Title: Inclusive Aging Act
Policy area: Social Welfare

Summary:
Inclusive Aging Act
This bill includes an older individual's status as lesbian, gay, bisexual, or transgender (LGBT) within the scope of greatest social needs and makes other changes to the functions of the Administration on Aging (AOA), grant programs, and other activities concerning older LGBT individuals. Under current law, certain programs and services for older Americans must target those with the greatest economic and social needs.
Specifically, the bill establishes the Office of Inclusivity and Sexual Health within the AOA and reestablishes the National Resource Center on Lesbian, Gay, Bisexual, and Transgender Aging to provide resources and other support pertaining to services for older LGBT individuals. The AOA must also report on the effectiveness of, and conduct data collection and studies on, services for older LGBT individuals.
With respect to grant programs, the bill establishes a program for states, tribes, and others to provide education and resources for sexual health and other services for older LGBT individuals in rural areas. It also expands eligibility for other grants to include, for example, organizations that serve LGBT individuals and broadens the scope of certain grant-funded activities specifically focused on families and caregivers to include individuals with the greatest social needs.
In addition, state long-term care ombudsmen must collect, and report on, data relating to discrimination of, and need for sexual health services by, older LGBT individuals and those in a protected class.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1159 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  1st Session
                                S. 1159

  To amend the Older Americans Act of 1965 to establish the Office of 
   Inclusivity and Sexual Health and a rural outreach grant program 
          carried out by that Office, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 11, 2019

 Mr. Bennet (for himself, Ms. Murkowski, and Mr. Casey) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To amend the Older Americans Act of 1965 to establish the Office of 
   Inclusivity and Sexual Health and a rural outreach grant program 
          carried out by that Office, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Inclusive Aging Act''.

SEC. 2. DEFINITIONS.

    Section 102 of the Older Americans Act of 1965 (42 U.S.C. 3002) is 
amended--
            (1) in paragraph (24)--
                    (A) in subparagraph (B), by striking ``and'' at the 
                end;
                    (B) in subparagraph (C)(ii), by striking the period 
                at the end and inserting ``; and''; and
                    (C) by adding at the end the following:
                    ``(D) status as a LGBT individual.'';
            (2) by redesignating--
                    (A) paragraphs (44) through (54) as paragraphs (46) 
                through (56), respectively; and
                    (B) paragraphs (34) through (43) as paragraphs (35) 
                through (44), respectively;
            (3) by inserting after paragraph (33) the following:
            ``(34) The term `LGBT' means lesbian, gay, bisexual, or 
        transgender.''; and
            (4) by inserting after paragraph (44), as so redesignated, 
        the following:
            ``(45) The term `protected class' means a class described 
        in any of subparagraphs (A) through (E) of section 2302(b)(1) 
        of title 5, United States Code.''.

SEC. 3. OFFICE OF INCLUSIVITY AND SEXUAL HEALTH.

    Section 201 of the Older Americans Act of 1965 (42 U.S.C. 3011) is 
amended by adding at the end the following:
    ``(g)(1) Not later than 1 year after the date of enactment of the 
Inclusive Aging Act, the Assistant Secretary shall establish an Office 
of Inclusivity and Sexual Health (referred to in this subsection as the 
`Office').
    ``(2)(A) The Office shall be headed by a Director of Inclusivity 
and Sexual Health (referred to in this subsection as the `Director') 
who shall be appointed by the Assistant Secretary.
    ``(B) The Office shall include an Assistant Director of LGBT Policy 
(referred to in this subsection as the `Assistant Director') who shall 
be appointed by the Director to assist the Director in carrying out 
this subsection, including by carrying out the activities under 
paragraph (4).
    ``(3) The Director shall--
            ``(A) coordinate activities within the Department of Health 
        and Human Services, and between other Federal departments and 
        agencies, to assure a continuum of improved services for LGBT 
        older individuals and older individuals of a protected class;
            ``(B) promote a continuum of improved sexual health 
        services for older individuals, including by ensuring access to 
        services for LGBT older individuals and older individuals of a 
        protected class;
            ``(C) collect and disseminate information related to the 
        challenges experienced by older individuals of a protected 
        class and all older individuals trying to seek sexual health 
        services, including information on the rise of sexually 
        transmitted diseases among the population of older individuals;
            ``(D) administer and evaluate grants that will help LGBT 
        older individuals, older individuals of a protected class, and 
        all older individuals seeking sexual health services, including 
        grants under section 423; and
            ``(E) coordinate with the Administrator of the Health 
        Resources and Services Administration on any sexual health 
        recommendations for older individuals.
    ``(4) The Assistant Director shall--
            ``(A) serve as the effective and visible advocate on behalf 
        of LGBT older individuals--
                    ``(i) within the Department of Health and Human 
                Services and with other departments and agencies of the 
                Federal Government regarding all Federal policies 
                affecting such individuals; and
                    ``(ii) in the States to promote the enhanced 
                delivery of services and implementation of programs, 
                under this Act and other Federal Acts, for the benefit 
                of such individuals;
            ``(B) support, conduct, and arrange for research in the 
        field of LGBT aging with a special emphasis on gathering 
        statistics on LGBT older individuals;
            ``(C) collect and disseminate information related to 
        challenges experienced by LGBT older individuals with an 
        emphasis on the challenges experienced by LGBT older 
        individuals residing in rural areas and LGBT older individuals 
        living with human immunodeficiency virus and acquired immune 
        deficiency syndrome (HIV/AIDS); and
            ``(D) recommend policies and priorities beneficial to LGBT 
        older individuals and promote the implementation and adoption 
        of culturally competent care and services for such individuals.
    ``(5) Not later than 3 years after the date of enactment of the 
Inclusive Aging Act, and every 3 years thereafter, the Director shall 
submit to Congress a report describing the activities carried out under 
this subsection during the preceding 3 years.''.

