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.

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 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 Secretary. 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 funding 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. 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 illness. 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. I Ensuring collaboration and promoting independence for older individuals 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 . 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 immunization status, after oral health, ; and (2) in subparagraph (D) by inserting infectious disease, and vaccine preventable disease, after disease), . 103. Functions of Assistant Secretary (a) Review of applications Section 202 of the Older Americans Act of 1965 ( 42 U.S.C. 3012 ) is amended— (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 applicant for a grant for a program for which such applicant previously received a grant unless the Assistant Secretary determines— (A) the program for which such application was submitted is operating effectively to achieve its stated purpose; and (B) such applicant complied with the assurances 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 annual basis, a list of centers and demonstration projects funded under each title of the Act. The Assistant Secretary shall ensure that this information is also directly provided to States and area agencies on aging. . (b) Addressing the needs of older individuals in disasters Section 202(a) of the Older Americans Act of 1965 ( 42 U.S.C. 3012(a) ) is amended— (1) in paragraph (30) by striking and at the end; (2) in paragraph (31) by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (32) provide technical assistance to and share best practices with States and area agencies on aging on how to collaborate and coordinate activities and develop long-range emergency preparedness plans with local and State emergency response agencies, relief organizations, local and State governments, federal agencies as appropriate, and any other institutions that have responsibility for disaster relief service delivery. . 104. Professional standards for nutrition official under Assistant Secretary Section 205(a)(2)(C)(ii) of the Older Americans Act of 1965 ( 42 U.S.C. 3016(a)(2)(C)(ii) is amended to read as follows: (ii) be a registered dietitian or registered dietitian nutritionist. . 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 Service 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 ability of older individuals to age in place, including through the provision of homelessness prevention services, support the ability of older individuals to access preventive health care, promote age-friendly communities, and address the ability of older individuals to access long-term care supports, including access to caregivers and home- 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 exception 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 connecting older individuals to services for which they may be eligible; ; (ii) in subparagraph (B)— (I) by inserting transportation, after housing, the 1st place it appears; (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 assistive technology services) that— (I) promote safe and accessible independent living environments; and (II) give older individuals access to information on available services or help in providing services to older individuals, including information on transportation services 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 following: (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)— (I) by striking nongovernmental experts and organizations, including public health interest and research groups and foundations and inserting nongovernmental organizations, academic or research institutions, community-based organizations, and philanthropic organizations ; and (II) by striking (F) and inserting (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 Federal agencies as appropriate, to develop recommendations, 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 (vi) by adding at the end the following: (9) In this subsection, the term age-friendly community means a community that— (A) is taking steps— (i) to include accessible housing, accessible 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 individuals in social opportunities, civic participation, volunteerism, and employment; and (iii) to facilitate access to supportive services 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 includes— (1) an inventory of Federal programs, administered by the Department of Health and Human Services, the Department of Housing and Urban Development, or any other Federal agency determined appropriate by the Comptroller General, that support 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 described 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 populations supported by the Federal programs described 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 individuals with disabilities and any considerations for improving coordination, which may include an indication of the Federal agency or department that is best suited to coordinate such Federal efforts, and (7) information on the extent to which consumer-friendly resources, such as a brochure, are available through the National Eldercare Locator Service established under section 202(a)(21), are accessible to all area agencies on aging, and contain information on home assessments and home modifications for older individuals attempting to live independently and safely in their homes and for the caregivers of such individuals. . 106. Technical assistance on age-friendly communities 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 subparagraph (D); and (2) by inserting after subparagraph (B) the following: (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 communities (as defined in section 203(c)(9)) regarding— (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. . 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 (including screening for malnutrition) before the semicolon at the end; and (2) in section 330(1) by striking and food insecurity and inserting , food insecurity, and malnutrition . 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; (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— (A) data collected to determine the services 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 effectiveness 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). . 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, . 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— (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. . 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 following: (13) bringing to scale and sustaining evidence-based falls prevention programs that will reduce the number of falls, fear of falling, and fall-related injuries 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 conditions; . 112. Extension of RAISE Family Caregivers Act Section 6 of the RAISE Family Caregivers Act ( Public Law 115–119 ; 132 Stat. 27) is amended by striking 3 and inserting 4 . 