II 

116TH CONGRESS 

1ST SESSION S. 2179 

To amend the Older Americans Act of 1965 to provide social service agencies 

with the resources to provide services to meet the urgent needs of 

Holocaust survivors to age in place with dignity, comfort, security, and 

quality of life. 

IN THE SENATE OF THE UNITED STATES 

JULY 18, 2019 

Mr. CARDIN (for himself, Mr. CRAMER, and Ms. ROSEN) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To amend the Older Americans Act of 1965 to provide 

social service agencies with the resources to provide services to meet the urgent needs of Holocaust survivors 

to age in place with dignity, comfort, security, and quality of life. 

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

3 SECTION 1. SHORT TITLE. 

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

5 ‘‘Trauma-Informed Modernization of Eldercare for Holo6 caust Survivors Act’’ or the ‘‘TIME for Holocaust Sur7 vivors Act’’. 


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1 (b) TABLE OF CONTENTS.—The table of contents for 

2 this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Findings. 

Sec. 3. Purposes. 

TITLE I—RESPONDING TO THE NEEDS OF HOLOCAUST 

SURVIVORS 

Subtitle A—Definitions, Grants for State and Community Programs, and 

Other Programs 

Sec. 101. Definitions. 

Sec. 102. Organization. 

Sec. 103. Area plans. 

Sec. 104. State plans. 

Sec. 105. Consumer contributions. 

Sec. 106. National Family Caregiver Support Program authorized. 

Sec. 107. Prevention of elder abuse, neglect, and exploitation. 

Subtitle B—Functions Within Administration for Community Living To 

Assist Holocaust Survivors 

Sec. 111. Designation of individual within the Administration. 

Sec. 112. Annual report to Congress. 

Sec. 113. National Resource Center for Older Individuals Experiencing the 

Long-Term and Adverse Consequences of Trauma. 

Sec. 114. Definitions. 

TITLE II—NUTRITION SERVICES FOR OLDER INDIVIDUALS 

Sec. 201. Nutrition services. 

TITLE III—TRANSPORTATION 

Sec. 301. Transportation services and resources. 

3 SEC. 2. FINDINGS. 

4 Congress finds the following: 

5 (1) During the Holocaust, which took place 

6 from 1933 through 1945, an estimated 6,000,000 

7 Jews, as well as millions of victims from other tar8 geted groups, were murdered by the Nazis and their 

9 collaborators. 


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1 (2) More than 200,000 Jews fleeing from Nazi2 occupied territory found refuge in the United States 

3 from 1933 through 1945, and approximately 

4 137,000 additional Jewish refugees settled in the 

5 United States from 1945 through 1952. 

6 (3) Hundreds of thousands of additional Jewish 

7 refugees continued to immigrate to the United 

8 States from Europe and countries of the former So9 viet Union during the subsequent decades. 

10 (4) The number of Holocaust survivors living in 

11 the United States at the end of 2018 was approxi12 mately 80,000 individuals, down from an estimated 

13 127,000 in 2010. 

14 (5) Every Holocaust survivor is now at least 74 

15 years old, most are in at least their mid-to-late 

16 eighties, and many are in their nineties and beyond. 

17 (6) One-third of all Holocaust survivors in the 

18 United States live at or below the official poverty 

19 threshold (as defined by the Bureau of the Census), 

20 including more than half of the Holocaust survivors 

21 who emigrated from the countries of the former So22 viet Union. 

23 (7) Holocaust survivors continue to live with 

24 the unique mental and physical scars of the uncon25 scionable trauma caused by the Holocaust, and while 


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1 institutionalized settings are beneficial for some, cer2 tain aspects of institutionalization may have particu3 larly adverse effects on Holocaust survivors. 

4 (8) For many Holocaust survivors, institutional5 ized settings produce sights, sounds, smells, emo6 tions, and routines that can induce panic, anxiety, 

7 and re-traumatization as a result of experiences 

8 from the Holocaust. 

