To amend the Older Americans Act of 1965 to define care coordination, include care coordination as a fully restorative service, and detail the care coordination functions of the Assistant Secretary, and for other purposes.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Care Coordination for Older 
Americans Act of 2012''.

SEC. 2. DECLARATION OF OBJECTIVES.

    Section 101(4) of the Older Americans Act of 1965 (42 U.S.C. 
3001(4)) is amended by inserting ``care coordination and'' after 
``including''.

SEC. 3. DEFINITIONS.

    Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is 
amended by adding at the end the following:
            ``(55)(A) The term `care coordination' means a person- and 
        family-centered, assessment-based, and interdisciplinary 
        approach to meet the needs and preferences of an older 
        individual and a family caregiver while enhancing the 
        capabilities of the older individual (including the ability to 
        self-direct services).
            ``(B) The term `care coordination' means coordination 
        that--
                    ``(i) integrates health care, long-term services 
                and supports, housing, and social support services in a 
                high-quality and cost-effective manner in which an 
                individual's needs, preferences, and capabilities are 
                assessed, along with the needs and preferences of a 
                family caregiver;
                    ``(ii) includes, as a core element, the active 
                involvement of the older individual, the family, or a 
                representative appointed by the older individual or 
                legally acting on the individual's behalf, community-
                based service professionals, and health care 
                professionals providing care to the older individual, 
                in the design and implementation of an individualized, 
                individual-centered service and support plan, through 
                which the services and supports will be provided in a 
                manner free from conflicts of interest;
                    ``(iii) integrates services and interventions that 
                are implemented, monitored, and evaluated for 
                effectiveness using an evidence-based process, which 
                typically involves a designated lead care coordinator 
                and involves feedback from the older individual;
                    ``(iv) includes activities that aim simultaneously 
                at meeting individual and family needs and preferences, 
                building on individual capabilities, and improving 
                outcomes and systems of care;
                    ``(v) includes provision of some or all of the 
                services and activities described in clauses (i) 
                through (iv) by trained professionals employed by or 
                under a contract with--
                            ``(I) area agencies on aging;
                            ``(II) Aging and Disability Resource 
                        Centers; or
                            ``(III) other service providers, including 
                        in-home service providers; and
                    ``(vi) is not furnished to directly diagnose, 
                treat, or cure a medical disease or condition.''.

SEC. 4. FUNCTIONS OF THE ASSISTANT SECRETARY.

    Section 202(a) of the Older Americans Act of 1965 (42 U.S.C. 
3012(a)) is amended--
            (1) in paragraph (27), by striking ``and'' at the end;
            (2) in paragraph (28), by striking the period and inserting 
        ``; and''; and
            (3) by adding at the end the following:
            ``(29)(A) encourage, provide technical assistance to, and 
        share best practices with, States, area agencies on aging, 
        Aging and Disability Resource Centers, and service providers to 
        carry out outreach and coordinate activities with health care 
        entities in order to assure better care coordination for 
        individuals with multiple chronic illnesses; and
            ``(B) coordinate activities with other Federal agencies 
        that are working to improve care coordination and developing 
        new models and best practices.''.

SEC. 5. ORGANIZATION.

    Section 305(a) of the Older Americans Act of 1965 (42 U.S.C. 
3025(g)) is amended--
            (1) in paragraph (2), by striking ``and'' at the end;
            (2) in paragraph (3), by striking the period and inserting 
        ``; and''; and
            (3) by adding at the end the following:
            ``(4) the State agency shall promote the development and 
        implementation of a State system to address the care 
        coordination needs of older individuals with multiple chronic 
        illnesses, and shall work with acute care providers, area 
        agencies on aging, service providers, and Federal agencies to 
        ensure that the system uses best practices and is evaluated on 
        its provision of care coordination.''.

SEC. 6. AREA PLANS.

    Section 306(a) of the Older Americans Act of 1965 (42 U.S.C. 
3026(a)) is amended--
            (1) in paragraph (4)(B)(i)(VII) by inserting ``with 
        multiple chronic illnesses or'' after ``older individuals'';
            (2) in paragraph (6)(D), by inserting ``(including acute 
        care providers)'' after ``service providers'';
            (3) in paragraph (16), by striking ``and'' at the end;
            (4) in paragraph (17) by striking the period and inserting 
        ``; and''; and
            (5) by adding at the end the following:
            ``(18) provide assurances that the area agency on aging 
        will--
                    ``(A) identify existing (as of the date of 
                submission of the plan) care coordination programs and 
                systems;
                    ``(B) identify unmet community need for care 
                coordination;
                    ``(C) facilitate the development and implementation 
                of an area-wide system to address the care coordination 
                needs of older individuals with multiple chronic 
                illnesses; and
                    ``(D) work with acute care providers, service 
                providers, and Federal and State agencies to ensure 
                that the system uses best practices in its provision of 
                care coordination.''.

SEC. 7. STATE PLANS.

    Section 307(a) of the Older Americans Act of 1965 (42 U.S.C. 
3027(a)) is amended--
            (1) in paragraph (2)(A), by inserting ``care 
        coordination,'' after ``information and assistance,'';
            (2) in paragraph (17), by striking ``and develop 
        collaborative programs, where appropriate,'' and inserting ``, 
        ensure care coordination, and (where appropriate) develop 
        collaborative programs,'';
            (3) in paragraph (18), in the matter preceding subparagraph 
        (A), by inserting ``and ensure care coordination that 
        integrates long-term care services and other care services,'' 
        before ``for older'';
            (4) in paragraph (23), by striking ``with other State 
        services'' and inserting ``with other Federal and State health 
        care programs and services''; and
            (5) by adding at the end the following:
            ``(31) The plan shall provide assurances that the area 
        agencies on aging in the State will facilitate the area-wide 
        development and implementation of an area-wide system to 
        address the care coordination needs of older individuals with 
        multiple chronic illnesses, and work with acute care providers, 
        service providers, and other Federal and State agencies to 
        ensure that the system uses best practices and is evaluated on 
        its provision of care coordination.''.

Summary: Care Coordination for Older Americans Act of 2012 - Amends the Older Americans Act of 1965 to make it a duty and function of the Administration on Aging (AOA) in the Department of Health and Human Services (HHS) to provide technical assistance to, and share best practices with, states, area agencies on aging, Aging and Disability Resource Centers, and service providers to carry out outreach and coordinate activities with health care entities in order to assure better care coordination for individuals with multiple chronic illnesses. Requires AOA also to coordinate activities with other federal agencies working to improve care coordination and developing new models and best practices.

Requires the designated state agency to promote the development and implementation of a state system to: (1) address the care coordination needs of older individuals with multiple chronic illnesses; and (2) work with acute care providers, area agencies on aging, service providers, and federal agencies to ensure that the system uses best practices.

Requires area and state plans to provide assurances that the area agencies on aging will facilitate the area-wide development and implementation of an area-wide system to address the care coordination needs of older individuals with multiple chronic illnesses.