II 118th CONGRESS 2d Session S. 4273 IN THE SENATE OF THE UNITED STATES May 7, 2024 Ms. Murkowski (for herself and Ms. Smith ) 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 enhance the longevity, dignity, empowerment, and respect of older individuals who are Native Americans, and for other purposes.

1. Short title This Act may be cited as the Enhancing Native Elders' Longevity, Dignity, Empowerment, and Respect Act or the Native ELDER Act . 2. Older Americans Tribal Advisory Committee Section 201(c) of the Older Americans Act of 1965 ( 42 U.S.C. 3011(c) ) is amended by adding at the end the following: (4) (A) In this paragraph: (i) The term Native Hawaiian has the meaning given such term in section 625. (ii) The term relevant committees of Congress means— (I) the Committee on Health, Education, Labor, and Pensions of the Senate; (II) the Committee on Education and the Workforce of the House of Representatives; (III) the Committee on Indian Affairs of the Senate; and (IV) the Subcommittee on Indian and Insular Affairs of the Committee on Natural Resources of the House of Representatives. (B) (i) From amounts appropriated pursuant to section 216(a), the Assistant Secretary shall establish, within the Office for American Indian, Alaskan Native, and Native Hawaiian Programs, an advisory committee, to be known as the Older Americans Tribal Advisory Committee (referred to in this paragraph as the Committee ) to provide advice and guidance to the Assistant Secretary on matters relating to Native Americans under this Act. (ii) The Committee shall facilitate, but not supplant, government-to-government consultation between the Administration and Indian tribes and confer with organizations representing Native Hawaiians. (C) (i) The Committee shall be composed of 11 members, of whom— (I) 3 shall be appointed by the Assistant Secretary; (II) 1 shall be appointed by the chairperson of the Committee on Indian Affairs of the Senate; (III) 1 shall be appointed by the ranking member of the Committee on Indian Affairs of the Senate; (IV) 1 shall be appointed by the chairperson of the Committee on Health, Education, Labor, and Pensions of the Senate; (V) 1 shall be appointed by the ranking member of the Committee on Health, Education, Labor, and Pensions of the Senate; (VI) 1 shall be appointed by the chairperson of the Committee on Education and the Workforce of the House of Representatives; (VII) 1 shall be appointed by the ranking member of the Committee on Education and the Workforce of the House of Representatives; (VIII) 1 shall be appointed by the chairperson of the Subcommittee on Indian and Insular Affairs of the Committee on Natural Resources of the House of Representatives; and (IX) 1 shall be appointed by the ranking member of the Subcommittee on Indian and Insular Affairs of the Committee on Natural Resources of the House of Representatives. (ii) Nominations for members of the Committee shall be from any of the following: (I) Indian tribes. (II) Tribal organizations. (III) Organizations representing Native Hawaiians. (iii) To the maximum extent feasible, the Assistant Secretary shall work with the individuals making appointments under clause (i) to ensure— (I) that the members of the Committee represent a diverse set of expertise on issues relating to geographic regions, Indian tribes, organizations representing Native Hawaiians, and the health and well-being of Native Americans; (II) that not less than one member is an Alaskan Native; and (III) that not less than one member is a Native Hawaiian. (iv) No member of the Committee shall be an officer or employee of the Federal Government. (v) (I) Each member of the Committee— (aa) subject to subclause (II), shall be appointed to a 3-year term; and (bb) may be reappointed to not more than 3 consecutive terms. (II) The first 3 appointments by the Assistant Secretary under clause (i)(I) shall be for a 2-year term. (III) Any vacancy in the Committee shall be filled in the same manner as the original appointment not more than 90 days after the date on which the position becomes vacant. (D) (i) The Committee shall meet in person not less than twice each year. (ii) Not fewer than 1 representative from the Office for American Indian, Alaskan Native, and Native Hawaiian Programs shall be present at each meeting of the Committee. (iii) Any representatives from the Office for American Indian, Alaskan Native, and Native Hawaiian Programs shall be nonvoting representatives at meetings of the Committee. (E) The Committee shall— (i) identify evolving issues of relevance to Native Americans relating to programs of the Administration under this Act; (ii) communicate to the Assistant Secretary the issues identified under clause (i); (iii) submit to the Assistant Secretary recommendations for, and solutions to— (I) the issues identified under clause (i); (II) issues relating to this Act involving Native Americans raised at the Tribal, regional, or national level; and (III) issues relating to any Tribal consultation carried out by the Administration under this Act; (iv) discuss issues and proposals for changes to the regulations, policies, and procedures of the Administration under this Act that impact Native Americans; (v) identify priorities and provide