II 

116TH CONGRESS 

1ST SESSION S. 1159 

To amend the Older Americans Act of 1965 to establish the Office of 

Inclusivity and Sexual Health and a rural outreach grant program carried 

out by that Office, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 11, 2019 

Mr. BENNET (for himself, Ms. MURKOWSKI, and Mr. CASEY) 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 

the Office of Inclusivity and Sexual Health and a rural 

outreach grant program carried out by that Office, and 

for other purposes. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Inclusive Aging Act’’. 

5 SEC. 2. DEFINITIONS. 

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

7 U.S.C. 3002) is amended— 

8 (1) in paragraph (24)— 


pamtmann on DSKBFK8HB2PROD with BILLS
2 

•S 1159 IS

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

2 ‘‘and’’ at the end; 

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

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

5 and 

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

7 ‘‘(D) status as a LGBT individual.’’; 

8 (2) by redesignating— 

9 (A) paragraphs (44) through (54) as para10 graphs (46) through (56), respectively; and 

11 (B) paragraphs (34) through (43) as para12 graphs (35) through (44), respectively; 

13 (3) by inserting after paragraph (33) the fol14 lowing: 

15 ‘‘(34) The term ‘LGBT’ means lesbian, gay, bi16 sexual, or transgender.’’; and 

17 (4) by inserting after paragraph (44), as so re18 designated, the following: 

19 ‘‘(45) The term ‘protected class’ means a class 

20 described in any of subparagraphs (A) through (E) 

21 of section 2302(b)(1) of title 5, United States 

22 Code.’’. 


pamtmann on DSKBFK8HB2PROD with BILLS
3 

•S 1159 IS

1 SEC. 3. OFFICE OF INCLUSIVITY AND SEXUAL HEALTH. 

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

3 U.S.C. 3011) is amended by adding at the end the fol4 lowing: 

5 ‘‘(g)(1) Not later than 1 year after the date of enact6 ment of the Inclusive Aging Act, the Assistant Secretary 

7 shall establish an Office of Inclusivity and Sexual Health 

8 (referred to in this subsection as the ‘Office’). 

9 ‘‘(2)(A) The Office shall be headed by a Director of 

10 Inclusivity and Sexual Health (referred to in this sub11 section as the ‘Director’) who shall be appointed by the 

12 Assistant Secretary. 

13 ‘‘(B) The Office shall include an Assistant Director 

14 of LGBT Policy (referred to in this subsection as the ‘As15 sistant Director’) who shall be appointed by the Director 

16 to assist the Director in carrying out this subsection, in17 cluding by carrying out the activities under paragraph (4). 

18 ‘‘(3) The Director shall— 

19 ‘‘(A) coordinate activities within the Depart20 ment of Health and Human Services, and between 

21 other Federal departments and agencies, to assure a 

22 continuum of improved services for LGBT older in23 dividuals and older individuals of a protected class; 

24 ‘‘(B) promote a continuum of improved sexual 

25 health services for older individuals, including by enVerDate Sep 11 2014 20:37 Apr 19, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1159.IS S1159

pamtmann on DSKBFK8HB2PROD with BILLS
4 

•S 1159 IS

1 suring access to services for LGBT older individuals 

2 and older individuals of a protected class; 

3 ‘‘(C) collect and disseminate information related 

4 to the challenges experienced by older individuals of 

5 a protected class and all older individuals trying to 

6 seek sexual health services, including information on 

7 the rise of sexually transmitted diseases among the 

8 population of older individuals; 

9 ‘‘(D) administer and evaluate grants that will 

10 help LGBT older individuals, older individuals of a 

11 protected class, and all older individuals seeking sex12 ual health services, including grants under section 

13 423; and 

14 ‘‘(E) coordinate with the Administrator of the 

15 Health Resources and Services Administration on 

16 any sexual health recommendations for older individ17 uals. 