113. Support for socially-isolated older Americans 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 subparagraph (M); and (4) by inserting after subparagraph (K) the following: (L) screening for the prevention of negative health effects associated with social isolation and coordination of supportive services and health care to address negative health effects associated with social isolation; and . 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 involving education about, prevention of, detection of, and response to negative health effects associated with social isolation among older individuals. . 115. Advisory council on health effects associated 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 advisory 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— (A) to review and evaluate efforts to address negative health effects associated with social isolation 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 findings. (3) The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply with respect to the advisory council convened under paragraph (1). . 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 paragraph (26); and (3) by inserting after paragraph (24) the following: (25) services that promote or support social connectedness and reduce negative health effects associated with social isolation; and . 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 paragraph (17); and (3) by inserting after paragraph (15) the following: (16) projects that address negative health effects 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. 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 . (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 . 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 individuals 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)— (i) in clause (IV) by striking or at the end; (ii) in clause (V) by striking the period at the end and inserting ; or ; and (iii) by adding at the end the following: (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 following: (H) has been incarcerated or is under supervision following the release from prison or jail within the last 5 years. . (b) Transition period This section shall take effect 1 year after the date of the enactment of this Act. 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 following: (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 diverse and high-quality direct care workforce, including providing wages, benefits, and advancement opportunities needed to attract or retain direct care workers; (B) to provide supportive services and career 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 appropriate safety training; . (b) Older American community service employment 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 direct care workforce, in consultation with the Assistant Secretary, providing for wages and benefits needed to reduce barriers to entry for a diverse and high-quality direct care workforce, supportive services and career planning, and paid on-the-job training or work-based learning, with appropriate safety training; . 121. National resource center for older individuals 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; (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 national resource center that shall— (A) provide training and technical assistance 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. . 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 ). (2) The Center shall— (A) provide basic financial management, retirement 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 outreach provided, including work to provide user-friendly consumer information and public education materials; (C) develop targeted outreach strategies; (D) provide technical assistance to State agencies and to other public and nonprofit private agencies and organizations; and (E) develop partnerships and collaborations to address program objectives. . 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 following: (41) The term person-centered, trauma-informed 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. . 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 include aggregate data in the report required by section 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 in paragraphs (18) and (19) of section 306(a), to identify such older individuals and their service needs. . 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”. 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 reduction, . 127. Extension of the Supporting Grandparents 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”. 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 . 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 amended— (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, rehabilitation, 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 associated with social isolation, ; and (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 dysfunction, ; (2) by striking and the 2d place it appears; and (3) by inserting and traumatic brain injury before the semicolon at the end. 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 following: (K) responses to public health emergencies and emerging health threats; . 131. Prevention of sexually transmitted diseases 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)”. 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 living (as described in part C of title VII of the Rehabilitation 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 desires ; and (3) in subparagraph (D) by striking ( 29 U.S.C. 796f et seq.), and other community-based entities, and inserting , and other community-based entities, including other aging or disability entities . II Empowering the Aging Network to meet the needs of older individuals 201. National family caregiver support program 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 caregivers (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 Senate 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 under part E of title III of the Older Americans Act of 1965 (42 U.S.C. 3030s—3030s–2). Each such report shall also be made available to the public. (2) Contents For purposes of reports required by paragraph (1), each State that receives an allotment under such National Family Caregiver Support Program for fiscal year 2020 or a subsequent fiscal year shall report to the Assistant Secretary for the fiscal year involved the amount of funds of the total Federal and non-Federal share allotment used by the State to provide support services for caregiver support for older relative caregivers and family caregivers. 202. Minimum funding level for State administrative 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 . 