advice on appropriate strategies for Tribal consultation on issues under this Act at the Tribal, regional, or national level regarding the Administration; (vi) ensure that pertinent issues of the Administration under this Act are brought to the attention of an Indian tribe and organization representing Native Hawaiians in a timely manner so that timely feedback from an Indian tribe and organization representing Native Hawaiians can be obtained; (vii) identify and propose solutions to any interdepartmental barrier between the Administration and other Federal agencies; and (viii) coordinate with the Secretary of Labor, the Administrator of the Centers for Medicare & Medicaid Services, and the Director of the Indian Health Service on relevant issues. (F) (i) Not less frequently than once each year, the Committee shall submit to the Assistant Secretary and the relevant committees of Congress a report that describes— (I) the activities of the Committee during the previous year; and (II) recommendations for legislative or administrative action for the following year. (ii) Not more than 45 days after the date on which the Assistant Secretary receives a report under clause (i), the Assistant Secretary shall submit a written response to that report to— (I) the Committee; and (II) the relevant committees of Congress. (G) Members of the Committee shall be compensated at a rate equal to the daily equivalent of the annual rate of basic pay prescribed for level IV of the Executive Schedule under section 5315 of title 5, United States Code, for each day (including travel time) during which the member is engaged in the performance of the duties of the Committee. (H) Chapter 10 of title 5, United States Code, shall not apply to the Committee. . 3. Supporting services for healthy aging and independence Section 636(b)(2) of the Older Americans Act of 1965 ( 42 U.S.C. 3057k–21(b)(2) ) is amended by striking in-home assistance and inserting in-home assistance (including for the modification of homes that is necessary to facilitate the ability of older individuals to remain at home) . 4. Funding set aside Section 644 of the Older Americans Act of 1965 ( 42 U.S.C. 3057o ) is amended— (1) by striking not more than ; and (2) in paragraphs (1) and (2), by striking 2019 and inserting 2024 . 5. Technical assistance and training programs Section 201(c)(3)(H) of the Older Americans Act of 1965 ( 42 U.S.C. 3011(c)(3)(H) ) is amended to read as follows: (H) develop and provide technical assistance and training programs to grantees under title VI, which technical assistance and training programs— (i) shall ensure adequate organizational capacity to deliver the services under such title; and (ii) may include topics such as program management, data development and use, basic business skills, grant development, program and service innovations, and staff training and certification; . 6. Reports (a) Assistant Secretary for Aging (1) In general Not later than 180 days after the date of enactment of this Act, the Assistant Secretary for Aging shall submit to the committees described in paragraph (2), and make publicly available, a report that— (A) evaluates the feasibility of modeling the Native American Caregiver Support Program under part C of title VI of the Older Americans Act of 1965 ( 42 U.S.C. 3057k–11 et seq. ) on the program of comprehensive assistance for family caregivers of eligible veterans under section 1720G(a) of title 38, United States Code; (B) evaluates the level of need for in-home services that include accessible home modifications for older individuals who are Native Americans, including the need for provisions under the Older Americans Act of 1965 to prioritize accessible home modifications as in-home services for such older individuals; and (C) evaluates and identifies barriers to Indian tribes accessing programs under title VI of the Older Americans Act of 1965, and coordination between programs funded under title III of such Act and programs funded under title VI of such Act, including by— (i) assessing the impacts of population-based formulas and tribal service population requirements on program participation; (ii) identifying the number of Indians unserved by programs under such title VI; (iii) identifying the States making grants to Indian tribes under title III of such Act; and (iv) providing estimates of funding necessary to support programs under title VI of such Act for all tribal organizations not eligible under such title as in effect on the date of enactment of this Act. (2) Committees of Congress The committees described in this paragraph are— (A) the Committee on Health, Education, Labor, and Pensions of the Senate; (B) the Committee on Education and the Workforce of the House of Representatives; (C) the Committee on Indian Affairs of the Senate; and (D) the Subcommittee on Indian and Insular Affairs of the Committee on Natural Resources of the House of Representatives. (b) Secretary of Labor Not later than 180 days after the date of enactment of this Act, the Secretary of Labor shall submit a report to Congress on how recipients of funding under title V of the Older Americans Act of 1965 ( 42 U.S.C. 3056 et seq. ) are serving older individuals who are Native Americans with such funding.