9 (9) Holocaust survivors are more economically 

10 and socially vulnerable, report poorer health and 

11 more health problems, and have greater social serv12 ice needs, than other older individuals. 

13 (10) In comparison to most other older individ14 uals, low-income Holocaust survivors are more reli15 ant on social service programs that provide services 

16 such as personal care, provision of home-delivered 

17 and congregate meals, transportation, counseling, 

18 and mental health support to promote health and 

19 quality of life. 

20 (11) Community organizations serving Holo21 caust survivors report that approximately one-quar22 ter of Holocaust survivors live alone, and living alone 

23 is a risk factor for hospitalization and nursing home 

24 admission, poverty, falls, depression, poor nutrition, 

25 social isolation, and loneliness, which have been asVerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179

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1 sociated with poor health outcomes and an increased 

2 risk of death. 

3 (12) Community organizations serving Holo4 caust survivors report that transportation is vital to 

5 help Holocaust survivors attend medical appoint6 ments, shop and purchase necessary items, visit 

7 family and friends, and participate in cultural, rec8 reational, or social events, such as congregate meals 

9 or religious services. 

10 (13) As the general population of older individ11 uals increases in the United States and many public 

12 or philanthropic resources remain constant, pro13 viders serving Holocaust survivors need additional 

14 capacity to cover needed services. 

15 (14) The Administration for Community Living 

16 in the Department of Health and Human Services 

17 serves as the Federal agency responsible for increas18 ing access to community supports for, focusing at19 tention and resources on the unique needs of, older 

20 individuals and individuals with disabilities across 

21 their lifespans. 

22 (15) The mission of the Administration for 

23 Community Living is to maximize the independence, 

24 well-being, and health of older individuals, individVerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179

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1 uals with disabilities, and their families and care2 givers. 

3 (16) The Administration for Community Living 

4 in 2017 issued guidance entitled ‘‘ACL Guidance for 

5 Outreach and Providing Services for Holocaust Sur6 vivors’’ in accordance with a requirement of the 

7 Older Americans Act Reauthorization Act of 2016 

8 which states that the Assistant Secretary for Aging 

9 shall ‘‘issue guidance to States, that shall be applica10 ble to States, area agencies on aging, and providers 

11 of services for older individuals, with respect to serv12 ing Holocaust survivors, including guidance on 

13 promising practices for conducting outreach to that 

14 population.’’. 

15 (17) Many social service agencies that receive 

16 funding under the Older Americans Act of 1965 for 

17 home-delivered or congregate meals serve diverse 

18 seniors, including Holocaust survivors, with special19 ized dietary needs based on religious, cultural, or 

20 ethnic requirements, and the necessary special meals 

21 often cost more than other meals. 

22 SEC. 3. PURPOSES. 

23 The purposes of this Act are— 

24 (1) to include ‘‘older individuals who are Holo25 caust survivors’’ in the list of groups that receive 


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1 preference, as specified in section 305(a)(2)(E) of 

2 the Older Americans Act of 1965, for services pro3 vided under that Act; 

4 (2) to require the designation within the Ad5 ministration for Community Living of an individual 

6 to have responsibility for the provision of services to 

7 older individuals who are Holocaust survivors; 

8 (3) to promote technical assistance and training 

9 for agencies that serve older individuals experiencing 

10 the long-term and adverse consequences of trauma; 

11 (4) to ensure that the providers of nutrition 

12 services through the Older Americans Act of 1965 

13 can meet the special health-related or other dietary 

14 needs of program participants; and 

15 (5) to help meet the urgent transportation 

16 needs of Holocaust survivors. 

