II 118th CONGRESS 2d Session S. 4776 IN THE SENATE OF THE UNITED STATES July 25, 2024 Mr. Sanders (for himself, Mr. Cassidy , Mr. Casey , Ms. Collins , Mr. Kaine , Mr. Mullin , and Mr. Markey ) 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 authorize appropriations for fiscal years 2025 through 2029, and for other purposes.

1. Short title This Act may be cited as the Older Americans Act Reauthorization Act of 2024 . 2. Table of contents The table of contents for this Act is as follows: Sec. 1. Short title. Sec. 2. Table of contents. Sec. 3. References. Sec. 4. Definitions. TITLE I—Strengthening the Aging Network to Meet the Needs of Older Individuals Sec. 101. Declaration of objectives. Sec. 102. Addressing mental health and substance use disorders and cognitive impairments of older individuals. Sec. 103. List of national resource centers. Sec. 104. Awareness of relevant Federal programs. Sec. 105. Evaluations and surveys. Sec. 106. Contracting and grant authority. Sec. 107. Guidance on transfers of funding between area agencies on aging. Sec. 108. Right to first refusal. Sec. 109. Area agency on aging capabilities. Sec. 110. Supporting older individuals with disabilities through improved coordination. Sec. 111. Business acumen, fiscal training, and technical assistance. Sec. 112. Enhancing access to assistive technology. Sec. 113. White House Conference on Aging. TITLE II—Improving Health Outcomes and Encouraging Independence for Older Individuals Sec. 201. Disease prevention and health promotion services. Sec. 202. Improving health outcomes. Sec. 203. Evidence-informed practices. Sec. 204. Enhancing multipurpose senior centers. Sec. 205. Addressing home modifications. Sec. 206. Multigenerational and civic engagement activities. Sec. 207. GAO study and report on access to housing for older individuals. Sec. 208. Report relating to health outcomes for older individuals living with or near family members. Sec. 209. Improving broadband coordination and reducing social isolation. TITLE III—Enhancing Innovation and Flexibility in Nutrition Services Sec. 301. Medically tailored meals. Sec. 302. Nutrition service providers. Sec. 303. Grab-and-go meals. Sec. 304. Nutrition Services Incentive Program innovation. Sec. 305. GAO study on Nutrition Services Incentive Program. Sec. 306. Innovations in nutrition programs and services. TITLE IV—Supporting Family Caregivers Sec. 401. Improving the National Family Caregiver Support Program. Sec. 402. Emphasizing respite care. Sec. 403. Clarifying supportive services. Sec. 404. Direct care workforce resource center. Sec. 405. Supporting Grandparents Raising Grandchildren Act. Sec. 406. RAISE Family Caregivers Act. TITLE V—Community Service Senior Opportunities Act Sec. 501. Improving the Community Service Employment Program. Sec. 502. GAO report on alignment within the Community Service Employment Program. TITLE VI—Improving Services for Native Elders Sec. 601. Older Americans Tribal Advisory Committee. Sec. 602. Supportive services; set aside. Sec. 603. GAO report on Tribal services. TITLE VII—Strengthening the Long-Term Care Ombudsman Programs and Elder Abuse Prevention Sec. 701. Director of the Office of Long-Term Care Ombudsman Programs. Sec. 702. Legal assistance training resources relating to elder abuse prevention. Sec. 703. Improving training of volunteers under the State Long-Term Care Ombudsman Program. Sec. 704. Reporting on State Long-Term Care Ombudsman Programs. Sec. 705. Study on State Long-Term Care Ombudsman Programs. TITLE VIII—Authorizations of appropriations Sec. 801. Administration on Aging. Sec. 802. Grants for State and community programs on aging. Sec. 803. Activities for health, independence, and longevity. Sec. 804. Community Service Senior Opportunities Act. Sec. 805. Grants for Native Americans. Sec. 806. Allotments for elder rights protection activities. 3. References Except as otherwise expressly provided in this Act, wherever in this Act an amendment or repeal is expressed in terms of an amendment to, or a repeal of, a section or other provision, the reference shall be considered to be made to that section or other provision of the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ). 4. Definitions In this Act, the terms “area agency on aging”, “Assistant Secretary”, “older individual”, and “Secretary” have the meanings given such terms in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 ). I Strengthening the Aging Network to Meet the Needs of Older Individuals 101. Declaration of objectives Section 101 ( 42 U.S.C. 3001 ) is amended— (1) in the matter preceding paragraph (1), by striking of the following objectives: and inserting of the objectives of— ; (2) in each of paragraphs (1) through (10), by amending the first word so that it begins with a lowercase letter; (3) in each of paragraphs (1) through (8), by striking the period at the end and inserting a semicolon; (4) in each of paragraphs (9) and (10), by striking the period at the end and inserting ; and ; (5) in paragraph (2), by inserting to improve health outcomes and reduce health care expenditures after economic status ; (6) by redesignating paragraphs (1) through (10) as subparagraphs (A) through (J), respectively, and adjusting the margins accordingly; (7) in the matter preceding subparagraph (A) (as so redesignated), by striking our democratic society, the older people and inserting the following: “our democratic society— (1) the older people ; and (8) by adding at the end the following: (2) the families of older individuals and community-based organizations, including faith-based organizations, also play a vital role in supporting and honoring older individuals and their happiness, dignity, and independence. . 102. Addressing mental health and substance use disorders and cognitive impairments of older individuals Section 201(f) ( 42 U.S.C. 3011(f) ) is amended to read as follows: (f) (1) The Assistant Secretary may designate an officer or employee who shall be responsible for the administration of services for mental health and substance use disorders and cognitive impairments authorized under this Act and serve as an effective and visible advocate for the related needs of older individuals within the Department of Health and Human Services, including by ensuring that relevant information disseminated and research conducted or supported by the Department takes into consideration such services. (2) It shall be the duty of the Assistant Secretary, acting through the individual designated under paragraph (1), and in consultation with the heads of relevant agencies within the Department of Health and Human Services, including the Substance Abuse and Mental Health Services Administration, to develop objectives, priorities, and a long-term plan for supporting State and local efforts under this Act involving education about and prevention, detection, and treatment of mental health and substance use disorders and cognitive impairment, including age-related dementia, depression, and Alzheimer’s disease and related neurological disorders with neurological and organic brain dysfunction. (3) Not later than 2 years after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , the Assistant Secretary shall report to 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 the Workforce of the House of Representatives on the activities of the officer or employee designated under paragraph (1) in carrying out the requirements under this subsection, including any activities to identify and reduce duplication and gaps across the Department in such information disseminated and research conducted or supported by the Department. . 103. List of national resource centers Section 202 ( 42 U.S.C. 3012 ) is amended— (1) in subsection (d)(4), by striking Resource Center on Elder Abuse and inserting Center ; and (2) by striking subsection (h) and inserting the following: (h) (1) The Assistant Secretary shall publish online in a publicly accessible format, on an annual basis, a list of national resource centers and demonstration projects authorized, or administratively established through funds provided under, this Act. (2) The Assistant Secretary shall ensure that the list published pursuant to paragraph (1)— (A) includes— (i) a description of each such center and demonstration project, including the projected goals and activities of each such center and demonstration project; (ii) a citation to the statutory authorization of each such center and demonstration project, or a citation to the statutory authority that the Assistant Secretary relied upon to administratively establish each such center and demonstration project; (iii) the award amount for each such center and demonstration project; and (iv) a summary of any evaluations required under this Act for each such center, including a description of any measures of effectiveness; and (B) is directly provided to State agencies, area agencies on aging, and the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and the Workforce of the House of Representatives. . 104. Awareness of relevant Federal programs Title II ( 42 U.S.C. 3011 et seq. ) is amended by inserting after section 203A ( 42 U.S.C. 3013a ) the following: 203B. Awareness of relevant Federal programs In carrying out section 203(a)(1), the Assistant Secretary shall coordinate with the heads of relevant Federal departments and agencies to ensure that the aging network and individuals served under this Act are aware of, and, subject to applicable eligibility criteria, have access to, Federal programs that may advance the objectives of this Act, including programs described in section 203(b) and other programs to meet housing, health care, and other supportive service needs to help such individuals age in place. . 105. Evaluations and surveys Section 206 ( 42 U.S.C. 3017 ) is amended— (1) by striking subsection (d) and inserting the following: (d) (1) In carrying out evaluations under this section, the Secretary shall— (A) award grants to, or enter into contracts with, public or nonprofit private organizations or academic or research institutions to survey State agencies, area agencies on aging, and other program and project participants about the strengths and weaknesses of the programs and projects; and (B) conduct, where appropriate, evaluations that compare the effectiveness of related programs in achieving common objectives. (2) The surveys and evaluations under paragraph (1) shall include information on programs, services, use and sources of funding (including any transfer of funding between area agencies on aging), identified unmet need for services and related indicators, and any other challenges faced by State agencies and area agencies on aging in carrying out the activities of this Act. (3) The Secretary shall, in carrying out the evaluations under paragraph (1), consult with organizations concerned with older individuals, including organizations that represent minority individuals, older individuals residing in rural areas, and older individuals with disabilities. ; and (2) in subsection (g), by striking him and inserting the Secretary . 