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‘‘(iii) older individuals at risk for in-
stitutional placement.’’; 
(5) in paragraph (32)(D), by inserting ‘‘, in-
cluding 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 indi-
vidual; 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 pro-
vide 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 community, including infor-
mation on the availability of integrated long- 
term care; 
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‘‘(B) personal counseling to assist individ-
uals in assessing their existing or anticipated 
long-term care needs, and developing and imple-
menting a plan for long-term care designed to 
meet their specific needs and circumstances; 
and 
‘‘(C) consumers access to the range of pub-
licly-supported 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 place-
ment’ means, with respect to an older individual, 
that such individual is unable to perform at least 2 
activities of daily living without substantial assist-
ance (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 facil-
ity. 
‘‘(46) The term ‘civic engagement’ means an in-
dividual 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, 
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treat, intervene in, and respond to elder abuse, 
neglect, and exploitation and to protect older 
individuals with diminished capacity while maxi-
mizing their autonomy; and 
‘‘(B) used with respect to an individual 
who is an older individual, means the recogni-
tion of the individual’s rights, including the 
right to be free of abuse, neglect, and exploi-
tation. 
‘‘(48) The term ‘fiduciary’— 
‘‘(A) means a person or entity with the 
legal responsibility— 
‘‘(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 con-
servator, an executor, an agent under a finan-
cial 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), 
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including a disease prevention and health promotion 
service, an in-home service, and a case management 
service— 
‘‘(A) intended to assist individuals in cop-
ing with, and to the extent practicable com-
pensate for, a functional impairment in car-
rying 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 sub-
section (h)(1), of section 1929 of the Social Se-
curity 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 
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under the direction and control of such indi-
vidual; 
‘‘(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; 
‘‘(C) the needs, capabilities, and pref-
erences of such individual with respect to such 
services, and such individual’s ability to direct 
and control the individual’s receipt of such serv-
ices, 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 
subparagraph (C), the area agency on aging (or 
other agency designated by the area agency on 
aging) develops together with such individual 
and the individual’s family, caregiver (as de-
fined in paragraph (18)(B)), or legal represent-
ative— 
‘‘(i) a plan of services for such indi-
vidual that specifies which services such in-
dividual will be responsible for directing; 
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‘‘(ii) a determination of the role of 
family members (and others whose partici-
pation is sought by such individual) in pro-
viding 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 individ-
ual’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 nec-
essary 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 administered by a State that provide, 
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support, or facilitate access to long-term care for in-
dividuals 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 serv-
ices 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 facil-
ity services, home and community- 
based services, personal care services, 
and case management services pro-
vided 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 estab-
lished under title XVIII of the Social 
Security Act (42 U.S.C. 1395 et seq.); 
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‘‘(II) the State plan for medical 
assistance under the Medicaid pro-
gram; or 
‘‘(III) any other federally funded 
health care program; and 
‘‘(B) includes items or services described in 
subparagraph (A) that are provided under a 
public or private managed care plan or through 
any other service provider.’’. 
(b) REDESIGNATION AND REORDERING OF DEFINI-
TIONS.—Section 102 of the Older Americans Act of 1965 
(42 U.S.C. 3002) is amended— 
(1) by redesignating paragraphs (1) through 
(54) as paragraphs (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. 
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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 fol-
lowing: 
‘‘(e)(1) The Assistant Secretary is authorized to des-
ignate within the Administration a person to have respon-
sibility for elder abuse prevention and services. 
‘‘(2) It shall be the duty of the Assistant Secretary, 
acting through the person designated to have responsi-
bility for elder abuse prevention and services— 
‘‘(A) to develop objectives, priorities, policy, and 
a long-term plan for— 
‘‘(i) facilitating the development, imple-
mentation, and continuous improvement of a 
coordinated, multidisciplinary elder justice sys-
tem in the United States; 
‘‘(ii) providing Federal leadership to sup-
port 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 
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‘‘(III) the development of a State 
comprehensive elder justice system, as de-
fined 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 annu-
ally collect, maintain, and disseminate data re-
lating to elder abuse, neglect, and exploitation, 
to the extent practicable; 
‘‘(v) establishing an information clearing-
house to collect, maintain, and disseminate in-
formation concerning best practices and re-
sources for training, technical assistance, and 
other activities to assist States and commu-
nities 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; 
‘‘(vii) providing technical assistance to 
States and other eligible entities that provide or 
fund the provision of the services described in 
title VII; 
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‘‘(viii) carrying out a study to determine 
the national incidence and prevalence of elder 
abuse, neglect, and exploitation in all settings; 
and 
‘‘(ix) promoting collaborative efforts and 
diminishing duplicative efforts in the develop-
ment 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 Sec-
retary, may issue such regulations as may be necessary 
to carry out this subsection and section 752. 
