H. R. 6197
One Hundred Ninth Congress
of the
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Tuesday, 
the third day of January, two thousand and six 
An Act 
To amend the Older Americans Act of 1965 to authorize appropriations for fiscal 
years 2007 through 2011, 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 ‘‘Older Ameri-
cans Act Amendments of 2006’’. 
(b) TABLE OF CONTENTS.—The table of contents for this Act 
is as follows:
Sec. 1. Short title; table of contents. 
TITLE I—GENERAL PROVISION 
Sec. 101. Definitions. 
TITLE II—ADMINISTRATION ON AGING 
Sec. 201. Elder abuse prevention and services. 
Sec. 202. Functions of the Assistant Secretary. 
Sec. 203. Federal agency consultation. 
Sec. 204. Administration. 
Sec. 205. Evaluation. 
Sec. 206. Reports. 
Sec. 207. Contracting and grant authority; private pay relationships; appropriate 
use of funds. 
Sec. 208. Nutrition education. 
Sec. 209. Pension counseling and information programs. 
Sec. 210. Authorization of appropriations. 
TITLE III—GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING 
Sec. 301. Purpose; administration. 
Sec. 302. Definitions. 
Sec. 303. Authorization of appropriations; uses of funds. 
Sec. 304. Allotments. 
Sec. 305. Organization. 
Sec. 306. Area plans. 
Sec. 307. State plans. 
Sec. 308. Payments. 
Sec. 309. Nutrition services incentive program. 
Sec. 310. Consumer contributions. 
Sec. 311. Supportive services and senior centers. 
Sec. 312. Nutrition service. 
Sec. 313. Congregate nutrition program. 
Sec. 314. Home delivered nutrition services. 
Sec. 315. Criteria. 
Sec. 316. Nutrition. 
Sec. 317. Study of nutrition projects. 
Sec. 318. Sense of Congress recognizing the contribution of nutrition to the health 
of older adults. 
Sec. 319. Improving indoor air quality in buildings where older individuals con-
gregate. 
Sec. 320. Caregiver support program definitions.
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Sec. 321. Caregiver support program. 
Sec. 322. National innovation. 
TITLE IV—ACTIVITIES FOR HEALTH, INDEPENDENCE, AND LONGEVITY 
Sec. 401. Title. 
Sec. 402. Grant programs. 
Sec. 403. Career preparation for the field of aging. 
Sec. 404. Health care service demonstration projects in rural areas. 
Sec. 405. Technical assistance and innovation to improve transportation for older 
individuals. 
Sec. 406. Demonstration, support, and research projects for multigenerational ac-
tivities and civic engagement activities. 
Sec. 407. Native American programs. 
Sec. 408. Multidisciplinary centers and multidisciplinary systems. 
Sec. 409. Community innovations for aging in place. 
Sec. 410. Responsibilities of Assistant Secretary. 
TITLE V—OLDER AMERICAN COMMUNITY SERVICE EMPLOYMENT 
PROGRAM 
Sec. 501. Community Service Senior Opportunities Act. 
Sec. 502. Effective date. 
TITLE VI—NATIVE AMERICANS 
Sec. 601. Clarification of maintenance requirement. 
Sec. 602. Native Americans caregiver support program. 
TITLE VII—ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION 
ACTIVITIES 
Sec. 701. Vulnerable elder rights protection activities. 
Sec. 702. Elder abuse, neglect, and exploitation. 
Sec. 703. Native American organization provisions. 
Sec. 704. Elder justice programs. 
Sec. 705. Rule of construction. 
TITLE VIII—FEDERAL YOUTH DEVELOPMENT COUNCIL 
Sec. 801. Short title. 
Sec. 802. Establishment and membership. 
Sec. 803. Duties of the Council. 
Sec. 804. Coordination with existing interagency coordination entities. 
Sec. 805. Assistance of staff. 
Sec. 806. Powers of the Council. 
Sec. 807. Report. 
Sec. 808. Termination. 
Sec. 809. Authorization of appropriations. 
TITLE IX—CONFORMING AMENDMENTS 
Sec. 901. Conforming amendments to other Acts.
TITLE I—GENERAL PROVISION 
SEC. 101. DEFINITIONS. 
(a) IN GENERAL.—Section 102 of the Older Americans Act of 
1965 (42 U.S.C. 3002) is amended—
(1) by striking paragraph (10) and inserting the following: 
‘‘(10)(A) The term ‘assistive device’ includes an assistive 
technology device. 
