II 
Calendar No. 280 
116TH CONGRESS 
1ST SESSION H. R. 4334 
IN THE SENATE OF THE UNITED STATES 
OCTOBER 29, 2019 
Received; read the first time 
OCTOBER 30, 2019 
Read the second time and placed on the calendar 
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 Representa-
tives 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 
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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 Sec-
retary. 
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 fund-
ing 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. 
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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 ill-
ness. 
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 COLLABO-
RATION 
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 ‘‘immuni-
zation status,’’ after ‘‘oral health,’’; and 
(2) in subparagraph (D) by inserting ‘‘infec-
tious disease, and vaccine preventable disease,’’ after 
‘‘disease),’’. 
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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 amend-
ed— 
(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 ap-
plicant for a grant for a program for which such ap-
plicant previously received a grant unless the Assist-
ant Secretary determines— 
‘‘(A) the program for which such applica-
tion was submitted is operating effectively to 
achieve its stated purpose; and 
‘‘(B) such applicant complied with the as-
surances 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 an-
nual basis, a list of centers and demonstration projects 
funded under each title of the Act. The Assistant Sec-
retary shall ensure that this information is also directly 
provided to States and area agencies on aging.’’. 
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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 Serv-
ice 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 abil-
ity of older individuals to age in place, in-
cluding through the provision of homeless-
ness prevention services, support the abil-
ity of older individuals to access preventive 
health care, promote age-friendly commu-
nities, and address the ability of older indi-
viduals to access long-term care supports, 
including access to caregivers and home- 
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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 ex-
ception’’ 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 con-
necting older individuals to services for which 
they may be eligible;’’; 
(ii) in subparagraph (B)— 
(I) by inserting ‘‘transportation,’’ 
after ‘‘housing,’’ the 1st place it ap-
pears; 
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(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 as-
sistive technology services) that— 
‘‘(I) promote safe and accessible inde-
pendent living environments; and 
‘‘(II) give older individuals access to 
information on available services or help in 
providing services to older individuals, in-
cluding information on transportation serv-
ices 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 fol-
lowing: 
‘‘(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)— 
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(I) by striking ‘‘nongovernmental 
experts and organizations, including 
public health interest and research 
groups and foundations’’ and insert-
ing ‘‘nongovernmental organizations, 
academic or research institutions, 
community-based organizations, and 
philanthropic organizations’’; and 
(II) by striking ‘‘(F)’’ and insert-
ing ‘‘(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 Fed-
eral agencies as appropriate, to develop rec-
ommendations, 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 
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(vi) by adding at the end the fol-
lowing: 
‘‘(9) In this subsection, the term ‘age-friendly com-
munity’ means a community that— 
‘‘(A) is taking steps— 
‘‘(i) to include accessible housing, acces-
sible 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 individ-
uals in social opportunities, civic participation, 
volunteerism, and employment; and 
‘‘(iii) to facilitate access to supportive serv-
ices 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 in-
cludes— 
‘‘(1) an inventory of Federal programs, admin-
istered by the Department of Health and Human 
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Services, the Department of Housing and Urban De-
velopment, or any other Federal agency determined 
appropriate by the Comptroller General, that sup-
port 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 de-
scribed 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 pop-
ulations supported by the Federal programs de-
scribed 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 in-
dividuals with disabilities and any considerations for 
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improving coordination, which may include an indi-
cation of the Federal agency or department that is 
best suited to coordinate such Federal efforts, and 
‘‘(7) information on the extent to which con-
sumer-friendly resources, such as a brochure, are 
available through the National Eldercare Locator 
Service established under section 202(a)(21), are ac-
cessible to all area agencies on aging, and contain 
information on home assessments and home modi-
fications 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 COM-
MUNITIES. 
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 sub-
paragraph (D); and 
(2) by inserting after subparagraph (B) the fol-
lowing: 
‘‘(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 com-
munities (as defined in section 203(c)(9)) regarding— 
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‘‘(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 ‘‘(includ-
ing screening for malnutrition)’’ before the semi-
colon at the end; and 
(2) in section 330(1) by striking ‘‘and food in-
security’’ and inserting ‘‘, food insecurity, and mal-
nutrition’’. 
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; 
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(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— 
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‘‘(A) data collected to determine the serv-
ices 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 effec-
tiveness 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— 
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(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 fol-
lowing: 
‘‘(13) bringing to scale and sustaining evidence- 
based falls prevention programs that will reduce the 
number of falls, fear of falling, and fall-related inju-
ries 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 con-
ditions;’’. 