106. Contracting and grant authority (a) In general Section 212 ( 42 U.S.C. 3020c ) is amended— (1) by striking subsection (a) and inserting the following: (a) In general Subject to subsection (b), this Act shall not be construed to prevent a recipient of a grant or a contract under this Act (other than title V) from entering into an agreement with a profitmaking organization for the recipient to provide services to individuals or entities not otherwise receiving services under this Act, provided that— (1) in the case funds provided under this Act are used in developing or carrying out the agreement— (A) such agreement guarantees that the cost is reimbursed to the recipient; (B) if such agreement provides for the provision of 1 or more services, of the type provided under this Act by or on behalf of such recipient, to an individual or entity seeking to receive such services— (i) the individuals and entities may only purchase such services at their fair market rate; (ii) all costs incurred by the recipient in providing such services (and not otherwise reimbursed under subparagraph (A)), are reimbursed to such recipient; and (iii) except in the case of an agreement with a health plan or health care provider, the recipient reports the rates for providing such services under such agreement in accordance with subsection (c) and the rates are consistent with the prevailing market rate for provision of such services in the relevant geographic area as determined by the State agency or area agency on aging (as applicable); and (C) any amount of payment to the recipient under the agreement that exceeds reimbursement under this subsection of the recipient's costs is used to provide, or support the provision of, services under this Act; and (2) subject to subsection (e), in the case no funds provided under this Act are used in developing or carrying out the agreement— (A) not later than 45 days after the agreement first goes into effect, and annually thereafter until the termination of such agreement, the recipient of a grant or contract under this Act shall, in writing— (i) notify the State agency of— (I) the existence of the agreement; and (II) the services provided and populations served under the agreement; and (ii) provide assurances to the State agency that— (I) nothing in the agreement— (aa) undermines— (AA) the duties of the recipient under this Act; or (BB) the provision of services in accordance with this Act; or (bb) violates any other terms and conditions of an award received by the recipient under this Act; and (II) any potential real or perceived conflict of interest with respect to the agreement has been prevented, mitigated, or otherwise addressed, including providing a description of any such conflicts of interest and a description of the actions taken to mitigate such conflicts of interest; and (B) not later than 45 days after the population or services under the agreement substantially change due to an amendment to the agreement, the recipient shall, in writing— (i) notify the State agency of such change; and (ii) provide the assurances described in subparagraph (A)(ii) with respect to such change. ; (2) by striking subsection (b) and inserting the following: (b) Ensuring appropriate use of funds An agreement— (1) described in subsection (a)(1) may not— (A) be made without the prior approval of the State agency (or, in the case of a grantee under title VI, without the prior recommendation of the Director of the Office for American Indian, Alaska Native, and Native Hawaiian Aging and the prior approval of the Assistant Secretary), after timely submission of all relevant documents related to the agreement including information on all costs incurred; or (B) directly or indirectly provide for, or have the effect of, paying, reimbursing, subsidizing, or otherwise compensating an individual or entity in an amount that exceeds the fair market value of the services subject to such agreement; and (2) described in subsection (a) may not— (A) result in the displacement of services otherwise available to an older individual with greatest social need, an older individual with greatest economic need, or an older individual who is at risk for institutional placement; or (B) in any other way compromise, undermine, or be inconsistent with the objective of serving the needs of older individuals, as determined by the Assistant Secretary. ; (3) in subsection (c), by striking subsection (a) and inserting subsection (a)(1) ; (4) by redesignating subsection (e) as subsection (f); and (5) by inserting after subsection (d) the following: (e) Requesting additional information for certain non-OAA agreements (1) In general In the case of an agreement described in subsection (a)(2), if the State agency has a reasonable belief that an agreement may violate the assurances provided under subsection (a)(2)(A)(ii), the State agency may request additional information from the recipient of funds under this Act that is a party to such agreement, which may include a request for a copy of such agreement. Such recipient shall make a good faith effort to address such request for additional information, except that such recipient shall not provide agreements or other data that are restricted under the terms of a non-disclosure agreement signed by such recipient. If such recipient declines to provide a copy of an agreement to a State agency, such recipient shall provide a justification to the State agency within 30 days of receiving such request. (2) Confidentiality A State agency shall keep confidential, as required by applicable Federal and State law, all information received under this subsection that is— (A) a trade secret; (B) commercial or financial information; and (C) information obtained from an individual that is privileged and confidential. . (b) Area plans Section 306 ( 42 U.S.C. 3026 ) is amended— (1) in subsection (a)(13)— (A) in subparagraph (B)(i), by striking any service to older individuals and inserting any service under this Act to older individuals or caregivers ; and (B) in subparagraph (E), by inserting or caregivers under this Act after older individuals ; and (2) in subsection (g), by inserting , except as provided under section 212(a)(2), after Nothing in this Act . 107. Guidance on transfers of funding between area agencies on aging Not later than 1 year after the date of enactment of this Act, the Assistant Secretary shall disseminate guidance to State agencies (as defined in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 )) and area agencies on aging on circumstances under which funds appropriated pursuant to part B and subparts 1 and 2 of part C of title III of the Older Americans Act ( 42 U.S.C. 3030d et seq. , 42 U.S.C. 3030e et seq. , 42 U.S.C. 3030f et seq. ) may be appropriate to transfer between area agencies on aging, with the approval of the State agency and the concurrence of any involved area agencies on aging, within a budget year. 108. Right to first refusal Section 305(b)(5)(B) ( 42 U.S.C. 3025(b)(5)(B) ) is amended to read as follows: (B) Whenever a State agency designates a new area agency on aging after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , the State agency shall give the right to first refusal to a unit of general purpose local government if— (i) such unit can meet the requirements of subsection (c); (ii) (I) such unit has demonstrated experience administering services for older individuals; or (II) the State agency determines that there is not another entity eligible under subsection (c)(1) within the planning and service area with such demonstrated experience; and (iii) the boundaries of such unit and the boundaries of the planning and service area are reasonably contiguous. . 109. Area agency on aging capabilities (a) Organization Section 305(c) ( 42 U.S.C. 3025(c) ) is amended— (1) by redesignating paragraphs (1) through (5) as subparagraphs (A) through (E), respectively, and moving such subparagraphs 2 ems to the right; (2) by striking shall be and inserting the following: “shall— (1) be— ; (3) in subparagraph (E), as so redesignated— (A) by striking (b)(5) and inserting (b)(5)(A) ; and (B) by inserting and after the semicolon; and (4) by striking and shall provide assurance, determined adequate by the State agency, that the area agency on aging will have the ability to develop an area plan and to carry out, directly or through contractual or other arrangements, a program in accordance with the plan within the planning and service area. and inserting the following: (2) provide assurance, determined adequate by the State agency, that the area agency on aging will have the ability, and maintain the capabilities necessary, to develop an area plan as required under section 306(a), and carry out, directly or through contractual or other arrangements, and oversee activities in accordance with— (A) the plan within the planning and service area; (B) any other relevant requirements of this Act; (C) other applicable Federal and State laws; and (D) other terms and conditions of awards received under this Act. . (b) Plans Section 306(f)(1) ( 42 U.S.C. 3026(f)(1) ) is amended— (1) by inserting the assurances required under section 305(c)(2), after of this section, ; and (2) by striking the period at the end and inserting , and if the State agency determines, in the discretion of the State agency, that an area agency on aging failed in 2 successive years to comply with the requirements under this title, then the State agency may require the area agency on aging to submit a plan for a 1-year period that meets such requirements, for subsequent years until the State agency determines that the area agency on aging is in compliance with such requirements. . 