‘‘(B) The terms ‘assistive technology’, ‘assistive technology 
device’, and ‘assistive technology service’ have the meanings 
given such terms in section 3 of the Assistive Technology Act 
of 1998 (29 U.S.C. 3002).’’; 
(2) by striking paragraph (12)(D) and inserting the fol-
lowing: 
‘‘(D) 
evidence-based 
health 
promotion 
programs, 
including programs related to the prevention and mitiga-
tion of the effects of chronic disease (including osteoporosis,
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hypertension, obesity, diabetes, and cardiovascular dis-
ease), alcohol and substance abuse reduction, smoking ces-
sation, weight loss and control, stress management, falls 
prevention, physical activity, and improved nutrition;’’; 
(3) by striking paragraph (24) and inserting the following: 
‘‘(24)(A) The term ‘exploitation’ means the fraudulent or 
otherwise illegal, unauthorized, or improper act or process of 
an individual, including a caregiver or fiduciary, that uses 
the resources of an older individual for monetary or personal 
benefit, profit, or gain, or that results in depriving an older 
individual of rightful access to, or use of, benefits, resources, 
belongings, or assets. 
‘‘(B) In subparagraph (A), the term ‘caregiver’ means an 
individual who has the responsibility for the care of an older 
individual, either voluntarily, by contract, by receipt of payment 
for care, or as a result of the operation of law and means 
a family member or other individual who provides (on behalf 
of such individual or of a public or private agency, organization, 
or institution) compensated or uncompensated care to an older 
individual.’’; 
(4) in paragraph (29)(E)—
(A) in clause (i), by striking ‘‘and’’ at the end; 
(B) in clause (ii), by striking the period at the end 
and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(iii) older individuals at risk for institutional 
placement.’’; 
(5) in paragraph (32)(D), by inserting ‘‘, including an 
assisted living facility,’’ after ‘‘home’’; 
(6) by striking paragraph (34) and inserting the following: 
‘‘(34) The term ‘neglect’ means—
‘‘(A) the failure of a caregiver (as defined in paragraph 
(18)(B)) or fiduciary to provide the goods or services that 
are necessary to maintain the health or safety of an older 
individual; or 
‘‘(B) self-neglect.’’; and 
(7) by adding at the end the following: 
‘‘(44) The term ‘Aging and Disability Resource Center’ 
means an entity established by a State as part of the State 
system of long-term care, to provide a coordinated system for 
providing—
‘‘(A) comprehensive information on the full range of 
available public and private long-term care programs, 
options, service providers, and resources within a commu-
nity, including information on the availability of integrated 
long-term care; 
‘‘(B) personal counseling to assist individuals in 
assessing their existing or anticipated long-term care needs, 
and developing and implementing a plan for long-term 
care designed to meet their specific needs and cir-
cumstances; and 
‘‘(C) consumers access to the range of publicly-sup-
ported long-term care programs for which consumers may 
be eligible, by serving as a convenient point of entry for 
such programs. 
‘‘(45) The term ‘at risk for institutional placement’ means, 
with respect to an older individual, that such individual is
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unable to perform at least 2 activities of daily living without 
substantial assistance (including verbal reminding, physical 
cuing, or supervision) and is determined by the State involved 
to be in need of placement in a long-term care facility. 
‘‘(46) The term ‘civic engagement’ means an individual 
or collective action designed to address a public concern or 
an unmet human, educational, health care, environmental, or 
public safety need. 
‘‘(47) The term ‘elder justice’—
‘‘(A) used with respect to older individuals, collectively, 
means efforts to prevent, detect, treat, intervene in, and 
respond to elder abuse, neglect, and exploitation and to 
protect older individuals with diminished capacity while 
maximizing their autonomy; and 
‘‘(B) used with respect to an individual who is an 
older individual, means the recognition of the individual’s 
rights, including the right to be free of abuse, neglect, 
and exploitation. 
‘‘(48) The term ‘fiduciary’—
‘‘(A) means a person or entity with the legal responsi-
bility—
‘‘(i) to make decisions on behalf of and for the 
benefit of another person; and 
‘‘(ii) to act in good faith and with fairness; and 
‘‘(B) includes a trustee, a guardian, a conservator, an 
executor, an agent under a financial power of attorney 
or health care power of attorney, or a representative payee. 
‘‘(49) The term ‘Hispanic-serving institution’ has the 
meaning given the term in section 502 of the Higher Education 
Act of 1965 (20 U.S.C. 1101a). 