18 ‘‘(4) The Assistant Director shall— 

19 ‘‘(A) serve as the effective and visible advocate 

20 on behalf of LGBT older individuals— 

21 ‘‘(i) within the Department of Health and 

22 Human Services and with other departments 

23 and agencies of the Federal Government re24 garding all Federal policies affecting such indi25 viduals; and 


pamtmann on DSKBFK8HB2PROD with BILLS
5 

•S 1159 IS

1 ‘‘(ii) in the States to promote the enhanced 

2 delivery of services and implementation of pro3 grams, under this Act and other Federal Acts, 

4 for the benefit of such individuals; 

5 ‘‘(B) support, conduct, and arrange for re6 search in the field of LGBT aging with a special em7 phasis on gathering statistics on LGBT older indi8 viduals; 

9 ‘‘(C) collect and disseminate information related 

10 to challenges experienced by LGBT older individuals 

11 with an emphasis on the challenges experienced by 

12 LGBT older individuals residing in rural areas and 

13 LGBT older individuals living with human immuno14 deficiency virus and acquired immune deficiency syn15 drome (HIV/AIDS); and 

16 ‘‘(D) recommend policies and priorities bene17 ficial to LGBT older individuals and promote the 

18 implementation and adoption of culturally competent 

19 care and services for such individuals. 

20 ‘‘(5) Not later than 3 years after the date of enact21 ment of the Inclusive Aging Act, and every 3 years there22 after, the Director shall submit to Congress a report de23 scribing the activities carried out under this subsection 

24 during the preceding 3 years.’’. 


pamtmann on DSKBFK8HB2PROD with BILLS
6 

•S 1159 IS

1 SEC. 4. ADMINISTRATION ON AGING. 

2 (a) ESTABLISHMENT OF ADMINISTRATION.—Section 

3 201(d)(3)(J) of the Older Americans Act of 1965 (42 

4 U.S.C. 3011(d)(3)(J)) is amended by inserting before the 

5 semicolon the following: ‘‘, including the effectiveness of 

6 such services in meeting the needs of LGBT older individ7 uals’’. 

8 (b) FUNCTIONS OF ASSISTANT SECRETARY.—Section 

9 202 of the Older Americans Act of 1965 (42 U.S.C. 3012) 

10 is amended— 

11 (1) in subsection (a)— 

12 (A) in paragraph (16)(A)(ii), by inserting 

13 ‘‘, and separately specifying the number of such 

14 individuals who are LGBT individuals’’ before 

15 the semicolon; 

16 (B) in paragraph (30), by striking ‘‘; and’’ 

17 at the end and inserting a semicolon; 

18 (C) in paragraph (31), by striking the pe19 riod at the end and inserting ‘‘; and’’; and 

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

21 ‘‘(32) conduct studies and collect data to deter22 mine the services that are needed by LGBT older in23 dividuals.’’; and 

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

25 ‘‘(h)(1) The Assistant Director of LGBT Policy ap26 pointed under section 201(g)(2)(B) (referred to in this 


pamtmann on DSKBFK8HB2PROD with BILLS
7 

•S 1159 IS

1 subsection as the ‘Assistant Director’) shall, directly or by 

2 grant or contract, establish and operate the National Re3 source Center on Lesbian, Gay, Bisexual, and 

4 Transgender Aging (in this subsection referred to as the 

5 ‘Center’). 

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

7 LGBT older individuals, the Center shall provide national, 

8 State, and local organizations, including those with a pri9 mary mission of serving LGBT individuals and those with 

10 a primary mission of serving older individuals, with the 

11 information and technical assistance the organizations 

12 need to effectively serve LGBT older individuals. 

13 ‘‘(3) The Center shall have 3 primary objectives, con14 sisting of— 

15 ‘‘(A) educating aging services organizations 

16 about the existence and special needs of LGBT older 

17 individuals; 

18 ‘‘(B) sensitizing LGBT organizations about the 

19 existence and special needs of older individuals; and 

20 ‘‘(C) providing educational resources to LGBT 

21 older individuals and their caregivers. 

22 ‘‘(4)(A) To be eligible to receive funds under this sub23 section, an entity— 


pamtmann on DSKBFK8HB2PROD with BILLS
8 

•S 1159 IS

1 ‘‘(i) shall have demonstrated expertise in work2 ing with organizations or individuals on issues af3 fecting LGBT individuals; 

4 ‘‘(ii) shall have documented experience in pro5 viding training and technical assistance on a na6 tional basis or a formal relationship with an organi7 zation that has that experience; and 

8 ‘‘(iii) shall meet such other criteria as the As9 sistant Director shall issue. 