SEC. 4. ADMINISTRATION ON AGING.

    (a) Establishment of Administration.--Section 201(d)(3)(J) of the 
Older Americans Act of 1965 (42 U.S.C. 3011(d)(3)(J)) is amended by 
inserting before the semicolon the following: ``, including the 
effectiveness of such services in meeting the needs of LGBT older 
individuals''.
    (b) Functions of 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 (16)(A)(ii), by inserting ``, and 
                separately specifying the number of such individuals 
                who are LGBT individuals'' before the semicolon;
                    (B) in paragraph (30), by striking ``; and'' at the 
                end and inserting a semicolon;
                    (C) in paragraph (31), by striking the period at 
                the end and inserting ``; and''; and
                    (D) by adding at the end the following:
            ``(32) conduct studies and collect data to determine the 
        services that are needed by LGBT older individuals.''; and
            (2) by adding at the end the following:
    ``(h)(1) The Assistant Director of LGBT Policy appointed under 
section 201(g)(2)(B) (referred to in this subsection as the `Assistant 
Director') shall, directly or by grant or contract, establish and 
operate the National Resource Center on Lesbian, Gay, Bisexual, and 
Transgender Aging (in this subsection referred to as the `Center').
    ``(2) To address the unique challenges faced by LGBT older 
individuals, the Center shall provide national, State, and local 
organizations, including those with a primary mission of serving LGBT 
individuals and those with a primary mission of serving older 
individuals, with the information and technical assistance the 
organizations need to effectively serve LGBT older individuals.
    ``(3) The Center shall have 3 primary objectives, consisting of--
            ``(A) educating aging services organizations about the 
        existence and special needs of LGBT older individuals;
            ``(B) sensitizing LGBT organizations about the existence 
        and special needs of older individuals; and
            ``(C) providing educational resources to LGBT older 
        individuals and their caregivers.
    ``(4)(A) To be eligible to receive funds under this subsection, an 
entity--
            ``(i) shall have demonstrated expertise in working with 
        organizations or individuals on issues affecting LGBT 
        individuals;
            ``(ii) shall have documented experience in providing 
        training and technical assistance on a national basis or a 
        formal relationship with an organization that has that 
        experience; and
            ``(iii) shall meet such other criteria as the Assistant 
        Director shall issue.
    ``(B) To be eligible to receive funds under this subsection, an 
entity shall submit an application to the Assistant Director at such 
time, in such manner, and containing such information as the Assistant 
Director may reasonably require.
    ``(5) The Assistant Director shall make available to the Center on 
an annual basis such resources as are necessary for the Center to carry 
out effectively the functions of the Center under this subsection and 
not less than the amount of resources made available to the National 
Resource Center on Lesbian, Gay, Bisexual, and Transgender Aging, 
existing on the day before the date of enactment of the Inclusive Aging 
Act, for fiscal year 2019.
    ``(6) The Assistant Director shall develop and issue operating 
standards and reporting requirements for the Center.''.
    (c) Reports.--Section 207 of the Older Americans Act of 1965 (42 
U.S.C. 3018) is amended--
            (1) in subsection (a)(3), by inserting ``LGBT 
        individuals,'' after ``low-income individuals,'';
            (2) in subsection (c)--
                    (A) in paragraph (1), by inserting ``, including 
                the number of such individuals that are LGBT 
                individuals'' before the semicolon;
                    (B) by redesignating paragraphs (4) and (5) as 
                paragraphs (5) and (6), respectively; and
                    (C) by inserting after paragraph (3) the following:
            ``(4) the effectiveness of such activities in assisting 
        LGBT older individuals;''; and
            (3) by adding at the end the following:
    ``(d) The Assistant Secretary shall ensure that--
            ``(1) no individual will be required to provide information 
        regarding the sexual orientation or gender identity of the 
        individual as a condition of participating in activities or 
        receiving services under this Act; and
            ``(2) no agency or other entity providing activities or 
        services under this Act that receives, for the purposes of this 
        Act, information regarding the sexual orientation or gender 
        identity of an individual will disclose the information in any 
        form that would permit such individual to be identified.
    ``(e) The Assistant Secretary shall develop appropriate protocols, 
demonstrations, tools, or guidance for use by State agencies and area 
agencies on aging, to ensure successful implementation of data 
collection requirements under this Act with respect to LGBT 
individuals.
    ``(f) The Assistant Secretary shall determine when the data 
collection requirements described in subsection (e) shall apply, taking 
into consideration the complexity and importance of each requirement, 
but each requirement shall apply not later than 1 year after the date 
of enactment of the Inclusive Aging Act.''.