‘‘(50) The term ‘long-term care’ means any service, care, 
or item (including an assistive device), including a disease 
prevention and health promotion service, an in-home service, 
and a case management service—
‘‘(A) intended to assist individuals in coping with, and 
to the extent practicable compensate for, a functional 
impairment in carrying out activities of daily living; 
‘‘(B) furnished at home, in a community care setting 
(including a small community care setting as defined in 
subsection (g)(1), and a large community care setting as 
defined in subsection (h)(1), of section 1929 of the Social 
Security Act (42 U.S.C. 1396t)), or in a long-term care 
facility; and 
‘‘(C) not furnished to prevent, diagnose, treat, or cure 
a medical disease or condition. 
‘‘(51) The term ‘self-directed care’ means an approach to 
providing services (including programs, benefits, supports, and 
technology) under this Act intended to assist an individual 
with activities of daily living, in which—
‘‘(A) such services (including the amount, duration, 
scope, provider, and location of such services) are planned, 
budgeted, and purchased under the direction and control 
of such individual; 
‘‘(B) such individual is provided with such information 
and assistance as are necessary and appropriate to enable 
such individual to make informed decisions about the 
individual’s care options;
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‘‘(C) the needs, capabilities, and preferences of such 
individual with respect to such services, and such individ-
ual’s ability to direct and control the individual’s receipt 
of such services, are assessed by the area agency on aging 
(or other agency designated by the area agency on aging) 
involved; 
‘‘(D) based on the assessment made under subpara-
graph (C), the area agency on aging (or other agency des-
ignated by the area agency on aging) develops together 
with such individual and the individual’s family, caregiver 
(as defined in paragraph (18)(B)), or legal representative—
‘‘(i) a plan of services for such individual that 
specifies which services such individual will be respon-
sible for directing; 
‘‘(ii) a determination of the role of family members 
(and others whose participation is sought by such indi-
vidual) in providing services under such plan; and 
‘‘(iii) a budget for such services; and 
‘‘(E) the area agency on aging or State agency provides 
for oversight of such individual’s self-directed receipt of 
services, including steps to ensure the quality of services 
provided and the appropriate use of funds under this Act. 
‘‘(52) The term ‘self-neglect’ means an adult’s inability, 
due to physical or mental impairment or diminished capacity, 
to perform essential self-care tasks including—
‘‘(A) obtaining essential food, clothing, shelter, and 
medical care; 
‘‘(B) obtaining goods and services necessary to maintain 
physical health, mental health, or general safety; or 
‘‘(C) managing one’s own financial affairs. 
‘‘(53) The term ‘State system of long-term care’ means 
the Federal, State, and local programs and activities adminis-
tered by a State that provide, support, or facilitate access 
to long-term care for individuals in such State. 
‘‘(54) The term ‘integrated long-term care’—
‘‘(A) means items and services that consist of—
‘‘(i) with respect to long-term care—
‘‘(I) long-term care items or services provided 
under a State plan for medical assistance under 
the Medicaid program established under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.), 
including nursing facility services, home and 
community-based services, personal care services, 
and case management services provided under the 
plan; and 
‘‘(II) any other supports, items, or services that 
are available under any federally funded long-term 
care program; and 
‘‘(ii) with respect to other health care, items and 
services covered under—
‘‘(I) the Medicare program established under 
title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.); 
‘‘(II) the State plan for medical assistance 
under the Medicaid program; or 
‘‘(III) any other federally funded health care 
program; and
H. R. 6197—6
‘‘(B) includes items or services described in subpara-
graph (A) that are provided under a public or private 
managed care plan or through any other service provider.’’. 
(b) REDESIGNATION AND REORDERING OF DEFINITIONS.—Section 
102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is 
amended—
(1) by redesignating paragraphs (1) through (54) as para-
graphs (45), (7), (50), (39), (26), (27), (54), (13), (48), (8), (29), 
(14), (1), (2), (3), (5), (6), (10), (30), (37), (11), (15), (16), (18), 
(21), (22), (23), (24), (28), (31), (33), (35), (36), (38), (40), (41), 
(42), (43), (44), (51), (53), (19), (49), (4), (9), (12), (17), (20), 
(25), (34), (46), (47), (52), and (32), respectively; and 
(2) so that paragraphs (1) through (54), as so redesignated 
in paragraph (1), appear in numerical order. 
TITLE II—ADMINISTRATION ON AGING 
SEC. 201. ELDER ABUSE PREVENTION AND SERVICES. 
Section 201 of the Older Americans Act of 1965 (42 U.S.C. 
3011) is amended by adding at the end the following: 
‘‘(e)(1) The Assistant Secretary is authorized to designate within 
the Administration a person to have responsibility for elder abuse 
prevention and services. 