17 TITLE I—RESPONDING TO THE 

18 NEEDS OF HOLOCAUST SUR19 VIVORS 

20 Subtitle A—Definitions, Grants for 

21 State and Community Pro22 grams, and Other Programs 

23 SEC. 101. DEFINITIONS. 

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

25 U.S.C. 3002) is amended— 


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1 (1) in paragraph (24)— 

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

3 ‘‘and’’; 

4 (B) in subparagraph (C)(ii), by striking 

5 the period at the end and inserting ‘‘; and’’; 

6 and 

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

8 ‘‘(D) status as a Holocaust survivor.’’; 

9 (2) by redesignating paragraphs (26) through 

10 (40) and paragraphs (41) through (54) as para11 graphs (27) through (41) and paragraphs (43) 

12 through (56), respectively; 

13 (3) by inserting after paragraph (25) the fol14 lowing: 

15 ‘‘(26) The term ‘Holocaust survivor’ means an 

16 individual who— 

17 ‘‘(A)(i) lived in a country in a year not 

18 earlier than 1933 and not later than 1945 

19 under a Nazi regime, under Nazi occupation, or 

20 under the control of Nazi collaborators; or 

21 ‘‘(ii) fled from a country in a year de22 scribed in clause (i) under a Nazi regime, under 

23 Nazi occupation, or under the control of Nazi 

24 collaborators; 


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1 ‘‘(B) was persecuted in a year described in 

2 clause (i) on the basis of race, religion, physical 

3 or mental disability, sexual orientation, political 

4 affiliation, ethnicity, or other basis; and 

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

6 persecuted by the Nazis.’’; and 

7 (4) by inserting after paragraph (41) the fol8 lowing: 

9 ‘‘(42) The term ‘person-centered, trauma-in10 formed’, used with respect to care, means care pro11 vided through an aging program, policy, or proce12 dure, that uses a holistic approach to service provi13 sion that promotes the dignity, strength, and em14 powerment of trauma victims by incorporating 

15 knowledge about the role of trauma in trauma vic16 tims’ lives.’’. 

17 SEC. 102. ORGANIZATION. 

18 Section 305(a) of the Older Americans Act of 1965 

19 (42 U.S.C. 3025(a)) is amended— 

20 (1) in paragraph (1)(E), by inserting ‘‘older in21 dividuals who are Holocaust survivors,’’ after ‘‘pro22 ficiency,’’ each place it appears; and 

23 (2) in paragraph (2)(E), by inserting ‘‘older in24 dividuals who are Holocaust survivors,’’ after ‘‘pro25 ficiency,’’. 


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1 SEC. 103. AREA PLANS. 

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

3 U.S.C. 3026) is amended— 

4 (1) in subsection (a)— 

5 (A) in paragraph (1), by inserting ‘‘older 

6 individuals who are Holocaust survivors,’’ after 

7 ‘‘proficiency,’’ each place it appears; 

8 (B) in paragraph (4)— 

9 (i) in subparagraph (A)— 

10 (I) in clause (i)(I)(bb), by insert11 ing ‘‘older individuals who are Holo12 caust survivors,’’ after ‘‘proficiency,’’; 

13 and 

14 (II) in clause (ii), by inserting 

15 ‘‘older individuals who are Holocaust 

16 survivors,’’ after ‘‘proficiency,’’ each 

17 place it appears; 

18 (ii) in subparagraph (B)(i)— 

19 (I) in subclause (VI), by striking 

20 ‘‘and’’ at the end; and 

21 (II) by inserting after subclause 

22 (VII) the following: 

23 ‘‘(VIII) older individuals who are 

24 Holocaust survivors; and’’; and 

25 (iii) in subparagraph (B)(ii), by strik26 ing ‘‘subclauses (I) through (VI)’’ and inVerDate Sep 11 2014 21:51 Jul 24, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2179.IS S2179

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1 serting ‘‘subclauses (I) through (VIII)’’; 

2 and 

3 (C) in paragraph (7)(B)(iii), by inserting 

4 ‘‘, in particular, older individuals who are Holo5 caust survivors,’’ after ‘‘placement’’; and 

6 (2) in subsection (b)(2)(B), by inserting ‘‘older 

7 individuals who are Holocaust survivors,’’ after 

8 ‘‘areas,’’. 