10 ‘‘(B) To be eligible to receive funds under this sub11 section, an entity shall submit an application to the Assist12 ant Director at such time, in such manner, and containing 

13 such information as the Assistant Director may reason14 ably require. 

15 ‘‘(5) The Assistant Director shall make available to 

16 the Center on an annual basis such resources as are nec17 essary for the Center to carry out effectively the functions 

18 of the Center under this subsection and not less than the 

19 amount of resources made available to the National Re20 source Center on Lesbian, Gay, Bisexual, and 

21 Transgender Aging, existing on the day before the date 

22 of enactment of the Inclusive Aging Act, for fiscal year 

23 2019. 


pamtmann on DSKBFK8HB2PROD with BILLS
9 

•S 1159 IS

1 ‘‘(6) The Assistant Director shall develop and issue 

2 operating standards and reporting requirements for the 

3 Center.’’. 

4 (c) REPORTS.—Section 207 of the Older Americans 

5 Act of 1965 (42 U.S.C. 3018) is amended— 

6 (1) in subsection (a)(3), by inserting ‘‘LGBT 

7 individuals,’’ after ‘‘low-income individuals,’’; 

8 (2) in subsection (c)— 

9 (A) in paragraph (1), by inserting ‘‘, in10 cluding the number of such individuals that are 

11 LGBT individuals’’ before the semicolon; 

12 (B) by redesignating paragraphs (4) and 

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

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

15 following: 

16 ‘‘(4) the effectiveness of such activities in as17 sisting LGBT older individuals;’’; and 

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

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

20 ‘‘(1) no individual will be required to provide in21 formation regarding the sexual orientation or gender 

22 identity of the individual as a condition of partici23 pating in activities or receiving services under this 

24 Act; and 


pamtmann on DSKBFK8HB2PROD with BILLS
10 

•S 1159 IS

1 ‘‘(2) no agency or other entity providing activi2 ties or services under this Act that receives, for the 

3 purposes of this Act, information regarding the sex4 ual orientation or gender identity of an individual 

5 will disclose the information in any form that would 

6 permit such individual to be identified. 

7 ‘‘(e) The Assistant Secretary shall develop appro8 priate protocols, demonstrations, tools, or guidance for use 

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

10 successful implementation of data collection requirements 

11 under this Act with respect to LGBT individuals. 

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

13 the data collection requirements described in subsection 

14 (e) shall apply, taking into consideration the complexity 

15 and importance of each requirement, but each requirement 

16 shall apply not later than 1 year after the date of enact17 ment of the Inclusive Aging Act.’’. 

18 SEC. 5. RURAL OUTREACH GRANT PROGRAM. 

19 Part A of title IV of the Older Americans Act of 1965 

20 (42 U.S.C. 3032 et seq.) is amended by adding at the end 

21 the following: 

22 ‘‘SEC. 423. RURAL OUTREACH GRANT PROGRAM. 

23 ‘‘(a) DEFINITIONS.—In this section: 


pamtmann on DSKBFK8HB2PROD with BILLS
11 

•S 1159 IS

1 ‘‘(1) DIRECTOR.—The term ‘Director’ means 

2 the Director of the Office of Inclusivity and Sexual 

3 Health established under section 201(g). 

4 ‘‘(2) ELIGIBLE ENTITY.—The term ‘eligible en5 tity’— 

6 ‘‘(A) means an entity that submits an ap7 plication to the Director in accordance with 

8 subsection (c), and is— 

9 ‘‘(i) a State; 

10 ‘‘(ii) an Indian tribe or tribal organi11 zation; or 

12 ‘‘(iii) an agency, organization, or in13 stitution, which may be a nonprofit agency, 

14 organization, or institution, that— 

15 ‘‘(I) focuses on serving the needs 

16 of older individuals, LGBT individ17 uals, or individuals of a protected 

18 class; or 

19 ‘‘(II) focuses on providing sexual 

20 health services to all older individuals; 

21 and 

22 ‘‘(B) may include an area agency on aging 

23 for a rural area or a multipurpose senior cen24 ter. 


pamtmann on DSKBFK8HB2PROD with BILLS
12 

•S 1159 IS

1 ‘‘(3) RURAL AREA.—The term ‘rural area’ 

2 means an area that is not designated by the United 

3 States Census Bureau as an urbanized area or 

4 urban cluster. 