‘‘(2) It shall be the duty of the Assistant Secretary, acting 
through the person designated to have responsibility for elder abuse 
prevention and services—
‘‘(A) to develop objectives, priorities, policy, and a long-
term plan for—
‘‘(i) facilitating the development, implementation, and 
continuous improvement of a coordinated, multidisciplinary 
elder justice system in the United States; 
‘‘(ii) providing Federal leadership to support State 
efforts in carrying out elder justice programs and activities 
relating to—
‘‘(I) elder abuse prevention, detection, treatment, 
intervention, and response; 
‘‘(II) training of individuals regarding the matters 
described in subclause (I); and 
‘‘(III) the development of a State comprehensive 
elder justice system, as defined in section 752(b); 
‘‘(iii) establishing Federal guidelines and disseminating 
best practices for uniform data collection and reporting 
by States; 
‘‘(iv) working with States, the Department of Justice, 
and other Federal entities to annually collect, maintain, 
and disseminate data relating to elder abuse, neglect, and 
exploitation, to the extent practicable; 
‘‘(v) establishing an information clearinghouse to col-
lect, maintain, and disseminate information concerning best 
practices and resources for training, technical assistance, 
and other activities to assist States and communities to 
carry out evidence-based programs to prevent and address 
elder abuse, neglect, and exploitation; 
‘‘(vi) conducting research related to elder abuse, 
neglect, and exploitation;
H. R. 6197—7
‘‘(vii) providing technical assistance to States and other 
eligible entities that provide or fund the provision of the 
services described in title VII; 
‘‘(viii) carrying out a study to determine the national 
incidence and prevalence of elder abuse, neglect, and exploi-
tation in all settings; and 
‘‘(ix) promoting collaborative efforts and diminishing 
duplicative efforts in the development and carrying out 
of elder justice programs at the Federal, State and local 
levels; and 
‘‘(B) to assist States and other eligible entities under title 
VII to develop strategic plans to better coordinate elder justice 
activities, research, and training. 
‘‘(3) The Secretary, acting through the Assistant Secretary, 
may issue such regulations as may be necessary to carry out this 
subsection and section 752. 
‘‘(f)(1) The Assistant Secretary may designate an officer or 
employee who shall be responsible for the administration of mental 
health services authorized under this Act. 
‘‘(2) It shall be the duty of the Assistant Secretary, acting 
through the individual designated under paragraph (1), to develop 
objectives, priorities, and a long-term plan for supporting State 
and local efforts involving education about and prevention, detec-
tion, and treatment of mental disorders, including age-related 
dementia, depression, and Alzheimer’s disease and related neuro-
logical disorders with neurological and organic brain dysfunction.’’. 
SEC. 202. FUNCTIONS OF THE ASSISTANT SECRETARY. 
Section 202 of the Older Americans Act of 1965 (42 U.S.C. 
3012) is amended—
(1) in subsection (a)—
(A) in paragraph (5), by inserting ‘‘assistive tech-
nology,’’ after ‘‘housing,’’; 
(B) by striking paragraph (12) and inserting the fol-
lowing: 
‘‘(12)(A) consult and coordinate activities with the Adminis-
trator of the Centers for Medicare & Medicaid Services and 
the heads of other Federal entities to implement and build 
awareness of programs providing benefits affecting older 
individuals; and 
‘‘(B) carry on a continuing evaluation of the programs and 
activities related to the objectives of this Act, with particular 
attention to the impact of the programs and activities carried 
out under—
‘‘(i) titles XVIII and XIX of the Social Security Act 
(42 U.S.C. 1395 et seq., 1396 et seq.); 
‘‘(ii) the Age Discrimination in Employment Act of 1967 
(29 U.S.C. 621 et seq.); and 
‘‘(iii) the National Housing Act (12 U.S.C. 1701 et 
seq.) relating to housing for older individuals and the set-
ting of standards for the licensing of nursing homes, inter-
mediate care homes, and other facilities providing care 
for such individuals;’’; 
(C) by striking paragraph (20) and inserting the fol-
lowing: 
‘‘(20)(A) encourage, and provide technical assistance to, 
States, area agencies on aging, and service providers to carry
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out outreach and benefits enrollment assistance to inform and 
enroll older individuals with greatest economic need, who may 
be eligible to participate, but who are not participating, in 
Federal and State programs providing benefits for which the 
individuals are eligible, including—
‘‘(i) supplemental security income benefits under title 
XVI of the Social Security Act (42 U.S.C. 1381 et seq.), 
or assistance under a State plan program under such title; 
‘‘(ii) medical assistance under title XIX of such Act 
(42 U.S.C. 1396 et seq.); 
‘‘(iii) benefits under the Food Stamp Act of 1977 (7 
U.S.C. 2011 et seq.); or 
‘‘(iv) benefits under any other applicable program; and 