203. Culturally-appropriate, medically-tailored 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 (including needs based on religious, cultural, or ethnic requirements) and medically tailored meals before the comma at the end. 204. Business acumen provisions and clarification regarding outside funding for area agencies on aging (a) Assistance relating to growing and sustaining capacity Section 202(b)(9) of the Older Americans Act of 1965 ( 42 U.S.C. 3012(b)(9) ) is amended— (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 individuals and caregivers most effectively; . (b) Clarifying partnerships for area agencies 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: (g) Nothing in this Act shall restrict an area agency on aging from providing services not provided or authorized by this Act, including through— (1) contracts with health care payers; (2) consumer private pay programs; or (3) other arrangements with entities or individuals that increase the availability of home and community-based services and supports in the planning and service area supported by the area agency on aging. . 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 following: (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. . 206. Caregiver assessments (a) Definition of caregiver assessment Section 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 gathering information about the situation of a caregiver 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 recognized caregiver to participate in such process; (B) requires direct contact with the caregiver 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 voluntary 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 assessments Section 373 of the Older Americans Act of 1965 ( 42 U.S.C. 3030s–1 ) is amended by adding at the end the following: (h) Technical assistance for caregiver assessments Not later than 1 year after the effective date of this subsection, the Assistant Secretary, in consultation with caregivers, older individuals, individuals with a disability who receive care from an older relative caregiver, the aging network, and other experts and stakeholders, shall provide technical assistance to promote and implement the use of caregiver assessments. Such technical assistance shall include sharing available tools and templates, comprehensive assessment protocols, and best practices concerning— (1) conducting caregiver assessments and reassessments; (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 activities with relevant State and local services. . (d) Reporting on caregiver assessment Section 373(e) of the Older Americans Act of 1965 ( 42 U.S.C. 3030s–1(e) ) is amended— (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 agencies, and organizations. Such report shall include— (i) an analysis of the current use of caregiver assessments, including a repository of caregiver assessment tools or templates and comprehensive assessment protocols; (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; (iii) an analysis of the impact of using caregiver assessments on the aging network; (iv) an analysis of how caregiver assessments are being used to identify the specific needs, barriers, and existing supports of family caregivers and older relative caregivers; (v) recommendations for using caregiver assessments, including in rural or underserved areas; and (vi) feedback from State agencies and area agencies on aging, particularly in rural or underserved areas, on the implementation 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 Education and Labor of the House of Representatives, the Committee on Health, Education, Labor, and Pensions of the Senate, and the Special Committee on Aging of the Senate. . 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 following: (g) (1) The Assistant Secretary shall coordinate the research and evaluation functions of this Act under a National Research, Demonstration, and Evaluation Center for the Aging Network (in this subsection referred to as the Center ), which shall be headed by a director designated by the Assistant Secretary from individuals described in paragraph (4). (2) The purpose of the Center shall be— (A) to coordinate research, research dissemination, evaluation, demonstration projects, and related activities carried out under this Act; (B) to provide assessment of the programs authorized under this Act; and (C) to increase the repository of information on evidence-based programs and interventions available to the aging network. Such information shall be applicable to existing programs and help in the development of new evidence-based programs and interventions. (3) Activities of the Center shall include conducting, promoting, coordinating, and providing support for— (A) research and evaluation activities that support the objectives of this Act, including— (i) evaluation of new and existing programs and interventions authorized by this Act; and (ii) research on and assessment of the relationship 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 program 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 activities described in this subparagraph. (4) The director shall be an individual with substantial knowledge of and experience in aging and health policy, 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. (8) The director shall, as appropriate, consult with experts on aging research and evaluation and aging network 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. . 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 follows: (a) Grants and contracts The Assistant Secretary shall award grants to, and enter into contracts with, eligible organizations to carry out projects— (1) to provide opportunities for older individuals to participate in multigenerational activities and civic engagement activities that contribute to the health and wellness of older individuals and individuals in younger generations by developing— (A) meaningful roles for participants; (B) reciprocity in relationship building; (C) reduced social isolation and improved participant social connectedness; (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 relative 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 programs; (3) to promote volunteerism, including becoming a mentor to young people; and (4) to facilitate development of and participation in multigenerational activities and civic engagement activities. ; (2) by amending subsection (b) to read as follows: (b) Use of funds (1) In general An eligible organization shall use funds made available under a grant awarded, 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 organizations 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: (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 follows: (e) Eligible organizations Organizations eligible to receive a grant or enter into a contract under subsection (a) shall— (1) be a State, an area agency on aging, or an organization that provides opportunities for older individuals to participate in activities described in such subsection; and (2) have the capacity to conduct the coordination, promotion, and facilitation described in such subsection through the use of multigenerational coordinators. ; (5) by striking subsection (g); (6) in subsection (h)(2)(B)(i) by striking individuals 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 following: (b) Grant period Each grant awarded or contract made under subsection (a) shall be to carry out projects for a period of not less than 36 months. . III Strengthening protections for older individuals 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 appropriated 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, State, and local funds expended to support activities 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 section 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 agencies pursuant to section 712 shall be used to supplement and not supplant other Federal, State, and local funds expended to support activities described in section 712. . 