9 SEC. 104. STATE PLANS. 

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

11 (42 U.S.C. 3027(a)) is amended— 

12 (1) in paragraph (4), by inserting ‘‘older indi13 viduals who are Holocaust survivors,’’ after ‘‘pro14 ficiency,’’; 

15 (2) in paragraph (16)— 

16 (A) in subparagraph (A)— 

17 (i) in clause (v), by striking ‘‘and’’ at 

18 the end; and 

19 (ii) by adding at the end the fol20 lowing: 

21 ‘‘(vii) older individuals who are Holo22 caust survivors; and’’; and 

23 (B) in subparagraph (B), by striking 

24 ‘‘clauses (i) through (vi)’’ and inserting 

25 ‘‘clauses (i) through (vii)’’; and 


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1 (3) in paragraph (28)(B)(ii), by inserting 

2 ‘‘older individuals who are Holocaust survivors,’’ 

3 after ‘‘areas,’’. 

4 SEC. 105. CONSUMER CONTRIBUTIONS. 

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

6 U.S.C. 3030c–2) is amended— 

7 (1) in subsection (c)(2), by inserting ‘‘older in8 dividuals who are Holocaust survivors,’’ after ‘‘pro9 ficiency,’’; and 

10 (2) in subsection (d), by inserting ‘‘older indi11 viduals who are Holocaust survivors,’’ after ‘‘pro12 ficiency,’’. 

13 SEC. 106. NATIONAL FAMILY CAREGIVER SUPPORT PRO14 GRAM AUTHORIZED. 

15 Section 373(c)(2)(A) of the Older Americans Act of 

16 1965 (42 U.S.C. 3030s–1(c)(2)(A)) is amended by strik17 ing ‘‘individuals)’’ and inserting ‘‘individuals and older in18 dividuals who are Holocaust survivors)’’. 

19 SEC. 107. PREVENTION OF ELDER ABUSE, NEGLECT, AND 

20 EXPLOITATION. 

21 Section 721(b)(13) of the Older Americans Act of 

22 1965 (42 U.S.C. 3058i(b)(13)) is amended— 

23 (1) in subparagraph (B), by striking ‘‘or’’ at 

24 the end; 


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

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

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

4 ‘‘(D) older individuals who are Holocaust 

5 survivors.’’. 

6 Subtitle B—Functions Within Ad7 ministration for Community 

8 Living To Assist Holocaust Sur9 vivors 

10 SEC. 111. DESIGNATION OF INDIVIDUAL WITHIN THE AD11 MINISTRATION. 

12 The Administrator of the Administration for Commu13 nity Living is authorized to designate, within the Adminis14 tration for Community Living, a person who has special15 ized training, background, or experience with Holocaust 

16 survivor issues— 

17 (1) to have responsibility within the Adminis18 tration for Community Living for implementing and 

19 coordinating services for older individuals who are 

20 Holocaust survivors; and 

21 (2) to serve as a liaison on those issues, and the 

22 provision of services for those individuals, with other 

23 relevant agencies of the Federal Government. 


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1 SEC. 112. ANNUAL REPORT TO CONGRESS. 

2 The Administrator, with assistance from the indi3 vidual designated under section 111, shall prepare and 

4 submit to Congress an annual report on— 

5 (1) the status and needs, including the priority 

6 areas of concern, of older individuals who are Holo7 caust survivors; and 

8 (2) how the aging network is identifying and 

9 serving older individuals experiencing the long-term 

10 and adverse consequences of trauma and how agen11 cies within the aging network are promoting and ad12 vancing person-centered, trauma-informed care to 

13 older individuals experiencing the long-term and ad14 verse consequences of trauma. 