‘‘(B) at the election of the Assistant Secretary and in 
cooperation with related Federal agency partners administering 
the Federal programs, make a grant to or enter into a contract 
with a qualified, experienced entity to establish a National 
Center on Senior Benefits Outreach and Enrollment, which 
shall—
‘‘(i) maintain and update web-based decision support 
and enrollment tools, and integrated, person-centered sys-
tems, designed to inform older individuals about the full 
range of benefits for which the individuals may be eligible 
under Federal and State programs; 
‘‘(ii) utilize cost-effective strategies to find older individ-
uals with greatest economic need and enroll the individuals 
in the programs; 
‘‘(iii) create and support efforts for Aging and Disability 
Resource Centers, and other public and private State and 
community-based 
organizations, 
including 
faith-based 
organizations and coalitions, to serve as benefits enrollment 
centers for the programs; 
‘‘(iv) develop and maintain an information clearing-
house on best practices and cost-effective methods for 
finding and enrolling older individuals with greatest eco-
nomic need in the programs for which the individuals are 
eligible; and 
‘‘(v) provide, in collaboration with related Federal 
agency partners administering the Federal programs, 
training and technical assistance on effective outreach, 
screening, enrollment, and follow-up strategies;’’; 
(D) in paragraph (26)—
(i) in subsection (D)—
(I) by striking ‘‘gaps in’’; and 
(II) by inserting ‘‘(including services that 
would permit such individuals to receive long-term 
care in home and community-based settings)’’ after 
‘‘individuals’’; and 
(ii) in subsection (E), by striking ‘‘and’’ at the end; 
(E) in paragraph (27)—
(i) in subparagraph (B), by adding ‘‘and’’ at the 
end; and 
(ii) by striking subparagraph (D); and 
(F) by adding at the end the following: 
‘‘(28) make available to States, area agencies on aging, 
and service providers information and technical assistance to
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support the provision of evidence-based disease prevention and 
health promotion services.’’; 
(2) by striking subsections (b) and (c), and inserting the 
following: 
‘‘(b) To promote the development and implementation of com-
prehensive, coordinated systems at Federal, State, and local levels 
that enable older individuals to receive long-term care in home 
and community-based settings, in a manner responsive to the needs 
and preferences of older individuals and their family caregivers, 
the Assistant Secretary shall, consistent with the applicable provi-
sions of this title—
‘‘(1) collaborate, coordinate, and consult with other Federal 
entities responsible for formulating and implementing pro-
grams, benefits, and services related to providing long-term 
care, and may make grants, contracts, and cooperative agree-
ments with funds received from other Federal entities; 
‘‘(2) conduct research and demonstration projects to identify 
innovative, cost-effective strategies for modifying State systems 
of long-term care to—
‘‘(A) respond to the needs and preferences of older 
individuals and family caregivers; and 
‘‘(B) target services to individuals at risk for institu-
tional placement, to permit such individuals to remain 
in home and community-based settings; 
‘‘(3) establish criteria for and promote the implementation 
(through area agencies on aging, service providers, and such 
other entities as the Assistant Secretary determines to be 
appropriate) of evidence-based programs to assist older individ-
uals and their family caregivers in learning about and making 
behavioral changes intended to reduce the risk of injury, dis-
ease, and disability among older individuals; 
‘‘(4) facilitate, in coordination with the Administrator of 
the Centers for Medicare & Medicaid Services, and other heads 
of Federal entities as appropriate, the provision of long-term 
care in home and community-based settings, including the 
provision of such care through self-directed care models that—
‘‘(A) provide for the assessment of the needs and pref-
erences of an individual at risk for institutional placement 
to help such individual avoid unnecessary institutional 
placement and depletion of income and assets to qualify 
for benefits under the Medicaid program under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.); 
‘‘(B) respond to the needs and preferences of such indi-
vidual and provide the option—
‘‘(i) for the individual to direct and control the 
receipt of supportive services provided; or 
‘‘(ii) as appropriate, for a person who was 
appointed by the individual, or is legally acting on 
the individual’s behalf, in order to represent or advise 
the individual in financial or service coordination mat-
ters (referred to in this paragraph as a ‘representative’ 
of the individual), to direct and control the receipt 
of those services; and 
‘‘(C) assist an older individual (or, as appropriate, a 
representative of the individual) to develop a plan for long-