II

106TH CONGRESS

1ST SESSION S. 1942

To amend the Older Americans Act of 1965 to establish grant programs

to provide State pharmacy assistance programs and medication management programs.

IN THE SENATE OF THE UNITED STATES

NOVEMBER 17, 1999

Mr. JEFFORDS 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 establish

grant programs to provide State pharmacy assistance

programs and medication management programs.

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

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Pharmaceutical Aid

5 to Older Americans Act’’.

6 SEC. 2. AMENDMENT TO OLDER AMERICANS ACT OF 1965.

7 Part B of title IV of the Older Americans Act of 1965

8 (42 U.S.C. 3034 et seq.) is amended by adding at the end

9 the following:
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1 ‘‘SEC. 429K. GRANTS FOR STATE PHARMACY ASSISTANCE

2 PROGRAMS.

3 ‘‘(a) PROGRAM AUTHORIZED.—The Assistant Sec4 retary may award grants to States to provide and admin5 ister State pharmacy assistance programs.

6 ‘‘(b) PREFERENCE.—In awarding grants under sub7 section (a), the Assistant Secretary shall give preference

8 to States that propose to develop and implement State

9 pharmacy assistance programs, or to provide assistance to

10 State pharmacy assistance programs in existence on the

11 date of enactment of this section, that provide services for

12 underserved populations or for populations residing in

13 rural areas.

14 ‘‘(c) USE OF FUNDS.—A State that receives a grant

15 under subsection (a) shall use funds made available

16 through the grant to—

17 ‘‘(1) develop and implement a State pharmacy

18 assistance program, or to provide assistance to a

19 State pharmacy assistance program in existence on

20 the date of enactment of this section; and

21 ‘‘(2) prepare and submit an evaluation to the

22 Assistant Secretary on the implementation of, or

23 provision of, or assistance to a program described in

24 paragraph (1).

25 ‘‘(d) APPLICATION.—To be eligible to receive a grant

26 under subsection (a), a State shall submit to the Assistant
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1 Secretary an application at such time, in such manner,

2 and containing such information as the Assistant Sec3 retary may require, including—

4 ‘‘(1) a description of a State pharmacy assist5 ance program that such State plans to develop and

6 implement, including information on the anticipated

7 number of individuals to be served, eligibility criteria

8 of individuals to be served, such as the age and in9 come level of such individuals, drugs to be covered

10 by the program, and performance measures to be

11 used to evaluate the program; or

12 ‘‘(2) a description of a State pharmacy assist13 ance program in existence on the date of enactment

14 of this section that such State plans to assist with

15 funds received under subsection (a), including infor16 mation on the number of individuals served, eligi17 bility criteria of individuals served, such as the age

18 and income level of such individuals, drugs covered

19 by the program, and performance measures used to

20 evaluate the program.

21 ‘‘(e) MINIMUM AMOUNT.—In awarding grants under

22 subsection (a), from the amount appropriated under sub23 section (l)(1) for each fiscal year, the Assistant Secretary

24 shall award, to each eligible State, an amount that is not

25 less than $250,000.
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1 ‘‘(f) DURATION OF GRANT.—In awarding grants

2 under subsection (a), the Assistant Secretary shall award

3 such grants for periods of 2 years.

4 ‘‘(g) MATCHING REQUIREMENT.—The Assistant Sec5 retary shall not award a grant to a State under subsection

6 (a) unless that State agrees that, with respect to the costs

7 to be incurred by the State in carrying out the program

8 for which the grant was awarded, the State will make

9 available (directly or through donations from public or pri10 vate entities) non-Federal contributions in an amount that

11 is not less than 30 percent of Federal funds provided

12 under the grant.

13 ‘‘(h) SUPPLEMENT NOT SUPPLANT.—Funds made

14 available under this section shall be used to supplement,

15 and not supplant, any other Federal, State, or local funds

16 expended by a State to provide the services for programs

17 described in this section.

18 ‘‘(i) EVALUATIONS AND REPORT.—

19 ‘‘(1) PROGRAM EVALUATIONS.—Not later than

20 6 months after the end of the period for which the

21 grant is awarded under subsection (a), the State

22 shall prepare an evaluation of the effectiveness of

23 programs carried out with funds received under this

24 section. Not later than 6 months after the end of

25 such period, the State shall submit to the Assistant
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1 Secretary a report containing the results of the eval2 uation, in such form and containing such informa3 tion as the Assistant Secretary may require.

4 ‘‘(2) REPORT TO CONGRESS.—Not later than

5 36 months after the date of enactment of this sec6 tion, the Assistant Secretary shall prepare and sub7 mit to the Speaker of the House of Representatives

8 and the President pro tempore of the Senate a re9 port that describes the effectiveness of the programs

10 carried out with funds received under this section.

11 ‘‘(j) SUNSET PROVISION.—This section shall not

12 apply beginning on the date of enactment of legislation

13 that provides comprehensive health care coverage for pre14 scription drugs under the medicare program under title

15 XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)

16 for all medicare beneficiaries.

17 ‘‘(k) DEFINITIONS.—In this section:

18 ‘‘(1) MEDICATION MANAGEMENT.—The term

19 ‘medication management program’ means a program

20 of services for older individuals, including pharmacy

21 counseling, medicine screening, or patient and health

22 care provider education programs, that—

23 ‘‘(A) provides information and counseling

24 on the prescription drug purchases that are
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1 currently the most economical, and safe and ef2 fective;

3 ‘‘(B) provides services to minimize unnec4 essary or inappropriate use of prescription

5 drugs; and

6 ‘‘(C) provides services to minimize adverse

7 events due to unintended prescription drug-to8 drug interactions.