15 SEC. 113. NATIONAL RESOURCE CENTER FOR OLDER INDI16 VIDUALS EXPERIENCING THE LONG-TERM 

17 AND ADVERSE CONSEQUENCES OF TRAUMA. 

18 (a) PROGRAM AUTHORIZED.— 

19 (1) CENTER.—The Administrator shall estab20 lish and operate a National Resource Center on In21 novative Services and Supports for Older Individuals 

22 Experiencing the Long-Term and Adverse Con23 sequences of Trauma (referred to in this section as 

24 the ‘‘Center’’). 

25 (2) FUNCTIONS.—The Center shall— 


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1 (A) provide training and technical assist2 ance to agencies in the aging network delivering 

3 services to older individuals experiencing the 

4 long-term and adverse consequences of trauma; 

5 (B) share best practices with the aging 

6 network; and 

7 (C) make subgrants to the agencies best 

8 positioned to advance and improve the delivery 

9 of services for older individuals experiencing the 

10 long-term and adverse consequences of trauma. 

11 (b) ASSISTANCE.—To carry out subsection (a), the 

12 Administrator shall make grants to or enter into contracts 

13 with one or more nonprofit organization that are experi14 enced— 

15 (1) in providing person-centered, trauma-in16 formed care; and 

17 (2) in providing support and technical assist18 ance on a nationwide basis to agencies within the 

19 aging network that offer services to older individuals 

20 experiencing the long-term and adverse consequences 

21 of trauma. 

22 SEC. 114. DEFINITIONS. 

23 In this subtitle: 


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1 (1) ADMINISTRATOR.—The term ‘‘Adminis2 trator’’ means the Administrator of the Administra3 tion for Community Living. 

4 (2) OTHER TERMS.—The terms ‘‘Holocaust 

5 survivor’’, ‘‘older individual’’, and ‘‘person-centered, 

6 trauma-informed’’ have the meanings given the 

7 terms in section 102 of the Older Americans Act of 

8 1965 (42 U.S.C. 3002). 

9 TITLE II—NUTRITION SERVICES 

10 FOR OLDER INDIVIDUALS 

11 SEC. 201. NUTRITION SERVICES. 

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

13 Americans Act of 1065 (42 U.S.C. 3030g–21(2)) is 

14 amended— 

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

16 (iii) to read as follows: 

17 ‘‘(iii) to the maximum extent prac18 ticable, are adjusted and appropriately 

19 funded to meet any special health-related 

20 dietary needs, and other dietary needs of 

21 program participants (including needs 

22 based on religious, cultural, or ethnic re23 quirements) if for the special health-related 

24 or other dietary needs involved there is 


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1 sufficient demand in a community to war2 rant special meals;’’; 

3 (2) in subparagraph (K), by striking ‘‘, and’’ 

4 and inserting a comma; 

5 (3) in subparagraph (L), by striking the period 

6 and inserting ‘‘, and’’; and 

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

8 ‘‘(M) encourages and educates individuals 

9 utilizing methodology that promotes person-cen10 tered, trauma-informed care who distribute nu11 trition services under subpart 2 to engage in 

12 conversation with homebound older individuals 

13 and to be aware of the warning signs of medical 

14 emergencies, injury, or abuse in order to reduce 

15 isolation and promote well-being.’’. 

16 TITLE III—TRANSPORTATION 

17 SEC. 301. TRANSPORTATION SERVICES AND RESOURCES. 

18 Section 411(a) of the Older Americans Act of 1965 

19 (42 U.S.C. 3032(a)) is amended— 

20 (1) by redesignating paragraph (14) as para21 graph (15); 

22 (2) in paragraph (13), by striking ‘‘; and’’ and 

23 inserting a semicolon; and 

24 (3) by inserting after paragraph (13) the fol25 lowing: 


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1 ‘‘(14) conducting programs that enable the mo2 bility and self-sufficiency of older individuals with 

3 greatest economic need and older individuals with 

4 greatest social need by providing transportation 

5 services and resources; and’’. 

Æ 


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