SEC. 5. RURAL OUTREACH GRANT PROGRAM.

    Part A of title IV of the Older Americans Act of 1965 (42 U.S.C. 
3032 et seq.) is amended by adding at the end the following:

``SEC. 423. RURAL OUTREACH GRANT PROGRAM.

    ``(a) Definitions.--In this section:
            ``(1) Director.--The term `Director' means the Director of 
        the Office of Inclusivity and Sexual Health established under 
        section 201(g).
            ``(2) Eligible entity.--The term `eligible entity'--
                    ``(A) means an entity that submits an application 
                to the Director in accordance with subsection (c), and 
                is--
                            ``(i) a State;
                            ``(ii) an Indian tribe or tribal 
                        organization; or
                            ``(iii) an agency, organization, or 
                        institution, which may be a nonprofit agency, 
                        organization, or institution, that--
                                    ``(I) focuses on serving the needs 
                                of older individuals, LGBT individuals, 
                                or individuals of a protected class; or
                                    ``(II) focuses on providing sexual 
                                health services to all older 
                                individuals; and
                    ``(B) may include an area agency on aging for a 
                rural area or a multipurpose senior center.
            ``(3) Rural area.--The term `rural area' means an area that 
        is not designated by the United States Census Bureau as an 
        urbanized area or urban cluster.
    ``(b) Authority for Grants.--The Director may make grants to 
eligible entities to carry out activities described in subsection (d) 
that are designed--
            ``(1) to create a cooperative and lasting partnership 
        between LGBT older individuals, or older individuals of a 
        protected class, residing in rural areas and the eligible 
        entity receiving the grant;
            ``(2) to meet the needs of the individuals described in 
        paragraph (1); and
            ``(3) to provide comprehensive sexual health services to 
        all older individuals residing in rural areas.
    ``(c) Applications.--
            ``(1) In general.--An eligible entity seeking a grant under 
        this section shall submit an application to the Director at 
        such time, in such manner, and containing such information as 
        the Director may reasonably require, including the contents 
        described in paragraph (2).
            ``(2) Contents.--An application for a grant under this 
        section shall contain--
                    ``(A) a description of the proposed activities to 
                be supported by the grant;
                    ``(B) a description of the size and characteristics 
                of the population in a rural area to be served by such 
                proposed activities;
                    ``(C) a description of the public and private 
                resources expected to be made available in connection 
                with such activities;
                    ``(D) a demonstrated intent to partner with local 
                organizations in rural areas in carrying out such 
                activities;
                    ``(E) evidence in a form acceptable to the Director 
                that such activities will meet needs that are not met 
                by available public and private sources; and
                    ``(F) such other information or certifications that 
                the Director determines necessary to achieve the 
                purposes described in paragraphs (1) through (3) of 
                subsection (b).
    ``(d) Use of Funds.--An eligible entity may use funds made 
available by a grant under this section to carry out activities that 
include initiatives that--
            ``(1) engage in education and training relating to 
        community outreach to LGBT older individuals, or older 
        individuals of a protected class, residing in rural areas;
            ``(2) reduce isolation and improve access to care for LGBT 
        older individuals, or older individuals of a protected class, 
        residing in rural areas by building relationships between such 
        individuals and the local community;
            ``(3) foster relationships between local service providers 
        and LGBT older individuals, or older individuals of a protected 
        class, residing in rural areas;
            ``(4) improve cultural competency with respect to LGBT 
        individuals, or older individuals of a protected class, among 
        organizations and personnel providing services to older 
        individuals residing in rural areas;
            ``(5) expand the use of nondiscrimination policies that--
                    ``(A) protect sexual orientation and gender 
                identity; and
                    ``(B) create community spaces that are inclusive to 
                LGBT older individuals or older individuals of a 
                protected class; and
            ``(6) focus on providing sexual health services to older 
        individuals residing in rural areas.
    ``(e) Standards and Guidelines.--The Director shall establish 
standards and guidelines for activities supported by a grant under this 
section. Such standards and guidelines shall permit an eligible entity 
receiving such a grant to refine or adapt the standards and guidelines 
for an individual project, where such a refinement or adaptation is 
made necessary by a local circumstance.
    ``(f) Coordination With Local Entities.--
            ``(1) Cooperation.--An eligible entity receiving a grant 
        under this section shall, in carrying out activities supported 
        by the grant, agree to cooperate and coordinate with--
                    ``(A) the agencies of the relevant State and local 
                governments responsible for providing services to LGBT 
                older individuals, or older individuals of a protected 
                class, in the area served by such activities; and
                    ``(B) other public and private organizations and 
                agencies providing services to LGBT older individuals, 
                or older individuals of a protected class, in such 
                area.
            ``(2) Prioritization.--An eligible entity receiving a grant 
        under this section shall prioritize cooperating and 
        coordinating with public and private organizations and agencies 
        that primarily serve populations of older individuals with the 
        greatest social need.
    ``(g) Reports.--Not later than 2 years after the date of enactment 
of the Inclusive Aging Act, and every 2 years thereafter, the Director 
shall submit to Congress a report describing the activities carried out 
under this section during the preceding 2 years.''.