9 ‘‘(2) STATE PHARMACY ASSISTANCE PRO10 GRAMS.—The term ‘State pharmacy assistance pro11 gram’ means a program that provides coverage for

12 prescription drugs and medication management pro13 grams for individuals who—

14 ‘‘(A) are not less than 65 years of age;

15 ‘‘(B) are not eligible for medical assistance

16 under title XIX of the Social Security Act (42

17 U.S.C. 1396 et seq.);

18 ‘‘(C) are from families with incomes at or

19 below 200 percent of the poverty line; and

20 ‘‘(D) have no coverage for prescription

21 drugs other than coverage provided by a State

22 pharmacy assistance program.

23 ‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—

24 ‘‘(1) IN GENERAL.—There are authorized to be

25 appropriated to carry out this section, $25,000,000
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1 for fiscal year 2001, and such sums as may be nec2 essary for each of fiscal years 2002 through 2005.

3 ‘‘(2) RESERVATION.—From the amount appro4 priated under paragraph (1), for each fiscal year,

5 the Assistant Secretary shall reserve not less than

6 33.3 percent of such amount to enable States to as7 sist State pharmacy assistance programs in exist8 ence on the date of enactment of this section.

9 ‘‘SEC. 429L. GRANTS FOR MEDICATION MANAGEMENT PRO10 GRAMS.

11 ‘‘(a) PROGRAM AUTHORIZED.—The Assistant Sec12 retary may award grants to State agencies to assist such

13 agencies or area agencies on aging in providing and ad14 ministering medication management programs.

15 ‘‘(b) USE OF FUNDS.—A State agency or area agency

16 on aging that receives funds through a grant awarded

17 under subsection (a) shall use such funds to—

18 ‘‘(1) develop and implement a medication man19 agement program, or to provide assistance to a

20 medication management program in existence on the

21 date of enactment of this section; and

22 ‘‘(2) prepare an evaluation on the implementa23 tion of or provision of assistance to a program de24 scribed in paragraph (1), and, in the case of an area
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1 agency on aging, submit the evaluation to the appro2 priate State agency.

3 ‘‘(c) APPLICATION.—To be eligible to receive a grant

4 under subsection (a), a State agency shall submit to the

5 Assistant Secretary an application at such time, in such

6 manner, and containing such information as the Assistant

7 Secretary may require.

8 ‘‘(d) MINIMUM AMOUNT.—In awarding grants under

9 subsection (a), from the amount appropriated under sub10 section (j) for each fiscal year, the Assistant Secretary

11 shall award, to each eligible State agency, an amount that

12 is not less than $50,000.

13 ‘‘(e) DURATION OF GRANT.—In awarding grants

14 under subsection (a), the Assistant Secretary shall award

15 such grants for a period of 2 years.

16 ‘‘(f) MATCHING REQUIREMENT.—The Assistant Sec17 retary shall not award a grant to a State agency under

18 subsection (a) unless that State agency agrees that, with

19 respect to the costs to be incurred in carrying out pro20 grams for which the grant was awarded, the State agency

21 will make available (directly or through donations from

22 public or private entities) non-Federal contributions in an

23 amount that is not less than 30 percent of Federal funds

24 provided under the grant.
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1 ‘‘(g) SUPPLEMENT NOT SUPPLANT.—Funds made

2 available under this section shall be used to supplement,

3 and not supplant, any other Federal, State, or local funds

4 expended by a State agency or area agency on aging to

5 provide the services for programs described in this section.

6 ‘‘(h) REPORTS.—

7 ‘‘(1) REPORT TO ASSISTANT SECRETARY.—Not

8 later than 24 months after receipt of a grant under

9 subsection (a), a State agency shall prepare and sub10 mit to the Assistant Secretary a report on the medi11 cation management programs carried out by the

12 State agency or area agencies on aging in the State

13 in such form and containing such information as the

14 Assistant Secretary may require, including an anal15 ysis of the effectiveness of the programs. Such re16 port shall in part be based on evaluations submitted

17 under subsection (b)(2).

18 ‘‘(2) REPORT TO CONGRESS.—Not later than

19 36 months after grants have been awarded under

20 subsection (a), the Assistant Secretary shall prepare

21 and submit to the Speaker of the House of Rep22 resentatives and the President pro tempore of the

23 Senate a report that describes the effectiveness of

24 the programs carried out with funds received under

25 this section.
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1 ‘‘(i) MEDICATION MANAGEMENT PROGRAMS.—In

2 this section, the term ‘medication management program’

3 means a program of services for older individuals, includ4 ing pharmacy counseling, medicine screening, or patient

5 and health care provider education programs, that—

6 ‘‘(1) provides information and counseling on the

7 prescription drug purchases that are currently the

8 most economical, and safe and effective;

9 ‘‘(2) provides services to minimize unnecessary

10 or inappropriate use of prescription drugs; and

11 ‘‘(3) provides services to minimize adverse

12 events due to unintended prescription drug-to-drug

13 interactions.

14 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There

15 are authorized to be appropriated to carry out this section,

16 $15,000,000 for fiscal year 2001, and such sums as may

17 be necessary for each of fiscal years 2002 through 2005.’’.

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