110. Supporting older individuals with disabilities through improved coordination (a) Area plans Section 306(a)(5) ( 42 U.S.C. 3026(a)(5) ) is amended by striking with agencies that develop or provide services for individuals with disabilities and inserting with entities that develop or provide services for individuals with disabilities, which may include centers for independent living, relevant service providers, and other community-based organizations, as appropriate . (b) Supporting older individuals with disabilities through improved coordination (1) In general The Administrator of the Administration for Community Living of the Department of Health and Human Services (referred to in this section as the Administrator ) shall identify— (A) opportunities to improve coordination between the aging and disability networks, which may include the formation of partnerships to serve individuals eligible for programs under the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ); (B) lessons learned from disability networks, including centers for independent living, State developmental disabilities councils, university centers on excellence in developmental disabilities, and State protection and advocacy agencies that could improve operations and service delivery within the aging network; and (C) any technical assistance needs related to subparagraphs (A) and (B). (2) Guidance Not later than 2 years after the date of enactment of this Act, the Administrator shall issue guidance to State agencies and area agencies on aging on strategies to leverage disability networks, including centers for independent living, State developmental disabilities councils, university centers on excellence in developmental disabilities, and State protection and advocacy agencies, as appropriate, to strengthen the provision of services under the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ). (3) Technical assistance The Administrator shall coordinate across the Administration for Community Living to address any technical assistance needs identified under paragraph (1)(C) in a manner that does not unnecessarily duplicate other technical assistance activities carried out prior to the date of enactment of this Act. 111. Business acumen, fiscal training, and technical assistance Section 307(a) ( 42 U.S.C. 3027(a) ) is amended by adding at the end the following: (31) The plan shall provide assurances that the State agency may provide technical assistance, as needed, for area agencies on aging related to the development of business acumen, sound fiscal practices, capacity building, organizational development, innovation, and other methods of growing and sustaining the capacity of the aging network to carry out activities funded under this Act to serve older individuals and caregivers most effectively. . 112. Enhancing access to assistive technology Section 307(a) ( 42 U.S.C. 3027(a) ), as amended by section 111 of this Act, is further amended by adding at the end the following: (32) The plan shall provide assurances that the State will coordinate services, to the extent feasible, with lead agencies designated to carry out State assistive technology programs under the Assistive Technology Act of 1998 ( 29 U.S.C. 3001 et seq. ) and with area agencies on aging to assist eligible older individuals, including older individuals with disabilities, in accessing and acquiring assistive technology. . 113. White House Conference on Aging Title II of the Older Americans Act Amendments of 1987 ( 42 U.S.C. 3001 note; Public Law 100–175 ) is amended by striking title II and inserting the following: II White House Conference on Aging 201. Authorization of the Conference (a) Authority To call conference Not earlier than January 21, 2025 and not later than December 31, 2025, the President shall convene the White House Conference on Aging in order to fulfill the purpose set forth in subsection (c) and to make fundamental policy recommendations regarding programs that are important to older individuals and to the families and communities of such individuals. (b) Planning and direction The Conference described in subsection (a) shall be planned and conducted under the direction of the Secretary, in cooperation with the Assistant Secretary for Aging, the Director of the National Institute on Aging, the Administrator of the Centers for Medicare and Medicaid Services, the Social Security Administrator, and the heads of such other Federal agencies serving older individuals as are appropriate. Planning and conducting the Conference includes the assignment of personnel. (c) Purpose The purpose of the Conference described in subsection (a) shall be to gather individuals representing the spectrum of thought and experience in the field of aging to— (1) evaluate the manner in which the objectives of the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ) can be met by using the resources and talents of older individuals, of families and communities of such individuals, and of individuals from the public and private sectors; (2) evaluate the manner in which Federal policies, programs, and activities meet and respond to the needs of older individuals, including an examination of innovative and fiscally responsible strategies relating to retirement security, caregiving, nutrition and supportive services, health care, elder justice, and long term services and supports; (3) review the work and recommendations of the Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities, and evaluate the recommendations of the Committee, which may include implementation strategies for such recommendations; (4) develop recommendations to guide the President, Congress, and Federal agencies in improving Federal programs that serve older individuals, which may relate to the prevention and mitigation of disease, injury, abuse, social isolation, loneliness, and economic insecurity, including food insecurity, and promotion of healthy aging in place. (d) Conference participants and delegates (1) Participants In order to carry out the purposes of this section, the Conference shall bring together— (A) representatives of Federal, State, Tribal, and local governments; (B) professionals and volunteers who are working in the field of aging; and (C) representatives of the general public, particularly older individuals. (2) Selection of delegates The delegates shall be selected without regard to political affiliation or past partisan activity and shall, to the best of the appointing authority's ability, be representative of the spectrum of thought in the field of aging. Delegates shall include older individuals, individuals who are professionals in the field of aging, individuals who are community leaders, minority individuals, individuals from rural areas, low-income individuals, and representatives of Federal, State, and local governments. 202. Conference administration (a) Administration In administering this section, the Secretary shall— (1) consult with relevant State, Tribal, and local officials, stakeholders, and subject matter experts in planning the Conference; (2) request the cooperation and assistance of the heads of such other Federal departments and agencies, including such officials of the Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities, as may be appropriate in the carrying out of this section; (3) make available for public comment a proposed agenda for the Conference, which will reflect to the greatest extent possible the major issues facing older individuals consistent with the provisions of subsection (a); (4) prepare and make available such background materials for the use of delegates to the Conference as the Secretary deems necessary; and (5) engage such additional personnel as may be necessary to carry out the provisions of this section without regard to provisions of title 5, United States Code, governing appointments in the competitive service, and without regard to chapter 51 and subchapter III of chapter 53 of such title, relating to classification and General Schedule pay rates. (b) Duties The Secretary shall, in carrying out the Secretary's responsibilities and functions under this section, and as part of the White House Conference on Aging, ensure that— (1) the agenda prepared under subsection (a)(3) for the Conference is published in the Federal Register not later than 30 days after such agenda is approved by the Secretary; (2) the personnel engaged under subsection (a)(5) shall be fairly balanced in terms of points of views represented and shall be appointed without regard to political affiliation or previous partisan activities; (3) the recommendations of the Conference are not inappropriately influenced by any appointing authority or by any special interest, but will instead be the result of the independent judgment of the Conference; and (4) current and adequate statistical data, including decennial census data, and other information on the well-being of older individuals in the United States are readily available, in advance of the Conference, to the delegates of the Conference, together with such information as may be necessary to evaluate Federal programs and policies relating to aging. In carrying out this subparagraph, the Secretary is authorized to make grants to, and enter into cooperative agreements with, public agencies and nonprofit private organizations. (c) Gifts The Secretary may accept, on behalf of the United States, gifts (in cash or in kind, including voluntary and uncompensated services), that shall be available to carry out this title. Gifts of cash shall be available in addition to amounts appropriated to carry out this title. Gifts may be earmarked by the donor for a specific purpose. (d) Records The Secretary shall maintain records regarding— (1) the sources, amounts, and uses of gifts accepted under subsection (c); and (2) the identity of each person receiving assistance to carry out this title, and the amount of such assistance received by each such person. 203. Report of the Conference (a) Preliminary report Not later than 100 days after the date on which the Conference adjourns, the Secretary shall publish and deliver to the States a preliminary report on the Conference. Comments on the preliminary report of the Conference shall be accepted by the Secretary. (b) Final report Not later than 180 days after the date on which the Conference adjourns, the Secretary shall publish and transmit to the President and to Congress recommendations resulting from the Conference and suggestions for any administrative action and legislation necessary to implement the recommendations contained within the report. 