II 113th CONGRESS 1st Session S. 999 IN THE SENATE OF THE UNITED STATES May 21, 2013 Mr. Cardin (for himself, Mr. Kirk , Ms. Mikulski , and Mr. Nelson ) 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 provide social service agencies with the resources to provide services to meet the urgent needs of Holocaust survivors to age in place with dignity, comfort, security, and quality of life.

1. Short title; table of contents (a) Short title This Act may be cited as the Responding to Urgent needs of Survivors of the Holocaust Act or the RUSH Act . (b) Table of contents The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. Sec. 2. Purposes. Sec. 3. Findings. TITLE I—Responding to the needs of holocaust survivors Subtitle A—Definition, grants, and other programs Sec. 101. Definition. Sec. 102. Organization. Sec. 103. Area plans. Sec. 104. State plans. Sec. 105. Consumer contributions. Sec. 106. Program authorized. Sec. 107. Prevention of elder abuse, neglect, and exploitation. Subtitle B—Functions within administration for community living To assist holocaust survivors Sec. 111. Designation of individual within the administration. Sec. 112. Annual report to congress. TITLE II—Nutrition services for all older individuals Sec. 201. Nutrition services. TITLE III—Transportation Sec. 301. Transportation services and resources. 2. Purposes The purposes of this Act are— (1) to include older individuals who are Holocaust survivors in the list of groups that receive preference for services as defined in section 305(a)(2)(E) of the Older Americans Act of 1965 ( 42 U.S.C. 3025(a)(2)(E) ); (2) to designate within the Administration on Aging an individual to have responsibility for older individuals who are Holocaust survivors; (3) to ensure that the providers of nutrition services through the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) can meet the special health-related or other dietary needs of program participants; and (4) to help meet the urgent transportation needs of Holocaust survivors. 3. Findings Congress finds the following: (1) During the Holocaust, which took place between 1933 and 1945, an estimated 6,000,000 Jews, as well as millions from other targeted groups, were murdered by the Nazis and their collaborators. (2) The United States Holocaust Memorial Museum Encyclopedia estimates that more than 200,000 Jews found refuge in the United States from 1933 to 1945, and estimates that approximately 137,000 Jewish refugees had settled in the United States from 1945 to 1952. (3) Jewish refugees continued to immigrate to the United States from Europe and countries of the former Soviet Union during the subsequent decades. (4) According to the Conference on Jewish Material Claims Against Germany’s 2011 Worldbook: A Guide to Claims Conference Programs Worldwide, the Estimated Nazi Victim Population in the United States is 120,935, down from an estimated 127,300 in 2010. (5) According to the Conference on Jewish Material Claims Against Germany’s 2011 Worldbook: A Guide to Claims Conference Programs Worldwide, of Nazi victims currently residing in the United States, three in five are women, and the average age of a Nazi victim is 80, but nearly one-quarter are age 85 or over. (6) Holocaust survivors continue to live with the unique mental and physical scars of the unconscionable trauma caused by the Holocaust, and while institutionalized settings are beneficial for some, certain aspects of institutionalization may have particularly adverse effects on Holocaust survivors. (7) For many Holocaust survivors, institutionalized settings produce sights, sounds, smells, emotions, and routines which can induce panic, anxiety, and re-traumatization as a result of experiences from the Holocaust. (8) According to Findings from the National Jewish Population Survey 2000–01, a Jewish Federations of North America Report produced in December 2003, Nazi victims are more economically and socially vulnerable, report poorer health and more health problems, and have somewhat greater social service needs. They also report poorer health and more disabilities that limit daily activities compared to nonvictims. (9) Low-income Holocaust survivors are more reliant on social service programs than most other older Americans, and proportionally more Holocaust survivors need services such as personal care, home-delivered and congregate meals, transportation, counseling, and mental health support to promote health and quality of life. (10) Community organizations serving Holocaust survivors report that approximately two-thirds of Holocaust survivors live alone, and living alone is a risk factor for hospitalization and nursing home admission, poverty, falls, depression, poor nutrition, social isolation and loneliness which have been associated with poor health outcomes and an increased risk of death. (11) According to Findings from the National Jewish Population Survey 2000–01, more than half of all Holocaust survivors who immigrated to the United States from the former Soviet Union after 1965 have annual incomes beneath the Federal poverty threshold and constitute an extremely vulnerable at-risk population in the United States. (12) Community organizations serving Holocaust survivors report that transportation is vital to help Holocaust survivors attend medical appointments, shop and purchase necessary items, visit family and friends, and participate in cultural, recreational, or social events, such as congregate meals or religious services. (13) As the general population of older adults increases and public or philanthropic resources remain constant, providers serving older adults including Holocaust survivors need additional capacity to cover the needed services. (14) The Administration for Community Living in the Department of Health and Human Services serves as the Federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan. (15) The mission of the Administration for Community Living is to maximize the independence, well-being, and health of older adults, people with disabilities, and their families and caregivers. (16) Many social service agencies that receive funding under the Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) for home-delivered or congregate meals serve diverse seniors with specialized dietary needs based on religious, cultural, or ethnic requirements, and the necessary special meals often cost more than nonspecial meals. I Responding to the needs of holocaust survivors A Definition, grants, and other programs 101. Definition 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 ; (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 Holocaust survivor. ; (2) by redesignating paragraphs (26) through (54) as paragraphs (27) through (55); and (3) by inserting after paragraph (25) the following: (26) The term Holocaust survivor means an individual who— (A) (i) lived in a country between 1933 and 1945 under a Nazi regime, under Nazi occupation, or under the control of Nazi collaborators; or (ii) fled from a country between 1933 and 1945 under a Nazi regime, under Nazi occupation, or under the control of Nazi collaborators; (B) was persecuted between 1933 and 1945 on the basis of race, religion, physical or mental disability, sexual orientation, political affiliation, ethnicity, or other basis; and (C) was a member of a group that was persecuted by the Nazis. . 