SEC. 6. GRANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING.

    Section 301(a)(2) of the Older Americans Act of 1965 (42 U.S.C. 
3021(a)(2)) is amended--
            (1) in subparagraph (E), by striking ``; and'' and 
        inserting a semicolon;
            (2) by redesignating subparagraph (F) as subparagraph (I); 
        and
            (3) by inserting after subparagraph (E) the following:
                    ``(F) organizations that serve LGBT individuals;
                    ``(G) organizations that serve a protected class; 
                and
                    ``(H) organizations that provide sexual health 
                services to older individuals; and''.

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

    Section 411(a)(11) of the Older Americans Act of 1965 (42 U.S.C. 
3032(a)(11)) is amended to read as follows:
            ``(11) conducting activities of national significance to 
        promote quality and continuous improvement in the support and 
        services provided to individuals with greatest social need, 
        through activities that include needs assessment, program 
        development and evaluation, training, technical assistance, and 
        research, concerning--
                    ``(A) addressing physical and mental health, 
                disabilities, and health disparities;
                    ``(B) providing long-term care, including in-home 
                and community-based care;
                    ``(C) providing informal care, and formal care in a 
                facility setting;
                    ``(D) providing access to culturally responsive 
                health and human services; and
                    ``(E) addressing other gaps in assistance and 
                issues that the Assistant Secretary determines are of 
                particular importance to older individuals with 
                greatest social need.''.

SEC. 8. DATA COLLECTION.

    Section 712 of the Older Americans Act of 1965 (42 U.S.C. 3058g) is 
amended--
            (1) in subsection (a)(3)--
                    (A) by redesignating subparagraphs (F) through (J) 
                as subparagraphs (G) through (K); and
                    (B) by inserting after subparagraph (E) the 
                following:
                    ``(F)(i) collect and analyze data, in coordination 
                with the Director of the Centers for Disease Control 
                and Prevention, relating to--
                            ``(I) discrimination, in the admission to, 
                        transfer or discharge from, or lack of adequate 
                        care provided in long-term care settings, 
                        against older individuals on the basis of 
                        actual or perceived sexual orientation or 
                        gender identity, a protected class, or 
                        inclusion in an Indian tribe or tribal 
                        organization; and
                            ``(II) the need of sexual health services 
                        for older individuals, the availability of such 
                        services, and any outbreaks of sexually 
                        transmitted diseases among older individuals; 
                        and
                    ``(ii) include the analyses under clause (i) in the 
                reports described in subsection (h)(1);''; and
            (2) in subsection (h)(6), in the matter preceding 
        subparagraph (A), by striking ``(A) through (G)'' and inserting 
        ``(A) through (H)''.
                                 <all>