204. Definitions In this title: (1) Conference The term Conference means the White House Conference on Aging. (2) Secretary The term Secretary means the Secretary of Health and Human Services. (3) State The term State means any of the several States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, American Samoa, the Virgin Islands of the United States, the Trust Territory of the Pacific Islands, or the Commonwealth of the Northern Mariana Islands. . II Improving Health Outcomes and Encouraging Independence for Older Individuals 201. Disease prevention and health promotion services Section 102(14) ( 42 U.S.C. 3002(14) ) is amended— (1) in subparagraph (B), by inserting heart rate, respiratory function, after hearing, ; (2) in subparagraph (K), by inserting providing before information ; (3) by redesignating subparagraphs (L), (M), (N), and (O), as subparagraphs (M), (N), (O), and (P), respectively; (4) by inserting after subparagraph (K) the following: (L) providing information concerning testing, diagnosis, and treatment of infectious diseases, taking into consideration infectious diseases for which older individuals are at increased risk of infection or serious health outcomes; ; and (5) in subparagraph (P), as so redesignated, by striking subparagraphs (A) through (N) and inserting subparagraphs (A) through (O) . 202. Improving health outcomes (a) Research and evaluation activities Section 201 ( 42 U.S.C. 3011 ) is amended— (1) in subsection (c)(3)(B), by striking in behalf and inserting on behalf ; and (2) in subsection (g)— (A) in paragraph (3)(A)(ii), by inserting reduction of health care expenditures, after quality of life, ; and (B) in paragraph (7), by inserting and recommendations relating to further research, evaluation, and demonstration projects conducted under this section after title IV . (b) Falls prevention programs Section 411(a)(15) ( 42 U.S.C. 3032(a)(15) ) is amended to read as follows: (15) bringing to scale and sustaining evidence-based or evidence-informed falls prevention programs to reduce the number of falls, fear of falling, and fall-related injuries affecting older individuals, including older individuals with disabilities, which programs shall— (A) provide training and technical assistance to the aging network; and (B) share best practices with the aging network, including the Aging and Disability Resource Centers; . (c) Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities Section 203(c) ( 42 U.S.C. 3013(c) ) is amended— (1) in paragraph (6)(B)— (A) in clause (ii), by striking and after the semicolon; (B) in clause (iii), by inserting and after the semicolon; and (C) by adding at the end the following: (iv) strategies to address social isolation, including by promoting strong and stable connections across different generations in a family and in the community; ; and (2) in paragraph (7)— (A) in subparagraph (B), by striking and at the end; (B) by redesignating subparagraph (C) as subparagraph (D); and (C) by inserting after subparagraph (B) the following: (C) contains an assessment of the effectiveness of relevant Federal efforts and programs, including implementation of best practices described in paragraph (6)(B); and . 203. Evidence-informed practices (a) Disease prevention and health promotion services Section 361(a) ( 42 U.S.C. 3030m(a) ) is amended— (1) by striking (a) and inserting (a)(1) ; (2) in the first sentence, by inserting after promotion services the following: , or, as applicable and appropriate, evidence-informed practices that are likely to improve health outcomes, ; and (3) by striking the second sentence and inserting the following: (2) In carrying out such program, the Assistant Secretary shall— (A) provide technical assistance on the delivery of evidence-based disease prevention and health promotion services, and, as applicable and appropriate, such evidence-informed practices, in different settings and for different populations; (B) develop, make publicly available, and update on a regular basis a list of such evidence-informed practices; and (C) consult with the Directors of the Centers for Disease Control and Prevention and the National Institute on Aging. . (b) Functions of Assistant Secretary Section 202 ( 42 U.S.C. 3012 ) is amended— (1) in subsection (a)(28), by inserting after promotion services the following: , or, as applicable and appropriate, evidence-informed practices that are likely to improve health outcomes ; and (2) in subsection (b)(9)(B), by inserting after services programs the following: , or, as applicable and appropriate, evidence-informed practices that are likely to improve health outcomes . (c) Falls prevention and chronic disease self-management education Section 411(a) ( 42 U.S.C. 3032(a) ) is amended, in paragraphs (15) and (16), by inserting or evidence-informed after evidence-based . 204. Enhancing multipurpose senior centers (a) In general Section 202(a)(30) ( 42 U.S.C. 3012(a)(30) ) is amended— (1) by inserting establishment, maintenance, and after to support the ; and (2) by inserting and access to services provided at multipurpose senior centers before the semicolon at the end. (b) Area agency on aging plans Section 306(a)(2)(A) ( 42 U.S.C. 3026(a)(2)(A) ) is amended by inserting , including those services provided at multipurpose senior centers, where appropriate before the semicolon at the end. (c) State plans Section 307(a)(2)(A) ( 42 U.S.C. 3027(a)(2)(A) ) is amended by inserting and, to the extent feasible, make such evaluation public before the semicolon at the end. 205. Addressing home modifications (a) Indoor air quality Section 361(c) ( 42 U.S.C. 3030m(c) ) is amended by striking buildings and all that follows and inserting buildings and residences where older individuals congregate or live . (b) Weatherization Section 321(a)(4) ( 42 U.S.C. 3030d(a)(4) ) is amended by striking subparagraph (A) and inserting (A) to assist older individuals to obtain adequate housing, including residential repair and renovation projects, and (if assistance for weatherization projects does not unnecessarily duplicate other Federal assistance available) weatherization projects, designed to enable older individuals to maintain their homes in conformity with minimum housing and other relevant standards, in order to support such older individuals in aging in place and maintaining their health; . 206. Multigenerational and civic engagement activities Section 417 ( 42 U.S.C. 3032f ) is amended— (1) in subsection (a)— (A) in the matter preceding paragraph (1), by striking projects, and all that follows and inserting the following: projects to serve individuals in younger generations and older individuals by developing, carrying out, and promoting participation in multigenerational activities, which projects may include— ; (B) in paragraph (1), in the matter preceding subparagraph (A), by striking provide and inserting providing ; (C) in paragraph (2)— (i) by striking coordinate and inserting coordinating ; and (ii) by adding and at the end; (D) by striking paragraphs (3) and (4) and inserting the following: (3) promoting volunteerism, including by providing opportunities— (A) for older individuals to become mentors to individuals in younger generations; and (B) at facilities that serve older individuals or individuals in younger generations, at which multigenerational activities might occur. ; (2) in subsection (c)(2), by striking (4) and inserting (3) ; (3) in subsection (d)— (A) by striking paragraph (1); and (B) by redesignating paragraphs (2) through (5) as paragraphs (1) through (4); and (4) in subsection (h)(1), by striking or a family support program. and inserting or a family support program, or a program at a multipurpose senior center, long-term care facility, or any other residential facility for older individuals. . 207. GAO study and report on access to housing for older individuals Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct, and submit to Congress a report describing the results of, a study that analyzes housing programs and services for older individuals under the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ), including— (1) an analysis of the Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities that— (A) assesses any metrics used by the Committee to evaluate the success of the Committee’s activities and related Federal programs; (B) evaluates interagency coordination of Federal housing programs for older individuals; and (C) assesses the availability of affordable housing for older individuals as the result of interagency coordination; (2) an analysis of any overlap between, and gaps in, housing programs and services that assist older individuals in obtaining accessible and affordable housing that achieves the objectives of the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ), including programs under the Administration for Community Living, the Department of Housing and Urban Development, and other Federal programs, as applicable, and the availability, accessibility, and demand for such services; (3) an analysis of the availability of affordable housing for such older individuals, to the extent such information is available and taking into consideration incomes and geographic and demographic trends; and (4) any recommendations to improve the supply, accessibility, and affordability of housing for older individuals and coordination of services provided under the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ) and other related Federal programs, as applicable. 208. Report relating to health outcomes for older individuals living with or near family members (a) In general The Secretary shall prepare a report that assesses— (1) the health outcomes for older individuals who live with, on the same property as, or otherwise in the community in close geographic proximity, relative to the area, to family members; and (2) the degree to which programs under the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ) promote living in the settings described in paragraph (1), as appropriate. (b) Inclusion The report described under subsection (a) shall include— (1) an assessment of physical and mental health outcomes of older individuals who live in the settings described in subsection (a)(1) in comparison to physical and mental health outcomes of older individuals who do not live in such settings; (2) an assessment of the extent to which living in such settings mitigates social isolation and loneliness in older adults; and (3) a description of the different types of such settings and whether, and to what extent, findings under paragraphs (1) and (2) vary across such different types. (c) Submission Not later than 2 years after the date of enactment of this Act, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and Workforce of the House of Representatives the report required by subsection (a). 