5 ‘‘(b) AUTHORITY FOR GRANTS.—The Director may 

6 make grants to eligible entities to carry out activities de7 scribed in subsection (d) that are designed— 

8 ‘‘(1) to create a cooperative and lasting part9 nership between LGBT older individuals, or older in10 dividuals of a protected class, residing in rural areas 

11 and the eligible entity receiving the grant; 

12 ‘‘(2) to meet the needs of the individuals de13 scribed in paragraph (1); and 

14 ‘‘(3) to provide comprehensive sexual health 

15 services to all older individuals residing in rural 

16 areas. 

17 ‘‘(c) APPLICATIONS.— 

18 ‘‘(1) IN GENERAL.—An eligible entity seeking a 

19 grant under this section shall submit an application 

20 to the Director at such time, in such manner, and 

21 containing such information as the Director may 

22 reasonably require, including the contents described 

23 in paragraph (2). 

24 ‘‘(2) CONTENTS.—An application for a grant 

25 under this section shall contain— 


pamtmann on DSKBFK8HB2PROD with BILLS
13 

•S 1159 IS

1 ‘‘(A) a description of the proposed activi2 ties to be supported by the grant; 

3 ‘‘(B) a description of the size and charac4 teristics of the population in a rural area to be 

5 served by such proposed activities; 

6 ‘‘(C) a description of the public and private 

7 resources expected to be made available in con8 nection with such activities; 

9 ‘‘(D) a demonstrated intent to partner 

10 with local organizations in rural areas in car11 rying out such activities; 

12 ‘‘(E) evidence in a form acceptable to the 

13 Director that such activities will meet needs 

14 that are not met by available public and private 

15 sources; and 

16 ‘‘(F) such other information or certifi17 cations that the Director determines necessary 

18 to achieve the purposes described in paragraphs 

19 (1) through (3) of subsection (b). 

20 ‘‘(d) USE OF FUNDS.—An eligible entity may use 

21 funds made available by a grant under this section to 

22 carry out activities that include initiatives that— 

23 ‘‘(1) engage in education and training relating 

24 to community outreach to LGBT older individuals, 


pamtmann on DSKBFK8HB2PROD with BILLS
14 

•S 1159 IS

1 or older individuals of a protected class, residing in 

2 rural areas; 

3 ‘‘(2) reduce isolation and improve access to care 

4 for LGBT older individuals, or older individuals of 

5 a protected class, residing in rural areas by building 

6 relationships between such individuals and the local 

7 community; 

8 ‘‘(3) foster relationships between local service 

9 providers and LGBT older individuals, or older indi10 viduals of a protected class, residing in rural areas; 

11 ‘‘(4) improve cultural competency with respect 

12 to LGBT individuals, or older individuals of a pro13 tected class, among organizations and personnel pro14 viding services to older individuals residing in rural 

15 areas; 

16 ‘‘(5) expand the use of nondiscrimination poli17 cies that— 

18 ‘‘(A) protect sexual orientation and gender 

19 identity; and 

20 ‘‘(B) create community spaces that are in21 clusive to LGBT older individuals or older indi22 viduals of a protected class; and 

23 ‘‘(6) focus on providing sexual health services to 

24 older individuals residing in rural areas. 


pamtmann on DSKBFK8HB2PROD with BILLS
15 

•S 1159 IS

1 ‘‘(e) STANDARDS AND GUIDELINES.—The Director 

2 shall establish standards and guidelines for activities sup3 ported by a grant under this section. Such standards and 

4 guidelines shall permit an eligible entity receiving such a 

5 grant to refine or adapt the standards and guidelines for 

6 an individual project, where such a refinement or adapta7 tion is made necessary by a local circumstance. 

8 ‘‘(f) COORDINATION WITH LOCAL ENTITIES.— 

9 ‘‘(1) COOPERATION.—An eligible entity receiv10 ing a grant under this section shall, in carrying out 

11 activities supported by the grant, agree to cooperate 

12 and coordinate with— 

13 ‘‘(A) the agencies of the relevant State and 

14 local governments responsible for providing 

15 services to LGBT older individuals, or older in16 dividuals of a protected class, in the area served 

17 by such activities; and 

18 ‘‘(B) other public and private organizations 

19 and agencies providing services to LGBT older 

20 individuals, or older individuals of a protected 

21 class, in such area. 