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SEC. 112. EXTENSION OF RAISE FAMILY CAREGIVERS ACT. 
Section 6 of the RAISE Family Caregivers Act (Pub-
lic Law 115–119; 132 Stat. 27) is amended by striking 
‘‘3’’ and inserting ‘‘4’’. 
SEC. 113. SUPPORT FOR SOCIALLY-ISOLATED OLDER AMER-
ICANS. 
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 sub-
paragraph (M); and 
(4) by inserting after subparagraph (K) the fol-
lowing: 
‘‘(L) screening for the prevention of nega-
tive health effects associated with social isola-
tion and coordination of supportive services and 
health care to address negative health effects 
associated with social isolation; and’’. 
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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 in-
volving 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 ASSO-
CIATED 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 ad-
visory 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— 
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‘‘(A) to review and evaluate efforts to address 
negative health effects associated with social isola-
tion 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 find-
ings. 
‘‘(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 para-
graph (26); and 
(3) by inserting after paragraph (24) the fol-
lowing: 
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‘‘(25) services that promote or support social 
connectedness and reduce negative health effects as-
sociated 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 para-
graph (17); and 
(3) by inserting after paragraph (15) the fol-
lowing: 
‘‘(16) projects that address negative health ef-
fects 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’’. 
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(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 in-
dividuals 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)— 
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(i) in clause (IV) by striking ‘‘or’’ at 
the end; 
(ii) in clause (V) by striking the pe-
riod at the end and inserting ‘‘; or’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(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 fol-
lowing: 
‘‘(H) has been incarcerated or is under super-
vision following the release from prison or jail within 
the last 5 years.’’. 
(b) TRANSITION PERIOD.—This section shall take ef-
fect 1 year after the date of the enactment of this Act. 
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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 fol-
lowing: 
‘‘(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 di-
verse and high-quality direct care workforce, in-
cluding providing wages, benefits, and advance-
ment opportunities needed to attract or retain 
direct care workers; 
‘‘(B) to provide supportive services and ca-
reer 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 appro-
priate safety training;’’. 
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(b) OLDER AMERICAN COMMUNITY SERVICE EM-
PLOYMENT 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 di-
rect care workforce, in consultation with 
the Assistant Secretary, providing for 
wages and benefits needed to reduce bar-
riers to entry for a diverse and high-qual-
ity direct care workforce, supportive serv-
ices and career planning, and paid on-the- 
job training or work-based learning, with 
appropriate safety training;’’. 
SEC. 121. NATIONAL RESOURCE CENTER FOR OLDER INDI-
VIDUALS 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; 
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(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 na-
tional resource center that shall— 
‘‘(A) provide training and technical assist-
ance 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’). 
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‘‘(2) The Center shall— 
‘‘(A) provide basic financial management, re-
tirement 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 out-
reach provided, including work to provide user- 
friendly consumer information and public education 
materials; 
‘‘(C) develop targeted outreach strategies; 
‘‘(D) provide technical assistance to State agen-
cies and to other public and nonprofit private agen-
cies 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 fol-
lowing: 
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‘‘(41) The term ‘person-centered, trauma-in-
formed’ 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 in-
clude aggregate data in the report required by sec-
tion 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 
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in paragraphs (18) and (19) of section 306(a), 
to identify such older individuals and their serv-
ice 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 re-
duction,’’. 
SEC. 
127. 
EXTENSION 
OF 
THE 
SUPPORTING 
GRAND-
PARENTS 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’’. 
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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 amend-
ed— 
(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, reha-
bilitation, 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 as-
sociated with social isolation,’’; and 
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(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 ‘‘dysfunc-
tion,’’; 
(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 fol-
lowing: 
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‘‘(K) responses to public health emer-
gencies and emerging health threats;’’. 
SEC. 131. PREVENTION OF SEXUALLY TRANSMITTED DIS-
EASES. 
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 liv-
ing (as described in part C of title VII of the Reha-
bilitation 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 ‘‘de-
sires’’; and 
(3) in subparagraph (D) by striking ‘‘(29 
U.S.C. 796f et seq.), and other community-based en-
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tities,’’ 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 INDI-
VIDUALS 
SEC. 201. NATIONAL FAMILY CAREGIVER SUPPORT PRO-
GRAM 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 CARE-
GIVERS.— 
(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 Sen-
ate 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 
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under part E of title III of the Older Americans Act 
of 1965 (42 U.S.C. 3030s—3030s–2). Each such re-
port shall also be made available to the public. 