209. Improving broadband coordination and reducing social isolation (a) In general The Assistant Secretary shall, as appropriate, coordinate with the Assistant Secretary of Commerce for Communications and Information of the National Telecommunications and Information Administration to ensure that the aging network (as defined in section 102 of the Older Americans Act of 1965 ( 42 U.S.C. 3002 )) and other relevant stakeholders are aware of, and, subject to applicable eligibility criteria, have access to, Federal programs relating to digital literacy and the adoption of broadband that may support aging in place for older individuals. (b) Report Not later than 90 days after the date of enactment of this Act, the Assistant Secretary shall prepare, and submit to the Committee on Health, Education, Labor, and Pensions, the Special Committee on Aging, and the Committee on Commerce, Science, and Transportation of the Senate and the Committee on Education and the Workforce of the House of Representatives, a report regarding any coordination efforts carried out pursuant to subsection (a). III Enhancing Innovation and Flexibility in Nutrition Services 301. Medically tailored meals (a) Definitions Section 102(14) ( 42 U.S.C. 3002(14) ) is amended— (1) in subparagraph (C), by inserting , which may include counseling related to the provision of medically tailored meals after counseling ; and (2) in subparagraph (D), by inserting (including from medically tailored meals) after improved nutrition . (b) Administration of nutrition services Section 205(a)(2)(A) ( 42 U.S.C. 3016(a)(2)(A) ) is amended— (1) in clause (vi), by inserting , including through the use of innovative approaches after systems ; and (2) in clause (viii), by inserting and innovative interventions after including strategies . (c) Nutrition education Section 214(2)(C) ( 42 U.S.C. 3020e(2)(C) ) is amended by inserting , including interventions, after other activities . (d) Nutrition services purposes Section 330(3) ( 42 U.S.C. 3030d–21(3) ) is amended by inserting , tailored to their individual medical and nutritional needs to the extent feasible, after services . 302. Nutrition service providers Section 339 ( 42 U.S.C. 3030g–21 )— (1) in paragraph (1), by striking and at the end; (2) in paragraph (2), by striking the period and inserting ; and ; and (3) by adding at the end the following: (3) where feasible, when selecting local nutrition providers, give consideration to the capabilities of community-based organizations if such organizations meet the requirements of subpart 1 or 2 and can provide nutrition services in the designated area. . 303. Grab-and-go meals Section 308(b)(4) ( 42 U.S.C. 3028(b)(4) ) is amended by adding at the end the following: (E) A State may elect in its plan under section 307 to allow use of not more than 25 percent of the funds received by such State under subpart 1 of part C, calculated after any transfers under subparagraphs (A) and (B) are completed, to make meals available at congregate meal sites or other community locations for consumption by older individuals outside such congregate meal sites. A State electing to allow use of funds under the preceding sentence shall— (i) ensure that such allowable use supplements but does not supplant the delivery of services through the congregate meals program under section 331; and (ii) notify the Assistant Secretary of such election, including a description of the amount and percentage of funds received by such State under subpart 1 of part C to be used for such purposes. . 304. Nutrition Services Incentive Program innovation Section 311 ( 42 U.S.C. 3030a ) is amended— (1) in subsection (b)(1), by striking subsection (e) and inserting subsection (f)(1) ; (2) by redesignating subsections (e) and (f) as subsections (f) and (g), respectively; (3) by inserting after subsection (d) the following: (e) (1) Subject to subsection (f)(2), a State agency or title VI grantee may implement innovative approaches, including any approaches demonstrated to be effective through an award under section 340, to achieve the purposes described in section 330(1) by improving— (A) the quality, composition, preparation, modality, delivery, or location of meals provided to older individuals under this Act; or (B) the efficiency and effectiveness of distributing, delivering, or otherwise making meals available to older individuals under this Act. (2) In implementing approaches under paragraph (1), a State agency or title VI grantee may, with the approval of the Assistant Secretary, waive any requirements of subparts 1 or 2 of part C or section 339 if the State agency or title VI grantee determines that such requirements impede the ability of such State agency or title VI grantee to successfully implement such approach. The Assistant Secretary shall approve a request for a waiver under the preceding sentence unless the Assistant Secretary determines that such waiver is not consistent with the objectives of this Act or the purposes described in section 330(1). (3) The authority to carry out activities described in paragraph (1) shall expire on October 1, 2029. (4) Not later than September 30, 2028, the Assistant Secretary shall submit a report to the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and the Workforce of the House of Representatives describing any activities carried out by State agencies or title VI grantees under paragraph (1), an assessment of the outcomes of such activities, and recommendations for scaling implementation of any successful innovative approaches within programs established under this section or subparts 1 and 2 of part C. ; and (4) in subsection (f), as so redesignated— (A) by striking There are and inserting (1) There are ; and (B) by adding at the end the following: (2) If the amount appropriated to carry out this section for a fiscal year exceeds the amount appropriated to carry out this section for fiscal year 2024, a State agency and title VI grantee in receipt of an allotment under subsection (b) may elect to use the difference between the allotment received for the fiscal year and the allotment received for fiscal year 2024 for activities described in subsection (e). . 305. GAO study on Nutrition Services Incentive Program (a) In general Not later than 18 months after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study to evaluate the Nutrition Services Incentive Program under section 311 ( 42 U.S.C. 3030a ) (referred to in this section as the Program ). (b) Inclusions The study under this section— (1) shall— (A) include an assessment of how States and Tribal organizations use funding provided under the Program, including the degree to which States and Tribal organizations use such funding to procure food products from local or regional producers for meals supported under the Program; and (B) identify any challenges or barriers to increasing the use of local and regional producers under the Program; and (2) may make recommendations related to improving the effectiveness of the Program, including with respect to the use of local and regional producers. 306. Innovations in nutrition programs and services Subpart 3 of part C of title III ( 42 U.S.C. 3030g–21 et seq. ) is amended by adding at the end the following: 340. Innovations in nutrition programs and services (a) In general From funds available under subsection (d), the Assistant Secretary shall make grants, on a competitive basis, to eligible entities, to achieve the purposes of section 330(1) by developing, implementing, and evaluating innovative local or regional approaches to improve the quality, effectiveness, efficiency, and outcomes of nutrition programs and services described in sections 311, 331, and 336. (b) Eligibility In order to be eligible for a grant under subsection (a), an entity shall— (1) be— (A) a State agency, an area agency on aging, an Indian tribe, a tribal organization, a nutrition service provider, a multipurpose senior center, a health care entity, an institution of higher education, or an other public or nonprofit private entity; or (B) a partnership between any entities described in subparagraph (A); and (2) submit an application at such time and in such manner as the Assistant Secretary may require, including— (A) a description of an innovative approach referred to in subsection (a) that the entity proposes to implement under the grant; (B) a plan for evaluating the effectiveness, including cost-effectiveness, of the innovative approach proposed; and (C) as appropriate, plans for the publication of the results of such evaluation. (c) Report Not later than 1 year after the date of enactment of the Older Americans Act Reauthorization Act of 2024 and annually thereafter, the Assistant Secretary shall submit a report to the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and the Workforce of the House of Representatives describing any activities carried out under subsection (a), an assessment of the outcomes of such activities, and recommendations for scaling implementation of any successful innovative approaches implemented under this section, through programs established under section 311, 331, or 336. (d) Reservation From the total of the amounts made available for a fiscal year under paragraphs (1) and (2) of section 303(b) and in section 311(e), the Assistant Secretary shall reserve an amount equal to not more than 1 percent, to carry out activities described in subsection (a). . IV Supporting Family Caregivers 401. Improving the National Family Caregiver Support Program (a) State requirements for State and community programs on aging grants Section 305(a)(3)(E) ( 42 U.S.C. 3025(a)(3)(E) ) is amended— (1) in clause (i), by striking and at the end; (2) in clause (ii), by striking the period at the end and inserting ; and ; and (3) by adding at the end the following: (iii) available supports for family caregivers and older relative caregivers (as defined in section 372(a)). . (b) Area plan requirements Section 306(a)(7)(D) ( 42 U.S.C. 3026(a)(7)(D) ) is amended— (1) in clause (i), by striking and at the end; (2) in clause (ii), by adding