22 ‘‘(2) PRIORITIZATION.—An eligible entity re23 ceiving a grant under this section shall prioritize co24 operating and coordinating with public and private 

25 organizations and agencies that primarily serve popVerDate Sep 11 2014 20:37 Apr 19, 2019 Jkt 089200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\S1159.IS S1159

pamtmann on DSKBFK8HB2PROD with BILLS
16 

•S 1159 IS

1 ulations of older individuals with the greatest social 

2 need. 

3 ‘‘(g) REPORTS.—Not later than 2 years after the date 

4 of enactment of the Inclusive Aging Act, and every 2 years 

5 thereafter, the Director shall submit to Congress a report 

6 describing the activities carried out under this section dur7 ing the preceding 2 years.’’. 

8 SEC. 6. GRANTS FOR STATE AND COMMUNITY PROGRAMS 

9 ON AGING. 

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

11 1965 (42 U.S.C. 3021(a)(2)) is amended— 

12 (1) in subparagraph (E), by striking ‘‘; and’’ 

13 and inserting a semicolon; 

14 (2) by redesignating subparagraph (F) as sub15 paragraph (I); and 

16 (3) by inserting after subparagraph (E) the fol17 lowing: 

18 ‘‘(F) organizations that serve LGBT indi19 viduals; 

20 ‘‘(G) organizations that serve a protected 

21 class; and 

22 ‘‘(H) organizations that provide sexual 

23 health services to older individuals; and’’. 


pamtmann on DSKBFK8HB2PROD with BILLS
17 

•S 1159 IS

1 SEC. 7. ACTIVITIES FOR HEALTH, INDEPENDENCE, AND 

2 LONGEVITY. 

3 Section 411(a)(11) of the Older Americans Act of 

4 1965 (42 U.S.C. 3032(a)(11)) is amended to read as fol5 lows: 

6 ‘‘(11) conducting activities of national signifi7 cance to promote quality and continuous improve8 ment in the support and services provided to individ9 uals with greatest social need, through activities that 

10 include needs assessment, program development and 

11 evaluation, training, technical assistance, and re12 search, concerning— 

13 ‘‘(A) addressing physical and mental 

14 health, disabilities, and health disparities; 

15 ‘‘(B) providing long-term care, including 

16 in-home and community-based care; 

17 ‘‘(C) providing informal care, and formal 

18 care in a facility setting; 

19 ‘‘(D) providing access to culturally respon20 sive health and human services; and 

21 ‘‘(E) addressing other gaps in assistance 

22 and issues that the Assistant Secretary deter23 mines are of particular importance to older in24 dividuals with greatest social need.’’. 


pamtmann on DSKBFK8HB2PROD with BILLS
18 

•S 1159 IS

1 SEC. 8. DATA COLLECTION. 

2 Section 712 of the Older Americans Act of 1965 (42 

3 U.S.C. 3058g) is amended— 

4 (1) in subsection (a)(3)— 

5 (A) by redesignating subparagraphs (F) 

6 through (J) as subparagraphs (G) through (K); 

7 and 

8 (B) by inserting after subparagraph (E) 

9 the following: 

10 ‘‘(F)(i) collect and analyze data, in coordi11 nation with the Director of the Centers for Dis12 ease Control and Prevention, relating to— 

13 ‘‘(I) discrimination, in the admission 

14 to, transfer or discharge from, or lack of 

15 adequate care provided in long-term care 

16 settings, against older individuals on the 

17 basis of actual or perceived sexual orienta18 tion or gender identity, a protected class, 

19 or inclusion in an Indian tribe or tribal or20 ganization; and 

21 ‘‘(II) the need of sexual health serv22 ices for older individuals, the availability of 

23 such services, and any outbreaks of sexu24 ally transmitted diseases among older indi25 viduals; and 


pamtmann on DSKBFK8HB2PROD with BILLS
19 

•S 1159 IS

1 ‘‘(ii) include the analyses under clause (i) 

2 in the reports described in subsection (h)(1);’’; 

3 and 

4 (2) in subsection (h)(6), in the matter pre5 ceding subparagraph (A), by striking ‘‘(A) through 

6 (G)’’ and inserting ‘‘(A) through (H)’’. 

Æ 


pamtmann on DSKBFK8HB2PROD with BILLS