(2) CONTENTS.—For purposes of reports re-
quired by paragraph (1), each State that receives an 
allotment under such National Family Caregiver 
Support Program for fiscal year 2020 or a subse-
quent fiscal year shall report to the Assistant Sec-
retary for the fiscal year involved the amount of 
funds of the total Federal and non-Federal share al-
lotment used by the State to provide support serv-
ices for caregiver support for older relative care-
givers and family caregivers. 
SEC. 202. MINIMUM FUNDING LEVEL FOR STATE ADMINIS-
TRATIVE 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-TAI-
LORED 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 (in-
cluding needs based on religious, cultural, or ethnic re-
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quirements) and medically tailored meals’’ before the 
comma at the end. 
SEC. 204. BUSINESS ACUMEN PROVISIONS AND CLARIFICA-
TION REGARDING OUTSIDE FUNDING FOR 
AREA AGENCIES ON AGING. 
(a) ASSISTANCE RELATING TO GROWING AND SUS-
TAINING CAPACITY.—Section 202(b)(9) of the Older 
Americans Act of 1965 (42 U.S.C. 3012(b)(9)) is amend-
ed— 
(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 in-
dividuals and caregivers most effectively;’’. 
(b) CLARIFYING PARTNERSHIPS FOR AREA AGEN-
CIES 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: 
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‘‘(g) Nothing in this Act shall restrict an area agency 
on aging from providing services not provided or author-
ized by this Act, including through— 
‘‘(1) contracts with health care payers; 
‘‘(2) consumer private pay programs; or 
‘‘(3) other arrangements with entities or indi-
viduals that increase the availability of home and 
community-based services and supports in the plan-
ning 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 fol-
lowing: 
‘‘(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.—Sec-
tion 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 
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gathering information about the situation of a care-
giver 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 rec-
ognized caregiver to participate in such process; 
‘‘(B) requires direct contact with the care-
giver 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 vol-
untary 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 AS-
SESSMENTS.—Section 373 of the Older Americans Act of 
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1965 (42 U.S.C. 3030s–1) is amended by adding at the 
end the following: 
‘‘(h) TECHNICAL ASSISTANCE FOR CAREGIVER AS-
SESSMENTS.—Not later than 1 year after the effective 
date of this subsection, the Assistant Secretary, in con-
sultation with caregivers, older individuals, individuals 
with a disability who receive care from an older relative 
caregiver, the aging network, and other experts and stake-
holders, shall provide technical assistance to promote and 
implement the use of caregiver assessments. Such tech-
nical assistance shall include sharing available tools and 
templates, comprehensive assessment protocols, and best 
practices concerning— 
‘‘(1) conducting caregiver assessments and re-
assessments; 
‘‘(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 ac-
tivities with relevant State and local services.’’. 
(d) REPORTING ON CAREGIVER ASSESSMENT.—Sec-
tion 373(e) of the Older Americans Act of 1965 (42 
U.S.C. 3030s–1(e)) is amended— 
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(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 agen-
cies, and organizations. Such report shall in-
clude— 
‘‘(i) an analysis of the current use of 
caregiver assessments, including a reposi-
tory of caregiver assessment tools or tem-
plates and comprehensive assessment pro-
tocols; 
‘‘(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; 
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‘‘(iii) an analysis of the impact of 
using caregiver assessments on the aging 
network; 
‘‘(iv) an analysis of how caregiver as-
sessments are being used to identify the 
specific needs, barriers, and existing sup-
ports of family caregivers and older rel-
ative caregivers; 
‘‘(v) recommendations for using care-
giver assessments, including in rural or un-
derserved areas; and 
‘‘(vi) feedback from State agencies 
and area agencies on aging, particularly in 
rural or underserved areas, on the imple-
mentation 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 Edu-
cation and Labor of the House of Representa-
tives, the Committee on Health, Education, 
Labor, and Pensions of the Senate, and the 
Special Committee on Aging of the Senate.’’. 
