiscal year 2020, $28,249,798 for fiscal year 2021, 
$29,944,786 for fiscal year 2022, $31,741,473 for fiscal year 2023, and 
$33,645,961 for fiscal year 2024.
    ``(e) There are authorized to be appropriated to carry out part E 
(relating to family caregiver support) $194,331,264 for fiscal year 
2020, $205,991,140 for fiscal year 2021, $218,350,609 for fiscal year 
2022, $231,451,645 for fiscal year 2023, and $245,338,744 for fiscal 
year 2024.''.
    (b) Section 311(e) of the Older Americans Act of 1965 (42 U.S.C. 
3030a(e)) is amended to read as follows:
    ``(e) There are authorized to be appropriated to carry out this 
section (other than subsection (c)(1)) $171,682,200 for fiscal year 
2020, $181,983,132 for fiscal year 2021, $192,902,120 for fiscal year 
2022, $204,476,247 for fiscal year 2023, and $216,744,822 for fiscal 
year 2024.''.
    (c) Section 411(b) of the Older Americans Act of 1965 (42 U.S.C. 
3032(b)) is amended to read as follows:
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out--
            ``(1) aging network support activities under this section, 
        $14,549,157 for fiscal year 2020, $15,422,107 for fiscal year 
        2021, $16,347,433 for fiscal year 2022, $17,328,279 for fiscal 
        year 2023, and $18,367,976 for fiscal year 2024; and
            ``(2) elder rights support activities under this section, 
        $15,650,667 for fiscal year 2020, $16,589,707 for fiscal year 
        2021, $17,585,090 for fiscal year 2022, $18,640,195 for fiscal 
        year 2023, and $19,758,607 for fiscal year 2024.''.
    (d) Section 517(a) of the Older Americans Act of 1965 (42 U.S.C. 
3056o(a)) is amended to read as follows:
    ``(a) In General.--There are authorized to be appropriated to carry 
out this title $429,020,486 for fiscal year 2020, $454,761,715 for 
fiscal year 2021, $482,047,418 for fiscal year 2022, $510,970,263 for 
fiscal year 2023, and $541,628,478 for fiscal year 2024.''.
    (e) Section 702 of the Older Americans Act of 1965 (42 U.S.C.3058a) 
is amended to read as follows:

``SEC. 702. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Ombudsman Program.--There are authorized to be appropriated 
to carry out chapter 2, $18,110,027 for fiscal year 2020, $19,196,629 
for fiscal year 2021, $20,348,427 for fiscal year 2022, $21,569,332 for 
fiscal year 2023, and $22,863,492 for fiscal year 2024.
    ``(b) Other Programs.--There are authorized to be appropriated to 
carry out chapters 3 and 4, $5,119,287 for fiscal year 2020, $5,426,444 
for fiscal year 2021, $5,752,031 for fiscal year 2022, $6,097,153 for 
fiscal year 2023, and $6,462,982 for fiscal year 2024.''.

SEC. 503. HOLD HARMLESS FORMULA.

    (a) In General.--Section 304(a)(3)(D) of the Older Americans Act of 
1965 (42 U.S.C. 3024(a)(3)(D)) is amended to read as follows:
                    ``(D)(i) In this subparagraph and paragraph (5):
                                    ``(I) The term `allot' means allot 
                                under this subsection from a sum 
                                appropriated under section 303(a) or 
                                303(b)(1), as the case may be.
                                    ``(II) The term `covered fiscal 
                                year' means any of fiscal years 2020 
                                through 2029.
                            ``(ii) If the sum appropriated under 
                        section 303(a) or 303(b)(1) for a particular 
                        fiscal year is less than or equal to the sum 
                        appropriated under section 303(a) or 303(b)(1), 
                        respectively, for fiscal year 2019, amounts 
                        shall be allotted to States from the sum 
                        appropriated for the particular year in 
                        accordance with paragraphs (1) and (2), and 
                        subparagraphs (A) through (C) as applicable, 
                        but no State shall be allotted an amount that 
                        is less than--
                                    ``(I) for fiscal year 2020, 99.75 
                                percent of the corresponding sum 
                                appropriated for fiscal year 2019;
                                    ``(II) for fiscal year 2021, 99.50 
                                percent of that sum;
                                    ``(III) for fiscal year 2022, 99.25 
                                percent of that sum;
                                    ``(IV) for fiscal year 2023, 99.00 
                                percent of that sum;
                                    ``(V) for fiscal year 2024, 98.75 
                                percent of that sum;
                                    ``(VI) for fiscal year 2025, 98.50 
                                percent of that sum;
                                    ``(VII) for fiscal year 2026, 98.25 
                                percent of that sum;
                                    ``(VIII) for fiscal year 2027, 
                                98.00 percent of that sum;
                                    ``(IX) for fiscal year 2028, 97.75 
                                percent of that sum; and
                                    ``(X) for fiscal year 2029, 97.50 
                                percent of that sum.
                            ``(iii) If the sum appropriated under 
                        section 303(a) or 303(b)(1) for a particular 
                        covered fiscal year is greater than the sum 
                        appropriated under section 303(a) or 303(b)(1), 
                        respectively, for fiscal year 2019, the 
                        allotments to States from the sum appropriated 
                        for the particular year shall be calculated as 
                        follows:
                                    ``(I) From the portion equal to the 
                                corresponding sum appropriated for 
                                fiscal year 2019, amounts shall be 
                                allotted in accordance with paragraphs 
                                (1) and (2), and subparagraphs (A) 
                                through (C) as applicable, but no State 
                                shall be allotted an amount that is 
                                less than the percentage specified in 
                                clause (ii), for that particular year, 
                                of the corresponding sum appropriated 
                                for fiscal year 2019.
                                    ``(II) From the remainder, amounts 
                                shall be allotted in accordance with 
                                paragraph (1), subparagraphs (A) 
                                through (C) as applicable, and 
                                paragraph (2) to the extent needed to 
                                meet the requirements of those 
                                subparagraphs.''.
    (b) Repeal.--Section 304(a)(3)(D) of the Older Americans Act of 
1965 (42 U.S.C. 3024(a)(3)(D)) is repealed effective October 1, 2029.

            Passed the House of Representatives October 28, 2019.

            Attest:

                                                                 Clerk.
116th CONGRESS

  1st Session

                               H. R. 4334

_______________________________________________________________________

                                 AN ACT

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