and after the semicolon; and (3) by adding at the end the following: (iii) available supports for family caregivers and older relative caregivers (as defined in section 372(a)); . (c) Definitions relating to the National Family Caregiver Support Program (1) In general Section 372(a) ( 42 U.S.C. 3030s(a) ) is amended— (A) in paragraph (1)— (i) in the first sentence, by striking The term and inserting the following: (A) In general The term ; and (ii) in subparagraph (A) (as so designated), in the second sentence— (I) by striking the period at the end and inserting ; and ; and (II) by striking Such assessment shall be administered through and inserting the following: (B) Administration of assessments A caregiver assessment under subparagraph (A) shall— (i) be administered through ; and (III) by adding at the end the following: (ii) take into account— (I) linguistic and cultural differences; (II) the ease for the caregiver to access information, supports, or services, and the timeliness of access to such information, supports, or services; (III) barriers to accessing information, supports, or services; (IV) the availability of information, supports, or services in accessible formats; and (V) the quality of information, supports, or services received, and the degree to which it is helpful to the caregiver. ; (B) by striking paragraph (2) and inserting the following: (2) Child or youth The term child or youth means an individual who is not more than— (A) 18 years of age; or (B) 22 years of age, in the case of an individual who is enrolled in any form of schooling (including on a part-time basis), including— (i) in high school or secondary school (as such terms are defined in section 8101 of the Elementary and Secondary Education Act of 1965 ( 20 U.S.C. 7801 )); or (ii) in an institution of higher education (as defined in section 102 of the Higher Education Act of 1965 ( 20 U.S.C. 1002 )). ; and (C) in paragraph (4)(B)(i), by inserting adult after or other . (2) Conforming amendments Part E of title III ( 42 U.S.C. 3030s et seq. ) is amended— (A) by inserting or youth after child each place it appears (other than in section 372(a)(2) (as amended by paragraph (1)(B)); and (B) by inserting or youth after children each place it appears (other than in section 373(c)(3)(A) (as amended by subsection (d)(2)(B)). (d) Program authorized Section 373 ( 42 U.S.C. 3030s–1 ) is amended— (1) in subsection (b)(3)— (A) by inserting which may include trauma-informed services, peer supports, after individual counseling, ; and (B) by inserting elder abuse prevention, after nutrition, ; (2) in subsection (c)— (A) in the subsection heading, by striking priority and inserting priority; consideration ; and (B) by adding at the end the following: (3) Consideration In providing services under this part, the State shall consider— (A) that older relative caregivers caring for multiple children or youth may need greater resources and supports; and (B) the circumstances and unique needs of different types of caregivers, including the needs of children and their older relative caregivers whose families have been affected by substance use disorder, including opioid use disorder. ; (3) in subsection (e)— (A) in the matter preceding paragraph (1), by striking Not later than and all that follows through the Assistant Secretary shall and inserting The Assistant Secretary shall, on a regular basis ; (B) in paragraph (1)— (i) in subparagraph (B)— (I) by inserting or evidence-informed after evidence based ; and (II) by striking and at the end; (ii) by redesignating subparagraph (C) as subparagraph (D); and (iii) by inserting after subparagraph (B) the following: (C) the use of caregiver assessments; and ; and (C) in paragraph (2), by striking make available and inserting prepare, publish, and disseminate ; (4) in subsection (i)— (A) in paragraph (1), by inserting , which may include the improvement of the quality and consistency of caregiver assessments and access to other information, supports, or services after section 631 ; and (B) in paragraph (2), by inserting (including outcome measures) after program evaluation ; and (5) in subsection (j)— (A) in the matter preceding paragraph (1), by striking Not later than and all that follows through shall provide technical assistance and inserting Beginning not later than 1 year after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , the Assistant Secretary, in consultation with stakeholders with appropriate expertise and, as appropriate, informed by the most recent strategy developed under the RAISE Family Caregivers Act ( 42 U.S.C. 3030s note) and the most recent report developed under the Supporting Grandparents Raising Grandchildren Act ( Public Law 115–196 ; 132 Stat. 1511), shall provide ongoing technical assistance ; (B) in paragraph (2), by striking and at the end; (C) by redesignating paragraph (3) as paragraph (4); and (D) by inserting after paragraph (2) the following: (3) the quality and consistency of caregiver assessments used across States; and . 402. Emphasizing respite care Section 321(a)(19) ( 42 U.S.C. 3030d(a)(19) ) is amended to read as follows: (19) services, which may include respite care through various models, designed to support family members and other persons providing voluntary care to older individuals that need long-term care services, which may include older individuals with cognitive impairments such as Alzheimer’s disease and related disorders with neurological and organic brain dysfunction; . 403. Clarifying supportive services Section 321(a)(18) ( 42 U.S.C. 3030d(a)(18) ) is amended by striking mentally impaired older individuals and inserting older individuals with cognitive, physical, or mental impairments . 404. Direct care workforce resource center Section 411(a)(13) ( 42 U.S.C. 3032(a)(13) ) is amended— (1) by striking subparagraph (B); (2) by striking (13) and all that follows through (A) to and inserting the following: (13) in coordination with the Secretary of Labor and, as appropriate, the heads of other relevant Federal departments and agencies, the establishment and operation of a national resource center that supports the growth and professionalization of the direct care workforce necessary to meet the needs of older individuals and individuals with disabilities, and, in a manner that does not unnecessarily duplicate the activities of other resource centers supported by the Assistant Secretary, that addresses training and other educational needs of family caregivers, which activities of the center may include— (A) the provision of training and technical assistance, including through the development and dissemination of educational materials, to direct care workers and family caregivers; and (B) supporting the demonstration of new, and promoting existing, strategies for the recruitment, retention, career development, or advancement of direct care workers to ; and (3) in subparagraph (B), as so designated in paragraph (2), by striking ; and at the end and inserting a semicolon. 405. Supporting Grandparents Raising Grandchildren Act (a) Findings The Supporting Grandparents Raising Grandchildren Act ( Public Law 115–196 ; 132 Stat. 1511) is amended by striking section 2. (b) Definitions The Supporting Grandparents Raising Grandchildren Act is amended by redesignating section 4 as section 2 and moving the section so as to follow section 1. (c) Advisory council Section 3 of the Supporting Grandparents Raising Grandchildren Act is amended— (1) in subsection (b)— (A) in paragraph (1)— (i) by redesignating subparagraphs (G) through (I) as subparagraphs (H) through (J); (ii) by inserting after subparagraph (F) the following: (G) The Assistant Secretary for Health. ; (iii) in subparagraph (I), as so redesignated, by striking of children ; and (iv) in subparagraph (J), as so redesignated, by striking relatives and inserting relative caregivers ; and (B) by adding at the end the following: (3) Limitation on non-Federal members Not more than 10 members of the Advisory Council may be individuals who are not Federal officers or employees. ; (2) in subsection (c)— (A) in paragraph (1)— (i) in subparagraph (A)— (I) in the matter preceding clause (i), by striking relatives and inserting relative caregivers ; and (II) in clause (i)— (aa) by striking the health, and inserting the near- and long-term health, including mental health, ; and (bb) by striking care; and and inserting care, including any needs related to the circumstances that caused such children to be raised by a grandparent or older relative caregiver; and ; and (ii) in subparagraph (B)— (I) by striking (B) and all that follows through In and inserting the following: (B) Considerations In ; and (II) by striking needs of those affected by the opioid crisis and inserting needs and challenges of individuals affected by substance use disorder, including opioid use disorder, or, as applicable and appropriate, needs and challenges of individuals related to other circumstances, which may include public health emergencies. ; (B) in paragraph (2)— (i) in subparagraph (A), in the matter preceding clause (i), by striking enactment of this Act and inserting enactment of the Older Americans Act Reauthorization Act of 2024 ; and (ii) in subparagraph (B)— (I) in clause (i)— (aa) by striking relatives and inserting relative caregivers ; and (bb) by striking needs of children and all that follows and inserting needs of children and their older relative caregivers who have been affected by substance use disorder, including opioid use disorder; ; (II) in clause (ii), by striking the and at the end; (III) by redesignating clause (iii) as clause (iv); and (IV) by inserting after clause (ii) the following: (iii) a description of any activities of the Department of Health and Human Services to evaluate the effectiveness of supportive services in addressing the needs of children and their older relative caregivers, including those who have been affected by substance use disorder, including opioid use disorder, and any related findings; and ; (C) in paragraph (3)— (i) in the matter preceding subparagraph (A)— (I) by striking (3) and all that follows through Not and inserting the following: (3) Follow-up reports Not ; (II) by striking 2 years and inserting 180 days ; and (III) by inserting after submitted, the following: and every 2 years thereafter until the Advisory Council terminates under subsection (f), ; and (D) in paragraph (4) by striking relatives each place it appears and inserting relative caregivers ; (3) in subsection (d), by striking the Federal Advisory Committee Act (5 U.S.C. App.). and inserting chapter 10 of title 5, United States Code. ; and (4) in subsection (f), by striking terminate and all that follows and inserting terminate on September 30, 2029. . 