‘‘(f)(1) The Assistant Secretary may designate an of-
ficer or employee who shall be responsible for the adminis-
tration 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, detection, and treatment of mental 
disorders, including age-related dementia, depression, and 
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Alzheimer’s disease and related neurological 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 ‘‘assist-
ive technology,’’ after ‘‘housing,’’; 
(B) by striking paragraph (12) and insert-
ing the following: 
‘‘(12)(A) consult and coordinate activities with 
the Administrator of the Centers for Medicare & 
Medicaid Services and the heads of other Federal 
entities to implement and build awareness of pro-
grams 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 Se-
curity Act (42 U.S.C. 1395 et seq., 1396 et 
seq.); 
‘‘(ii) the Age Discrimination in Employ-
ment Act of 1967 (29 U.S.C. 621 et seq.); and 
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‘‘(iii) the National Housing Act (12 U.S.C. 
1701 et seq.) relating to housing for older indi-
viduals and the setting of standards for the li-
censing of nursing homes, intermediate care 
homes, and other facilities providing care for 
such individuals;’’; 
(C) by striking paragraph (20) and insert-
ing the following: 
‘‘(20)(A) encourage, and provide technical as-
sistance to, States, area agencies on aging, and serv-
ice providers to carry out outreach and benefits en-
rollment assistance to inform and enroll older indi-
viduals with greatest economic need, who may be eli-
gible 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 
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‘‘(iv) benefits under any other applicable 
program; and 
‘‘(B) at the election of the Assistant Secretary 
and in cooperation with related Federal agency part-
ners administering the Federal programs, make a 
grant to or enter into a contract with a qualified, ex-
perienced entity to establish a National Center on 
Senior Benefits Outreach and Enrollment, which 
shall— 
‘‘(i) maintain and update web-based deci-
sion support and enrollment tools, and inte-
grated, person-centered systems, designed to in-
form older individuals about the full range of 
benefits for which the individuals may be eligi-
ble under Federal and State programs; 
‘‘(ii) utilize cost-effective strategies to find 
older individuals 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 organiza-
tions and coalitions, to serve as benefits enroll-
ment centers for the programs; 
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‘‘(iv) develop and maintain an information 
clearinghouse on best practices and cost-effec-
tive methods for finding and enrolling older in-
dividuals with greatest economic need in the 
programs for which the individuals are eligible; 
and 
‘‘(v) provide, in collaboration with related 
Federal agency partners administering the Fed-
eral 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 serv-
ices that would permit such individ-
uals 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 
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(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 support the provision of evi-
dence-based disease prevention and health promotion 
services.’’; 
(2) by striking subsections (b) and (c), and in-
serting the following: 
‘‘(b) To promote the development and implementa-
tion of comprehensive, coordinated systems at Federal, 
State, and local levels that enable older individuals to re-
ceive long-term care in home and community-based set-
tings, in a manner responsive to the needs and preferences 
of older individuals and their family caregivers, the Assist-
ant 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 programs, benefits, and services 
related to providing long-term care, and may make 
grants, contracts, and cooperative agreements with 
funds received from other Federal entities; 
‘‘(2) 
conduct 
research 
and 
demonstration 
projects to identify innovative, cost-effective strate-
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gies 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 institutional placement, to permit such indi-
viduals to remain in home and community- 
based settings; 
‘‘(3) establish criteria for and promote the im-
plementation (through area agencies on aging, serv-
ice providers, and such other entities as the Assist-
ant Secretary determines to be appropriate) of evi-
dence-based programs to assist older individuals and 
their family caregivers in learning about and making 
behavioral changes intended to reduce the risk of in-
jury, disease, and disability among older individuals; 
‘‘(4) facilitate, in coordination with the Admin-
istrator of the Centers for Medicare & Medicaid 
Services, and other heads of Federal entities as ap-
propriate, the provision of long-term care in home 
and community-based settings, including the provi-
sion of such care through self-directed care models 
that— 
‘‘(A) provide for the assessment of the 
needs and preferences of an individual at risk 
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