102. Organization Section 305(a) of the Older Americans Act of 1965 ( 42 U.S.C. 3025(a) ) is amended— (1) in paragraph (1)(E), by inserting older individuals who are Holocaust survivors, after proficiency, each place it appears; and (2) in paragraph (2)(E), by inserting older individuals who are Holocaust survivors, after proficiency, . 103. Area plans Section 306 of the Older Americans Act of 1965 ( 42 U.S.C. 3026 ) is amended— (1) in subsection (a)— (A) in paragraph (1), by inserting older individuals who are Holocaust survivors, after proficiency, each place it appears; (B) in paragraph (4)— (i) in subparagraph (A)— (I) in clause (i)(I)(bb), by inserting older individuals who are Holocaust survivors, after proficiency, ; and (II) in clause (ii), by inserting older individuals who are Holocaust survivors, after proficiency, each place it appears; (ii) in subparagraph (B)(i)— (I) in subclause (VI), by striking and at the end; and (II) by inserting after subclause (VII) the following: (VIII) older individuals who are Holocaust survivors; and ; and (iii) in subparagraph (B)(ii), by striking subclauses (I) through (VI) and inserting subclauses (I) through (VIII) ; and (C) in paragraph (7)(B)(iii), by inserting , in particular, older individuals who are Holocaust survivors, after placement ; and (2) in subsection (b)(2)(B), by inserting older individuals who are Holocaust survivors, after areas, . 104. State plans Section 307(a) of the Older Americans Act of 1965 ( 42 U.S.C. 3027(a) ) is amended— (1) in paragraph (4), by inserting older individuals who are Holocaust survivors, after proficiency, ; (2) in paragraph (16)— (A) in subparagraph (A)— (i) in clause (v), by striking and at the end; and (ii) by adding at the end the following: (vii) older individuals who are Holocaust survivors; and ; and (B) in subparagraph (B), by striking clauses (i) through (vi) and inserting clauses (i) through (vii) ; and (3) in paragraph (28)(B)(ii), by inserting older individuals who are Holocaust survivors, after areas, . 105. Consumer contributions Section 315 of the Older Americans Act of 1965 ( 42 U.S.C. 3030c–2 ) is amended— (1) in subsection (c)(2), by inserting older individuals who are Holocaust survivors, after proficiency, ; and (2) in subsection (d), by inserting older individuals who are Holocaust survivors, after proficiency, . 106. Program authorized Section 373(c)(2)(A) of the Older Americans Act of 1965 ( 42 U.S.C. 3030s–1(c)(2)(A) ) is amended by striking individuals ) inserting individuals and older individuals who are Holocaust survivors) . 107. Prevention of elder abuse, neglect, and exploitation Section 721(b)(12) of the Older Americans Act of 1965 ( 42 U.S.C. 3058i(b)(12) ) is amended— (1) in subparagraph (B), by striking or at the end; (2) in subparagraph (C), by striking the period at the end and inserting ; or ; and (3) by adding at the end the following: (D) older individuals who are Holocaust survivors. . B Functions within administration for community living To assist holocaust survivors 111. Designation of individual within the administration The Administrator for Community Living is authorized to designate within the Administration for Community Living a person who has specialized training, background, or experience with Holocaust survivor issues to have responsibility for implementing services for older individuals who are Holocaust survivors. 112. Annual report to congress The Administrator for Community Living, with assistance from the individual designated under section 111, shall prepare and submit to Congress an annual report on the status and needs, including the priority areas of concern, of older individuals (as defined in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 )) who are Holocaust survivors. II Nutrition services for all older individuals 201. Nutrition services (a) In general Section 339(2) of the Older Americans Act of 1065 (42 U.S.C. 3030g–21(2)) is amended— (1) in subparagraph (A), by amending clause (iii) to read as follows: (iii) to the maximum extent practicable, are adjusted and appropriately funded to meet any special health-related or other dietary needs of program participants, including needs based on religious, cultural, or ethnic requirements, ; (2) in subparagraph (J), by striking , and and inserting a comma; (3) in subparagraph (K), by striking the period and inserting , and ; and (4) by adding at the end the following: (L) encourages and educates individuals who distribute nutrition services under subpart 2 to engage in conversation with homebound older individuals and to be aware of the warning signs of medical emergencies, injury or abuse in order to reduce isolation and promote well-being. . (b) Study of nutrition projects Section 317(a)(2) of the Older Americans Act Amendments of 2006 ( Public Law 109–365 ) is amended— (1) in subparagraph (B), by striking ; and and inserting a semicolon; (2) in subparagraph (C), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (D) an analysis of service providers' abilities to obtain viable contracts for special foods necessary to meet a religious requirement, required dietary need, or ethnic consideration. . III Transportation 301. Transportation services and resources Section 411(a) of the Older Americans Act of 1965 ( 42 U.S.C. 3032(a) ) is amended— (1) by redesignating paragraph (13) as paragraph (14); (2) in paragraph (12), by striking ; and and inserting a semicolon; and (3) by inserting after paragraph (12) the following: (13) supporting programs that enable the mobility and self-sufficiency of older individuals with the greatest economic need and older individuals with the greatest social need by providing transportation services and resources; and .