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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 fol-
lowing: 
‘‘(g)(1) The Assistant Secretary shall coordinate the 
research and evaluation functions of this Act under a Na-
tional Research, Demonstration, and Evaluation Center 
for the Aging Network (in this subsection referred to as 
the ‘Center’), which shall be headed by a director des-
ignated by the Assistant Secretary from individuals de-
scribed in paragraph (4). 
‘‘(2) The purpose of the Center shall be— 
‘‘(A) to coordinate research, research dissemi-
nation, evaluation, demonstration projects, and re-
lated activities carried out under this Act; 
‘‘(B) to provide assessment of the programs au-
thorized under this Act; and 
‘‘(C) to increase the repository of information 
on evidence-based programs and interventions avail-
able to the aging network. Such information shall be 
applicable to existing programs and help in the de-
velopment of new evidence-based programs and 
interventions. 
‘‘(3) Activities of the Center shall include conducting, 
promoting, coordinating, and providing support for— 
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‘‘(A) research and evaluation activities that 
support the objectives of this Act, including— 
‘‘(i) evaluation of new and existing pro-
grams and interventions authorized by this Act; 
and 
‘‘(ii) research on and assessment of the re-
lationship 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 pro-
gram 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 activi-
ties described in this subparagraph. 
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‘‘(4) The director shall be an individual with substan-
tial knowledge of and experience in aging and health pol-
icy, 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. 
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‘‘(8) The director shall, as appropriate, consult with 
experts on aging research and evaluation and aging net-
work 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 fol-
lows: 
‘‘(a) GRANTS AND CONTRACTS.—The Assistant Sec-
retary shall award grants to, and enter into contracts 
with, eligible organizations to carry out projects— 
‘‘(1) to provide opportunities for older individ-
uals to participate in multigenerational activities and 
civic engagement activities that contribute to the 
health and wellness of older individuals and individ-
uals in younger generations by developing— 
‘‘(A) meaningful roles for participants; 
‘‘(B) reciprocity in relationship building; 
‘‘(C) reduced social isolation and improved 
participant social connectedness; 
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‘‘(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 rel-
ative 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 pro-
grams; 
‘‘(3) to promote volunteerism, including becom-
ing a mentor to young people; and 
‘‘(4) to facilitate development of and participa-
tion in multigenerational activities and civic engage-
ment activities.’’; 
(2) by amending subsection (b) to read as fol-
lows: 
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‘‘(b) USE OF FUNDS.— 
‘‘(1) IN
GENERAL.—An eligible organization 
shall use funds made available under a grant award-
ed, 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 or-
ganizations 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: 
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‘‘(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 fol-
lows: 
‘‘(e) ELIGIBLE ORGANIZATIONS.—Organizations eli-
gible to receive a grant or enter into a contract under sub-
section (a) shall— 
‘‘(1) be a State, an area agency on aging, or an 
organization that provides opportunities for older in-
dividuals to participate in activities described in such 
subsection; and 
‘‘(2) have the capacity to conduct the coordina-
tion, promotion, and facilitation described in such 
subsection through the use of multigenerational co-
ordinators.’’; 
(5) by striking subsection (g); 
(6) in subsection (h)(2)(B)(i) by striking ‘‘indi-
viduals 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 fol-
lowing: 
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‘‘(b) GRANT PERIOD.—Each grant awarded or con-
tract 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 IN-
DIVIDUALS 
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 appro-
priated 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, 
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State, and local funds expended to support ac-
tivities 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 sec-
tion 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 agen-
cies pursuant to section 712 shall be used to 
supplement and not supplant other Federal, 
State, and local funds expended to support ac-
tivities described in section 712.’’. 
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SEC. 302. STATE LONG-TERM CARE VOLUNTEER OMBUDS-
MAN 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 sub-
paragraph (E); and 
(2) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) 
VOLUNTEER
OMBUDSMAN
REP-
RESENTATIVES.—An individual designated as a 
volunteer ombudsman representative may re-
ceive financial support and recognition from the 
Office of the State Long-Term Care Ombuds-
man 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 enact-
ment 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 op-
erate senior legal hotlines; 
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(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 ‘‘commu-
nity outreach and education,’’ after ‘‘technical as-
sistance’’; and 
(2) in subparagraph (F)— 
(A) by striking ‘‘studying’’ and inserting 
‘‘implementing’’; and 
(B) by inserting ‘‘, programs, and mate-
rials’’ after ‘‘practices’’. 
SEC. 306. PRINCIPLES FOR PERSON-DIRECTED SERVICES 
AND SUPPORTS DURING SERIOUS ILLNESS. 