302. State long-term care volunteer ombudsman 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 subparagraph (E); and (2) by inserting after subparagraph (C) the following: (D) Volunteer ombudsman representatives An individual designated as a volunteer ombudsman representative may receive financial support and recognition from the Office of the State Long-Term Care Ombudsman Program for expenses incurred during service. . 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, . 304. Report on legal hotlines Not later than 3 years after the date of the enactment 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 operate senior legal hotlines; (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. 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 community outreach and education, after technical assistance ; and (2) in subparagraph (F)— (A) by striking studying and inserting implementing ; and (B) by inserting , programs, and materials after practices . 306. Principles for person-directed services and supports during serious illness (a) Definitions (1) Administrator The term Administrator means the Administrator of the Administration for Community Living. (2) Area agency on aging; Assistant Secretary; State agency The terms area agency on aging , Assistant Secretary , and State agency 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 Department of Health and Human Services, and a unit of that Department other than the Administration on Aging, that the Assistant Secretary 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 Supports during Serious Illness, issued by the Administration on September 1, 2017, or an updated set of such Principles. (b) Dissemination The Administrator shall disseminate the principles to appropriate stakeholders within the aging network, as determined by the Assistant Secretary, 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. IV Meeting the needs of older Native Americans 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: 643. Authorization of appropriations There are authorized to be appropriated to carry out this title— (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: 644. Funding set aside Of the funds appropriated under section 643(1) for a fiscal year, not more than 5 percent shall be made available 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 resources made available for fiscal year 2019. ; (2) by redesignating part D as part E; and (3) by inserting after part C the following: D Supportive services for healthy aging and independence 636. Program (a) In general The Assistant Secretary shall carry out a competitive demonstration program for making 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 independence 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, information and referral, case management, health and wellness programs, legal services, family caregiver support services, and other services that directly support the independence of the older individuals served. (c) Rule of construction Nothing in this section shall be construed or interpreted to prohibit the provision of supportive services under part A or B. . 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 ensure 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, program 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: 216. Authorization of appropriations (a) In general For purposes of carrying out this Act, there are authorized to be appropriated for administration, 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. (b) Authorization of appropriations for programs 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 fiscal 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 fiscal 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 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. . V Miscellaneous 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 paragraph (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 Administrator of the Health Care Finance Administration and inserting Administrator of the Centers for Medicare and Medicaid Services ; (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 (excluding and all that follows through 303(a)(3)) ; (8) in section 306(a)— (A) by inserting the number of older individuals at risk for institutional placement residing 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, Engineering, and Medicine ; (10) in section 611 by striking (a) ; and (11) in section 614(c)(4) by striking “(a)(12)” and inserting “(a)(11)”. 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: 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 fiscal 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 nutrition services) $531,279,663 for fiscal year 2020, $563,156,443 for fiscal year 2021, $596,945,830 for fiscal 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 nutrition services) $269,577,167 for fiscal year 2020, $285,751,797 for fiscal year 2021, $302,896,905 for fiscal 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— (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 coordinated 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 promotion 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 fiscal year 2021, $218,350,609 for fiscal year 2022, $231,451,645 for fiscal year 2023, and $245,338,744 for fiscal year 2024. . (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 fiscal 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: (a) In general There are authorized to be appropriated 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 fiscal 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: 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. . 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 paragraph (5): (I) The term allot means allot under this subsection from a sum appropriated 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 particular 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 particular 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 appropriated for fiscal year 2019; (II) for fiscal year 2021, 99.50 percent of that sum; (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 particular 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: (I) From the portion equal to the corresponding sum appropriated for fiscal year 2019, amounts shall be allotted 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 the percentage 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 accordance with paragraph (1), subparagraphs (A) through (C) as applicable, and paragraph (2) to the extent needed to meet the requirements of those subparagraphs. . (b) Repeal Section 304(a)(3)(D) of the Older Americans Act of 1965 ( 42 U.S.C. 3024(a)(3)(D) ) is repealed effective October 1, 2029.

Passed the House of Representatives October 28, 2019. Cheryl L. Johnson, Clerk

October 30, 2019 Read the second time and placed on the calendar