406. RAISE Family Caregivers Act (a) Strategy Section 3 of the RAISE Family Caregivers Act ( 42 U.S.C. 3030s note) is amended— (1) in subsection (c)— (A) in the matter preceding paragraph (1), by inserting (or the Secretary's designee) after The Secretary ; and (B) in paragraph (1), by inserting and made publicly available by the Secretary, after caregiver programs, ; and (2) in subsection (d)(2), by inserting in after caregiver programs . (b) Council Section 5(e) of that Act ( 42 U.S.C. 3030s note) is amended by striking The Federal Advisory Committee Act (5 U.S.C. App.) and inserting Chapter 10 of title 5, United States Code, . (c) Sunset extension Section 6 of that Act ( 42 U.S.C. 3030s note) is amended by striking terminate and all that follows and inserting terminate on September 30, 2029. . V Community Service Senior Opportunities Act 501. Improving the Community Service Employment Program (a) Program Section 502(b)(1) ( 42 U.S.C. 3056(b)(1) is amended— (1) in subparagraph (C)(ii), by striking section 513(a)(2)(E) and inserting section 513(a)(2)(F) ; and (2) in subparagraph (E), by inserting older individuals, after youth, . (b) Performance Section 513 ( 42 U.S.C. 3056k ) is amended— (1) in subsection (a)(2)— (A) by redesignating subparagraph (E) as subparagraph (F); and (B) by inserting after subparagraph (D) the following: (E) Biennial report Not later than 2 years after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , and every 2 years thereafter during the period of the program described in section 502(a)(1), the Secretary shall prepare and submit to the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and the Workforce of the House of Representatives a report regarding the methodology used to arrive at the expected levels of performance described in subparagraph (B) for each grantee, including the particular statistical model used and other factors taken into account, as described in subparagraph (D). ; (2) in subsection (c) and paragraphs (1)(A), (2)(A), (3)(A) of subsection (d), by striking subsection (a)(2)(E) and inserting subsection (a)(2)(F) ; and (3) in subsection (d)— (A) in paragraph (2)(B)(iii), by adding at the end the following: For grants awarded on or after the date that is 2 years after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , any grantee who has failed to meet the expected levels of performance for the 2 consecutive years prior to the subsequent grant competition under section 514 shall not be allowed to compete in the subsequent grant competition under section 514 following the second consecutive year of failure but may compete in the next such grant competition after that subsequent competition. ; and (B) in paragraph (3)(B)(iii), by adding at the end the following: For grants awarded on or after the date that is 2 years after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , if the Secretary determines that the State fails to meet the expected levels of performance described in subparagraph (A) for 2 consecutive program years, the Secretary shall provide for the conduct by the State of a competition to award the funds allotted to the State under section 506(e) for the first full program year following the Secretary’s determination. . (c) Definitions Section 518(a)(1)(A) ( 42 U.S.C. 3056p(a)(1)(A) ) is amended to read as follows: (A) social, health, welfare, and educational services (including literacy tutoring and services provided by the aging network), legal and other counseling services and assistance (including tax counseling and assistance and financial counseling), and library, recreational, and other similar services; . 502. GAO report on alignment within the Community Service Employment Program (a) Review Not later than 18 months after the date of enactment of this Act, the Comptroller General of the United States shall complete a review in which the Comptroller General— (1) evaluates— (A) the distinct differences and similarities between the older American community service employment program as authorized under title V of the Older Americans Act of 1965 ( 42 U.S.C. 3056 et seq. ) and the programs carried out under title I of the Workforce Innovation and Opportunity Act ( 29 U.S.C. 3111 et seq. ); and (B) how the programs described in subparagraph (A) serve older individuals in seeking and obtaining community service employment; (2) analyzes the efficacy and impacts of the indicators of performance described in section 513(b) of the Older Americans Act of 1965 ( 42 U.S.C. 3056k(b) and corrective measures described in section 513(d) of the Older Americans Act of 1965 ( 42 U.S.C. 3056k(d) ) for the older American community service employment program, compared with the efficacy and impacts of the indicators of performance and corrective measures described in section 116 of the Workforce Innovation and Opportunity Act ( 29 U.S.C. 3141 ) for programs authorized under title I of such Act; and (3) evaluates how the Department of Labor coordinates delivery of services with State and national grantees under title V of the Older Americans Act of 1965 and States and local workforce development areas under title I of the Workforce Innovation Opportunity Act to serve older individuals. (b) Report to Congress Not later than 180 days after the date of enactment of this Act, the Comptroller General shall submit to the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and the Workforce of the House of Representatives a report on the results of such review. VI Improving Services for Native Elders 601. Older Americans Tribal Advisory Committee Section 201(c) ( 42 U.S.C. 3011(c) ) is amended by adding at the end the following: (4) (A) In addition to other methods of government-to-government consultation between the Administration and Indian tribes and conferring with organizations representing Native Hawaiians, the Assistant Secretary shall establish 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 the needs of older individuals who are Native Americans and implementation of related programs and activities under this Act. (B) The Committee shall be composed of 11 voting, non-Federal members, including— (i) geographically diverse individuals with expertise on the range of issues affecting Indian tribes, organizations representing Native Hawaiians, and older individuals who are Native Americans; (ii) not less than 1 member who is an Alaska Native; and (iii) not less than 1 member who is a Native Hawaiian. (C) The Committee shall include non-voting, ex officio representatives of relevant Federal departments and agencies, including— (i) the Administration; (ii) the Indian Health Service; (iii) the Centers for Medicare & Medicaid Services; (iv) the Department of the Interior; (v) the Department of Labor; and (vi) any other agency or office with subject matter expertise that the Assistant Secretary determines appropriate. (D) The Committee shall meet in person not less frequently than twice each year. (E) The Committee shall coordinate, as appropriate, with the Secretary’s Tribal Advisory Committee of the Department of Health and Human Services. (F) (i) Not less frequently than once each year, the Committee shall submit to the Assistant Secretary and make publicly available a report that describes— (I) the activities of the Committee during the previous year; and (II) recommendations for administrative action, including the identification of any statutory barriers to carrying out such recommendations, for the following year. (ii) Not later than 60 days after the date on which the Assistant Secretary receives a report under clause (i), the Assistant Secretary shall submit to the Committee a written response to such report. (G) Chapter 10 of title 5, United States Code, shall not apply to the Committee. (H) In establishing, developing procedures for, and operating the Committee, the Assistant Secretary shall— (i) consult with Indian tribes and confer with organizations representing Native Hawaiians; and (ii) take into consideration best practices of other tribal advisory committees operated by the Department of Health and Human Services before the date of enactment of the Older Americans Act Reauthorization Act of 2024 . . 602. Supportive services; set aside (a) Supportive services Section 636 ( 42 U.S.C. 3057k–21 ) is amended— (1) in subsection (a), by striking may and inserting shall, as practicable, ; and (2) in subsection (b)(2), by striking in-home assistance and inserting in-home services . (b) Funding set aside Section 644 ( 42 U.S.C. 3057o ) is amended— (1) by striking Of and inserting (a) In general.— Of ; and (2) by adding at the end the following: (b) Report Not later than 1 year after the date of enactment of the Older Americans Act Reauthorization Act of 2024 , the Assistant Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Education and the Workforce of the House of Representatives, a report on the use of funds under part D. Such report shall include— (1) the total amount of funds made available under subsection (a) to carry out part D for each fiscal year; (2) a list of award recipients under part D; and (3) a summary of supportive services for healthy aging and independence provided under part D. . 603. GAO report on Tribal services Not later than 18 months after the date of enactment of this Act, the Comptroller General of the United States shall submit to Congress a report that— (1) evaluates and identifies barriers to Indian Tribes (as defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 )) and organizations serving Native Hawaiians accessing programs under title VI of the Older Americans Act of 1965 ( 42 U.S.C. 3057 et seq. ), and coordination of such programs under such title VI with programs funded under titles III and IV of such Act ( 42 U.S.C. 3021 et seq. , 42 U.S.C. 3031 et seq. ), including by— (A) estimating the number of Native Americans unserved by programs under such title VI; (B) identifying States making grants to Indian Tribes under such title III; and (C) providing estimates of funding necessary to support programs under such title VI for all Tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act) and organizations serving Native Hawaiians that are not eligible under such title VI (as in effect on the date of enactment of this Act); and (2) details how grantees 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 funds received under such title V, including by evaluating how the Secretary of Labor coordinates with State and national grantees under such title V to serve older individuals who are Native Americans. VII Strengthening the Long-Term Care Ombudsman Programs and Elder Abuse Prevention 701. Director of the Office of Long-Term Care Ombudsman Programs Section 201(d)(2)(A) ( 42 U.S.C. 3011(d)(2)(A) ) is amended in the second sentence by inserting serve on a full-time basis and after shall . 