(a) DEFINITIONS.— 
(1) ADMINISTRATOR.—The term ‘‘Adminis-
trator’’ means the Administrator of the Administra-
tion for Community Living. 
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(2) AREA AGENCY ON AGING; ASSISTANT SEC-
RETARY; STATE AGENCY.—The terms ‘‘area agency 
on aging’’, ‘‘Assistant Secretary’’, and ‘‘State agen-
cy’’ 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 De-
partment of Health and Human Services, and 
a unit of that Department other than the Ad-
ministration on Aging, that the Assistant Sec-
retary 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 Sup-
ports during Serious Illness, issued by the Adminis-
tration on September 1, 2017, or an updated set of 
such Principles. 
(b) DISSEMINATION.—The Administrator shall dis-
seminate the principles to appropriate stakeholders within 
the aging network, as determined by the Assistant Sec-
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retary, 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— 
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‘‘(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 avail-
able 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 re-
sources made available for fiscal year 2019.’’; 
(2) by redesignating part D as part E; and 
(3) by inserting after part C the following: 
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‘‘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 mak-
ing 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 inde-
pendence 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, informa-
tion and referral, case management, health and 
wellness programs, legal services, family caregiver 
support services, and other services that directly 
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support the independence of the older individuals 
served. 
‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed or interpreted to prohibit the provi-
sion 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 en-
sure 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, pro-
gram 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 ad-
ministration, 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. 
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‘‘(b) AUTHORIZATION OF APPROPRIATIONS FOR PRO-
GRAMS.—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 fis-
cal 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 fis-
cal 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 
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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 ‘‘para-
graph (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 ‘‘Admin-
istrator of the Health Care Finance Administration’’ 
and inserting ‘‘Administrator of the Centers for 
Medicare and Medicaid Services’’; 
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(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 ‘‘(ex-
cluding’’ and all that follows through ‘‘303(a)(3))’’; 
(8) in section 306(a)— 
(A) by inserting ‘‘the number of older indi-
viduals at risk for institutional placement resid-
ing 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, Engi-
neering, 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: 
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‘‘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 fis-
cal 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 nu-
trition services) $531,279,663 for fiscal year 2020, 
$563,156,443 for fiscal year 2021, $596,945,830 for fis-
cal 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 nutri-
tion services) $269,577,167 for fiscal year 2020, 
$285,751,797 for fiscal year 2021, $302,896,905 for fis-
cal 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— 
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‘‘(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 co-
ordinated 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 pro-
motion 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 fis-
cal year 2021, $218,350,609 for fiscal year 2022, 
$231,451,645 for fiscal year 2023, and $245,338,744 for 
fiscal year 2024.’’. 
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(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 fis-
cal 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: 
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‘‘(a) IN GENERAL.—There are authorized to be ap-
propriated 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 fis-
cal 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 para-
graph (5): 
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‘‘(I) The term ‘allot’ means allot 
under this subsection from a sum ap-
propriated 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 par-
ticular 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 par-
ticular 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 ap-
propriated for fiscal year 2019; 
‘‘(II) for fiscal year 2021, 99.50 
percent of that sum; 
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‘‘(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 par-
ticular 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: 
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‘‘(I) From the portion equal to 
the corresponding sum appropriated 
for fiscal year 2019, amounts shall be 
allotted in accordance with para-
graphs (1) and (2), and subpara-
graphs (A) through (C) as applicable, 
but no State shall be allotted an 
amount that is less than the percent-
age 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 accord-
ance with paragraph (1), subpara-
graphs (A) through (C) as applicable, 
and paragraph (2) to the extent need-
ed to meet the requirements of those 
subparagraphs. 
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(b) REPEAL.—Section 304(a)(3)(D) of the Older 
Americans Act of 1965 (42 U.S.C. 3024(a)(3)(D)) is re-
pealed effective October 1, 2029. 
Passed the House of Representatives October 28, 
2019. 
Attest: 
CHERYL L. JOHNSON, 
Clerk. 
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Calendar No. 280 
116TH CONGRESS 
1ST SESSION 
H. R. 4334 
AN ACT 
To amend the Older Americans Act of 1965 to au-
thorize appropriations for fiscal years 2020 
through 2024, and for other purposes. 
OCTOBER 30, 2019 
Read the second time and placed on the calendar 
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