702. Legal assistance training resources relating to elder abuse prevention Section 201(e)(2)(A) ( 42 U.S.C. 3011(e)(2)(A) ) is amended by striking clause (v) and inserting the following: (v) establishing an information clearinghouse to collect, maintain, and disseminate information concerning best practices and resources for training, technical assistance, and other activities, which may include training resources for paralegals or law students who are under the direct supervision of an attorney, to assist Long-Term Care Ombudsman programs, adult protective services programs, and other legal services relating to defense of guardianship and the matters described in clause (ii)(I), to assist States and communities to carry out evidence-based programs to prevent and address elder abuse, neglect, and exploitation; . 703. Improving training of volunteers under the State Long-Term Care Ombudsman Program Section 712 ( 42 U.S.C. 3058g ) is amended— (1) in subsection (h)(5)— (A) in the matter preceding subparagraph (A)— (i) by striking the representatives and inserting each type of representative ; and (ii) by inserting types of before unpaid volunteers ; (B) in subparagraph (A), by inserting for each such type of representative before the semicolon at the end; (C) in subparagraph (B)(iii), by striking and at the end; (D) in subparagraph (C), by adding and at the end; and (E) by adding at the end the following: (D) with respect to representatives of the Office who are unpaid volunteers, take into consideration the degree to which each such type of unpaid volunteer performs activities requiring specialized training, with a goal of reducing unnecessary training requirements for prospective unpaid volunteers; ; and (2) by adding at the end the following: (k) Training requirements for unpaid volunteers (1) In general In providing the model standards described in subsection (h)(5), the Director of the Office of Long-Term Care Ombudsman Programs shall review and, as necessary, update such model standards on a regular basis to tailor such model standards to the individualized training needs of each type of representative of the Office, including each type of unpaid volunteer. (2) Considerations In carrying out paragraph (1), the Director of the Office of Long-Term Care Ombudsman Programs shall take into consideration the degree to which each type of representative of the Office performs activities that require specialized training, with a goal of reducing unnecessary training requirements for unpaid volunteers. . 704. Reporting on State Long-Term Care Ombudsman Programs Chapter 2 of subtitle A of title VII ( 42 U.S.C. 3058f et seq. ) is amended by adding at the end the following: 714. Reports to Congress Each year, the Assistant Secretary shall submit, to the Committee on Health, Education, Labor, and Pensions and the Special Committee on Aging of the Senate and the Committee on Education and the Workforce of the House of Representatives, and make publicly available, a report that— (1) aggregates all reports submitted under section 712(h) for such year; and (2) provides a summary of the findings of such reports. . 705. Study on State Long-Term Care Ombudsman Programs (a) In general The Assistant Secretary shall seek to enter into a contract with the National Academies of Sciences, Engineering, and Medicine (referred to in this section as the National Academies ) to conduct a study on the State Long-Term Care Ombudsman programs carried out under the Older Americans Act of 1965 ( 42 U.S.C. 3001 et seq. ), including an assessment of the effectiveness of such programs and any related challenges, and recommendations. The study shall include an assessment of the current (as of the date on which the contract is entered into) recommended staff-to-bed ratio for such programs, as appropriate. (b) Report Not later than 18 months after the date on which a contract is entered into under subsection (a), the National Academies shall publicly issue a report on the findings of such study. VIII Authorizations of appropriations 801. Administration on Aging Section 216 ( 42 U.S.C. 3020f ) is amended— (1) in subsection (a), by striking $43,937,410 and all that follows through fiscal year 2024 and inserting $55,469,968 for fiscal year 2025, $58,034,197 for fiscal year 2026, $60,716,964 for fiscal year 2027, $63,523,747 for fiscal year 2028, and $66,460,281 for fiscal year 2029 ; and (2) in subsection (b)— (A) in paragraph (1), by striking $2,180,660 and all that follows through fiscal year 2024 and inserting $2,753,033 for fiscal year 2025, $2,880,298 for fiscal year 2026, $3,013,447 for fiscal year 2027, $3,152,751 for fiscal year 2028, and $3,298,494 for fiscal year 2029 ; (B) in paragraph (2), by striking $1,988,060 and all that follows through fiscal year 2024 and inserting $2,509,880 for fiscal year 2025, $2,625,905 for fiscal year 2026, $2,747,294 for fiscal year 2027, $2,874,294 for fiscal year 2028, and $3,007,165 for fiscal year 2029 ; (C) in paragraph (3), by striking $1,371,740 and all that follows through fiscal year 2024 and inserting $1,731,790 for fiscal year 2025, $1,811,846 for fiscal year 2026, $1,895,603 for fiscal year 2027, $1,983,232 for fiscal year 2028, and $2,074,911 for fiscal year 2029 ; and (D) in paragraph (4), by striking $8,687,330 and all that follows through fiscal year 2024 and inserting $10,967,554 for fiscal year 2025, $11,474,555 for fiscal year 2026, $12,004,993 for fiscal year 2027, $12,559,952 for fiscal year 2028, and $13,140,565 for fiscal year 2029 . 802. Grants for State and community programs on aging (a) In general Section 303 ( 42 U.S.C. 3023 ) is amended— (1) in subsection (a)(1), by striking $412,029,180 and all that follows through fiscal year 2024 and inserting $520,177,347 for fiscal year 2025, $544,223,762 for fiscal year 2026, $569,381,780 for fiscal year 2027, $595,702,785 for fiscal year 2028, and $623,240,541 for fiscal year 2029 ; (2) in subsection (b)— (A) in paragraph (1), by striking $530,015,940 and all that follows through fiscal year 2024 and inserting $669,132,913 for fiscal year 2025, $700,065,148 for fiscal year 2026, $732,427,298 for fiscal year 2027, $766,285,465 for fiscal year 2028, and $801,708,804 for fiscal year 2029 ; and (B) in paragraph (2), by striking $268,935,940 and all that follows through fiscal year 2024 and inserting $339,525,428 for fiscal year 2025, $355,220,786 for fiscal year 2026, $371,641,698 for fiscal year 2027, $388,821,705 for fiscal year 2028, and $406,795,899 for fiscal year 2029 ; (3) in subsection (d), by striking $26,587,360 and all that follows through fiscal year 2024 and inserting $33,565,929 for fiscal year 2025, $35,117,593 for fiscal year 2026, $36,740,986 for fiscal year 2027, $38,439,424 for fiscal year 2028, and $40,216,376 for fiscal year 2029 ; and (4) in subsection (e), by striking $193,869,020 and all that follows through fiscal year 2024 and inserting $244,755,171 for fiscal year 2025, $256,069,552 for fiscal year 2026, $267,906,966 for fiscal year 2027, $280,291,593 for fiscal year 2028, and $293,248,728 for fiscal year 2029 . (b) Nutrition services incentive program Section 311 ( 42 U.S.C. 3030a ), as amended by section 304 of this Act, is amended in subsection (f), by striking $171,273,830 and all that follows through fiscal year 2024 and inserting $216,229,264 for fiscal year 2025, $226,224,968 for fiscal year 2026, $236,682,747 for fiscal year 2027, $247,623,961 for fiscal year 2028, and $259,070,958 for fiscal year 2029 . 803. Activities for health, independence, and longevity Section 411(b) ( 42 U.S.C. 3032(b) ) is amended— (1) in paragraph (1), by striking $14,514,550 and all that follows through fiscal year 2024 and inserting $18,324,285 for fiscal year 2025, $19,171,368 for fiscal year 2026, $20,057,609 for fiscal year 2027, $20,984,819 for fiscal year 2028, and $21,954,892 for fiscal year 2029 ; and (2) in paragraph (2), by striking $15,613,440 and all that follows through fiscal year 2024 and inserting $19,711,608 for fiscal year 2025, $20,622,823 for fiscal year 2026, $21,576,161 for fiscal year 2027, $22,573,570 for fiscal year 2028, and $23,617,086 for fiscal year 2029 . 804. Community Service Senior Opportunities Act Section 517(a) ( 42 U.S.C. 3056o(a) ) is amended by striking $428,000,000 and all that follows through fiscal year 2024 and inserting $540,340,193 for fiscal year 2025, $565,318,627 for fiscal year 2026, $591,451,804 for fiscal year 2027, $618,793,048 for fiscal year 2028, and $647,398,205 for fiscal year 2029 . 805. Grants for Native Americans Section 643 ( 42 U.S.C. 3057n ) is amended— (1) in paragraph (1), by striking $37,102,560 and all that follows through fiscal year 2024 and inserting $47,028,435 for fiscal year 2025, $49,202,434 for fiscal year 2026, $51,476,932 for fiscal year 2027, $53,856,574 for fiscal year 2028, and $56,346,220 for fiscal year 2029 ; and (2) in paragraph (2), by striking $10,759,920 and all that follows through fiscal year 2024 and inserting $13,584,151 for fiscal year 2025, $14,212,110 for fiscal year 2026, $14,869,098 for fiscal year 2027, $15,556,457 for fiscal year 2028, and $16,275,591 for fiscal year 2029 . 806. Allotments for elder rights protection activities Section 702 ( 42 U.S.C. 3058a ) is amended— (1) in subsection (a), by striking $18,066,950 and all that follows through fiscal year 2024 and inserting $22,809,108 for fiscal year 2025, $23,863,512 for fiscal year 2026, $24,966,659 for fiscal year 2027, $26,120,801 for fiscal year 2028, and $27,328,297 for fiscal year 2029 ; and (2) in subsection (b), by striking $5,107,110 and all that follows through fiscal year 2024 and inserting $6,447,609 for fiscal year 2025, $6,745,665 for fiscal year 2026, $7,057,499 for fiscal year 2027, $7,383,748 for fiscal year 2028, and $7,725,079 for fiscal year 2029 .